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.

If it ain’t broke don’t fix it?

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You can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.). Scroll to the bottom of this page to visit the ‘Breathe Strong’ Amazon store.

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As a scientist, I feel a duty to exploit new knowledge to drive innovation, and in doing so, to make things better. So when someone tells me that, “the POWERbreathe works perfectly well”, and cautions me, “if it ain’t broke don’t fix it”, my natural response is to say, “it’s good, but it could be even better”.

In this Blog I thought I’d share with you some of the scientific insights that led to the development and launch of one of the most exciting new training products to hit the market in a very long time…the POWERbreathe® K-Series. (but then I would say that, wouldn’t I?)

The birth of POWERbreathe®

When I first conceived the idea for the POWERbreathe® in the late 1980s, we knew comparatively little about how to train the breathing muscles. However, what was abundantly clear was that the devices that preceded POWERbreathe® didn’t work very well. Early products were very crude; they generated training loads using simple, static flow resistors, which were akin to breathing through a straw. In other words, they made breathing harder by passing inhaled air through small holes with fixed diameters. This type of breathing training is known as inspiratory flow resistive loading (IFRL) and typical training products allow users to select from a range of different sized holes that occlude the inspiratory port of the device. In theory, for a given rate of inhalation, the smaller the orifice, the greater the load to breathing. In practice, the training load doesn’t just vary with the size of the hole, it also varies with the rate of airflow; the faster one breathes through a given hole, the harder it is to inhale, and vice versa for slow inhalation. This makes IFRL is a bit like pulling a trolley loaded with passengers who keep jumping on and off the trolley; the load is never constant, or predictable. For this reason, IFRL fell out of fashion, and whilst some IFRL products still persist in the market, the primary reason for their continued existence is their low manufacturing cost, because their efficacy is highly questionable.

So, at the time that I undertook my first breathing training studies, there was nothing in the market that met my need for a device that delivered an effective training stimulus to the inspiratory muscles. Without any commercialisation agenda (see Blog 1), I therefore set about creating a training device that would provide that most important requirement for any device that is to be used to train muscles - a reliable load. The resulting device was a little “Heath Robinson”, but it imposed a reliable inspiratory resistance using a spring-loaded valve, and became the precursor to the mechanical POWERbreathe® range.

The drive to optimise

As knowledge and understanding of the inspiratory muscles increased, it became apparent (to me at least) that the inherent characteristics of the load provided by the mechanical POWERbreathe® were not optimised. Why so you might ask, surely all you need is a reliable load, a suitable training regimen, and the muscles will do the rest? That’s true up to a point, but effective is not the same as optimal, and I wanted optimal. In order to understand my discontentment with the loading provided by the mechanical POWERbreathe®, it is necessary to delve into some fundamental muscle physiology.

Muscles have a number of inherent properties, which if they are overlooked, can impose limitations upon their ability to adapt to training. One of the most important is the fact that the force generating capacity (strength) of muscles varies, depending upon their length. For example, the biceps is weakest when the elbow is fully extended, becomes stronger as the elbow flexes, and then becomes weaker again at full flexion. This property is known as the ‘length-tension’ relationship, and it was first described in detail by an English physiologist called A.V. Hill in the 1930s. Most modern gym weight training machines incorporate a cam system that accommodates the ‘length-tension’ properties of the muscle group being trained. This innovation makes it possible to overload muscles maximally, and also maximises the number of repetitions that can be achieved.

In the context of the breathing muscles, their ‘length-tension’ relationship determines the tension (force) they can generate at any given lung volume. Since we cannot measure the force generated by the respiratory muscles directly, the relationship is expressed as a ‘volume-pressure’ relationship. As might be predicted, the inspiratory muscles are strongest when the lungs are empty, and the expiratory muscles are strongest when they are full. But this relationship is so potent that the inspiratory and expiratory muscles have little or no pressure generating capacity at their weakest lung volumes (see Figure 1 below for the inspiratory muscles). This phenomenon is also known as “functional weakening”.

Figure 1. Strength (pressure) vs. lung volume for the inspiratory muscles. Note there is functional weakening as lung volume increases.

