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Health & Exercise Forum

Seasonal Allergies in Athletes: Part 2 of 2

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May 7, 2012

Dr. Mackarey's Health & Exercise ForumAllergies affect 30 % of adults and 40% of children in the United States. Last week we discussed the definition, incidence, causes and treatment for allergy sufferers. However, many of those who suffer from allergies are those engaging in athletics. Avoiding the outdoors is often not an option. Not long ago, it was unthinkable that an athlete with serious allergies could compete at a high level, such as the Olympics. Now, in great part due to advanced research, medications and proper management, an Olympic gold medal for those suffering from allergies is a reality. Recently, the National Institute of Allergy and Infectious Disease at the National Institutes of Health have published research on this topic to provide a better understanding and make recommendations.

The most common allergic reactions which athletes suffer from are sneezing, itchy and watery eyes, runny nose and coughing. Moreover, 67% of those with these symptoms also suffer from asthma. The athlete in NEPA is particularly vulnerable when the pollen count is high during spring and fall for several reasons. One, after being indoors all winter, one might develop a heightened sensitivity to allergens. Also, increased rapid and deep breathing during exercise makes athletes more susceptible to significant symptoms when exposed to allergens such as tree, grass and weed pollens.

Allergy Treatment Options

Allergy Shots/Drops

As mentioned last week, allergy skin testing can be performed to determine the allergens to which you are susceptible. Once determined, allergy shots are effective in building up tolerance to these allergens. If appropriate, you may be able to use allergy drops, administered under the tongue and conveniently used at home.


Asthma suffers should use their inhaler BEFORE symptoms occur. A recent study found that pretreatment using a short-acting bronchodilator inhaler within 15 minutes before exercise is very effective in preventing asthma symptoms for more than four hours. It is important to keep a bronchodilator available. If you fail to benefit from this, see your physician for other methods to control your exercise-induced symptoms.

Warm-up/Cool Down

Whether you have allergic respiratory problems from rhinitis or asthma, you many benefit from conditioning your airways with a 10 to 15 minute warm-up before and cool-down after the activity. This may serve to gradually prepare your lungs for an increased demand.


In addition to preventing dehydration on hot and humid days, constant hydration is very important for the athlete with allergies to prevent dry airways in athletes.

Guidelines for Athletes with Allergies:

from the National Athletic Trainers Association:

Educate Staff

Know the signs and symptoms of asthma (coughing, wheezing, tightness in chest, shortness of breath).

Plan for the Problem

Some schools have a file on each student athlete with a allergic or asthmatic problem which requires medication. The file includes information such as medical doctor release and instruction, emergency contacts and medications. Students must have their medications on hand before they can enter the field. The National Athletic Trainers Association recommends using a peak flow meter to monitor at risk players and can determine when a player can return to the field.

Practice in Climate Control

If possible, find an alternate practice facility with climate control for athletes at risk. Plan practices for these athletes when the pollen count is low. Check the newspaper or internet for pollen counts in your area. Training by the water, (ocean) where there is a breeze and less pollen is helpful.

Additional Suggestions:

Shower and change clothing immediately after being outdoors

During a flare up, do less aerobic exercise to limit stress on respiratory system. Try strength training indoors instead.

When pollen count is high, keep windows shut at home and in your car….use air-conditioning.

Keep pets out of your bedroom…especially when sleeping

Dry clothing in dryer…do not hang on clothesline outdoors

Medical Contributor: Michael Freiman, MD, The Northeast Ear, Nose, and Throat Allergy Center located at 503 Sunset Drive in Dickson City, PA.

Sources: American College of Allergy, Asthma, and Immunology. National Athletic Trainers Association.