Altitude training, IHT, Hypercapnia recovery and the benefits.

Many athletes now days have some sort of altitude camp or Intermittent Hypoxic Training (IHT). There are various combinations of Living high training high or living high training low etc. With living high and training low (which could be done using a altitude tent) a athlete can avoid reduced muscle recruitment found when training high so have a better training session at lower altitude with the benefit of increased red blood cells.  A more common practice now days is IHT which has shown to be more effective than altitude tents. Depending on the protocol the body will adapt to the hypoxia effect and increase red blood cell production so there is more oxygen carrying blood going to the working muscles.

If you have read the post FaCT way of looking at the body you might understand why there could be altitude responders and non-responders. Example: If your muscles are the limitation before the altitude camp, then after e.g. three weeks at altitude  they may not have changed at all but in fact the muscle "may" be worse from the camp due to a reduced muscle recruitment at altitude. If that is so and we have better oxygen transportation with more Oxygenated blood (higher red blood cell count) it is much easier for the heart to keep the vital organs happy. Pumping more blood to the muscle will make no sense, as the limitation of muscle can't take more oxygen in anyway (muscle recruitment/utilization). This would be a non-responder and the same holds true when athletes use EPO and in some cases there are also non-responders. So once again knowing what each individual athletes limitation is through testing and not guessing will help one to understand the effects of training at altitude.

What I would like to give more in depth information on is the lesser known benefits of Hypoxia or Hypercapnia.  Many of the ideas come from the Russian school and one of the "leading" researchers is, Dr. Buteyko. Here is a abstract which might make you see the bigger picture.

• Oxygenation: Carbon dioxide (CO2) plays a large role in oxygen transport from the blood to the cells of the brain and body. A reduction in CO2 levels brings with it reduced oxygenation of tissue and vital organs (Verigo-Bohr Effect).
• Acid/Alkaline Balance and the Immune System: CO2, through its conversion to carbonic acid, is a primary regulator of the acid/alkaline balance of the body. 
• Vessels: CO2 helps to dilate smooth muscle tissue.
• The Cardiovascular System: CO2 helps regulate the cardiovascular system.
• The Digestive System: A direct relationship exists between the level of CO2 in the body and the functioning of the digestive glands.

Tatiana V. Serbrovskaya (High Altitude Medicine & Biology ( Department of hypoxic States, Bogomoletz Institute of physiology (Kiev Ukraine ) Volume 3, number 2 2002 @ Mary Ann Liebert Inc.

"Intermittent hypoxia research in the former Soviet Union and the Commonwealth of Independent States : History and review of the concept and selected applications. High Alt Med Biol 3:205-221,2002.- This review aims to summarize the basic research in the field of intermittent hypoxia in the Soviet Union and the Commonwealth of Independent States (cis) that scientists in other Western countries may not be familiar with, since Soviet scientists were essentially cut off from the global scientific community for about 60 years. In the 1930s the concept of repeated hypoxic training was developed and the following induction methods were utilized: repeat stays at high-mountain camps for several weeks, regular high altitude flights by plane, training in altitude chambers, and training by inhalation of low-oxygen-gas mixture. To the present day, intermittent hypoxic training (IHT) has been used extensively for altitude pre acclimatization; for the treatment of a variety of clinical disorders, including chronic lung diseases, bronchial asthma, hypertension, diabetes mellitus, Parkinson's disease, emotional disorders, and radiation toxicity, in prophylaxis of certain occupational diseases; and in sports. The basic mechanisms underlying the beneficial effects of IHT are mainly in three areas: regulation of respiration, free-radical production, and mitochondrial respiration. It was found that IHT induces increased ventilatory sensitivity to hypoxia, as well as other hypoxia-related physiological changes, such as increased hematopoiesis, alveolar ventilation and lung diffusion capacity, and alterations in the autonomic nervous system. Due to IHT, antioxidant defence mechanisms are stimulated, cellular membranes become more stable, Ca2+ elimination from the cytoplasm is increased, and O2 transport in tissue is improved. IHT induces changes within mitochondria , involving NAD-dependent metabolism, that increase the efficiency of oxygen utilization in ATP production. These effects are mediated partly by NO-dependent reactions. The marked individual variability both in animals and humans in the response to, and tolerance of, hypoxia is described. Studies from Soviet Union and the CIS significantly contributed to the understanding of intermittent hypoxia and its possible beneficial effects and should stimulate further research in this direction in other countries."

If you are still awake and have followed up to now well done!  So from these benefits one can summarise that IHT has many health benefits also.  Athletes are known to use Hypercapnia for recovery from day after day hard sessions or stage races but the protocol for this is hard to find and one would unlikely complete a full IHT course.  It is a matter of research and thinking how  and when to best apply it after ie a hard race.    

Here is another article to read. The lung and carbon dioxide:

There are many manufacturers of equipment that can be used for IHT and hypercapnia ie  AltiPower, the main disadvantage is maintenance cost of the CO2 filters, but also it can be hard to control SpO2 levels, the SpiroTiger  can be "abused" and allot more precisely control SpO2 levels through breathing alone. Disclaimer: SpiroTiger is NOT build to be used as IHT equipment but only as a diaphragmatic endurance training equipment. It is essential that with any IHT equipment a pCO2 and at the minimum a  Pulse Oximeter is used during IHT.  Dropping the blood saturation (SpO2)  to low, could lead to hospitalization or even death.