The practical implications of functional weakening are not obvious at first sight, but they have a profound influence on how the inspiratory muscles respond to a load of fixed intensity (like that provided by a mechanical POWERbreathe®). The problem with fixed intensity inspiratory load is that its relative intensity increases with lung volume. In other words, as the muscles become weaker throughout inhalation, the relative intensity of the load increases. For example, when the lungs are empty, and the inspiratory muscles are strong, the load might be only 50% of the maximal strength. As inhalation progresses, the muscles become functionally weaker, and this same absolute load becomes a progressively greater and greater proportion of the strength of the muscles. Finally, the load exceeds the maximal strength of the muscles at that lung volume, and inhalation must cease. This leads to a phenomenon that I call “breath clipping’.

In the Figure 2, the implications of the changing relative intensity of a fixed load are clearer.  It illustrates the interactions between inspiratory muscle strength (black line), different training loads (40%, 50%, 60% and 70% of maximal inspiratory muscle strength [coloured lines]) and the breath volume that can be achieved during training, as well as the effect of fatigue (dotted lines). For example, at a load of 40%, it is possible to inhale to around 60% of lung volume, whereas at a load of 70% it is only possible to inhale to around 35% of lung volume before the breath is clipped. This is equivalent to being restricted to the first 35 degrees of elbow flexion of a bicep curl – not very satisfactory.

Figure 2. The interactions between inspiratory muscle strength (black line), different training loads (coloured lines). The slopes on the coloured lines illustrate how the relative intensity of the load increases during inhalation.

The paradox of heavy loading

So, what are the practical implications of functional weakening and the breath clipping that results? Although muscle is a very adaptable tissue, research has shown that the adaptations elicited by inspiratory muscle training are specific to a number of characteristics of the training stimulus (Romer & McConnell, 2003 -  http://www.ncbi.nlm.nih.gov/pubmed/12569211), including the lung volume at which training takes place. The practical implication of this is that optimal results are only achieved if inspiratory muscle training is undertaken across the full range of lung volume, i.e., from the point at which the lungs are as empty as they can be, to the point at which they are full. Failure to do this will lead to sub-optimal adaptation at some lung volumes, which may have a performance impact if these volumes are called upon during exercise. As can be seen in Figure 2, if the load is too heavy, it’s not possible to train across the full range of lung volume, and the heavier the load, the lower this range is. Furthermore, when you add fatigue into the mix, it becomes even worse.

In addition, loading too heavily can also compromise the amount of work that can be undertaken during training, which also impairs the training response. In a recently published study (McConnell & Griffiths, 2010 - http://www.ncbi.nlm.nih.gov/pubmed/20142783), we examined the effects of various inspiratory loads upon a range of different variables, including the number of repetitions that could be tolerated, the volume of each breath during the training session, the amount of work completed during the session, and whether the session activated the inspiratory muscle metaboreflex (see Blog 2 for information about this important reflex). We studied well-trained young rowers who had not undergone any IMT previously. As expected, the number of breaths (reps) declined as load increased (e.g., just 4 breaths at 90% of maximal inspiratory muscle strength and 84 breaths at 60%), and the volume of each breath declined with increasing load, as well as during each session (because of fatigue). The most surprising finding was the influence of heavy loads (>70%) upon the amount of work that was undertaken per breath (work is equivalent to the load multiplied by the breath volume). Because the volume of each breath was lower with heavy loads, the amount of work done per breath was reduced markedly. This effect is completely counter-intuitive, because during limb muscle training, heavier loads mean more work (that’s because if you’re maintaining good form, the range of movement doesn’t change a great deal when moving from moderate to heavy loads). The detrimental effect of the reduction in breath volume upon the training stimulus delivered to the inspiratory muscles was compounded by the reduction in the number of breaths at heavy loads. In other words, the total amount of work done by the inspiratory muscles is reduced markedly by increasing the load above 70%. This finding explained some confusing results from previous, unpublished studies undertaken by two of my Masters students. In two separate studies, we noted that professional rugby players, and professional soccer players showed virtually no change in inspiratory muscle function in response to training at loads in excess of 70%. So you can have too much of a good thing!

