Improving your breathing can improve your performance in sport, and indeed in other aspects of life. But despite increasing research evidence to show this, there is little attention paid to breathing training by athletes of all levels. Even those who do pay attention to their breathing are often using breathing techniques that are not right for them at that stage.
In my work as a Chartered Physiotherapist specialising in Cardiac and Respiratory Physiotherapy, I have worked with people suffering from a variety of Breathing Pattern Disorders since 1999, from fun runners who felt their “asthma was out of control” to elite level athletes who simply wanted to do all they could to perform better.
In my build-up to the 2014 London Marathon, I was past my 40th birthday and my performance was starting to deteriorate. I was picking up niggling injuries. Having attended a course by Dinah Bradley (world leading authority in breathing retraining) I started using the techniques I had used on patients for years as part of my own training. Having had no personal bests for almost five years, I achieved four in five weeks, including a 2.48 marathon! I also didn’t miss a single training session due to injury.
In this article I shall explain the concepts around breathing training in relation to running, and how improving your breathing can improve your performance. I will also explain how bad breathing can affect our mental performance (which we all know is important in endurance events). And I’ll discuss whether better breathing can actually help you lose weight as claimed in some other articles.
Breathing may seem simple, but it is the most ingrained activity we do, so it can take a bit of concentration to focus on how we’re actually breathing. So let’s start with a few questions to get to grips with the basics…
- What does “good” or “bad” breathing mean?
- What can go wrong with breathing?
- What should a normal breathing pattern be like? How does this change with exercise/running?
- Nose breathing rather than breathing through the mouth.
- Relaxed breathing which is quiet rather than noisy.
- The shoulders and upper chest being relaxed and barely moving.
- The diaphragm and lower intercostal muscles doing the work. The diaphragm is the large dome shaped muscle that sits under your ribs just above your abdomen (see diagram), designed to be the main muscle of breathing at rest and during low to moderate levels of exercise.
- The abdomen swelling by 1- 2” during inspiration (breathing in).
- Expiration (breathing out) being relaxed and effortless.
- Breathing being in a smooth, equal rhythm and at a rate of about 12 breaths per minute.
- Emphasis on slow rather than deep breathing.
You may find this pattern easier to achieve lying with your hands behind your head in the beach pose.
As we start to exert ourselves, our breathing should change, but the changes should be in the correct sequence (as shown below), and should be proportionate to the increase in level of exertion.
The most common problem I see is with individuals (of all abilities) who switch to using their accessory muscles too easily rather than the diaphragm, or may even use the accessory muscles for breathing at rest. This is detrimental to performance because you use far more energy to breathe with your accessory muscles than you do with the diaphragm.
Research shows that when you switch from diaphragmatic breathing to primarily using the accessory muscles, blood is stolen from the working muscles reducing their ability to work. So your whole body is working less efficiently.
Unfortunately we get little or no feedback to our brains from the diaphragm when it is working well. When we use the accessory muscles, however, our brains are bombarded with information and this unfortunately increases our sensation of breathlessness and our perception of how hard we are working.
Another common problem is over-breathing, which worsens as exercise progresses. This causes carbon dioxide levels to fall, resulting in airways and blood vessels tightening. Tight airways make it more difficult to breathe and can also cause athletes to wheeze and cough up mucus, which is why Exercise Induced Hyperventilation is often difficult to tell apart from Asthma. Tight blood vessels mean it is more difficult for the blood to reach its target sites like the working muscles and the brain. Common symptoms of this are that your muscles “feel the burn” a lot earlier than they should, fingers may feel tingly or numb, and you could feel dizzy or even disorientated.
Breathing for Runners
So what happens when runners have poor breathing?
The most common problems I have seen in runners that are not down to true Asthma are:
1. Exercise Induced Hyperventilation
Hyperventilation simply means you are breathing more than your body physically requires. It can happen at rest or during exercise and can be quite subtle rather than a panic attack. It can also be short lived (acute episodes) or can be there all the time (chronic).
- Typical symptoms include chest tightness, wheezing, tingling fingers and dizziness.
- Carbon dioxide levels are affected (rather than oxygen directly). This results in tightening of the airways and blood vessels and makes it difficult for the oxygen to travel from the blood to the muscles and other tissues.
- This means your body works less efficiently, you tend to feel tired more easily and your muscles often “feel the burn” earlier than they should do.
