The majority of illnesses that triathletes face are usually from the environment in which they train or race.<\/p>\n
A recent review of 30 studies showed endurance athletes were more susceptible to respiratory infections than normal exercising controls. This is because depression in immunity, as seen\u00a0in ultra-endurance athletes following competition, leads to the increased frequency of colds.<\/p>\n
Furthermore, colds are more common in athletes with pre-existing chronic conditions related to an inflamed nasal lining, such as nasal allergies, due to increased ventilation and exposure to sport-specific environmental factors (e.g. pollution, pollen, dust, cold air or chlorination products).<\/p>\n
- Nine tips for dodging injury and illness as a triathlete<\/a><\/strong><\/li>\n
- What are the most important nutrients for keeping your immune system healthy?<\/a><\/strong><\/li>\n<\/ul>
What are URTIs?\u00a0<\/strong><\/h2>\n
Upper respiratory tract infections (URTIs) are infections of parts of the body involved in breathing, such as the sinuses, throat, airways or lungs. Most URTIs get better without treatment, but sometimes you may need to see a GP.<\/p>\n
- How to avoid infection as an athlete<\/a><\/strong><\/li>\n
- How to boost your immune system during winter<\/a><\/strong><\/li>\n<\/ul>
What are the most common URTIs that affect triathletes?<\/strong><\/h2>\n
The environmental illnesses encountered while running or cycling are the same airborne viruses you would encounter in any other area of life.\u00a0There are, however, some more unusual ones that you can encounter when swimming, both in chlorinated pools and in open-water environments.<\/p>\n
- How athletes can look after their immunity and respiratory health<\/a><\/strong><\/li>\n<\/ul>
Adenovirus<\/strong><\/h3>\n
Many scientific research studies have outlined the myriad of diseases you can pick up in swimming pools, even with chlorination, that can be a little unnerving.<\/p>\n
In 2019, a review listed a number of outbreaks at swimming pools over the last 70 years (1). The most common cause of illness was found to be adenovirus, which can survive for long periods in water, are very common (we\u2019ve probably all had one at least), and can cause gastric, respiratory, eye or urinary symptoms.<\/p>\n
Prevention<\/strong> \u2013\u00a0Keeping your nasal airway healthy reduces the risk of illnesses. Following a swimming session in the pool treated with chlorination products, it\u2019s advisable to rinse your nose with a saline solution.<\/p>\n
- Why do I sneeze after swimming?<\/a><\/strong><\/li>\n
- Best nose clips for swimming<\/a><\/strong><\/li>\n<\/ul>
Gastrointestinal issues<\/h3>\n
In a 2019 review on illnesses contracted in lakes (2), open-water swimming was unsurprisingly at the top of the list due to total immersion and the risk of ingesting the water.<\/p>\n
Although the causes were not discussed, the symptoms were mainly gastrointestinal, and the summer appeared to be higher risk, due to increased faecal indicator bacteria (yuck) than in the winter.<\/p>\n
Prevention<\/strong> \u2013 A simple counter to this (with no evidence to it) is to have a cola drink after your swim!<\/p>\n
- A review and update on waterborne viral diseases associated with swimming pools. Bonadonna L, La Rosa G. Int J Environ Res Public Health. 2019,\u00a016(2), 166.<\/span><\/li>\n
- Risk of human illness from recreational exposure to pathogens in freshwater bodies: a systemic review. Adhikary RK, Mahfuj MS\u00a0et al.\u00a0Exposure and Health. 2022,\u00a014, 325-343<\/span><\/li>\n<\/ol>
<\/p><\/div> <\/section>
Infectious rhinitis (common cold)\u00a0<\/strong><\/h3>\n
A study based on detailed training logs of the Norwegian triathlon national team members<\/strong><\/a>, demonstrated the source of virus transmission. Flights, unsurprisingly, were a major risk factor, likely due to crowded planes and dry air.<\/p>\n
If sick athletes travel in groups to training camps or competitions, they tend to pass it on to their teammates, as has been evident with the Covid-19 pandemic.<\/p>\n
Monotonous hard training was also identified as a risk factor for illnesses<\/strong><\/a>. This is likely related to a steady weakening of the immune system.<\/p>\n
Prevention<\/strong> \u2013 Wearing masks or delay the flight to avoid travelling in a group. Interchange hard days with easy training sessions will also help to reduce the risk.<\/p>\n
Treatment<\/strong>\u00a0\u2013 In most cases, a common cold is a self-resolving viral disease, and the treatment is rest, hydration and symptomatic control. However, some medications can help to relieve the symptoms while you\u2019re waiting to recover; these are listed in the table below.<\/p>\n
- How to eat healthily when travelling abroad to race<\/a><\/strong><\/li>\n
- How to beat jet lag when racing abroad<\/a><\/strong><\/li>\n<\/ul>
Acute and recurrent tonsillitis<\/strong><\/h3>\n
Acute tonsillitis often complicate URTIs. These are common in children and adolescents but can occur in athletes as part of recurrent URTI. One-off acute tonsillitis are not often a problem but recurrent episodes can be a real burden as it will negatively impact training and performance.<\/p>\n