It should be apparent by now that, although the mechanical POWERbreathe® ain’t broke (it works extremely well), it could benefit from some improvement. The optimal training device would be one that enabled heavy loading, without compromising lung volume achieved, and work done.  That was the conclusion I reached in 1997, and it sparked an ambition in me to develop the “perfect POWERbreathe®”.  Somewhat frustratingly, it has taken more than a decade to realise my original vision, but it’s finally here.

Designing the “perfect POWERbreathe®”

From the preceding paragraphs, it should be apparent that in order to deliver an optimised training load, the perfect POWERbreathe® must do the following -

1.  Promote maximal volume excursion

2. Promote maximal load setting without compromising volume

3. Maximise the amount of work undertaken during a given training session

As luck would have it, all of these requirements can be satisfied by a loading mechanism that is sympathetic to functional weakening of the breathing muscles (Figure 1). In other words, rather than maintaining the same absolute load throughout the breath, it maintains the same relative load, i.e., despite functional weakening, the load starts at 50% of the strength, and ends at 50%. To achieve this the device needs to taper the absolute load during inhalation, so that it is the same shape as Figure 1 (above).

The POWERbreathe K-Series is born…

The POWERbreathe® K-Series (PBK) does precisely what the physiology specified for the perfect POWERbreathe® - it provides a tapered load that optimises breath volume, work and tolerability during training.

The PBK design is a departure from the spring-loaded valve technology of the past, favouring instead, real-time, dynamic adjustment of a flow resistor valve. In essence, the surface area of a variable flow orifice is adjusted within each breath according to the prevailing respiratory flow rate.  It’s the world’s first dynamically adjusted flow resistance trainer, and it is the result of a long-term collaboration between POWERbreathe®, myself and colleagues at Brunel University in London.

Adjustments to the valve are made 500 per second, taking less than a millisecond to complete (see video clip 1 below). This means that, in theory, ANY pressure load profile can be imposed. In practice, a tapered load akin to that in Figure 1 is provided (see video clip 2 below). This allows for maximal volume excursion, and a considerable improvement in tolerability, which enhances the number of breaths before ‘failure’. Trials have also revealed that at loads above 50% of inspiratory muscle strength, the amount of work completed per breath is greater using the PBK than when using the mechanical POWERbreathe®. The tapered load also permits ‘heavier’ loading, improving the amount of work done per breath still further.

Video Clip 1: PBK valve adjusting at 500 times per second

The first PBK products were launched in 2010, and real-time PC connectivity via POWERbreathe®’s unique BreatheLink® software came on stream just this month. The BreatheLink® software is a revelation, even for me. You can observe key functional indices in real time as you train, which makes it possible to correct bad technique, as well as focussing on maximising key variables such as volume and airflow rate.  Even I’ve noticed how much better my technique has become over the period I’ve been test-driving the BreatheLink® software. More importantly (and remarkably), I even notice an improvement in how my breathing feels under ‘stress’, such as during interval and hill training. That’s amazing, given that I’m the longest serving member of the POWERbreathe® training club! It’s VERY addictive…see the video below for a quick peak…

Video Clip 2: BreatheLink® software providing continuous feedback during PBK training. Top left panel is the training load during each breath.

Of the many unique and innovative features offered by the PBK, its auto load setting utility is one that many users will find especially helpful. Every training session starts with two unloaded set-up breaths, during which the user must exert maximal effort to inhale as quickly and deeply as possible. These set-up breaths provide data that are used to calculate an index of inspiratory muscle function, and a measurement of lung volume. In “Automatic” mode, the former is used to automatically programme the appropriate training load; the latter is used to provide a personalised taper for the training session. This means that the loading of each and every training session is optimised to the prevailing function of the inspiratory muscles. Of course, it’s also possible to set your load manually, and with the BreatheLink® software it’s even possible to create your own training sessions, and to upload these to the PBK unit. I’ve been experimenting with some interval training sessions using this facility. Needless to say, the ability to make within and between breath adjustments makes this type of device extremely versatile from the loading perspective.

More than a decade after concluding POWERbreathe® was “good, but could be better”, I finally have my perfect POWERbreathe® - it’s taken longer than I expected, but it’s been well worth the wait – there’s virtually nothing that the PBK and BreatheLink® software cannot deliver...

        …breathing training really has become 

          “a piece of cake”.

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Look out for the FREE Breathe Strong Foundation Training App on iTunes at the end of the month.

