Breathing Problems and Prevention for Kumite

Prevention and Screening

  1. Athletes who may have or are suspected of having asthma should undergo a thorough medical history and physical examination before kumite.
  2. Athletes with asthma should participate in a structured warmup protocol before kumite or other strenuous sport activity to decrease reliance on medications and minimize asthmatic symptoms and exacerbation.
  3. The referee staff should educate athletes with asthma about the use of asthma medications as prophylaxis before exercise, spirometry devices, asthma triggers, recognition of signs and symptoms, and compliance with monitoring the condition and taking medication as prescribed.
  4. The referee staff should ask if any medical conditions exist before beginning the match and to have the athletes medication (i.e. inhaler) be visible and available at ring side


The referee staff should be aware of the major asthma signs and symptoms:

A. confusion

B. sweating

C. drowsiness

D. difficulty exhaling

E. low level of oxygen (looking pale)

F. use of belly muscles for breathing, huffing and puffing for more than 30 seconds after stopping activity

G. wheezing

H. cyanosis (turning blue)

I. coughing

J. hypotension (low blood pressure)

K. mental status changes

L. loss of consciousness

M. inability to lie supine

N. inability to speak coherently

O. agitation


  • For a sudden asthma attack, the athlete should use their inhaler. In a severe attack, the speed of getting the medication is of the essence.  More than one dose may be needed for severe attacks.  If 3 administrations of medication do not relieve distress, the athlete should be referred promptly to an appropriate health care facility.
  • Inhaled corticosteroids or leukotriene inhibitors can be used for asthma prophylaxis and control. Athletes should be taught to use these medicines as prescribed by their physician if they are to compete in kumite or other strenuous sport activity.
  • Supplemental oxygen should be offered to improve the athlete’s available oxygenation during asthma attacks.
  • If despite treatment, the asthma attack returns on the same day once kumite resumes, the athlete should be removed from competition.
  • In the athlete with asthma, physical activity should be initiated at low intensity levels and training intensity gradually increased while monitoring occurs for recurrent asthma symptoms.