Diaphragm and respiratory training (SpiroTiger).

This is the SpiroTiger (ST) article that I published over a year ago and has been rewritten with a year and a half worth of experience and improvements. Keep in mind that every person is a individual and he or her has their own weaknesses, so there may be different reaction to what I have found.

Background

Most athletes do not even think of training their lungs, they think that they can not train their lungs, that their lungs could not possibly limit their performance. And that their body is limited by how high their heart can beat and how much watts their muscle can push.

When we look at the body in terms of what could limit performance we see that there are a few trainable systems in the body. The muscular system, the cardiac system and the respiratory system. This is a very broad view and obviously each system can be broken down further and interact with each other. When we use certain equipment we can find our weaknesses within these systems and train them. In the case of this article topic, if we find the need to train the respiratory system we have certain means by which we can do this.

What you have found through testing will determine how you can use a breathing device to strengthen your respiratory system. Now there are a few devices out there with which you can train the respiratory system and you can make your own. But the only current one that I am aware of that has a safety system build into it is the SpiroTiger. Any other system you will need a oximeter and capnometer at a minimum to control blood saturation and PCO2 levels, the price of a capnometer would already have overshot the price of a SpiroTiger. The build in sensors for the SpiroTiger monitor the amount of air movement and calculate if you continue at the current breathing rate if you will move into a hypercapnia state in which case the system will shut down as a safety precaution. For Hypercapnia specific work we override the safety features. The bonus is that there is no filters to replace on the ST as with other hypoxi equipment. (hypercapnia and hypoxia work is not supported by the manufacturer and is not recommended unless you have had instruction).

With the ST we can dial in breathing frequencies from 15 up to 60 breaths per minute and change the breathing ratios. Show me another breathing device that can do this and with which you can do endurance work for the breathing muscles? Most work outs on other devices last 30 seconds which will not challenge the respiratory endurance muscles. You may ask why would you use a device and not just go out and train? By challenging your respiratory system specifically you don’t risk over stressing any of your other systems. If your respiratory system is compensating for something else that is a weaker system, you will need to overstress the weaker system first before placing enough stress on the respiratory system, in this way with the ST we can dial in on the respiratory system without stressing other systems that we want to keep recovered.

Training ideas

One idea would be to do a training session, and perhaps you have challenged your cardiac system, but your respiratory system still needs a workout, this is where the respiratory work can come in. But then if you look at it at from another angle if you were perhaps swimming and you were really trying to challenge your lungs by instead of breathing every other stroke and breathing say every fifth or sixth stroke. This could challenge the inhalation and the gas exchange due to the time delay and short period you have to breath, then because your lung are already stressed then it may not be such a great idea to stress them again with the ST.

The idea behind the ST is to train the endurance muscle of the lungs which will train the diaphragm, breathing co-ordination and the inter and intra muscles involved during breathing. By training our respiratory system we may reduce or slow down the effect of the respiratory Metaboreflex (studies from Dempsey).

So the big question that a lot of people will want to know is will breathing training make me faster and stronger? The simple answer to this is it depends on what your limiter is, is your limiter your respiratory system? And then it depends how you use the ST to challenge your limiter?

Diaphragm training

Here are some of my experiences over a year and a half. I used mainly larger bag sizes to challenge my diaphragm strength, with 4-6 ST sessions a week, although I have now reduced this to 3 session unless I am doing hypoxia work. The diaphragm is one of the main supporting core muscles. You can do as many sit ups, planks and traditional core work as you like, but if you can't target your diaphragm all this traditional core work will only make you good at sit ups etc. Plus a six pack is not going to make you race faster. From video footage I know that my technique 'falls apart' from the core area when I am tired at the end of a race. Knowing that the breathing training might have a effect on my core, I decided to totally avoid traditional core work, the only place that I would still target my core is when lifting weight during squatting, dead lift, olympic lift etc. This would allow me to know that any diaphragm strength gain came mainly from the breathing training. Which it did, and it took about 5 months to notice. A year later (still avoiding core specific work) looking at new video footage you can see I do not 'fall apart' from the core anymore, and I am convinced that this is from training my diaphragm with the ST. (I am not suggesting that you do not do core work, but simply that you understand that there are better ways to target the main core muscles).