If you found my Blog interesting, please come back for further articles and news, as well as my musings on all things breathing and sport related. Also, don’t forget that you can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.). Scroll to the bottom of this page to visit the ‘Breathe Strong’ Amazon store.

A bit about my book…a story of heresy and heavy breathing

You can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.). Visit the ‘Breathe Strong’ Amazon store by clicking here.

On Weds November 9^th 2011,  I’m presenting a FREE 60-minute webinar that’s been orgainsed by the publisher of my book, Human Kinetics Inc. Entitled, "Breathing Strong, the Easy Way to Improve Performance", the Webinar starts at 1pm EST, which is 5pm UK time. I plan to talk about the many roles of breathing muscles in sport and exercise, how these vital muscles limit exercise performance, and how specific breathing muscle training overcomes these limitations. To register, just follow this link – http://humankinetics.wordpress.com/2011/10/21/breathing-strong-the-easy-way-to-perform-better

In preparing for my webinar, it occurred to me that I should perhaps post a Blog entry about my book, Breathe Strong, Perform Better, only a snapshot of which I will provide in my webinar. Please feel free to leave any comments or feedback about Breathe Strong, Perform Better at this Blog site.

How it all began…

Almost 20 years ago, I began to question the universally held belief (among sport scientists) that breathing did not limit exercise performance. The magnitude of this heresy cannot be overstated, and the shift in thinking that has occurred over those 20 years has been nothing short of seismic. Now, specific training of the breathing muscles is an integral part of conditioning in elite sport, and it has filtered to the grassroots level in a huge range of sport and fitness settings. So obvious is the logic of breathing muscle training—and so impressive are its outcomes—that it has become one of those “no-brainers” that so often arise with the benefit of 20/20 hindsight. Just as we now wonder how our grandparents didn’t understand the importance of fluid balance during exercise, people now wonder why it’s taken until the first decade of the 21st century for breathing muscles to be considered an integral part of the conditioning process.

Although huge strides have now been made, we still have a way to go, because even the most progressive and enlightened of scientists and coaches still don’t fully appreciate how fundamentally the breathing muscles contribute to performance and movement in sports. In other words, the need for breathing to be considered as an integral part of functional training is not widely understood. Nor should it be, because the science that underpins this is relatively new and highly specialised.

Who’s it for…?

Breathe Strong, Perform Better seeks to plug the knowledge gap alluded to above. It gives non-specialists access to information that is normally the preserve of scientists, professional coaches, and elite athletes. The book is for anyone who wants to optimise the many benefits that arise from improving the physical performance of the breathing muscles. 

Don't be fooled by the cover, it's not just for cyclists; in fact it covers activities as diverse as running and weight training. Whether you are an Olympic contender, a coach of high-level athletes, or a fitness enthusiast who just wants to make your workouts more comfortable, this book contains something for you, or someone you know (Christmas is coming!).

The book will therefore be of interest to the following:

•       Athletes and recreationally active people
•      Coaches, sport scientists, and sports medicine practitioners
•      Physical therapists, rehabilitation professionals, and personal trainers

I'm very proud to say that the Foreward to my book is by one of Britain's greatest Olympians, Sir Matthew Pinsent. In his Foreward he says of breathing training, “Advances in sport science knowledge are few and far between, but numbered amongst these rarities is the discovery that breathing has such a profound influence upon performance that it merits specific training”.

Breathe Strong, Perform Better is a distillation of almost 20 years of research and practical experience of breathing training. It is based on world-leading scientific research, and describes cutting-edge applications of breathing training for a wide range of sports and fitness activities, including techniques that have been applied to athletes who were (or have become) world or Olympic champions. The book provides readers with the knowledge they need to get the best possible results from breathing training and get better results from their other training by optimising the breathing muscle contribution to that training.

Why should you be interested…?

If you’ve never heard of breathing muscle training (unlikely as that seems), your first question might be “Why would I want to train my breathing muscles?” The long answer is contained within the pages of Breathe Strong, Perform Better, but the short answer is that whoever you are, training your breathing muscles can make any physical challenge feel easier. So whether you’re participating in a 40K time trial, an interval training session, or a step class, training your breathing muscles will help you breathe easier.

