The stakes were high in the MLS cup final last week as the Los Angeles Galaxy's golden boy, David Beckham, tore back and forth across the wide field trying - in vain - for a win.
As he sat on the bench at half time, the winded 34-year-old soccer star pulled out a puffer and pumped pressurized medication into his airways - unknowingly in the sightline of a photographer.
After the match, he was outed as an asthmatic, much to the surprise of fellow players and fans.
It has since been revealed that Mr. Beckham has had mild asthma since he was a child. He likely kept it under wraps due to public misconceptions about the illness.
The belief that asthma can hinder physical performance has prompted many athletes, including retired NHL star Gary Roberts, to hide the illness through most of their careers. But doctors say asthmatics can handle even the most gruelling of workouts if they take proper medication.
"Having exercise-induced asthma symptoms is an indicator of poor asthma control," explains Sharon Dell, a respiratory specialist at Sick Kids Hospital in Toronto.
If asthmatics take on strenuous physical activity but skip medication, they can cause serious damage to their lungs, she says. But combining regular doses of medicine with exercise can actually strengthen them.
Retired speed skater Susan Auch, who now lives in Calgary, might never have won her three Olympic medals had it not been for her asthma.
When she was diagnosed with the illness as a toddler, her parents were told that vigorous physical activity would help her develop strong, healthy lungs, and that's why they pushed her into many sports.
Ms. Auch still remembers the 1995 World Cup in Davos, Switzerland, when she had a cold, which had already made breathing difficult.
"I was there contemplating skating or not skating. It's only a minute-and-a-half race and I thought, 'Screw it. I'm going to go ahead and race,'" she recounts.
At the end of the 1,000-metre event (in which she won a bronze medal), her lungs were begging for warm air. Every laboured breath was punctuated with a coughing fit. But as she came off the ice, she took a few puffs from her rescue puffer, which opened up her airways again and calmed her down.
While the rescue puffer came in handy after an attack, Ms. Auch learned in the last few years of her career to take her medication before she got on the ice to pre-emptively calm her lungs.
"It was definitely the best response I ever had," she says.
Some asthmatics are "anti-antibiotic" and just want to stay away from all medications until they really need them, which is the wrong approach, says Christine Hampson, president of the Asthma Society of Canada.
"You have to think of asthma the same way you think of diabetes. You wouldn't just take your insulin once in a while," she says.
Shawn Strachan, 45, as asthmatic amateur triathlete from Cochrane, Alta., received different advice than Ms. Auch as he grew up: exercise would hurt his lungs and should be avoided.
But when Mr. Strachan was in his late 30s he decided to train for a race after decades of living a sedentary life. His body did not take kindly to it. The doctor told him his lungs were so damaged from his severe asthma that he only had 50 per cent use of them.
With that grim diagnosis, he started taking medication in the morning and afternoon and regularly carrying a rescue puffer with him. After a few months, he started training again.
"During the bike I take it really easy, but when I hit the run it's like breathing through a straw," he says.
Exercise brings his lung functionality down to about 25 or 30 per cent, he says, but taking medication helps bring it back up to the 50-per-cent range.
Though the struggle to breathe can make competing incredibly stressful, Mr. Strachan says staying active has greatly improved his overall health.
Ms. Auch says she kept her asthma a secret as a teen, but later in her career became far more open about it.
"I didn't love people knowing because I thought it would make people think I was weaker," she says. "Once I was successful I didn't care if people knew."Report Typo/Error