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Diaphragmatic Breathing: What are we changing?

by Carson Boddicker on Aug 6th, 2010

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There are many who are critical of attempting to change diaphragmatic breathing patterns simply because we don’t have much evidence that they exist, as I do fall into that category I seek to demonstrate that we are actually changing something.  One repeated statement I’ve heard recently is that “if we don’t have spirometry measures to show the effectiveness of the protocol, how do we know it’s working.”  Unfortunately, I’m not wholly convinced that the argument is as effective as it could be and leaves me with the question that we must answer, what, exactly are we trying to change with diaphragmatic breathing training?

I can say assertively that I don’t think we’re changing anything valuable from a perspective that is measurable via spirometry.  Spirometry simply measures volumes and velocities of air moved by the lungs.  Unless we’re talking about diaphragmatic breathing training for those suffering from COPD, we’ll have a pretty difficult time changing lung volume, though resisted training may lead to improved velocities in inspiration and expiration.

If we are going to measure respiratory gasses relating to breathing dysfunction, we need to be more specific than simply “air,” and must look at the components of expired air.  To this end, capnography reigns far supreme to spirometry as it can tell us the air’s contents of CO2, a vital player in breathing drive.  In individuals who are “over-breathers,” the big issue is often respiratory alkalosis from exhaling too much CO2 and become oxygen drunk, which drives the pH of the body up as CO2 cannot disassociate and form carbonic acid.  What we get in this case, then, is some funky responses.  Those with diaphragmatic breathing dysfunction forced into hypocapnia run into a number of pitfalls including smooth muscle constriction (bear in mind that many connective tissues have some smooth muscle fibers), the Bohr effect takes place facilitating greater ischemia and increased risk of trigger point evolution, and the sympathetic nervous system kicks into overdrive with more rapid reflex arcs, decreased pain threshold (and long term hyperalgesia), and altered balance.  Couple this with the body’s drive for maintained homeostasis, thus the kidneys begin to pump out more bicarbonate, leading to disturbed calcium and magnesium balances, a perceived “normal” blood pH, and increased anxiety and we have a vicious, self-perpetuating issue.

Normal breathers should take between 10 and 14,000 breaths per day, however, over breathers do a lot more, slightly smaller “reps” but the gas exchange is not proportionally small enough, forcing too much CO2 to go visit the trees.  Ideally with retraining of a good diaphragmatic breathing pattern, we can begin to normalize the amount of CO2 within the system by slowing down breathing and resetting the brain’s perception of “normal” blood gas levels.

Using capnography biofeedback may be an excellent tool in retraining and can help answer the all-important question “is it working”, however, the machines are impractical.  Thus, I defer to the “common sense” and “supported by literature” ideas of Charlie Weingroff’s evidence informed practice beliefs.  In 2008 McLaughlin and Goldsmith demonstrated that, in an average of 5 sessions including diaphragmatic breathing training, subjects were able to improve respiratory chemistry (measured by capnography) and gain increased function.  While it’s only a single piece of literature, it does provide me with enough support to believe that I’m not walking sheep.

Regards,

Carson Boddicker

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Leave a Comment »13 Comments
  • Dmetri Landness August 6, 2010

    I think this is a toughie but a goodie nonetheless. Once again a post of yours has caught my attention. This time I can only agree wholeheartedly with what you say here, Sir.

    :-o )

    There are many people in our field who try and have a run at it, but they don’t know when they are doing things that could hurt other people. This is one of those instances. Is it experimental or is it matter of fact? These are questions our leaders need to be asking themselves everyday.

    Good training!

    Dmetri

  • Aaron Schwenzfeier August 6, 2010

    Carson,
    Very informative and detailed write-up… however…

    I have to apologize but this just seems ridiculous. Everything you stated can be improved by good old fashioned exercise. Vigorous movement daily. Dare I say, traditional cardiovascular exercise most days, laced with some hard intervals once or twice a week.

    Like I said, deconditioned vs. conditioned. A fit person is a fit person.

