Non-Asthma Related Breathing Problems In Athletes

This BASES Expert Statement looks into exercise respiratory symptoms, such as wheezing, tight chest, difficulty breathing, shortness of breath and coughing which are commonly reported by athletes.

These non-specific symptoms need to be assessed in order to confirm or eliminate the presence of cardio-pulmonary causes.

There is a high prevalence – 70% – of asthma and exercise induced bronchoconstriction (EIB) in sports with high breathing requirements, and it has been assumed that exercise-induced respiratory symptoms in these athletes is due to asthma or exercise-induced-asthma (EIA).

Symptoms however are misleading and this Expert Statement looks at these differential causes of exercise respiratory symptoms: Exercise-Induced Laryngeal Obstruction (EILO) and Dysfunctional Breathing.

Interventions are then discussed which include breathing pattern retraining and inspiratory muscle training and finally conclusions are made.

You can read the full Expert Statement here, Assessment and Management of Non-asthma Related Breathing Problems in Athletes.

Proper Breathing – POWERbreathe Can Help

Your primary breathing muscle is your diaphragm; a dome shaped thin sheet of muscle separating your rib cage from your abdomen.

When you inhale this dome shape flattens out as your diaphragm contracts, pushing down on the contents of your abdomen (your gut) and increasing the space in your chest cavity.

Because your gut has to go somewhere as your diaphragm descends, it forces it down and out and your tummy expands. Because of this, this natural, healthy and proper way of breathing is often referred to as abdominal breathing or diaphragmatic breathing.

If you do already have a good breathing technique it can often go awry when you start exercising as you demand more air and your breathing increases to compensate. This is when your breathing technique can change from good diaphragmatic breathing to reverse breathing i.e. pulling in your tummy as you breathe in and letting your tummy go as you breathe out.

Because your diaphragm is a muscle, you can train it like any other muscle to become stronger and helping you retain that good diaphragmatic breathing even when pushed to your limit. POWERbreathe targets your inspiratory muscles – not only your diaphragm but also your intercostal muscles, the tiny muscles in between your ribs, which are recruited during a slightly forced respiration.

You’ll notice when training with POWERbreathe that you have to work harder to breathe in. This is the effect of resistance training acting on your inspiratory muscles. When breathing out, POWERbreathe offers no resistance because when you exhale normally, your diaphragm and intercostals naturally relax and move back up, pushing the air from your lungs.

Effects of IMT on Resistance to Fatigue of Respiratory Muscles in Exercise

EliteVelo Kalas Sportswear Cycling Race Team by Richard Fox Photography

EliteVelo Kalas Sportswear Cycling Race Team using POWERbreathe Plus IMT (above)
PHOTO: Richard Fox Photography

STUDY:

Effects of Inspiratory Muscle Training on Resistance to Fatigue of Respiratory Muscles During Exhaustive Exercise
M. O. Segizbaeva, N. N. Timofeev, Zh. A. Donina, E. N. Kur’yanovich, N. P. Aleksandrova

This study, published in Body Metabolism and Exercise – Advances in Experimental Medicine and Biology (Volume 840, 2015, pp 35-43) concluded that IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.

PURPOSE:

To assess the effect of inspiratory muscle training (IMT) on resistance to fatigue of the diaphragm, parasternal, sternocleidomastoid and scalene muscles in healthy humans during exhaustive exercise.

The sternocleidomastoid muscle flexes the neck and helps with the oblique rotation of the head. Also, the muscle helps in forced inspiration while breathing, and it raises the sternum. As for forced inspiration, the muscle also works in concert with the scalene muscles in the neck. The scalene muscles are lateral vertebral muscles that begin at the first and second ribs and pass up into the sides of the neck. There are three of these muscles. (SOURCE: Healthline.com)

CONCLUSION:

“The study found that in healthy subjects, IMT results in significant increase in MIP (+18 %), a delay of inspiratory muscle fatigue during exhaustive exercise, and a significant improvement in maximal work performance. We conclude that the IMT elicits resistance to the development of inspiratory muscles fatigue during high-intensity exercise.”

Read Effects of Inspiratory Muscle Training on Resistance to Fatigue of Respiratory Muscles During Exhaustive Exercise

Check out more Inspiratory Muscle Training Research here >

Discover POWERbreathe used in Research here >

What causes exercise-induced asthma?