- Oxygen also struggles to leave the blood to reach target tissues, because carbon dioxide is required for this to happen.
2. Dysfunctional Breathing Pattern
This is a biomechanical problem and means that you are not using your breathing muscles correctly. Most commonly this means the neck and shoulder muscles are the dominant muscles of breathing rather than the diaphragm.
The typical symptoms reported for this problem are:
- Feeling a lot more short of breath than you should.
- Lots of aches and pains around the neck, shoulders and upper chest due to increased muscle tension or activity.
Understanding Your Own Breathing
To get you thinking about your own breathing, let’s consider a few questions…
- How do you know if you have good or bad breathing?
- What steps can you take to understand how you breathe?
- What leads to losing control of breathing? What are the triggers for poor breathing?
If you suspect you may have a problem with your breathing, you may find it helpful to take the Nijmegen Questionnaire which is a screening tool of symptoms for Hyperventilation (a score of 23 or more is positive) or Dysfunctional Breathing Pattern (scoring highly in 3 or more symptoms suggests a problem).
Also think about your breathing at rest and on exertion: Does it match up with what has been described above as normal breathing at rest and appropriate changes during exercise? Self-analysis is useful but sometimes if a person has poor breathing awareness they may feel their breathing is normal when it is way off what it should be.
Using the information in this article, you and your training partners can look at each other’s breathing before training sessions. Alternatively you can have your breathing screened by a Specialised Physiotherapist via the Physiotherapists for Hyperventilation website (www.physiohypervent.org).
There are many triggers to make people’s breathing change, and often it is an accumulation of these rather than one particular factor that causes breathing to become problematic. Some common triggers are shown in the table below.
Most of the time when people have a breathing issue, it is because they have just got into a bad habit (just like bad posture is a bad habit that can cause back pain). Bad breathing can cause horrible symptoms, but these can be corrected by doing the right things, starting with managing your triggers.
Can You Really Lose Weight By Breathing Better?
There are several articles I’ve seen in health and fitness magazines recently making big claims about the benefits better breathing, with one of the common ones being that it can help you lose weight.
So can it really?
Well, it may help unlock a chain of events which allows a motivated person who suffers from Hyperventilation Syndrome to regain control of their weight, but these articles have a lot of assumptions behind their claims.
If someone hyperventilates, they are consequently tired all the time, which can often lead to poor food choices and a tendency to go for quick fix, high sugar foods. This, combined with a lack of energy to exercise, will lead to weight gain. By correcting their breathing, these individuals may have more energy, make better food choices and feel more able to exercise, so may lose weight. But if someone corrects their breathing but doesn’t alter other parts of their lifestyle, weight loss is unlikely.
Why Do I Feel the Burn More When My Breathing is Bad?
People feel tired when they breathe wrongly for various reasons. Poor breathing is harder work than it should be, so it steals energy/blood/oxygen from other working muscles, thus causing them to switch from working aerobically to anaerobically (working without oxygen and producing lactic acid). This is made even worse given that the lower carbon dioxide levels will also cause decreased oxygen delivery to muscles.
Some recent research has also shown that to adjust for imbalances in body acidity, some chronic hyperventilators produce lactic acid at rest to compensate for low CO2 levels, so they are unable to handle any lactic acid produced at even moderate exercise.
Correct the breathing at rest and often everything else falls into place.
Techniques For Improving Your Breathing
How can you improve your breathing? Let’s take a look at some specific techniques, and how you can apply this to training and races.
1. Practice breathing at rest
The first stage to improving your breathing is to ingrain a breathing pattern at rest by practising normal breathing at rest as described above. This is often not what athletes want to hear, but it is vital that a good foundation is laid down with focused breathing, not just lying back and relaxing!
Once this has been practised for 10-15 minutes twice a day for 2-3 weeks (initially in lying, then sitting then standing) then it is time to focus on breathing in running.
2. Start applying in training
I don’t advocate running in time with your stride (2in/2out, 3in/3out) as I find it can make things worse. We take about 180 strides per minute, so to start jogging at 30-45 breaths per minute is too fast, will make you feel dizzy and cause your performance to suffer.
Instead, I tell people to focus on breathing “low and slow” to try to engage the diaphragm and maintain a controlled breathing rhythm, sometimes counting rhythmically but not per stride.
3. Practise nose breathing
Nose-breathe running (in and out through your nose) has many advantages but is sometimes tricky to master. Learn the technique when walking or slow running, then build up to the best level you can sustain.