  • Carson Boddicker August 6, 2010

    Aaron,

    Do fit people automatically choose the most ideal and efficient pattern of stability? If this is the case, most of my athletes should have flawless breathing patterns as I work with some of the most aerobically equipped athletes in the world. Unfortunately I don’t see a direct correlation to fitness and breathing pattern appearance as you suggest I should. Instead several use modulation of breathing to make up for inauthentic stabilization patterns.

    Take your “fit” athletes and have them all do an ASLR, I’m sure you’ll come across several breath-holders, who use breath to achieve a “high threshold strategy” or whatever you want to call it, for a task that should be relatively low load and low difficulty where breathing should be easy. In my AP experience, there were a number of very high level athletes from a number of sports who were “fit” but still moved poorly upon initial evaluation across a range of patterns.

    I’m not discounting the role of fitness in it’s ability to play with the autonomic response and facilitate more “free” breathing patterns, but it is not as black and white as you seem to suggest in the athletes with whom I work.

    Regards,
    Carson Boddicker

  • Carl Valle August 7, 2010

    Carson,

    This is a very important blog site as you will share great subject matter. From your posts you are putting a lot of effort to what you are reading and from my own elitetrack.com blog I full support that. My question is this a blog for personal journaling of ideas, like a Steinbeck or Chuck Palahniuk writing practice or sharing best practices in sports performance? If the latter I think a bigger snapshot of the entire training process. I would love to see more workouts to see how you are integrating all the therapy, physiology, weight training, core work, and more into one program.

    Aaron and myself (I think Charlie W as well) went to the BSMPG conference and Dr. Cahalin spoke on Inspiratory Muscle Training in Ice Hockey. Guess what he talked about? Sure he talked about biofeedback, yes biomechancis of breathing, MIP and SMIP, and other pulmonary performance factors. The question is, what are we spending our time on and how are our athletes doing compared to the standards?

    While you are recalling Paul Check’s information in early 2000 (were you doing rehab in middle school or reviewing the materials recently?), the first step in many core training programs he was coaching breathing training. Heck I have blogged about it and coached it myself since 1997 after speaking to a PHD and PT that instructed yoga. If I didn’t know she was involved with pulmonary rehab I may have not put the effort in.

    We know breathing is important but without evidence so superior results in best practices I would conclude this is a blog of musings and ideas vs demonstrations of wielding techniques and methods based on experience and practice. Nothing wrong with theory and discussion, but without evidence (Besides studies of bodywork with
    Laurie McLaughlin ). Heck in one class I could raise my heart rate from 52-85 and lower it down to 44 with biofeedback but that will not do much if a 300 pound DL is going to trying to sack me if I was a QB.

  • Carson Boddicker August 7, 2010

    Carl,

    Thank you for the post. The blog is very much a selfishly written one with the intent of exploring the best practices in sport. You’ve repeatedly asked for a bigger picture and you’ll get one, but I write these far in advance, so patience is king. In reality, I have written a great deal about the minute details that make up a very small part of my programming because I think everyone should know by now that producing force (quickly) is of paramount importance to the athlete. It seems that Aaron and yourself are thinking all we do is train breathing, when in reality, we may use a bona-fide breathing exercise to develop awareness of a proper pattern in the first few sessions. In fact, if you take a look at all the programs completed in the past two weeks at my facility, you’ll see that nobody did “breathing” exercises, but we did have them to “harness the breath” in much more demanding situations.

    I was first introduced to Paul Chek in 2004, so I believe I was in high school. In fact, one of his quotes from around that time period is one that I try to stick with and one that perfectly illustrates why I write about the small things. Chek said, “Everybody wants to swim on the surface, but we really need to go deep sea diving.”

    In reality, however, Carl, some things that have value in performance are not quantifiable by and large. One that I deal with daily is training at altitude, which has many relative uncertainties. Should we not do it? I contend that the burden of proof that this doesn’t work is upon you, not me to prove that it works to you. You’re welcome to the titles of what I’ve read to formulate my conclusions to experiment with your own athletes.

