Curated by Luigi Ferritto (1) |
Introduction
The cyclist engages the respiratory system significantly and constantly, in the peculiar function of greater supply of oxygen and removal of carbon dioxide produced by the increase in muscular activity.
The pathologies of the respiratory system that are most frequently observed in cyclists are acute and chronic infections of viral or bacterial origin, and bronchial asthma from exercise.
Infectious diseases
Causes
A decisive role for the onset of respiratory tract infections is covered by the decrease in immune defenses.
It has been known for over a century that lymphocytes are activated in the blood before and after physical exercise; however, the concentration of lymphocytes is greatly reduced at the end of the effort. In the post-exercise phase there is therefore a generalized decrease in the activity of the immune system; this phenomenon, called "open window", is detectable in different physical stress conditions, such as an intense training session or a competition.
During the "open window" phase the subject is particularly exposed to the risk of infections. For a cyclist it is easy to imagine how this phase corresponds to a time when the possibility of contact with pathogens is particularly high: immediately after a race, in fact, the embrace of the fans, the stay in the hospitality together with other people, the water vapor of showers and the air conditioning of rooms or means of transport, represent an optimal vehicle for the transmission of infectious agents.
A transient deficiency of immune function increases the risk of contracting respiratory infections, especially of viral origin.
Symptoms
The manifestations generally consist of local symptoms, such as nasal congestion, pharyngodynia, rhinorrhea, and systemic symptoms, such as febrile temperature, headache, asthenia and myocardiality. These infections, generally limited to the supra-galling structures, can also affect the pulmonary structure, with the appearance of tracheitis and / or tracheo-bronchitis.
Diagnosis and Treatment
The diagnosis is given by the clinical examination: the tracheitis rarely presents objective signs, while the bronchitis can be characterized by mucopurulent expectoration and by widespread pathological noises when ascending, such as ronches, rales and hisses.
The therapy is symptomatic, with the use of antibiotic treatment only in the case of bronchitis with purulent sputum. In order to prevent complications, it is advisable to take a short break for two or three days.
Stress Asthma
Bronchial asthma, considered a reversible obstructive airway inflammation, is a disease characterized by bronchial hyper-reactivity, which can be induced or worsened by physical activity.
Causes
Endurance exercise, such as cycling, can cause a more or less marked increase in airway resistance, resulting in difficulty breathing of varying intensity and duration.
In predisposed athletes, the increased frequency of breathing (hyperpnea) during exercise is the trigger for the onset of bronchospasm (reduction in volume of the respiratory bronchioles). Hyperpnea induces a cooling of the bronchial mucosa, which in turn determines an initial vasoconstriction of the peribronchial capillaries; during the pause, instead, there is a haematic influx in these vessels, with hyperemia and mucosa edema, and consequent narrowing of the bronchial lumen.
Given the above, the higher the ventilatory level required by sporting activity, the greater the risk of bronchospasm; as an essential factor, of course, there is always bronchial hyperreactivity induced by chronic inflammation.
Favoring factors are the climatic and environmental conditions; for example, the colder and drier the inhaled air, the greater the risk of bronchospasm. The presence of pollutants or allergens can also promote bronchial constriction.
Prevention
Today cyclists and athletes generally tend to underestimate certain symptoms, which are worthy of attention due to the risk of chronic respiratory disease. Very often, for example, a trivial flu accompanied by sore throat and low-grade fever is neglected by the athlete, who returns to the saddle with the immune defenses still committed to fighting the viral infection, exposing himself in fact to the risk of overlapping an infection bacterial.
Preventing respiratory diseases is simple, just follow a few simple steps:
- when it is cold outside, go out for the exercise well covered, with suitable technical material:
- allergy sufferers must consult the health care professional to use specific drugs;
- those who train during the winter season must pay attention to the arrival of spring, when they have to abandon their heavy jackets; in fact, at this time of year there is the greatest risk of viral infection;
- if you incur a flu, suspend the activity and resume it only when you are clinically recovered
- if the cough persists consult a doctor
- drink plenty of fluids during sports
- the vaccination is recommended for those subjects who get sick during the winter-spring period, with high fever and respiratory complications
- recommended to take a multivitamin preparation.
Prevention is better than cure, so cyclists and athletes generally need to know what they are facing if they exceed the limit by asking too much about their body.
The human machine lives in perfect balance; if we expect more the immune system decreases its protective function, making the body more vulnerable to infection.
For correspondence: Dott. Luigi Ferritto
Department of Internal Medicine Respiratory Physiopathology Unit "Athena" Villa dei Pini
Piedimonte Matese (CE)
