Supporting Athletes with Asthma, Diabetes, and Chronic Conditions

The coach pulls you aside after the first practice of the season. Your 11-year-old just made the travel soccer team — she's thrilled, you're proud, and then the coach says, "I saw on her form that she has type 1 diabetes. I've never had a player with that before. Honestly, I'm not sure what to do if something happens." He's not being unkind. He's being honest. And that honesty reveals a gap that exists in nearly every youth sports program in the country: we are not prepared to support athletes with chronic conditions.

Here's the uncomfortable truth: chronic conditions in youth athletes are not rare. They are common, they are manageable, and the biggest barrier to full participation isn't the condition itself — it's the adults around the athlete who don't know what to do. That gap between diagnosis and support is where kids get sidelined unnecessarily, where coaches make fear-based decisions, and where talented young athletes quietly quit because the system wasn't built for them.

Asthma and Exercise-Induced Bronchoconstriction: More Common Than You Think

Asthma is the most common chronic condition in young athletes. The Asthma and Allergy Foundation of America estimates that approximately 6 million children in the US have asthma, and exercise-induced bronchoconstriction (EIB) — where airways narrow during or after physical activity — affects roughly 10% of the general population and up to 90% of people with diagnosed asthma. This means that on a typical youth team of 15 players, one or two are likely dealing with some form of exercise-related breathing difficulty.

The good news: with proper management, asthma and EIB are almost never a reason to limit participation. A joint position statement from the American College of Sports Medicine (ACSM) and the American Thoracic Society confirms that athletes with well-controlled asthma can participate fully in all sports, including high-intensity and endurance events. The key is "well-controlled" — and that depends on adults doing their part.

What coaches need to know:

• Pre-exercise medication works: A short-acting bronchodilator (typically albuterol) taken 15 to 30 minutes before exercise prevents symptoms in the vast majority of cases. The athlete's inhaler must be accessible at every practice and game — not locked in a car or left in a locker.
• Warm-ups matter more: A gradual 10-to-15-minute warm-up significantly reduces EIB episodes. Jumping straight into sprints on a cold, dry day is the single biggest trigger.
• Environmental awareness: Cold, dry air, high pollen counts, poor air quality, and chlorinated pool environments all increase risk. On high-risk days, check in with the athlete before pushing intensity.
• Know the warning signs: Wheezing, persistent cough during exercise, chest tightness, unusual shortness of breath relative to effort level, and inability to keep up with normal activity. If symptoms don't resolve with rest and rescue inhaler use, seek medical attention.

Consider this: at the 2012 London Olympics, 21% of British athletes reported asthma or EIB . Among them were gold medalists. Asthma does not define athletic potential. Management defines outcome.

Type 1 Diabetes: Managing Blood Sugar Through Sport

Type 1 diabetes (T1D) is an autoimmune condition in which the body produces no insulin. According to the American Diabetes Association , approximately 244,000 children and adolescents in the United States have T1D, and many of them are athletes. The ADA's Position Statement on Exercise and Diabetes is unequivocal: regular physical activity is recommended for all people with diabetes, including youth. The challenge isn't whether they should play — it's how to manage blood glucose during activity safely.

Exercise affects blood sugar in complex ways. Aerobic activity (running, swimming, cycling) generally lowers blood glucose, sometimes rapidly. Anaerobic activity (sprinting, weightlifting) and high-adrenaline competition can temporarily raise it. A soccer game — with its mix of jogging, sprinting, and competitive stress — can swing blood sugar in either direction, sometimes within the same half.

• Pre-exercise blood sugar check: The athlete (or parent, for...