The reason why asthma symptoms may be brought on during exercise has not been completely established but it is thought that because breathing becomes heavy and we breathe faster when we exercise, the linings of our airways narrow and dry out. Also weather conditions and allergies, such as an allergy to pollen, can also trigger asthma-like symptoms when exercising.

Recognising exericse-induced asthma (EIA)

Diagnosis is often made after symptoms, such as wheezing and a tight chest, are experienced during exercise, but this can result in either over-diagnosis, where athletes report symptoms but DO NOT have narrowing of the airways, or under-diagnosis where athletes who’re asymptomatic (showing no symptoms) DO have narrowing of the airways which affects their performance.

The scenarios above are supported in studies where elite athletes have been screened and shown to have EIA, such as reported by British Olympic Teams in the 2012 Olympics where it found that 25% of Team GB suffers from exercise-induced asthma. And at the 1996 Olympic games 20% of athletes reported asthma upon exercising.

Why screen for EIA?

The main reason is because exercise-induced asthma may be detrimental to an athlete’s performance, as it’s already been shown to reduce exercise capacity and running speed in colder environments which will not only affect an athlete during training but also during competition.

Treatment of EIA

Both pharmacological and non pharmacological therapies are currently successfully used to treat EIA, and studies have also highlighted the benefits of adjunctive intervention. POWERbreathe Inspiratory Muscle Training can be used as an adjunctive intervention, not only for daily training, but also as a respiratory warm-up prior to exercise.

Read more about Respiratory Disorders in endurance athletes in our blog.

And here’s an interesting article that looks at Pollen and Exercise Induced Asthma >

Breathe deeply with POWERbreathe for more energy

Deep breathing reaches the deepest depths of your lungs, and by practicing POWERbreathe inspiratory muscle training you’ll be training your respiratory muscles to breathe deeply into your diaphragm, taking in as much air as possible, breathing more in per breath.

As you’re breathing in more air per breath, you’re receiving more oxygen into your body, giving you more energy.

Senior consultant at the National heart Institute, India, and Founder, SAANS Foundation in India, Partha Pratim Bose offers a good example of this,

“By deep breathing exercises you breathe more per breath. If you breathe more per breath you expand your lungs more, you receive more oxygen. You will feel more energetic and also save your breaths. For example, if you breathe 250 ml per breath and your requirement is 5 litres then you need 20 breaths per minute. If you breathe more breath say double i.e. 500ml then you will require only ten breaths. So by breathing deep you breathe less and you feel better and conserve energy.”

Thankfully you can train your breathing muscles to breathe deep, as your respiratory muscles respond in the same way as skeletal muscles do to a training stimuli as they undergo adaptations to their structure and function. POWERbreathe is one such training stimuli, using the principles of resistance training to strengthen the inspiratory muscles. Its pressure loaded inspiratory valve offers the resistance on the inhale, while an unloaded expiratory valve allows for normal, passive exhalation.

How POWERbreathe Works >

You can read about other benefits of deep conscious breathing in Bose’s article ‘Wellness: Breathe like a tortoise, live like a king’ and here in POWERbreathe Benefits.

Breathing – your magic bullet to improved sports performance

Breathing properly could just be your magic bullet to improved sports performance and sporting achievements.

In an article about The Dangers of Dysfunctional Breathing, international performance consultant Brandon Marcello, Ph.D., MS, CSCS says, “Having improper breathing form is no different from having improper squat form.”

The article goes on to say that ‘when it comes to physical activity, breathing ineffectively can alter your performance’. Therefore breathing effectively will also alter your performance, but for the better!

POWERbreathe inspiratory muscle training (IMT) exercises your breathing muscles, improving their strength and stamina, reducing fatigue which in turn enables you to train harder, for longer and with less effort which ultimately translates into improved performance.

POWERbreathe IMT has been scientifically proven to:

 

Metabolic reflection of respiratory muscles limiting athletic performance

 

We’re grateful to our friends Fit & Breathe Concept for bringing this article to our attention. It’s written by Germain Fernandez Monterrubio, Bachelor of Science in Physical Activity and Sport and can be found in its original language here: ‘El reflejo metabólico de la musculatura respiratoria como factor limitante del rendimiento deportivo’.

We’ve translated the original text as best we can (as follows), but if it is not entirely clear then you may also be interested in reading this research, published in The Journal (2007) of The Physiological Society, ‘Insights into the role of the respiratory muscle metaboreflex’.

