We are excited to welcome Pete Dewar to the Pace community this year. This week, Pete shares with us some information on asthma versus vocal cord dysfunction.

Do you suffer from asthma? Are you sure it’s asthma? Over my career, I have often found that many young athletes are often misdiagnosed as asthmatics when in fact they have what is called vocal cord dysfunction or VCD. The symptoms are very similar, but there are some slight differences. Let’s break it down.

Both asthma and VCD can produce symptoms such as wheezing, chest pain or tightness, throat discomfort and difficulty breathing; however, it is important to note which phase of respiration is difficult—inspiration or expiration—and the timing of the “attack” in relation to when exercise was performed.

In asthma, the airways tighten, which makes breathing difficult. With VCD, it is the vocal cord muscles that tighten, which cause difficulty in breathing. This is not an allergic reaction and thus does not respond to typical asthma medications such as albuterol. Please note that some people may suffer from both!

The first thing I ask a student-athlete who is struggling to breathe is if it is difficult to take a breath in or out. Asthma presents with difficulty exhaling, and with controlled breathing student-athletes can often self manage without the use of medication. VCD is just the opposite; the vocal cords close causing difficulty when trying to breathe in. Because the vocal cords are involved, you may also notice changes in a patient’s voice when they are actively suffering from VCD.

The gold standard for diagnosing VCD is a fiberoptic laryngoscopy. This procedure involves putting a camera on your vocal cords while exercising to determine if they are closing while you exercise and causing difficulty breathing.

Treatments are very different for the two issues, which is why a proper diagnosis is important. If you suffer from VCD, you may be referred to a speech therapist to focus on relaxing your throat muscles. We also may incorporate some sports psychology to work on breathing techniques and ways to handle anxiety. It is often found that people can become nervous/anxious around athletics events, and this causes the vocal cords to operate improperly. Those deep breaths you take before you toe the line are more important than you think!

Let me know of any questions you might have through email, and stay healthy!