The biggest challenge in any work out is for this to transfer to the sport that you do, you lift weights so that it would transfer to cycling, you might do cross country skiing in winter to become a better cyclist in summer, you might run and bike to become a better cross country skier. With the breathing training it is the same concept. I want to be able to use a larger portion of my Vital Capacity (VC) so in effect increase my Tidal Volume (TV). But over the past year this work hasn’t really transferred, although I have been able to reduce my breathing frequency (RF). So the plan now is to use a bag size and RF that resembles my TV and RF at the level where things become critical in my body, and in this way challenge my respiratory system which could possibly make a structural change. Time will tell.

Hypercapnia and cool downs

I have misused the ST and used if for hypoxi work, always using a oximeter and pulse watch to check that I control my SpO2. I played with this idea over the summer and took it one step further into my cool downs and recovery in between sessions. What does this mean? I do not do a cool down in the traditional sense anymore. I use hypercapnia. We all know that Lactate is our friend and the body uses it as a fuel. Some background. During exercise, hydrogen ions H+ accumulate in the body which leads to a drop in the body’s intermuscular pH which will affect muscle performance. The more the body relies on glycolysis as the primary energy system the higher the production of H+ and lactate. Although the level of lactate has very little to do with the pH. Lactate gets produced as a by product and helps to buffer the H+ which there fore helps to prolong our workout. (The H+ may have a negative effect on the coupling of Ca++ and Mg-- on ATP production). So by keeping lactate in our system we have firstly a good source of energy plus we have a buffer system for the H+.

Now by cooling down traditionally we are taking away blood from the vital system. Because blood is needed again for the muscle and we are taking away the Lactate needed to fuel our brain, heart and get rid of the bad H+. So this is how I have done it, with out any negative results and keeping lactate and blood available where it is needed for faster recovery.

As soon as I can, after a race when every one else is 'cooling down' I use respiratory intervention to cool down instead, using hypercapnia. This creates a respiratory induced acidosis, (during exercise your body creates metabolic acidosis). Initially this will create some more H+ , but also your body will increase the CO2 level, Increase CO2 will release O2 from haemoglobin which will aid recovery. I do this for some time and it depends on how tired my respiratory system is, I will never push it further based on a time. Simply feeling and generally aim for several minutes. followed by a second session later in the evening. What I will start to add to this idea now is to first load the haemoglobin with O2 directly before the hypercapnia so that there is more O2 that can be released from the haemoglobin and possibly myoglobin. The early release of O2 through CO2 creates a better use of lactate and helps shuttle the H+ out of the system. And that is my recovery, only thing I might ad to at the end is a walk, thats it. 

Hypercapnia and warm up 

I have added hypercapnia in my warm up. Similar to above, so I have done my normal warm up which is up to race pace, straight from this I will go on the ST and go hypercapnic for 5 min.  From here I am ready to go. This season I will experiment with hypocapnia before the hypercapnia then race. The same idea could be used in between intervals. (5 min at hypercapnia is a ball park figure as it is just long enough to get the desired result but not so long that I am sitting around losing the optimal blood flow from the warmup). 

All these ideas are trial and error, and they are individual dependant, some people may respond to it, some may not, the results will depend on your limiters. Some people may benefit from a more hypocapnia versus hypercapnia state just before their race start dependant on the type of race start and how there body reacts. Other people who have more of a respiratory limitation might benefit from doing some race pace breathing before a race or hard session as to avoid or slow down the process of the metaboreflex reaction during the race. I wanted to integrate ST work into my training, so go hiking with it, but I decided against this as a lot of the time my blood saturation is already very low, and adding more stress with breathing which would likely lead to a even further drop in blood saturation would not be the smartest idea if I want to increase the muscle recruitment (this assumes that the blood saturation is a reflection of the muscle tissue saturation which is not always the case).

Lastly, would I recommend buying a SpiroTiger? Put it this way I have bought a second ST, which is a upgrade from the first one I owed. The SpiroTiger is a powerful tool if used correctly. Find your limiter, figure out how it will react, then trial it and apply the physiology instead of following every one else just because they do it. 