Metabolic reflection of the respiratory muscles as a limiting factor in athletic performance

Numerous studies show ventilatory fatigue (the inability of the respiratory muscles to achieve preural given pressure) (Chicharro, 2010) is considered as a limiting factor in performance, especially in disciplines that require endurance (such as marathon, rowing, swimming , triathlon etc).

One of the limiting factors that future studies will focus on is that of determining the specific influence of Metabolic Reflection of Respiratory Musculature (RMMR) in different cases.

The RMMR initiates fatigue of the respiratory muscles, which through III and IV afferents reach the supraspinal level, triggering a sympathetic response by vasoconstriction of peripheral muscle locomotive, which intensifies the fatigue of active muscles and increases also perception of effort, contributing to the limitation of return linked to intense aerobic exercise. (Romer and Polkey, 2008).

In aerobic performance, the TOTAL energy demand is not a limiting factor (Santalla, 2009), the production of energy in the time given is the determinant of fatigue… the “metaboreflex”. Respiratory muscles induce a number of mechanisms by which respiratory muscle fatigue can affect exercise tolerance (Jack mackerel, 2010, Santalla 2010, Romer and Polkey, 2008), incurring a series of cardiorespiratory interactions:

Pulmonary level:

  • Fatigue contraction of the diaphragm and accessory muscles of respiration.
  • Increased reflexes activated metabolites.
  • Increased afferent discharge (track III and IV).

Muscular level:

  • Increased efferent sympathetic discharge.
  • Increased vasoconstriction members.
  • Decreased oxygen transport.
  • Increased locomotor muscle fatigue.
  • Increased perception of effort.

In an experiment carried out with cyclists (Fischer, 2013) participants were induced to metaboreflex with post-exercise muscle ischemia, indicating that the increase in heart rate and the partial withdrawal of cardiac parasympathetic tone, is mainly attributed to increased cardiac sympathetic activity, and only after exercise with large muscle masses.

We speak of respiratory muscles (and mechanical); of autonomic nervous, central nervous system and cardiovascular system regulation in humans. A review by Douglas R. Seals raised the premise that if the RMMR represented the “Robin Hood” of the body to the locomotor muscles (Seals, 2001), determining that this reflex can have as its main objective the delivery of oxygen to the respiratory muscles, guarantees the ability to maintain pulmonary ventilation, adequate regulation of the gases in the blood flow and the pH and general organ homeostasis. The reflection is considered the “vital organ” responsible for supporting lung function and perfusion of the respiratory muscles, especially during physiological states in which there is competition for cardiac output, as in the exercise to maximum and submaximal intensities. This overrides the locomotor muscles.

Usually this phenomenon is found in those training for a sport or competition in which there will normally be a struggle between the respiratory muscles and the locomotor muscles for blood flow. Determining this is not so simple, as it also depends on the intervention of the central nervous system, which impinge on some physiological and psychological responses, such as the perception of effort. Generalizing, we can say that to focus on metabolic compromise reflects both muscles (respiratory and locomotor) at maximal or submaximal, rather than related to aerobic capacity.

Author: Germain Fernandez Monterrubio, Bachelor of Science in Physical Activity and Sport.

www.fermentourbano.com

COURSES

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REFERENCES

  • SEALS, DR. (2001). Robin Hood for the Lungs? A respiratory metaboreflex that “steals” blood flow from locomotor muscles. J Physiol. 537(Pt 1):2
  • FISHER, JP y otros (2013). Muscle metaboreflex and autonomic regulation of heart rate in humans. J Physiol. 591.15 pp 3777–3788 3777
  • ROMER, LM y POLKEY, MI (2008). Excercise-induced respiratory muscle fatigue: implications for performance. J App Physiol. 104 pp 3879 3888
  • SANTALLA, A (2010). Presentation High Performance Program. Physiological Basis of Sports Performance. SE
  • CHICHARRO LOPEZ, JL (2010). Presentation Respiratory muscle fatigue induced by exercise: implications for clinical and performance.
  • HAJ GHANBARI, B. et alt. (2012) Effects of respiratory muscle training on performance in athletes: a systematic review with meta-analyses. J. of Strength & Conditioning Research.

View list of published research that used POWERbreathe as the IMT intervention of choice in POWERbreathe in Research.

Find more published research on our Inspiratory Muscle Training Research blog.

