Another FREE webinar on breathing training

I'm presenting another FREE webinar on breathing training on November 20th at 3pm GMT. The event is being hosted and sponsored by Human Kinetics and the British Association of Sport & Exercise Sciences (BASES).

The title of this presentation is "Inspiratory muscle training: the state of the art and its application".

The research evidence base has moved on a since my previous webinar in 2011, so even if you attended this, there will be something new for you in this update. Here's a little synopsis of what you can expect:

Unlike many exercise-training methods in sport and physical activity, inspiratory muscle training (IMT) is now supported by robust evidence from systematic reviews and meta-analyses. Furthermore, substantial advances have been made in understanding how IMT exerts its ergogenic effects. For many though, IMT remains “too good to be true”, after all, how can something so simple possibly improve performance in only 4 weeks, with just 5 minutes per day of training? This webinar will describe the diverse roles of the respiratory musculature in sport, as well as the demands these muscles must meet. It will describe the evidence that IMT enhances performance in athletes, and explain the physiological mechanisms that underpin these changes. Finally, the webinar will introduce the emerging concept of “functional” IMT. 

At the end of the webinar, you should be able to: 

• Identify the respiratory and non-respiratory roles of the respiratory muscles 
• Recognise the situations under which the respiratory muscles are overloaded functionally 
• Describe the situations in which inspiratory muscle training enhances performance 
• Describe the mechanisms by which inspiratory muscle training does and does not enhance performance 
• Describe the rationale and implementation of functional training approaches in IMT

To book your place just click on this link. Don't worry if you can't attend in real time, everyone who registers will be sent a link to view the webinar offline.

In the meantime, if your itching to find out more about the benefits of IMT, visit Breathstrong.com.

I'm never ill...

I’m never ill, but last month I contracted the first serious upper respiratory tract infection (URTI) I’ve had in years. With perfect timing, my symptoms started two days into my one-week water sports holiday. The “bug” was most likely contracted the on the flight to my holiday destination, but that’s what you get if you spend three hours sealed in a metal tube with 200 kids! My plans to continue my half marathon training were completely scuppered by long (embarrassing) coughing fits and an inability to do anything more energetic than potter about in a dinghy. My lungs felt tight and tender, and I couldn’t even take a deep breath without coughing.

What, you might ask, has all this got to do with “breathing training”? More than you’d think. The experience taught me some very valuable lessons about the effect of inactivity upon inspiratory muscle performance, as well as how much function you can lose, and how long it can take to get it back. I want to share these with you, in case you’re unlucky enough to find yourself in a similar situation, now that we’re heading into winter…

Back to my holiday disaster. To add insult to injury, not only could I not do anything more energetic than sit in a dinghy, I also couldn’t do any IMT, an experience I’ve not had for years, and years, and years…. This situation lasted for 10 long days…

My first challenge upon returning home was attending and speaking at a conference. The day before my presentation I had to rush out of the auditorium five times because of coughing fits – things weren’t looking good for my “big prezo” the next day. However, dosed-up with cough suppressant, I managed a slightly croaky lecture without coughing, and was mighty relieved to get to the end with hardly a splutter.

My next challenge on the road to recovery was my first run. This caused some amusement to the people I passed by, as I coughed uncontrollably with every breath for the first five minutes - I was heckled by calls of “I thought running was supposed to be good for you” , which was almost as funny [not] as overweight teenagers shouting “Run Forrest run”. However, the coughing subsided gradually, and the rest of the run was fairly uneventful, though breathless…until I stopped, when I coughed continuously for another five minutes, but thankfully I was in the privacy of my own home. Then came the biggest challenge, my first IMT session. It was disheartening, to say the least – I couldn’t manage even one breath on my usual training load, BUT thanks to the POWERbreathe® K5 BreatheLink® software I was able to dial the load down “on the fly” so that I could finish the 30 breath session - I needed to drop the load by 16%, but at least I completed the set. However, I was horrified to see the “stats” on my session (I monitor these data daily using the BreatheLink® software) – power down 29%, breath volume down 30%, flow down 20%, total work down 29%. I needed some serious breathing rehab’ if I was to regain the benefits of my years of breathing training! (follow this link for a summary of the many benefits of breathing training)