Prevention<\/strong> \u2013 As per \u2018common cold\u2019, above.<\/p>\n
Treatment<\/strong> \u2013 For acute episodes, rest, take hydration symptomatic relief and antibiotic therapy. For recurrent episodes, especially for those who have suffered more that four episodes a year requiring antibiotic therapy, tonsillectomy may be beneficial.<\/p>\n
Seasonal and perennial allergic rhinitis (hayfever<\/a>)<\/strong><\/h3>\n
Allergic rhinitis affects approximately 30% of the general population, so by definition the same percentage of triathletes will be affected.<\/p>\n
As triathlon is a seasonal sport, athletes will be more susceptible to exposure to allergens, mainly pollen, during the three disciplines and this may have a negative impact on their performance. It will therefore be necessary to address their symptoms to maximise their performance.<\/p>\n
Symptoms can include itchy red eyes, nasal watery discharge and blockage and shortness of breath, especially if you also suffer from seasonal or exercise-induced asthma.<\/p>\n
Prevention<\/strong> \u2013 Non-sedating antihistamines, antihistamine eye drops, topical nasal steroids with or without topical antihistamines during the season. If symptoms are not controlled by the above medications, a desensitisation programme should be considered.<\/p>\n
Treatment<\/strong> \u2013 The best treatment for AR is its prevention, as it will take a few days for some of these medications to have a full effect, especially the topical nasal steroids.<\/p>\n
- Do antihistamines affect triathlon improvement?<\/a><\/strong><\/li>\n<\/ul>
![\"""\"]( "\\"\"\"\\"\/")
<\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/source><\/picture><\/div>Fokkens WJ. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020 Feb 20;58(Suppl S29):1-464. doi: 10.4193\/Rhin20.600. PMID: 32077450<\/span><\/figcaption><\/div>\n Exercise-induced laryngeal obstruction<\/a> (EILO)<\/strong><\/h3>\n
EILO is a condition that has been more recently recognised. It occurs when the athlete starts breathing hard, massively increasing the airflow through the larynx (voicebox).<\/p>\n
Normally the muscles in and around the larynx open up the airway maximally to allow as much air through as possible.<\/p>\n
However, in EILO some of the tissues are more flexible, or floppy, than normal and increasing airflow causes these tissues to collapse into the airway, narrowing it and causing noisy breathing (stridor) and a restriction in exercise tolerance.<\/p>\n
This can happen without any stimulus and these cases are a function of increased airflow due to increased breathing rate, but it can also be triggered if the airway is sensitive to certain airborne particles, such as pollens or chlorinated water.<\/p>\n
If this happens regularly then a referral to a specialist may be needed. You\u2019re not on your own though, as there are a number of elite international athletes who have struggled with \u2018asthma<\/strong><\/a>\u2019 only to find out that they have EILO.<\/p>\n
Prevention<\/strong> \u2013 Awareness and avoidance of trigger factors.<\/p>\n
Treatment<\/strong> \u2013 Diagnosis and treatment will require specialist referral. Speech-behavioural therapy, inspiratory muscle training, general relaxation and psychotherapy are all part of upfront treatment strategies. In severe cases, it can be corrected surgically in the form of supraglottoplasty.<\/p>\n
- How does endurance sports affect your lungs and respiratory system?<\/a><\/strong><\/li>\n
- Why do my muscles ache when I\u2019m ill?<\/a><\/strong><\/li>\n<\/ul>
Otitis externa<\/strong><\/h3>\n
Otitis externa is an infection of the external ear canal. It\u2019s very common in swimmers and it\u2019s due to the water getting in the ear canal and not being properly cleared, mainly due to wax build-up.<\/p>\n
The symptoms include ear pain, especially when pressing the tragus (small cartilage protrusion in front of the ear canal), discharge (usually watery) and referred pain to the side of the head and jaw.<\/p>\n
Prevention<\/strong> \u2013 Appropriate ear protection with both a swim cap<\/strong><\/a> and ear plugs<\/strong><\/a>.<\/p>\n
- Why do my muscles ache when I\u2019m ill?<\/a><\/strong><\/li>\n<\/ul>
- How does endurance sports affect your lungs and respiratory system?<\/a><\/strong><\/li>\n
- How to beat jet lag when racing abroad<\/a><\/strong><\/li>\n<\/ul>
- Risk of human illness from recreational exposure to pathogens in freshwater bodies: a systemic review. Adhikary RK, Mahfuj MS\u00a0et al.\u00a0Exposure and Health. 2022,\u00a014, 325-343<\/span><\/li>\n<\/ol>
- Best nose clips for swimming<\/a><\/strong><\/li>\n<\/ul>
- Why do I sneeze after swimming?<\/a><\/strong><\/li>\n
- How to boost your immune system during winter<\/a><\/strong><\/li>\n<\/ul>
- What are the most important nutrients for keeping your immune system healthy?<\/a><\/strong><\/li>\n<\/ul>
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