FaCT testing

I recently had some FaCT testing done to find my weaknesses. Here are some pictures to give a idea of how versatile and portable the equipment is. 

It can not be seen in this picture but under my shirt I have EKG pads that have a wireless link to the  computer next to me. On my right thigh under the cycling short is a phone size device (NIRS) that gives the tissue saturation information which is also transmitted via a wireless live transfer to the computer next to me.

On the left computer screen is the live hemodynamic feedback, middle computer screen is live blood flow and tissue saturation information, the orange grey box leads to the mask on my face which gives live respiratory info, and finally the small blue device is for lactate info.

Testing is done where ever you want to do it.

The mobile sports laboratory, doing a roller ski to compare treadmill and road results. The equipment has enough range to pick up live blood flow and hemodynamic info from the car following close behind.

The respiratory info needs to be carried in a back pack and can be analysed later.

Here some screen shots from some of the testing where all the information is looked at as a whole, and a better understanding of how each of the systems influences each other. Instead of traditional testing where conclusions are sometimes made based on one system only. 

The aim is to find the Limiter which we can then train so that there is a performance improvement where as traditional testing tends to look at how good you are, comparing VO2 and statistics to other athletes, how much wattage you can push  or testing running economy, all the traditional type test which help you very little in training and finding your weakest system.

From this one FaCT test I now have a much clearer idea of what my body is doing and how to train it than any of the previous traditional tests done over the last 13 years.

I was tested by Duncan Clarke who does level V testing, contact information for him and other test centers can be found on the FaCT Canada website.

How valid is a VO2 test and results?

VO2 max: is the value of the total amount of oxygen used by the body at maximal intensity. It is the oxygen used by the muscle, heart, respiratory system and the brain. The maximum amount of oxygen that the body can use is expressed as a VO2 value.

Traditionally VO2 is used as an assessment for training intensities of which percentage of VO2 Max is most commonly used. Which is based on the VO2 Max and give a performance ability to compare against other athletes.

There are two ways in which we can view VO2 max.

• The typical traditional view: VO2 is the limiting factor to human performance, to improve VO2 max we need to train at or near VO2 max. 

• The alternative view: The weakness of either the cardiac system, the respiratory system or the muscular system will limit the VO2 performance. Finding the weakest link and training the weakest system will improve the efficiency of VO2. 

If we then view VO2 max from the alternative view, then to have the highest VO2, if simplified we require the respiratory system to collect oxygen and transfer it to the blood stream, extract the CO2 from the blood and transport it back to the outside world. The body requires a efficient cardiac system to pump the oxygen and CO2 around the body to and away from the muscle, and finally the muscles require mitochondria which loves oxygen for energy.

Sport where more muscle is involved will have a higher VO2, e.g. cross country skiing versus cycling, as there is a greater requirement for blood getting delivered around the body etc. Assuming technique does not hinder performance (as the extra muscle required to compensate for balance and coordination in technique require more energy) then the harder you go, the greater the requirement for oxygen and VO2 will go up. The faster you go the more you will push one of the limitations in your body which will limit you from reaching a higher VO2 performance.

A higher VO2 means your body requires more oxygen, but is a higher VO2 value always a good thing? Retesting for VO2 max where your VO2 has decreased for the same speed or wattage is often looked at negatively, rather it should be seen as a good thing as the lower VO2 at the same LBP is now more efficient so in theory you should be able to push longer with a more efficient system.

Some problems with VO2 tests:

There are various protocols developed to test VO2 max and each will give a different VO2 value for the same athlete. The problem is that if a VO2 test was truly physiological then you should get the same VO2 value every time for that sport. Some individuals during supra maximal test reached higher VO2 max result than during a standard incremental one (Hawkins et al).