Here’s what I did to regain my “pumping power”. I did IMT every day, but only once; every other day, I did my IMT after an aerobic workout. I always use the manual load setting on the POWERbreathe® K5, and I increased the training load 2-3 cmH2O each day; however, I also allowed myself to decrease the load during a session if it got too “heavy”, and compromised the quality of the session (i.e., impaired power, flow or breath volume). I found that my “stats” recovered fairly quickly on the days when I did the IMT “fresh”, but on the days were I did an aerobic workout beforehand, the stats took much longer to recover. This indicated that my aerobic workouts had become more fatiguing for my inspiratory muscles (find out why that’s bad news?). In fact, 12 days into my “rehab”, I’m still not quite able to achieve my pre-URTI performance, but I’m getting closer by the day. As for my aerobic training, at first, my pace was slower, and I was more aware of my breathing than I’d been in years, and it’s not a nice feeling! But 12 days on, my pace has recovered, and I’d say I’m back to normal in terms of breathing effort perception – it’s negligible most of the time.

Was the demise of my “pumping power” worse because it was caused by a URTI? Possibly, because the URTI caused ANY increase in flow or volume to induce coughing. However, in my view, any situation that causes a decrease in the activity of the respiratory pump will lead the muscles to detrain. If the cause of this decrease is a musculoskeletal injury, then respiratory pump deterioration can be prevented by maintaining IMT throughout the “lay off”. In fact, if you can do any amount of IMT during a period of illness or injury, you should, because depending upon the duration of the “lay off”, it could take you a couple of weeks to get your breathing back on track.

My experience was salutary for a number of reasons, not least because it gave me a small insight into how much of a “knock back” a respiratory infection can be for a patient with chronic lung disease (and I didn’t even have a lower respiratory tract infection). It also confirmed what is known about detraining of inspiratory muscles from patients who need to be mechanically ventilated – in their case, the inspiratory muscles are essentially switched off, and a pump forces air into their lungs – in my case, my inspiratory muscles experienced a dramatic decrease in their physical activity. In both cases, inspiratory muscle function appears to fall off a cliff!

What else have I learnt? It’s staggering how quickly “you lose it” when “you don’t use it”. In my case, my inspiratory muscles had virtually no exercise AT ALL for 10 days – no aerobic-related work, and no IMT (my expiratory muscles were kept in fine fettle by my coughing fits!). The good news is that I’ve been able to recover almost all of my lost function in the 12 days that followed the URTI. The keys to this were: doing IMT every day; allowing myself to decrease my normal training load to maintain “reps” and training quality; being aware that my IMT would be more affected than usual in a pre-fatigued state (i.e., after an aerobic workout) and adjusting my load accordingly; increasing the training load slowly, but surely each day.

When it comes to the inspiratory muscles, the “use it or lose it” phenomenon appears to be particularly potent. This probably reflects the fact that, under normal conditions, the inspiratory muscles are active from our first to our last breath. This seems to make them extremely sensitive to changes in the demands that are placed upon them – wasting away quickly when demand decreases. However, the reverse is also true, and with the right training stimulus, it’s possible to increase function quickly and substantially.

Inspiratory Muscle Training Symposium A Breathtaking Success!

The level and breadth of interest inspiratory muscle training (IMT) was confirmed by both the number and diversity of attendees at this unique symposium, which was hosted by the Centre for Sports Medicine & Human Performance at Brunel University. As well as sport and exercise physiologists, delegates included clinicians, human factors specialists, commercial companies, end users of IMT, and even an equine vet. They were rewarded with a “feast” of integrative physiology, covering the respiratory, cardiovascular, muscular and neural systems, in both health and disease.

