Expert comment: Dr John Dickinson on the truth about cycling and asthma

Commenting on the continuing allegations about the prevalence, effects and treatment of asthma among cyclists, Dr John Dickinson, the UK’s foremost expert in asthma in sport, says such a diagnosis gives no athlete an advantage.

‘Athletes are far more prone to asthma-related problems, mainly because of the environments they’re exposed to and the breathing demands of sport, such as cycling outdoors, often means breathing large volumes of dry, polluted air.

‘For athletes with asthma, optimising inhaler therapy will enable them to compete on a level playing field with their non-asthmatic counter parts. In sport, the principle goal of asthma treatment is prevention, not performance. If a good prevention plan is in place, it should eliminate the need to have a puff on the inhaler while riding. Good asthma management results in better quality training.

‘Research shows that other than protecting against and reversing airway muscle constriction (asthma), therapeutic doses of inhalers will not provide further benefits to athletic performance. So athletes without asthma will not improve their performance by using therapeutic doses of asthma inhalers.

‘Athletes whose inhaler therapy has not controlled their asthma can apply for a Therapeutic Use Exemption (TUE) to enable them to use stronger medication. However some of this stronger medication can potentially improve endurance performance which is where this use becomes controversial. Rules may have to be adjusted so that athletes with a TUE taking stronger asthma medication cannot compete during the time they are using it. This rule change would protect the athlete’s health and the integrity of sport.’

Dr John Dickinson is head of the respiratory clinic at the University of Kent and lecturer in the School of Sports and Exercise Sciences. He carries out breathing assessments at Medway Park Sports Centre. He has tested Olympians and elite athletes from almost every sport, including GB cyclists and members of Team Sky.

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