With the VO2 test you are really only getting feed back on the respiratory system and the amount of oxygen that the body can use, and one variable of the cardiac system, i.e. heart rate. The entire test is based on VO2 and at what heart rate this occurs, in some VO2 test (that has been done on me) lactate was not even taken so you do not even have the metabolic feed back. The main problem with only having heart rate for the cardiac system is you have one variable and only know how fast the heart is beating, there is absolutely no information on stroke volume or cardiac output! Yes we could use formulas to calculate Cardiac output (VO2 Max= CO x (a-v) O2 difference), but most VO2 tests last 6 to 12 min and with such a short test time the intensity steps may be to big, too quick and in this case we could miss physiological markers. FeO2, CO2, Lactate, SpO2 etc all have a lag time of about 30 seconds, which means we will miss certain bio markers! Using a device like a physioflow which is non invasive gives you live feed back on hemodynamics and gives a fuller picture of the whole body’s reaction. With live hemodynamics we have information on Left Ventricle function,, Ventricular Ejection time, Stroke volume etc.

More practical and useful information can be gained from a VO2 test by looking at changing body position, RPM, stride length, breathing patterns to see if this changes the O2 and CO2 relationship. How many athletes know their breathing rate at LBP or even race pace? Or their breathing Tidal Volume? Why is this important? This information can be used to plan breathing training with a SpiroTiger to improve core stability, breathing coordination, diaphragm strength, and if you want to explore breathing training further even gas exchange.

A VO2 max test looks for a plateau to find the VO2 max value, Tim Noakes, 2008, demonstrated that in most test this plateau does not occur. Knowing when a test will end, i.e., the length of the test also will effect the outcome value (Baden et al). The first time I do a new fitness test is always the hardest, (e.g. a 60 second jumps test measuring sustained power) because I don’t know what to expect, in a follow up test I know how to pace so I have changed the results with out likely actually really improving). Lactate threshold can be completely missed, probably overestimated during a VO2 max (even standard Lactate test the so called anaerobic point is over estimated in most cases). Athletes training at the same percentage of VO2 max with similar VO2 max values can have huge variants in training outcomes (Scharhag-Rosenberger et al). The entire VO2max protocol needs to be reviewed.

Once again with a training program where training zones are based on VO2 max percentages, we do not have a clue what we are training. What is the cardiac system doing? what system in the body are we stressing? At what point is the Left Ventricle function being challenged which will affect stroke volume? With out looking at the body as a whole we do not have a clue. Rethinking the VO2 protocol to follow physiological reactions would be one step in the right direction. A Lactate Balance Point or Zone test (LBP developed by FaCT) with lactate for metabolic changes combined with VO2 for pulmonary information and cardiac feed back on hemodynamics gives more information than a VO2 max test EVER will. Unfortunately our coaches and physiologist are traditionalist and follow what they were taught in University and these ideas will take time to be accepted until they look at how we can train the body as a whole and instead of training speed, power, endurance rather think train muscle, cardiac, respiratory and how these system react during speed, power, endurance and when they fatigue so that we understand how much overreaching is required.

The LBP idea and testing using respiratory and hemodynmic devices is part of FaCT's continued research. FaCT Canada is actively engaged in researching and continuously testing more reliable ways of assessing the body, currently they are looking how CO2 can be used as a biomarker by using a capnometer. To read more in depth discussions go to their site at FaCT. There is a in depth article on The Fallacy of Vo2max and %VO2max on the site Science of Running.

Drifting slightly off the VO2 subject, this is simply me thinking loud. We often wonder why we get different outcomes with research studies on training ideas and altitude training (or even VO2 training zones) etc where we have responders and non responders to the training load. If research really wanted to have a controlled group, they could simply do a full assessment where they find which people in a control group have what limitation. And when at the end of a study they have there responders and non responders they will more likely have a clearer picture of why certain subjects responded in certain ways because they were limited by there cardiac system or ability for muscle to utilize the fuel given to it etc. At least this is how I would do a controlled physiological study.

Power balance bands exposed

This is a very interesting read and by no means surprising, the follow up articles on this are also a good read.  A piece of plastic with a hologram plate which will improve balance and performance worn by many pro athletes! Sounds too good to be true.  Go to the link to read the complete article.

http://www.sportsscientists.com/2011/01/power-balance-bracelets-no-credible.html and http://www.sportsscientists.com/2011/01/power-balance-placebo-and-perceptions.html