Nose breathing when running:
- stops you from going too fast (you will struggle to go past 80% of max even when practised),
- encourages diaphragmatic breathing,
- filters, heats and humidifies your air,
- provides gentle resistance so can strengthen inspiratory muscles,
- promotes the natural release of nitric oxide which promotes efficient breathing and circulation.
4. Can kinesiology tape help?
Colourful kinesiology tape was used on almost every body part during the Olympics so it begs the question: could it be used to improve breathing too?
I have used it in clinical practice to give patients feedback about when they are using their diaphragm correctly. Having played about through trial and error with various suggested techniques, I find the simplest one is the best in terms of giving feedback and being user friendly. Here’s how…
- Practise diaphragmatic breathing at rest and note where maximum abdominal movement occurs.
- Secure a piece of tape to the central line above your belly button at the level of maximal movement then stretch the tape out horizontally to the borders of the ribs.
- The tape should be applied with enough tension to give feedback – so that it is being stretched without being restrictive.
- Then try practising running with it in place and training your body and brain that this gentle stretch is a positive sign that you’re breathing correctly.
5. Nasal rinsing
Nasal rinsing seems to be getting more popular again as an alternative to spraying chemicals up your nose to keep the air passages open, especially during allergy season. Maintaining good nasal hygiene helps you breathe more easily through your nose, and reduces nasal and sinus infections and irritation, according to many well respected Ear, Nose and Throat consultants.
Although there’s an increasing number of aerosol sprays on the market, nothing seems to compare to the full nasal rinse that is given by the original NeilMed system, if you can tolerate it.
Inspiratory Muscle Training is dubbed as “Dumbbells for your Diaphragm” by Powerbreathe (www.powerbreathe.com) the biggest suppliers of IMT in the world. The theory is that by improving strength and endurance of inspiratory muscles, breathing will be more efficient and so performance will improve.
Have a look on their website if you are interested in more of the research. Just like weights, IMT can be performed in various ways to produce benefits. My favourite is using it for doing 30 breaths at moderate resistance as part of my warm up then at a harder resistance as part of my resistance/stretching/recovery after my running session. I would usually perform this at the highest resistance that I could maintain a good breathing pattern, often with my hands behind my head to maximise the use of the diaphragm.
7. Holding your breath
Breathe-hold techniques can be used to correct chronic hyperventilation when individuals suffer from many of the chemical reactions associated with lower CO2 levels. By holding your breath until you feel mild discomfort (this is an indication you have reached CO2 levels your body is no longer used to) you can re-adjust the levels you feel the need to breathe at, and reverse many of the problems described earlier in the article.
8. Race day preparation
Many of the strategies for good breathing during an important race should be part of a runner’s preparation anyway. As always, don’t try anything new on the day:
- Good hydration and nutrition before and during the race will help stabilise blood sugars and optimal hydration, avoiding two of the triggers of Exercise Induced Hyperventilation.
- If you have been nasal rinsing, do this several hours before the race to allow any excess solution to drain out and leave you with clean and clear passages.
- Using Powerbreathe as part of your warm up seems to “switch on” breathing muscles. So if you have used it in training, take your device in your bag for the day.
- Keep calm – after my warm up and Powerbreathe I usually lie down in the start area of the London Marathon to make sure my breathing is slow and controlled despite the pre-race nerves. Having better breathing at rest will mean you start in a more controlled manner when the gun goes. Try to maintain a calm, well-practised breathing pattern through the early part of the race especially as a frantic, agitated breathing pattern could spell disaster later on.
- If you have practised nose-breathe running, doing this in the first part of a longer race can help optimise your breathing and stop you going off too fast.
- If you find that you do lose control, don’t be afraid to stop and refocus, putting your hands above head to re-engage the diaphragm.
- Use taping if you have found this successful in practice.
- After the race, focus on relaxed breathing as you have your recovery drink to re-establish resting breathing pattern and promote healing and recovery.
Finally, I hope you feel motivated to go and try these suggestions and techniques, and that you find them helpful. Good luck!
Robin McNelis is a chartered physiotherapist specialising in cardiac and respiratory physiotherapy at Wellington Hospital in London. He is a qualified athletics coach and runs his own health, fitness and wellbeing consultancy, Run Robin Run. Contact Robin by email at firstname.lastname@example.org or on Twitter @runrobinrun73.