If you found this interesting (and if you found the translation not entirely easy to follow), you’ll probably find ‘Insights into the role of the respiratory muscle metaboreflex’ useful too.

2012 Olympic Bronze Medallist, Karina Bryant on POWERbreathe

“POWERbreathe really made the difference to me prior to and during the games and now I have the medal to prove it!”

Judo heavyweight Karina won bronze in her Olympic success at London 2012. Earlier in the year Karina and her coach started looking to see if there was anything they could implement in training that would help clear lactate between fights. They also wondered if there was anything that could help Karina perform at her best during the later stages of her fight, such as improving her breathing stamina.

POWERbreathe offered Karina a POWERbreathe inspiratory muscle training device to incorporate into her training, prior to the Olympics, and here’s her feedback:

“In preparation for the Olympic Games I went through several periods of heavy training. This included developing maximum strength, aerobic capacity, lactate tolerance and accumulating high work loads of Judo. I would always develop my aerobic capacity prior to making large gains in strength. I used the Power Breathe in order to maintain the gains made in aerobic capacity during periods of heavy strength training. The advantage of this was clearly seen as I was able to maintain my aerobic capacity (measured during testing) throughout this heavy strength period.

When I went to training camps in Japan and South Korea to accumulate a high volume of intensive Judo training, the power breathe was used to train my inspiratory muscles in order to aid recovery from these sessions. The advantages of this were realised during competition when I used the Power Breathe to assist with the clearance of lactate between fights, aiding myself to recover and win a Bronze medal at the 2012 Olympic Games. There wasn’t a single moment in London that I was concerned about my fitness or lactic acid building up during my fights.

POWERbreathe really made the difference to me prior to and during the games and now I have the medal to prove it!”

We know you’ll all like to join us in wishing Karina congratulations on winning her Olympic medal, but if you have any other wishes you’d like to share, please leave a comment here.

Congratulations to Anthony Ogogo who’s been selected for Team GB!

The British Olympic Association (BOA) selected Anthony, silver medallist at the Delhi 2010 Commonwealth Games and Men’s Middleweight (75kg) to be part of Team GB’s largest ever Olympic boxing squad.

We presented Anthony with a POWERbreathe to help him quickly improve his breathing strength and stamina following a period of inactivity as he recovered from a sports injury. Anthony will be keeping us updated with his training progress, which understandably will be ad hoc as he obviously has more pressing matters to think about.

Rob McCraken, Team GB Boxing Team Leader and British Amateur Boxing Association Performance Director said of Anthony,

“Anthony really deserves this after everything he has been through. He has had to overcome some terrible luck with injury and it is great to see that his dedication, hard work and determination have been rewarded. He is a top class boxer who has proven he can beat anyone in the world on his day.”

Anthony’s pride shines though in his response to being selected for Team GB,

“It is an amazing feeling to know I am going to the Olympics after all the challenges I have had to overcome. I have had so much bad luck with injuries but I never lost faith in myself and have had some amazing support from the coaches and all of the back-up team that have helped me to get over my shoulder injury and make it to London. It will be a dream-come-true to represent Great Britain in a home Olympics and I cannot wait to walk out in that Arena in London.”

Good luck from us all Anthony, and we’ll keep following your news on your website.

And keep checking back for POWERbreathe training feedback from Anthony, on the POWERbreathe Blog.

Anthony Ogogo – first experience of training with my POWERbreathe

Firstly I want to thank the guys at POWERbreathe for sending me a POWERbreathe to aid me in my training block leading up to the Olympic qualifier. It was very kind of them.

Training three times a day like we do on the GB Boxing team, I wanted something that could help me with my breathing and my general fitness but without physically exerting my body any more than the three gruelling sessions. So my friend advised me to try a POWERbreathe.

In typical Anthony Ogogo Ultra competitive fashion I put it on a level 7, thinking that as I was an elite athlete I’d already be good at it. I was wrong. I was surprised how hard it was maintaining a good technique and so started at level one. I did manage to get up to level 6 and 7 in the 4 weeks I was using it leading up to the qualifier, whilst maintaining a good technique. Something that I was nowhere near being able to do the first time I used it, which shows my breathing capacity definitely got better.

Thanks again POWERbreathe, Anthony.

You can read about Anthony’s victory in European Olympic qualifier in Turkey in our previous blog.  You can also read more about Anthony on his website , follow him on Twitter or visit his YouTube channel.