Breathe Strong, Perform Better is also a response to an important development that has taken place in rehabilitation and conditioning over recent years—the rise of functional training. The application of functional training techniques to a wide range of settings has become mainstream, but it lacks a vital component. The missing link in functional training is the integration of breathing and the contribution of breathing muscles to functional movements. Breathe Strong, Perform Better provides this link, and it explains how to achieve the best results for specific sports and fitness settings. Functional breathing training will therefore reduce the risk of injury, because it enables the breathing muscles to accommodate their role in helping to stabilise the body’s core more effectively.

Breathe Strong, Perform Better is intended to answer all your questions about breathing training, whether those questions are scientific or highly applied. Your questions might include the following: What are the benefits to performance? What’s the best equipment to use? How long will it take? What’s the best training regimen? How do I ensure that I get results? How do I know I’ve improved? How does it work? How do I train functionally for my sport? In addition to answering these questions, the book contains case studies that illustrate how different people came to try breathing muscle training, how they approached it, and the results they achieved.

Why I became interested in breathing…

I’m often asked why I became interested in the fairly obscure subject of breathing. As is often the case with scientists, my interest originated from my own experience and my desire to understand what was happening and why. As a student in the early 1980s, my life was dominated by two things: my interest in human physiology and my love of competitive sport. These two interests were not unconnected. As a mediocre rower, I was always let down by the apparent inability of my breathing to keep pace with the demands of racing (or training for that matter). 

One of my crewmates once commented that I sounded as though someone had taken me by the throat at 500 meters and hadn’t let go. I felt severely limited by my breathing, but everything I’d been taught about the limitations to exercise performance told me that breathing was not a limiting factor to my performance (see Blogs 2 to find out how wrong this was).

[There are two points to note from this photo’ of my competitive rowing days, 1) I’m so old that it’s in black and white, 2) the expression on my face tells you everything you need to know about why I became interested in breathing…my lungs were in my mouth!]

For some time, I accepted the common belief that breathing does not limit exercise performance. However, my personal (mostly excruciating) experience eventually propelled me on a quest to understand more about breathing, about the conditions under which it becomes limiting, and especially about how we might overcome these limitations. The rest, as the saying goes, is history. My quest for understanding has been a fascinating journey that has led me beyond exercise physiology and into territory that has broadened my horizons. Like so much of science, the journey began as a bit of a detective story, where snippets of evidence from seemingly unrelated areas were pieced together, eventually providing that final “eureka” moment when everything fell into place. Breathe Strong, Perform Better enables its readers to share in what I’ve learned on my journey; the many tangents from my original path are reflected in the breadth of applications for breathing training that now exist (breathing muscle training is not just for mediocre, breathless rowers!). Some of these applications are medical and are beyond the scope of Breathe Strong, Perform Better (except asthma), but the number of applications in sport has amazed even me. I’ll be addressing the medical applications of breathing training in a new book that I am currently working on with the publisher Elsevier (out in early 2013).

Exercise scientists are arguably unique among scientists, because we are usually practitioners in what we study. Unlike, say, an astrophysicist who has no experience of going into space, exercise scientists know exactly what the challenges of sport competition are, because they have almost certainly taken part in competitive sport at some time. In other words, exercise scientists have the ability to view things from both sides of the fence. One of the most gratifying compliments that I ever received was from a coach who told me, “You have an excellent feel for the practical application of research to [elite] sport.” This ability is reflected in my experience of applying the knowledge and insight I have gained as a scientist to the task of providing innovative, evidence-based advice on how to get the best results from breathing training. Breathe Strong, Perform Better enables everyone to benefit from this, as well as from the feedback I’ve gained from the athletes, coaches, and other practitioners whom I’ve worked with over the past 15 years.

A bit about the contents…

Breathe Strong, Perform Better is divided into two parts. The first part explains some of the science and theory of breathing, while the second part is a practical guide on how to get the most out of breathing training. Although these sections are inevitably interlinked, it is not necessary to read the science in order to benefit from the practical guidance. The theoretical section (part I) provides information on the theoretical building blocks that support the practice (part II). Accordingly, readers can dip in and out of part I based on their need and interest. For example, coaches are quite rightly suspicious of snake oil sellers who peddle potions and gadgets “guaranteed” to improve performance. Therefore, most coaches will want to review the section describing the underpinning theory and evidence of the ergogenic effect of breathing muscle training before committing themselves (or their athletes) to putting it into practice.

