I hope this blog finds you well and healthy! Though COVID-19 continues to impact the world, it is encouraging to see society come together in order to overcome this trial as quickly as possible. With COVID-19 having a great impact on the lungs, people may be wondering about the health and vulnerability of their own lungs – especially athletes.

Elite endurance athletes experience a high prevalence of exercise induced asthma (EIA) and bronchial hyper responsiveness (BHR) (7, 8, 10, 11, 15). Exercise induced asthma is caused by airflow obstruction or narrowing of the airway which can be caused by increased breathing during exercise. Bronchial hyper responsiveness is excessive bronchial narrowing in response to various inhaled stimuli, both chemical and physical. Swimmers are particularly at risk as chlorine inhalation is thought as an airway provoking factor (3, 10). So, as an athlete, how is your sport, in conjunction with your lifestyle, influencing your risk for breathing problems? What measures can be taken to reduce it?

A group of scientists decided to seek answers, investigating potential association between physical and psychological recovery and breathing problems in elite swimmers.

Let’s Take a Look at Their Science:

This 2012 study, assessed 24 competitive swimmers (15-25 years old) using 3 physiological tests and a series of psychological questionnaires. Each athlete was training a minimum of 2-3 hours a day, as well as attending school full time. Four swimmers had already been diagnosed with asthma and five swimmers had a diagnosed allergy. (10)

Physiological Tests

All swimmers performed a single Methacholine challenge and 2 Eucapnic Voluntary Hyperventilation (EVH) tests.

A Methacholine challenge is type of bronchoprovocation test where methacholine is inhaled, causing mild narrowing of the airways in the lungs. A positive test result occurs if methacholine causes a drop of 20% or more in lung function (FEV1) when compared to your baseline. A negative test results suggest a negative diagnosis for asthma.

Eucapnic voluntary hyperventilation tests entail breathing at greater rate than normal to match a precalculated target breathing rate. During the test, subjects inhale cold, dry air enriched with 5% carbon dioxide over a span of 6 minutes.

While EVH is an indirect test for BHR (1, 10), Methacholine provocation is considered a direct measurement of BHR (2, 10).

Psychological Tests

This study assessed each athlete’s psyche in 4 areas: motivation, recovery, perfectionism, and burnout.

Motivation: Degree of motivation was measured with the Perceived Motivational Climate in Sport Questionnaire (13). This assessment depicts 2 subscales: mastery-motivational, and performance-motivational. A mastery climate suggests a cooperative atmosphere. Meaning, there is emphasis on team work. For example, working together and self-improving to better develop the team. On the other hand, a performance climate has a more competitive atmosphere. Meaning, there is emphasis on your own performance and to be the best. For example, an athlete comparing their own ability and/or scores to others.

Recovery: The degree at which swimmers did well at achieving proper recovery was measured using part the Training Practice Inventory Scale (9). The section used included: 1) different types of recovery, 2) finding the balance between training and recovery, and 3) awareness of body signals.

Perfectionism: The nature of each athletes’ perfectionism was measured using a sport specific version (6) of the Multidimensional Perfectionism Scale (5). This assessment depicts 5 subscales: personal standards, concern over mistakes, doubts about actions, parental expectations, and parental criticism (10).

Burnout: Burnout was measured using the sport specific Athlete Burnout Questionnaire (12). There are 3 subscales depicted in this questionnaire: reduced sense of accomplishment, emotional and physical exhaustion, and reduction of sport participation.

So, what did they find?

At least one of the physical tests (EVH or Methacholine challenge) tested positive for 15 out of the 24 swimmers (10). This study also found significant associations between BHR and several psychological variables. BHR showed a negative relationship with ‘accomplished recovery'(10). Meaning, as the degree of “accomplished recovery” improved, BHR decreased. In addition, BHR showed a positive relationship with perfectionism (10). Meaning, as the degree of perfectionism increased, so did the degree of BHR. To put it in perspective, excessive training due to the need for achieving perfectionism, may put an athlete at greater risk for respiratory issues (10).

What does this mean for me?

This study suggests excessive training and high stress can negatively impact an athlete’s recovery and psychological perspective on the sport. BHR has a high presence among elite swimmers (10) and breathing problems can lead to lack luster performances. Endurance sports tend to require vigorous training regimes (10). In addition, athletes have other life obligations, adding to their overall physical and mental load. Thus, competitive athletes experience an increased risk of over training and burnout – leading to potential breathing problems. Therefore, it is important to monitor your training, physical and mental health. A balanced training regime and lifestyle can reduce risk and improve your mental health.

Things to Remember

While this study provided great insight, it is a single study and had several limitations. For instance, only a small cohort was assessed. Here, only 24 young individuals were evaluated, specifically elite swimmers – a wider age range, amateurs, or other types of athletes may have generated differing results. However, the Cognitive Activation Theory of Stress (CATS) (4, 14), suggested a similar conclusion, stating “if the total load of an athlete becomes elevated, the recovery of the athlete might suffer.”(10) This study was also not assessed over time. A longitudinal study may provide additional information on how breathing issues may change over an athletic season, a year, and so forth.

Thank you for reading! I hope you feel more informed. If you have any questions or comments, please feel free to leave a shout out.





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