Wednesday, September 4, 2013

Staying Active with your Autumn Allergies

Happy September and welcome to my very first Sports Medicine blog post! Since it is becoming my very favorite time of year for outdoor running and cycling (and hiking if given the opportunity), I thought it might be nice to talk about the challenges some folks face during this time of year with regard to simple things like breathing. Depending on where you live, the mornings are becoming what I think is the perfect environment for running outdoors—60-70 degrees Farenheit, cool and brisk, refreshing, and invigorating…for the first few minutes until you realize—I can’t breathe through my nose! Hello, fall...hello, allergies.

If you’ve been doing outdoor activities for many years, you may have realized which times of year are particularly difficult for you in terms of allergic rhinitis/conjunctivitis (that’s fancy doctor talk for itchy, allergic nose and eyes) or allergic asthma symptoms. In New York, beginning in mid-August is the beginning of the grass pollen season. So for those of you starting to sniffle, clear your throat, or rub your red burning eyes when you go outside but not when you’re inside, and you don’t think you have a cold, you may have allergies to grass pollen. This can make enjoying autumn runs/bikes/hiking or any other outdoor activity difficult. How are you supposed to enjoy the clean cool air if you can’t breathe it in? So here are some helpful tips to keep you enjoying the change of season and breathing relatively normally.

1.   Know your trails...
Pay attention to the different flora on your favorite running trails. Maybe you have more symptoms when you run on a certain path at a particular time of year, and that could be one to avoid in the future. Don’t worry, if in the summer you don’t have symptoms there, you can exercise there to your heart’s content, and that trail will be all the more special and fun for you for the time you have spent away. Along the same line, if you live in a city or suburban area, make note of what day they cut the grass and plan to for an indoor workout that day.

2.   Relish the rain...
If you don’t have a mold allergy, running/biking in the rain or shortly after a rain can be the best time for you to be outdoors. Rain clears away some of the pollen. If you do have a mold allergy, this could be the worst time, so try it out and see.

3.   Shower and launder!
Your allergy season is not the time to try to stretch those workout clothes into next week. If you do an outdoor workout, make sure to shower, wash your hair, and launder your clothes. I guess that goes without saying, but I know how much I hate doing laundry. Pollen can linger! (Also workout harder and you won’t think twice about a second round for that outfit.)

4.   Medicate...
Over-the-counter:
Allegra is probably the best oral antihistamine in my opinion. It’s non-drowsy but can still cause issues with dryness (dry eyes, dry mouth), so be sure to drink plenty of water on this medication (in addition to what you would for your normal hydration and training).
Claritin, Zyrtec, etc. are other options. Try them out and see what works for you. Many people find that the standard dose of Claritin isn’t enough to help their allergies significantly, but it is non-drowsy at that dose. Zyrtec is non-drowsy for about 70% of the population; you could be the 30% that becomes a Zombie on Zyrtec. Again, see what works for you. The older antihistamines (Benadryl) are very sedative, so these are really not the best when you’re about to go for a run.
Ask your doctor:
The above medications are systemic, in that they affect the whole body. If you just have eye symptoms or just have nose symptoms, try asking your doctor about eye drops (Naphcon, Pataday) or a nasal spray (Flonase, Nasonex). Some people with severe allergies need the oral medicine in addition to a nasal spray and eye drops to control symptoms effectively.
When to start:
Start your medicines about 2 weeks prior to your known allergy season.

5.   Hibernate...
Know your season and maybe spend a little more time on the treadmill or indoor trainer at that time of year if you are really struggling. It’s all up to you and how important those fresh air workouts are to you. Pollen.com and Weather.com also have local pollen counts, which can be helpful for you to pick and choose the days that are maybe a bit better for indoor workouts.

6.     What’s your poison?
If all of the above still haven’t helped much, try asking your doctor about a referral to your local Allergy specialist (Allergy & Immunology is the field). He or she can do skin testing and determine what the common culprits are that are causing your symptoms. They may suggest other medications or strategies to help. In addition, they may recommend immunotherapy (allergy shots) to help desensitize you. You can go from a sniffling, red-eyed, throat-clearing, head-throbbing, wheezing runner to a happy, smiling one after 6 months or so of therapy 

Megan Long, M.D.

On deck: Foam rolling and the science behind myofascial release techniques!