The theoretical building blocks include aspects of the relevant anatomy and physiology of the respiratory muscles and other associated muscles. As a part of this discussion, the rationale for specific breathing muscle training is established. This includes a description of the respiratory system as a source of exercise limitation, as well as a description of the most common chronic condition that affects athletes—asthma. The role of breathing muscles in functional movements is also explained, because this provides the rationale for functional breathing training. Consideration is also given to breathing patterns during different exercise modalities. From this scene setter, we move on to consider how breathing muscles limit training and competition. This information is subdivided into specific sporting contexts, providing insights into the range of benefits that can be derived in these contexts. The rationale for functional breathing training is also presented, before moving on to consider how breathing muscles respond to training, which sets the scene for a description of the performance benefits of breathing muscle training in a range of sports.

The practical section of the book (part II) begins by guiding readers through generic aspects of the most widely used form of breathing training—that is, inspiratory resistance training. The general principles of training are considered, as well as different methods of training (resistance versus endurance) and proprietary equipment. Foundation training¹ is described, as well as guidance on principles such as posture and breathing technique. There is also a step-by-step guide to getting started with Foundation training. Finally, there are four chapters that introduce some functional training techniques, each taking a sport-specific approach. These chapters are supplemented by case studies and narratives from advanced users that contain top tips for optimal results. The insights from these elements will help you see how creatively inspiratory muscle training can be applied.

My aim in writing Breathe Strong, Perform Better was to provide the wider public with the knowledge, insight, and confidence to tailor breathing muscle training creatively to the specific needs of their own applications. If, as a result, I have made myself obsolete as an expert on breathing training, then as the saying goes, “my work here is done.”

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1. Foundation Training refers to the fist four to six weeks of specific, isolated resistance training of the breathing muscles. By using a device that can be likened to a dumbbell for your breathing muscles (e.g., the POWERbreathe®), the strength, power and endurance of these muscles can be increased. A typical training regimen consists of 30 breaths, inhaling against a moderate intensity load, twice per day. Training sessions last less than two minutes, and can be undertaken virtually anywhere, making this one of the quickest and easiest training adjuncts around.

 

Look out for the FREE Breathe Strong Foundation Training App on iTunes at the end of November '11.

Don’t forget to register for my Webinar on Weds November 9^th - "Breathing Strong, the Easy Way to Improve Performance". It starts at 1pm EST, which is 5pm UK time. To register, just follow this link – http://humankinetics.wordpress.com/2011/10/21/breathing-strong-the-easy-way-to-perform-better

If you found my Blog interesting, please come back for further articles and news, as well as my musings on all things breathing and sport related. Also, don’t forget that you can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.). Scroll to the bottom of this page to visit the ‘Breathe Strong’ Amazon store.

How inspiratory muscle training (IMT) improves performance…in a nutshell

You can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.). Scroll to the bottom of this page to visit the ‘Breathe Strong’ Amazon store.

So, having cleared the air in my previous Blog, this second instalment provides an introduction to how IMT improves performance, and explains why it has nothing to do with maximal oxygen uptake (VO2max), or inhaling more oxygen (a common misconception).

Let’s start by returning to the question of what people believe they know about the role of breathing in exercise limitation, and why it’s only half of the story. We’ll begin by considering a factor that is synonymous with training and improved performance – maximal oxygen uptake (VO2max). Most lay people  ‘buy into’ IMT because they [incorrectly] assume that IMT increases the amount of oxygen in the blood, thereby increasing VO2max. It’s therefore a surprise to learn that breathing more DOESN’T do any of this (find out why below). On the other hand, sport scientists know that breathing more doesn’t increase VO2max, so they find it hard to understand how on earth IMT can possibly improve performance. So for many people who know about VO2max, the ‘knee-jerk’ response to the concept of IMT is to conclude that it can’t possibly work, i.e., because there is no obvious underlying mechanism. However, IMT improves performance via an entirely different mechanism to VO2max, but one that is, nonetheless, linked to oxygen delivery. I’ll provide more detail in a later Blog, but what follows is the ‘abridged’ version of how IMT improves performance. If you want to know the nitty-gritty detail, then please revisit my Blog, as I’ll be discussing this in due course. In the meantime, you can also find out more in my book, “Breathe Strong, Perform Better” (see www.breathestrong.com or scroll to the bottom of this page to visit the ‘Breathe Strong’ Amazon store).

