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patient name: Ciara Dwyer

age: 16

seen in: Center for the Female Athlete

Swimming is in 16-year-old Ciara Dwyer’s blood. With her father being a swim coach, she has been swimming since before she could walk. When physical and mental challenges started to impact her participation in the sport she loved, the Center for the Female Athlete helped her get back to feeling her best in the pool. 

“Ciara loves to swim,” said Nicole Dwyer, Ciara’s mother and an occupational therapist at Dayton Children’s Hospital. “When she was little, she would typically be the last to get out of the water. I remember watching her bob up and down while warming up for a swim meet when she was around 8 years old – the expression on her face was pure joy.” 

Even though swimming was one of Ciara’s favorite activities, it wasn’t always easy for her. With a chest wall deformity known as pectus excavatum, her sternum and ribs grew inward instead of outward, meaning they were putting pressure on her heart and lungs.  

“Ciara underwent surgery for pectus excavatum 3 years ago, when she was 13 years old,” Nicole said. “She currently has two titanium bars positioned within her chest to lift her sternum and ribs off of her heart and lungs.”  

Ciara came to Dayton Children’s for physical therapy following her surgery, helping her gain strength and adjust to the placement of the titanium bars. While the bars make sure Ciara’s heart and lungs are protected, they also present some challenges for her as a multi-sport athlete in swimming, track and cross-country.  

On top of this, Ciara was struggling to manage the nutritional habits necessary for her high levels of physical activity. Between athletics and school, she also experienced stress and anxiety that took some of the fun out of sports. Nicole and Ciara turned to the center for help. 

“Through colleagues and other patient stories, I learned about all the amazing things the center was doing to help young female athletes in our community,” Nicole said. 

Ciara’s work with the center began just after her first high school swim season. At the end of the season, she had qualified for the state finals, but was disappointed with her results. After an initial assessment, Ciara’s plan of care focused on behavioral health intervention and nutritional changes to manage her stress and diet.

Ciara learned breathing techniques, such as box breathing, and mindfulness techniques that help her regulate her feelings of stress before athletic events. Over the summer, she used these skills on a big stage: the 2023 USA Swimming Summer Speedo Sectionals Central Zone East Sectional swim meet! 

“I was very nervous about racing because it was one of my first big swim meets and the 200 butterfly is a tough race, but I practiced my box breathing to regulate my stress before my race,” Ciara said.  

Not only did Ciara qualify for and compete in the 200 butterfly, she also made the finals in the event with a personal best time! 

Along with her breathing and mindfulness exercises, the specialists at the center taught Ciara how to manage her physical health through nutritional tips and exercises that help with the occasional aches and pains she experiences as a multi-sport athlete. 

“I use my daily stretches for the pain in my knee from cross-country running,” Ciara said, “I also practice deep breathing to help with side stitches I was getting during the cross-country season.” 

With cross-country in the fall, swim in the winter and track in the spring, there is rarely a time Ciara isn’t preparing for an upcoming race. To keep her body strong and ready, Ciara learned proper nutritional habits before and after her workouts. She also started taking iron supplements after bloodwork revealed her iron levels were low. 

Using these tools and more, Ciara had successful track and cross-country seasons! She won the mile at the district finals track meet and had a podium finish in the mile at the regional track meet with a personal best time. She also finished her final cross-country meet of the year with a time that was over a minute faster than the previous year. 

Working with the center has helped Ciara take the stressors of being an athlete in stride. By having a better understanding of her mental and physical needs, Ciara said she now knows that it is just as important to prepare her mind as it is to prepare her body. 

“It is so inspiring to witness such positive change in Ciara – with sports and daily life activities,” Nicole said. “I am so proud that she values a healthy, fit and performance ready mind, as much as healthy, fit and performance ready body.”