The seminar was opened by Professor Alison McConnell, who provided an introductory overview of the history of IMT, the "state of the art", as well as the rationale for each of three putative mechanisms for the well-established ergogenic effect of IMT. These mechanisms were expanded and developed by the other three speakers. The Centre’s own Dr Lee Romer described the surprisingly high metabolic cost of respiratory muscle work in highly trained individuals, the conditions under which exercise-induced fatigue of the inspiratory and expiratory muscles arises, and its implications for exercise tolerance. Dr Romer then reviewed the evidence that feedback from respiratory muscle afferents can exacerbate locomotor muscle contractile fatigue and impair performance. Dr Romer was followed by the University of Brighton’s Dr Emma Ross, who provided some fascinating insights into another role for muscle afferent feedback, viz., its role in central fatigue. This included consideration of the potential role of respiratory muscle afferents in central fatigue as part of an “ensemble” of feedback that serves to maintain and optimise exercise performance. The final presentation came from King’s College Hospital physician Dr Caroline Jolley who explained the role of respiratory muscle function in the perception of breathing effort, focussing in particular upon patients with chronic obstructive pulmonary disease (COPD). A neurophysiological model of breathlessness was presented in which disordered lung mechanics and diaphragm weakness, lead to an uncoupling of inspiratory pressure generation and ventilation to create a state of “neuromechanical dissociation” and efferent-afferent mismatch. Finally, Dr Jolley considered whether IMT might ameliorate this mismatch. The morning was rounded off by a panel “question and answer” session.

The presenters answer questions and consider the future directions for inspiratory muscle training research. From the left: Dr Lee Romer, Prof Alison McConnell, Dr Emma Ross, Dr Caroline Jolley

The four presentations are available to view on the Centre for Sports Medicine & Human Performance YouTube channel.

For further information about inspiratory muscle training for sport please visit www.breathetsrong.com, and for information about the many clinical applications of respiratory muscle training please visit www.physiobreathe.com.

FREE half day research seminar on Breathing Training hosted by Brunel University

Frontiers in Sport and Exercise Science and Medicine:

"Mechanisms underlying improvements in exercise tolerance following inspiratory muscle training"

This free seminar will focus on the respiratory system, but will provide attendees with a “feast” of integrative physiology. Systematic reviews and meta-analyses now confirm that inspiratory muscle training (IMT) improves exercise tolerance in both healthy people, and people with lung and/or heart disease. Accordingly, the focus of research on IMT is now shifting from“if”, to “how”, exercise tolerance improves. The seminar will begin with an introductory overview of the history of IMT, the "state of the art", and the rationale for each of three putative mechanisms for the ergogenic effect of IMT (given by Prof Alison McConnell). The physiology of each mechanisms will be described by a leading expert in the field:

Link to Centre website

Mechanism 1 - Modulation of metaboreflex activation originating from respiratory muscles leading to preserved muscle blood flow after IMT. Dr Lee Romer, Brunel University

Mechanism 2 - Modulation of afferent feedback from respiratory muscles leading to reduced central fatigue after IMT. Dr Emma Ross, University of Brighton

Mechanism 3 - Alteration of the demand/capacity relationship of the respiratory pump in favour of capacity leading to amelioration of breathing effort after IMT. Dr Caroline Jolley, King's College, University of London.

The seminar will close with a panel discussion of the morning’s presentations, leading to the identification and/or prioritisation of the most important research questions for IMT, and how these might be answered.

The seminar deals with the integrative physiology of the respiratory, cardiovascular, muscular and neural systems, and will consider both healthy and patient populations. It will therefore be of interest to academics and post-graduate students in exercise and sports physiology, as well as clinicians working in cardiovascular and pulmonary rehabilitation.

Wednesday 24th April 2013 - 0900-1300

Click here for further details and to register.