There are, of course, far worse things to suffer from than hay fever, but that’s cold comfort when every outdoor excursion during the sunnier months results in fits of sneezing and eyes that itch for hours.
Hay fever, or more properly allergic rhinitis, can be particularly awful for those who have to train for a big event during a period of high pollen levels, or are simply desperate to get outdoors for a bit. For advice on how to stop hay fever ruining your summer of outdoor sport, we spoke to Dr James Hull, respiratory physician at The Centre for Health & Human Performance.
How can hay fever affect athletic performance?
It can have a massive effect. It can really stuff people’s events or their season, because many events occur at a time when pollen is high. And it’s not just the symptoms that a standard hay fever sufferer might struggle with—sneezing, itchy eyes, feeling fatigued—it’s also the fact that you can’t sleep very well.
Another common complaint is that people tend to get infections as well. Part of that is that if your nose is blocked you’re forced to breathe through your mouth. It’s not so much when you’re doing sport, but at night-time or when you’re sitting around, you breathe through your mouth and that means you inhale the toxins in your environment, including bugs, and that makes you more susceptible to infection.
What can you do?
I advocate this thing called PEAK. It has four components to it:
Prevention: By the time you realise you’re getting hay fever, the histamine release has already occurred and often the histamines are bound to the receptors, so you’re chasing your tail the whole time. Whereas if you know roughly when your hay fever occurs each season, you can start treatment at least two weeks ahead of symptoms starting – then you start the season in a much better place. This has been shown to be effective in improving hay fever control significantly.
Elimination: Secondly, it’s important to try and eliminate the amount of pollen you are exposed to. When you get in from a run, wash your hair to get the pollen out otherwise it hangs around your face. Wear sunglasses and, when washing your kit, don’t hang it outside where it can pick up pollen – hang it indoors to dry. You can spend money on things like nasal filters or air clearance systems in cars if it’s a really big issue for you.
Action: Then there’s treatment, which is generally quite mild. Start with a tablet form of antihistamine, which is non-sedating. You don’t want things like Piriton which have a sedative effect and make your performance go downhill. If that doesn’t work you can add a nasal steroid, and if that doesn’t work you can now get sprays which have both steroid and antihistamine combined, which treat both the nose and the eyes together. Competitive athletes can’t take certain types of nasal spray or decongestant tablets—UK Anti Doping has good, clear information [PDF] about what can and can’t be taken for hay fever.
Keep re-evaluating: People start off with good intentions to manage all these different aspects, and then after about three weeks they forget all about it. Or they drop the tablets because their symptoms get better, then it flares up again after a few days. Be proactive like you would with your nutrition or hydration – don’t just give up after two weeks and go back to square one, keep going back over things and thinking if you can improve the other aspects.
The British Society for Allergy and Clinical Immunology website has more information. Occasionally people who have very severe symptoms can consider being referred for immunotherapy, which is a desensitisation to the allergens. There’s information on that website about how you might get referred for that.
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Are there certain times of day when it’s better to exercise?
There’s conflicting evidence but it’s thought that the middle of the day is best. And sometimes very early in the morning is OK.
Can you do anything special for race day to reduce the impact of hay fever?
It’s all about the preparation. So on race day think about when you’re going to take your medications, how you’re going to package and travel with them. When you’re travelling to a race can you limit the amount of pollen you’re exposed to on the way? Or when you’re waiting for the event to start? Sitting in a field is not going to be the best preparation.
If you’re in a city where air pollution is a concern, is it better to run in a park or on the street?
There are some studies now that show that pollutants may interact with the pollen’s structure to amplify the antigenic effect. The best place to go in a city is a park but it depends on your exact sensitisation profile. Some people are sensitised to London plane tree for example. Most are sensitised to grass pollens.
If you work out what you’re sensitised to you can avoid the environment. There are two ways to do that. One is to think about what time of year your symptoms typically start. The tree cycle starts a bit earlier in the year. There’s lots of information online about what you might be sensitised to based on the seasonal variations. The second is to get a skin test or a blood test that tells you exactly what you are sensitised to. Then you can work out where certain plants might be, and train in certain environments. But a lot of people don’t have that luxury. I’d suggest running around a park is more pleasant and you don’t want to be running alongside roads anyway. In many ways, being pragmatic is the way to go.
