Exercise Induced Rhinitis: Why Your Nose Runs When You Run

We all know exercise is good for us. But as much as you might want to go for a jog right now, you might be suffering from a condition that isn’t widely known. This somewhat rare condition is known as exercise induced rhinitis. It can take the form of a non-stop runny nose (or ‘rhinorrhea’ in medical terms—you’re welcome) when vigorous exercise is undertaken, but other symptoms can also be observed. 

What is Exercise Induced Rhinitis?

Symptoms and Prevalence

As the name suggests, exercise induced rhinitis is a nasal congestion caused by the exertion of exercise. Other common symptoms of exercise induced rhinitis are sneezing, inflammation of the nasal passages, a blocked nose, itching, and a runny nose¹. Not all of these symptoms are present during every instance of exercise, and there are undoubtedly many sufferers who attribute their symptoms to their environment (e.g., dusty air, allergens in the gym, cold weather, etc.).

While this may be the true cause of rhinitis for some people, athletes who undergo rigorous exercise schedules show a higher prevalence for rhinitis than non-athletes. A 2010 study of exercise induced rhinitis in swimmers and runners found that 21% and 23%, respectively, experienced the condition^2,3.

Furthermore, certain sports seem more likely to trigger rhinitis than others; these include swimming (where chloroamines can be the cause of irritation) and winter sports (where exposure to cold and dry air can cause rhinitis)². 

Besides being just plain annoying, exercise induced rhinitis can have effects more severe than just needing an excessive amount of tissues. These include lower sleep quality, decreased concentration and an inability to reach peak fitness levels³. For high-level athletes who need to compete at their best, this could mean that they face an unfair disadvantage. And for everyday folks who want the benefits of exercise, this could prevent maintaining a healthy lifestyle by disrupting their regular exercise routines.

Causes of Exercise Induced Rhinitis

Exercise induced rhinitis has not been the focus of much research, perhaps due to its prevalence in only a fraction of the population who undertake extensive exercise. However, the cause may lie in a number of factors, including damage to the epithelial layer in the nasal passage (the layer of skin lining the inside of the nose).

As this is caused by water loss from airway surfaces, it is made worse by the increased movement of air that occurs during exercise. Environmental irritants also play a role, such as in the case of swimmers, who may suffer exposure to known irritants such as nitrogen trichloride⁴.  

Although some cases of exercise induced rhinitis can be attributed to irritants in the outside environment (such as dust or pollen), rhinitis can still be experienced indoors. Furthermore, it can affect both nasal allergy sufferers and non-allergy sufferers. However, those with pre-existing allergies are more likely to report experiencing exercise induced rhinitis⁵.

Management of Rhinitis and Symptoms

At present, there is no way to cure exercise induced rhinitis, though one can prevent it by avoiding sports that might instigate it. However, you can’t ask someone to simply stop doing a sport, especially if they have already invested a great deal of time, money or effort into it.

Ensuring a Clean Environment

Therefore, a more feasible approach is to avoid exercising in environments with pollutants or irritants; this means running at the gym instead of in dusty outdoor environments (although – from the author’s experience – running indoors does not prevent exercise induced rhinitis but does lessen its symptoms).

Swimming in the ocean or in lakes instead of chlorinated pools might help, or even using a nasal clip while swimming to avoid breathing in chlorine byproducts through the nose.

Medical Treatment

There is also the possibility of using medication to reduce the symptoms. Such medications include leukotriene receptor antagonists (which are used in the treatment of asthma), nasal corticosteroids (which are also used to treat asthma and nasal allergies and have anti-inflammatory effects) and decongestants (which require usage moderation, since long term use could result in elevated heart rates and blood pressure and decreased effectiveness of the treatment)².

Living with Exercise Induced Rhinitis

Thanks to major public health campaigns such as the UK’s ‘This Girl Can’ and Australia’s ‘Measure Up’, most of us will know that exercise is an important part of maintaining good health. Regular vigorous exercise reduces the risk of coronary heart disease and prevents Type II diabetes, osteoporosis and hypertension⁵. 

Physical activity also provides psychological benefits by alleviating symptoms of depression, anxiety and panic disorder. Furthermore, incorporating running into daily routines can actually be a form of therapy, alongside psychological therapy and medication⁶. For those who suffer from exercise induced rhinitis, though, they have to overcome more than just laziness to enjoy the benefits of regular exercise.

Until more research on this condition is available, it appears that some of us will simply need to avoid swimming in chlorinated pools and exercising in the cold. Luckily, over-the-counter nasal decongestant sprays can provide temporary relief, with prescription drugs available for severe rhinitis.

In any case, make sure to keep a pack of tissues with you—it will probably come in handy the next time your nose runs while you do!

Reference

1. Hope, M. T., & Yao, L. (2018). Exercise-Induced Rhinitis: A Prevalent but Elusive Disease. Annals of Allergy, Asthma & Immunology, 121(5), S128-S128
2. Steelant, B., Hox, V., Hellings, P. W., Bullens, D. M., & Seys, S. F. (2018). Exercise and Sinonasal Disease. Immunology and Allergy Clinics of North America, 38(2), 259-269. 
3. Alves, A., Martins, C., Delgado, L., Fonseca, J., & Moreira, A. (2010). Exercise-induced rhinitis in competitive swimmers. American Journal of Rhinology and Allergy, 24(5), e114-e117.
4. Anderson, S. D., & Daviskas, E. (2000). The mechanism of exercise-induced asthma is . . . Journal of Allergy and Clinical Immunology, 106(3), 453-459.
5. Silvers, W. S., & Poole, J. A. (2006). Exercise-induced rhinitis: a common disorder that adversely affects allergic and nonallergic athletes. Annals of Allergy, Asthma & Immunology, 96, 334-340. 
6. Powell, K. E., & Paffenbarger, R. S., Jr. (1985). Workshop on Epidemiologic and Public Health Aspects of Physical Activity and Exercise: A Summary. Public Health Reports (1974), 100(2), 118-126.
7. Fontaine, K. R. (2000). Physical Activity Improves Mental Health. Physician and Sportsmedicine, 28(10), 83-84.