Anyone from the weekend golfer to the elite Olympic competitor can experience problems due to allergies. Symptoms may range in severity from trivial but annoying to life threatening. Treatment involves special considerations because medication for symptom relief can affect sports performance, causing both positive and negative effects. Also, some organized competitions pose additional limitations to treatment.
Allergic Rhinitis and Conjunctivitis
Several aspects of the sports experience can affect rhinitis (inflammation of the mucous membranes of the nose). Many outdoor sports expose the athlete to airborne particles that can trigger allergic symptoms such as nasal discharge, sneezing, and itching. Grass pollen, for example, is airborne in high concentrations during the spring and early summer. Baseball players, golfers, soccer players, and those involved in other field sports face significant exposure, especially on windy days and after a recent mowing. Weed pollens, including ragweed, may cause problems in late summer and fall for those practicing on fields surrounded by uncut weeds. Mold spore counts tend to be high whenever climatic conditions produce heat and moisture, and some molds are also dispersed in high concentrations on windy days. The triggers of allergic conjunctivitis, which may transiently affect vision, follow similar patterns.
In addition to allergenic particles, the nasal passages are also sensitive to temperature. Cold air can cause watery nasal discharge in many individuals and sometimes a degree of congestion. Skiers, ice skaters, and hockey players often notice this problem. Treatment of rhinitis symptoms can involve antihistamines, decongestants, and topical sprays. Nonsedating antihistamines are favored for sports activities requiring quick reaction times, such as most ball sports. However, endurance does not seem to be affected by either sedating or nonsedating antihistamines. Treadmill testing of athletes on both types of medication at the Uniformed Services University did not show impaired performance. A topical antihistamine spray, azelastine, is available; it acts rapidly and causes minimal drowsiness.
Decongestant use is more controversial in sporting events. A healthy weekend tennis player may use a medication such as pseudoephedrine to decongest the nose without problems, but high levels of decongestant medications are banned during Olympic competitions. Decongestants in high concentrations act like stimulants, such as amphetamines, and may both unfairly enhance performance and lead to health risks.
Your doctor may also suggest other methods of treatment, such as topical sprays containing cromolyn or corticosteroids. When used for treatment of allergic rhinitis, these medications must be taken for at least several days prior to exposure to be effective. Topical ipratropium is also available and is effective for decreasing watery nasal discharge during exercise and exposure to cold air.
Allergen immunotherapy is useful for decreasing allergic symptoms, but treatment must be started prior to exposure and needs to be continued for three to five years. Various mechanical devices (such as Breathe Right Nasal Strips) are available for relief of nasal congestion and are used by many professional athletes. These are less effective for many allergic individuals because nasal swelling occurs within the bony vault of the nose, which cannot be expanded by a mechanical device.
Symptoms of allergic conjunctivitis generally will improve with treatment of rhinitis. If necessary, your doctor may also prescribe topical eye medications, such as cromolyn, lodoxamide, or olopatadine.
Source:Bruce Ryhal, M.D., Allergies and Asthma in Sports
Allergic Rhinitis and Conjunctivitis
Several aspects of the sports experience can affect rhinitis (inflammation of the mucous membranes of the nose). Many outdoor sports expose the athlete to airborne particles that can trigger allergic symptoms such as nasal discharge, sneezing, and itching. Grass pollen, for example, is airborne in high concentrations during the spring and early summer. Baseball players, golfers, soccer players, and those involved in other field sports face significant exposure, especially on windy days and after a recent mowing. Weed pollens, including ragweed, may cause problems in late summer and fall for those practicing on fields surrounded by uncut weeds. Mold spore counts tend to be high whenever climatic conditions produce heat and moisture, and some molds are also dispersed in high concentrations on windy days. The triggers of allergic conjunctivitis, which may transiently affect vision, follow similar patterns.
In addition to allergenic particles, the nasal passages are also sensitive to temperature. Cold air can cause watery nasal discharge in many individuals and sometimes a degree of congestion. Skiers, ice skaters, and hockey players often notice this problem. Treatment of rhinitis symptoms can involve antihistamines, decongestants, and topical sprays. Nonsedating antihistamines are favored for sports activities requiring quick reaction times, such as most ball sports. However, endurance does not seem to be affected by either sedating or nonsedating antihistamines. Treadmill testing of athletes on both types of medication at the Uniformed Services University did not show impaired performance. A topical antihistamine spray, azelastine, is available; it acts rapidly and causes minimal drowsiness.
Decongestant use is more controversial in sporting events. A healthy weekend tennis player may use a medication such as pseudoephedrine to decongest the nose without problems, but high levels of decongestant medications are banned during Olympic competitions. Decongestants in high concentrations act like stimulants, such as amphetamines, and may both unfairly enhance performance and lead to health risks.
Your doctor may also suggest other methods of treatment, such as topical sprays containing cromolyn or corticosteroids. When used for treatment of allergic rhinitis, these medications must be taken for at least several days prior to exposure to be effective. Topical ipratropium is also available and is effective for decreasing watery nasal discharge during exercise and exposure to cold air.
Allergen immunotherapy is useful for decreasing allergic symptoms, but treatment must be started prior to exposure and needs to be continued for three to five years. Various mechanical devices (such as Breathe Right Nasal Strips) are available for relief of nasal congestion and are used by many professional athletes. These are less effective for many allergic individuals because nasal swelling occurs within the bony vault of the nose, which cannot be expanded by a mechanical device.
Symptoms of allergic conjunctivitis generally will improve with treatment of rhinitis. If necessary, your doctor may also prescribe topical eye medications, such as cromolyn, lodoxamide, or olopatadine.
Source:Bruce Ryhal, M.D., Allergies and Asthma in Sports
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