How IMT improves performance

Over the course of the past decade, an important cardiovascular reflex has been discovered. The reflex originates from the breathing muscles, and when it’s activated, it causes blood flow to the limbs to be restricted (a process known as vasoconstriction). Impairment of blood flow to exercising muscles reduces the delivery of oxygen and nutrients, as well as impairing the removal of metabolic by-products such as lactic acid. The reflex is activated when the breathing muscles are forced to work hard, or for prolonged periods, and it’s triggered by build-up of metabolic by-products in the breathing muscles (for this reason, it’s called a metaboreflex). The impairment of blood flow and oxygen delivery to limb muscles resulting from activation of the metaboreflex causes them to fatigue more quickly, thereby impairing performance. Research has now shown that the intensity of breathing work required to activate the metaboreflex can be increased by IMT. In other words, athletes can work harder, and longer before the metaboreflex causes blood flow to be directed away from their limbs. The result is that IMT improves performance in a wide range of sports and exercise modalities because it preserves oxygen delivery and metabolite removal from exercising muscles. It’s that simple, and that profound.

In addition to influencing the metaboreflex, IMT also makes breathing feel easier. Because the inspiratory muscles are stronger and more powerful after IMT, they are able to undertake the work of breathing more ‘comfortably’. In other words, the muscles are operating at a lower percentage of their maximum capacity, which makes the activity feel easier. For the same reason, being stronger also increases the endurance of the inspiratory muscles, delaying fatigue, and making breathing feel easier. Finally, because breathing feels easier, and because the limb muscles are better supplied with blood (delivering oxygen and removing metabolites), leg discomfort, and the sense of effort associated with exercise (perceived exertion) is also lower – athletes feel as though they are not working as hard.

Now you know how IMT does work, let’s finish by explaining why IMT does not increase VO2max.

Why breathing doesn’t limit VO2max

The transport of oxygen to the working muscles involves four stages:

1. Alveolar ventilation—Delivery of atmospheric air to the alveoli (breathing).

2. Pulmonary diffusion—Transfer of oxygen from the alveoli to the capillary blood.

3. Transport by the blood—Collection and delivery of oxygen in combination with the blood from the lungs to the muscles.

4. Tissue diffusion—Transfer of oxygen from the muscle capillary blood to the muscle cells.

There is no active transport of oxygen at any point in its journey from lungs to tissues. The entire journey occurs via a process of passive diffusion. During diffusion, oxygen moves from an area of high concentration (the atmosphere) to one of lower concentration (the muscle). The rate and efficiency of diffusion are directly related to the size of the gradient. Think of a river flowing downhill; the steeper the gradient of the hill, the faster the water flows.

In theory, any one of the four listed stages could limit the transport of oxygen. In practice, for people with healthy lungs who are at sea level (not at an altitude where the oxygen gradient is reduced), steps 1 and 2 operate with almost 100 percent efficiency in terms of their purpose, which is to oxygenate the blood fully before it leaves the lungs. Steps 1 and 2 are the only steps in the transport of oxygen that can be influenced by breathing, and because the blood is almost 100 percent saturated with oxygen when it leaves the lungs, increasing breathing cannot improve oxygen transport (the oxygenation of the blood is already almost 100 percent). In other words, breathing more cannot increase maximal oxygen uptake, and this is why people sometimes incorrectly jump to the conclusion that IMT cannot possibly improve performance. This is incorrect, so spread the word!

If you found my first blog interesting, please come back for further articles and news, as well as my musings on all things breathing and sport related. Also, don’t forget that you can obtain more information about breathing training at www.breathestrong.com, where you can also find out about my comprehensive guide to breathing and exercise “Breathe Strong, Perform Better” (published by Human Kinetics Inc.). Scroll to the bottom of this page to visit the ‘Breathe Strong’ Amazon store.