News: What makes 63% of Liverpool players asthmatic?

Professor John Dickinson said: “I'm shocked by the allegations and I am disappointed to see this kind of misinformation circulating in the media. We treat asthmatics on a daily basis and we know that it’s impossible for Liverpool’s players to be using asthma drugs.

The theories are similar to previous ones relating to asthma inhalers and performance enhancing substances, which we have examined here.

Has the Hillsborough tragedy and subsequent legal investigations made Liverpool’s players feel they have been treated with a lack of respect by the media?

We’ve decided to provide some evidence-based analysis of these rumours with the help of the country’s leading expert on asthma in elite athletes, Professor John Dickinson.

How come 22 from the 35 Liverpool players labored breathing?

Professor John Dickinson from the University of Liverpool, has spoken about Liverpool’s asthma problem. The rumour I saw was 63%, as you say. There is no official data out there on this. A club is not going to pin the number of players that are using various medications on a board somewhere.

Liverpool FC players are known to have a history of P.E.A (exercise induced bronchoconstriction). However, no official figures have been released to acknowledge the extent of this illness.

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Why could be the incidence of bronchial asthma excessive?

We found that 27.8% of footballers within our sample had exercise-induced asthma, so almost one in three. The prevalence within the general population is somewhere between 9 and 12%, so roughly 1 in 10. This figure of 63% wouldn’t necessarily be unreasonable though.

Liverpool have managed to identify over 60% of their players with asthma, which is a higher figure than we’ve published from elite football in the past.

Liverpool are leading the way in how they look after their athletes. The club has a medical team of over 20 clinicians who were responsible for identifying 63% of the club's footballers as suffering from asthma. This is much higher than the average rate within the general population, which is estimated at around 10%.

Liverpool's medical staff are using a new method to screen the club's players for asthma. Dr Rory O'Hanlon of the Premier League club told BBC Sport that 33% of the players in their ongoing screening trial have been diagnosed with exercise-induced asthma, compared to an estimated 10% prevalence in the general population. The team hope it will help them identify those at risk of airway problems and reduce chances of injury by improving player monitoring.

What is the best treatment option for asthma?

Most footballers have asthma, but the extent and severity of the disease can vary between individuals. The blue inhaler is salbutamol and it relieves the muscle constriction, but it doesn’t really touch the inflammation. If an athlete solely relied on that, the inflammation would still be there and their bodies would get used to the salbutamol, so they would have to take more of it as time went on.

If you have mild to moderate asthma, it would only require use of an inhaler two to three times a year.

The salbutamol inhaler helps reduce the symptoms of asthma, but it doesn’t actually cure it.

Asthma is an inflammatory lung disease that makes breathing difficult. It’s sometimes described as a chronic (long-lasting) condition and can be triggered when there is exposure to allergens or irritants, such as pollen or tobacco smoke, or if your body has an allergic reaction. If you have asthma, you will usually have inflammation in your airways, causing them to narrow and become inflamed. This makes it harder for you to breathe and makes asthma symptoms worse.

Do asthma inhalers have any performance boosting features?

In therapeutic doses, no. From an anti-doping point of view an athlete isn’t allowed to use more than six puffs of the blue salbutamol inhaler during a 12-hour period. The only thing they really saw was an elevated heart rate, which is actually detrimental to performance, because for a given workload you’re having to work harder. There's also a fair chance you would get the shakes and perhaps heart palpitations too."

In normal therapeutic doses, no. From an anti-doping point of view athletes are not allowed to use more than six puffs of the blue inhaler in four hours. They do have a higher content in them though and could cause you certain side effects like shakes and heart palpitations if taken orally rather than inhaled. If you are talking about the yellow inhaler, then no. It has a different chemical composition and is not banned by WADA.

As a drug, salbutamol has been around for a long time and there's not really any evidence of it affecting performance. We certainly don't think there's going to be any issue with those people who have taken it a few times, but we would certainly advise against taking any more than you need.

It can work through the GI tract and into the brain, where it blocks the actions of a chemical called acetylcholine. Acetylcholine is responsible for increasing heart rate and blood pressure. Salbutamol acts quickly and generally has an effect within 5 to 10 minutes.

How do you find out if a player is asthmatic?

We don't make fun of people with asthma. We just want to find out if it affects their ability to play football, which is why we make them breath really hard for a few minutes and measure how well their lungs work afterwards.

Your lungs work like a hydraulic system, with air flowing through open spaces in the air sacs and into tiny tubes called alveoli. The alveoli are lined with millions of tiny capillaries, which carry oxygen to every cell in your body. In asthma, the lining of the lung’s airways swells up and causes them to narrow. This makes it difficult for your body to breathe.

Liverpool looks at the function of the airways. We take a measure of how well an athlete can breathe in and out in terms of the flow of air, and we also take a measure of inflammation inside their airways as well. We do that at rest, but that’s not enough because for most footballers their lung function will look normal then.

Our objective is to objectively look at the function of the airways. We perform a flow volume curve to measure how well an athlete can breathe in and out in terms of the flow of air, and we determine inflammation inside their airways as well. We do this at rest and then trigger an asthma response by challenging them with cold, dry gas for six minutes.

Why is it important to diagnose exercise-induced asthma in players?

When you yourself have asthma and continue steadily to exercise at excessive intensity can result in some long haul thickening with all the airway divider. It does not appear in everybody.

Because asthma is a superb inflammation issue, also, they are most likely to catch splutters and colds. We all also found the fact that asthmatic players find a decrease for aerobic performance compared to non- asthma players.

They cannot make use of the whole adaptations from workout aswell while all others. If you have a normal throat, you can generate more out from the training lessons.

How do you treat asthmatic players in football?

A great club would generally call someone with this issue to do therapy. I do not get many calls. A great lot of that time period the dance clubs is going to do the screening in- house.

It 's not at the very top using their priority list. How can a medical day go? Most of the time it 's practical testing, peak electric power and body structure.

Asthma will simply be found when the ball player signs for your club. Without the original objective test, doctors wont understand how to control asthma.

I wouldn't say screening of athletes in first-rate football has shifted as a result article we did in 2017. The golf club depends on medics making screening a concern.

The expense of screening a group is not that much- about£ 150 per player if categories of 12 or more are tested. Each player takes about an hour to complete the test.

If you are looking to get through a group of 30, you have to write off the day. I have done 12- 15 players in four hours. We usually tend to bring a team of 4 people. Within pre season medical times we now have inlayed all of us.

The players do not like the hyperventilation. Olympic athletes endure it better. We do exactly the same test using them. It 's not happening if you don't undertake it within the pre season.

This is not about making money, it 's about improving screening and education so that breathing difficulties can get better.