The International Olympic Committee (IOC) has recently issued a position statement on non-infective acute respiratory illnesses (such as asthma). Medical professionals at major sporting events deal with more than just sprains, strains, and blood. They report that about 50% of their consultations are about acute illnesses, and of those, 50% are about the respiratory system.

So, 1 in 4 athletes, who visit a medic at a major sporting event, have a respiratory problem.

The IOC statement includes advice on how athletes can manage this problem and reduce symptoms without medicine. This article will expand on the advice given and list practical solutions to help athletes manage these distressing conditions. It is not designed to replace medical advice and does not apply to infectious respiratory diseases.


What are some of the common illnesses and problems?

Asthma is the most well-known of the respiratory illnesses that affect athletes and the general population. It can be a distressing condition with symptoms including tightness of the chest and difficulty breathing. Many people are prescribed inhalers to help them alleviate the symptoms. Athletes, if they have one prescribed, should take these to competitions.

Allergies, such as hay fever, can also cause breathing difficulties. One of the reactions is known as rhinitis: a term that describes the itchy, runny nose, blocked nose, and sneezing feeling that you might have without otherwise feeling ‘ill.’

There is a distinction made in much medical research between ‘upper-airway’ illnesses that arise from the larynx (your voice-box) and above, such as allergies, and ‘lower-airway’ illnesses that arise from below the larynx, such as asthma.

However, rather than a sharp dividing line, there is a continuum between lower and upper airways, and physicians now treat the whole illness.

A nasal blockage also causes breathing problems. This can be caused by trauma, such as a ‘broken nose’ from a hockey stick or punch, or a structural abnormality that has developed naturally. Nasal blockages can cause sleep disruption and might hamper recovery but don’t affect exercise as much because athletes switch to mouth breathing during intensive exercise. Some blockages might require a procedure to correct them.


Strategies to reduce and relieve some of the symptoms

Providing medical advice has been sought to treat any acute symptoms and diagnose any potential illnesses; athletes can look to implement some of the following strategies to reduce their discomfort and, potentially, improve their performance.


Reduce exposure to cold and dry air, allergens, pollution, or other airway irritants

This is difficult if you are asked to run a marathon in a major city such as Los Angeles: the pollution levels are hazardous and might mean running at the least-polluted time of day or in ‘green lungs’ of the city such as large parks or beside a river. A mask can help filter against airborne particles but not gases.

Some swimmers are affected by chlorine and other chemicals in pools. Nose rinsing with saline before or after swimming may help reduce the symptoms, as might wearing a nasal clip.

Exercising in cold and dry air increases the number of respiratory symptoms; avoiding this is difficult if you live in a region that has cold and dry air most of the year. The advice is to modify your training so that you avoid the worst parts of the day or wear a mask.

Wear a heat and moisture exchange face mask.

These masks help warm and humidify inspired air and have been shown to reduce exercise-induced symptoms in asthmatics. If you live in a cold and dry environment, this might be a good investment. If you are going to compete in such an environment, and suffer from exercise-induced respiratory problems, then buying a mask and training in it prior to competition might be a good idea.

Modify dietary intake.

There is some evidence that supplementing your diet can help alleviate the adverse respiratory symptoms associated with exercise. Supplements shown to have worked include omega-3 polyunsaturated fatty acids and fish oils. One study has shown that prebiotic supplementation worked. The prebiotic used was Bimuno-galactooligosaccharide (B-GOS) which can be bought in most health stores.

Reducing salt intake has also been shown to work. The reason for this has yet to be determined, but the results are what matters to the athlete.

If you do try and modify your diet, I suggest that you try one supplement at a time. If it works, then there is no need to do more.

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