Allergies, Asthma, and The Summer Athlete

Athlete Allergies.Premier Allergist

Athletic performance clichés, while inspiring, can often be full of terrible advice.  “No pain, no gain,” “the pain in only temporary,” “pain is weakness leaving the body,” and “suffer now and live the rest of your life like a champion” are among the sayings that would have your primary care physician shaking their head in dismay.   Society lifts up the wounded champion.  From Kirk Gibson’s 1988 World Series home run on a bad hamstring and torn ligaments to Tiger Woods winning the US Open in 2001 on a torn ACL and leg fracture, it’s hard not to idolize the person who persevered through such great physical adversity.  It is no wonder that many athletes when faced with some sniffles, watery eyes, or even some chest tightness tend simply shrug off their symptoms.

Contact our healthcare professionals at The Allergy and Asthma Center today to learn more about allergy and asthma treatments.

Summer athletes get exposed to poor air quality, excessive heat, and grass and tree pollen particles.   The region, sport, and time of year will determine what type of pollen to which an athlete will be exposed.  Football, field hockey, lacrosse, baseball, and soccer fields in the Northern US will typically consist of ryegrass, bluegrass, fescue, or other cool season grass, while in the Southern US most fields will consist of a Bermuda grass blend.  Similarly, golfers in the northern regions will experience exposure to the cool grasses with the addition of bent-grass.   In the south, many courses are turning to non-native zoysia grass. (6) Grass pollen tends to be most prolific in the summer months, while tree pollen season most infamously occurs every spring.  The most common tree pollens in the US are birch, oak, alder, and maple.  Even people who aren’t allergic can be affected by tree pollen by the sheer volume of it invading our airspace.  Couple this with excessive heat and poor air quality, a child’s tee-ball game in July can become a minefield of asthma triggers.  A study of Olympians found that even indoor athletes, swimmers in particular, can be at higher risk of being asthmatic due to their large, gulping breaths and the inhalation of chemicals and dry air.  (1)

The prevalence of asthma and allergies in all athletes is generally on par with the non-athlete.  A study done in 2014 found that out of 636 athletes surveyed approximately 42% of them had reported suffering from pollen allergies and out of those sufferers 82% reported performance impairment from their allergies (2)   Athletes tend to be more prone to asthma then non-athletes.  In the 2014 study 30% of the athletes reported impairment from asthma.  (2)  In the 2008 Beijing Olympics 17% of cyclist and 19% of swimmers were reported to be asthmatic.  The average worldwide population of asthma has been reported to be approximately 7.6%.

Typical pollen allergy symptoms including sneezing, itchiness, watery eyes, and stuffy nose.    While allergies would be the most likely diagnosis for these symptoms that isn’t always correct.  Exercise induced rhinitis is defined as inflammation of the nasal passages leading to rhinorrhea, sneezing, congestion or nasal itching related to physical activity.  A 2006 study determined that exercise induced rhinitis affects both the allergic and non-allergic equally. (4) Asthma exacerbations are also commonly linked to allergies during outdoor physical activity but are not always the real cause.  Exercise-induced bronchospasm (formerly exercise induced asthma) can be triggered by the act of physical activity itself.  There is strong evidence to suggest that athletes are more likely to be affected by EIB.  (5)

Interestingly, few people will actually treat their allergies and asthma.  While some athletes (42%) will symptomatically treat their allergies, most will not take proactive steps to improve their performance. (2) A 2006 study of recreational road runners found that out of the 42% who reported allergies only 0.5% of them took any prescription medication or medications before racing. (3) The study reported higher instances of medication usage with asthmatics, (6%), and for people with symptoms of allergies and asthma (31%).  The majority of were concerned about side effects, negative impacts on sports performance, and lack of long-term effects.

Taking medication may not be the right answer either, especially if you are a higher-level athlete.  Anti-histamines will often have side effects that negatively enhance performance and some drugs, such as beta2 agonists, are prohibited by the World Doping Agency.  Athletes who use allergen immunotherapy had fewer impaired training bouts than those who used symptomatic and alternative therapies. (2) Anyone experiencing performance decline from allergies or asthma should see an allergist to determine proper treatment.  Most allergists want patients to be proactive when it comes to your symptoms and prefer athletes to learn a different sports cliché: proper diagnosis can prevent poor performance.

Contact our healthcare professionals at The Allergy and Asthma Center today to learn more about allergy and asthma treatments.

  1. Ilkka Helenius, MD, Phd, Tari Haahtela, MD, PhD. Allergy and asthma in elite summer sport.  Journal of Allergy and Clinical Immunology.  September 2000Volume 106. Issue 3, Pages 444–452
  2. Salem L, Dao VA, Shah-Hosseini K, de Marees M, Mester J, Mösges R, Vent J. Impaired sports performance of athletes suffering from pollen-induced allergic rhinitis: a cross-sectional, observational survey in German athletes. J Sports Med Phys Fitness. 2019 Apr;59(4):686-692. doi: 10.23736/S0022-4707.18.08556-0. Epub 2018 Jul 16.
  3. Randolph CC, Dreyfus D, Rundell KW, Bangladore D, Fraser B. Prevalence of allergy and asthma symptoms in recreational roadrunners. Med Sci Sports Exerc. 2006 Dec;38(12):2053-7.
  4. Silvers WS, Poole JA. Exercise-induced rhinitis: a common disorder that adversely affects allergic and nonallergic athletes. Annals of Allergy Asthma Immunol. 2006 Feb;96(2):334-40.
  5. M. Ienna, D. C. McKenzie The Asthmatic Athlete: Metabolic and Ventilatory Responses to Exercise With and Without Pre-Exercise Medication.  Int J Sports Med 1997; 18(2): 142-148
  6. Christenson, Skylar. J  BEST GRASS SEED CHOICES FOR ATHLETIC FIELDS. June 3, 2018. https://www.naturesseed.com/blog/best-grass-seed-choices-for-athletic-fields/
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