    Regards,
    Carson Boddicker

  • Carl Valle August 8, 2010

    Carson,

    I am skeptical and open at the same time. If you believe in anything please share what you are doing. Can you fault me when no video or data tables are shared? If this is a blog for your own personal journey great….but open blogs seem more like discussion points and I willing to hear you out. You respond to my questions and I thank you. Since I must wait with bated breath, I will follow the blog and pick up what the current trends are for high end corrective measures. I don’t need exercise catalogs or 5 quick tips, but general theoretical or shared reading is more abstract. I don’t don’t know what I would do in altitude training wise, but I would likely do more conditioning!

    Keep sharing what you believe in as it takes guts to put your name to beliefs. Share what your findings are with Spider-Tech since you are advocating a bit in the product. No matter what you do, sharing more value type data would help those that read a lot of blogs that are not as transparent to what is going on.

    Later….CV

  • Aaron Schwenzfeier August 8, 2010

    Carson,

    I agree that it is not as black and white as you think I am suggesting. It’s why I ask the multiple scenario questions regarding breathing.

    Do you or did AP use capnography? Can someone who uses what appears to be mechanically “dysfunctional” breathing patterns still respirate “normal” gas ratios? Or the reverse?

    Just curious. Good discussion.

  • Carson Boddicker August 8, 2010

    Aaron,

    Excellent question, and I’ve only used capnography while toying around in the lab. Gray Cook and I had a discussion regarding capnography and breathing patterns, but we did not cover that task. I have sent out an e-mail to get a little bit of feedback on your question from a few who use capnography regularly.

    Regards,
    Carson Boddicker

  • Aaron Schwenzfeier August 8, 2010

    Thanks, I look forward to hearing what you find.

  • Carl Valle August 9, 2010

    Aaron,

    I have some PHD specialists that work with capnography and actually live near a company that makes some of the best capturing technologies. Not only do they work with exercise labs and rehabilitation, they are very well versed in speed and power differences.

  • Ian Mills August 12, 2010

    Gentleman,

    I appreciate your attention to the details on something as “Simple” as breathing. I am a huge advocate of diaphragmatic breathing while I train because it helps me recover my heart rate in between sets and also stay relaxed at the line. I am a skeleton athlete and we are not privy to being tested with monitoring equipment like the big name sport professionals do however I train myself to the limit just as they do.

    The reason for speaking instead of listening here is because the last 2 years I have competed in Park City Utah (7000ft), I have seen my performance levels go down the toilet and I didnt feel like I had any control over the machine. Calgary is at 3500ft in which I train all summer. Now its obvious why my performance is top notch in Lake Placid, NY or Whistler, BC, but what can I do to prepare myself properly to light it up when I am competing at higher elevations?

    Again, Thank you for your dedication to higher learning and sharing with everyone

    Ian “Mad Dog” Mills

  • Carson Boddicker August 15, 2010

    Ian,

    Altitude definitely influences breathing drive, and the research points to the fact that those born at altitude, even if they are gone for an extended period of time, respond to reintroductions at higher elevations with a more “normal” breathing drive, whereas those born at sea level go through a lot more stress and breathing drive upon going to altitude. This may largely be an autonomic response or a result of the “oxygen sensor” that Noakes speaks about when discussing the Central Governor Hypothesis.

    As far as what can you do, I haven’t come across anything in particular that addresses the question, but theoretically, going to altitude with better breathing patterns cannot hurt, but spending time frequently doing some “relaxing” breath work like Aaron mentions may help reduce the alarm response. In working with our endurance crowd here as well, there may be benefit to being very precise with your travel schedule and competition schedule at altitude.

    Going up you usually have a 24-48 hour period where you won’t see a big performance detriment (physiologically) that is then followed by up to 10-14 days of “fast adaptation” and decreased performance then a little bit more of a chronic adaptation period that allows things to normalize a bit more toward the 12-16wk mark. If it’s truly the breathing thing that is standing in your way, it may be something to consider. I have a paper somewhere talking about breathing drive increases being the impetus for more EPO production at altitude that I’ll review sometime soon.

    Regards,
    Carson Boddicker

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