SpiroTiger

SpiroTiger:  Spiro what? sounds like a fuzzy little animal that lives in the woods!  Rather it is currently the only training device that can train your lungs effectively.  Sure there are other low cost devices such as Powerbreathe and PowerLung out there, but they will only allow one to train the respiratory muscles for about 30 seconds before one goes blue in the face and keels over panting.

The PowerLung is more like gym training for the lung where as the SpiroTiger was designed 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.

If used correctly will a athlete develop a larger VO2? Will you run/bike/ski/swim faster? Will you have more power? It all depends on what is limiting your performance... if you have a respiratory limitation and then strengthen this limiter then the answer to the previous questions is a possible yes. So for the same given heart rate, power output and effort your lungs could be more efficient.  Depending on how much you use and abuse the SpiroTiger (abuse because there is some unofficial protocols for hypoxia (IHT) training, disclaimer: The Spiro Tiger is not ( NOT ) build to be used as a IHT equipment but only as a diaphragmatic endurance training equipment the reason is the O2 and pCO2 reactions) you could improve the gas exchange in the lungs, improve muscle coordination of the muscles involved.  Example: If a athlete was tested to have a limitation of the respiratory system and strengthened the lungs he will likely be able to race or train longer before his diaphragm muscles starts to tire out, where upon his vT or TV (Tidal Volume) might likely drop (smaller TV), his breathing rate will increase and the body will have one of several reactions, one could be metaboreflex (here is another explanation, metaboreflex) or the ECGM (Extended Central Governor Model).   The better we can train our weakest system (which can be found through various tests) the better we can train the system before the ECGM or CGM "kicks in".

You may ask don't we train our lungs when doing normal exercise?  Yes and no!  How often can you stress your respiratory system to get the training effect you want for the lungs? If your lungs is not your weakest link and example your muscle utilisation is the limiter and you train just up to the point where the muscle is stressed (assume the other two systems do not compensating for it) then it is unlikely you will be able to efficiently and regularly train the respiratory system through normal exercise.

With the SpiroTiger a athlete can effectively train his lungs every day, but within reason, I wouldn't use it the day before a race or hard session in case the breathing muscles involved has not recovered in time.

Abit more on the device and my own findings using the SpiroTiger: The device works with a hand held unit that can be programmed for breathing frequency and bag size.  The unit will also give information if you continue to breath incorrectly at the current breathing rate (inhaling more air than is being exhaled and vice versa) that you will start to hyperventilate or go hypercapnia in which case the machine will shut down as a safety precaution.  Apart from washing the device there is zero maintenance cost to it.  A Pulse Oximeter is used as part of my Spiro training to monitor blood oxygen saturation which is also vital when doing Hypercapnia workouts. 

Using it one will unlikely see any difference for some weeks. The main problem with the device is boredom, working out session which is interesting and fits in with my normal training programme.

Is it a training session?  Damn right, a average session is about 25 - 45 minutes. Sometimes after a session I am totally knackered, out of breath and my stomach muscles hurt!   Why my stomach muscles are hurting is probably because  I am using my diaphragm more than normal. The Diaphragm plays a big part in core stabilization.  So strengthening of the diaphragm with breathing training could prevent or slow the process of a athlete falling apart at the core. 

I have noticed huge differences in breathing using the SpiroTiger as part of a warm up before a race or hard training session. Yup breathing into a bag that resembles a over sized condom in front of your team mates does make one look like a plonker! But while they are lying on the floor from the last sprint session and I am already walking down the hill for the next rep who's laughing then!  Some differences I have notice both from daily use and as part of a warm up is, not gulping or gasping for air, I seem to recover (respiratory) quicker between intervals.  I don't have erratic breathing patterns in the early parts of a session and my lungs don't hurt as much anymore. A warm up may vary depending on what kind of race warm up a athlete needs respiratory wise.  One theory is a warm up of the diaphragm to give a metaboreflex reaction before the start of a race so you have pushed the respiratory rate into over drive so that when the race starts the body doesn't panic and the metaboreflex is delayed. Or you simply need to control the CO2 level, so you could go either hypercapnia or hypocapnia all dependent on your race start type. There is no specific protocol and it is very individual, I myself am still trying different variations to see what works. 

Another area that I have noticed differences compared to the past has been when training at altitude (IHT and Hypercapnia is not suported by the manufacturer, a athlete should work with a physiologist or doctor when planning to use the SpiroTiger for other than what the manufacturer recommends). With all of this there could be other factors also involved but I believe a lot has to do with how I have trained my lungs which was previously not possible. Another area I will summarise in a later blog is the use of hypercapnia for recovery which comes mainly from Russian studies.

SpiroTiger is not the solution to winning a race that will make you go from zero to hero, but it will add another tool to your training box. Keep in mind when training the respiratory system with this device that you are only training a part of the whole working system and the results are very individual. For further reading on SpiroTiger training visit the SpiroTiger FaCT, SpiroTiger Time to try harder.

Core exercises, are we sure we are activating the core?

Nearly every personal trainer, fitness advisor, coach advocates core work.  But once again do we understand what we are doing by following the trend!  We would like to think that what we are training with core exercises is the best way to activate the core muscle, and that it would improve posture, stability, balance etc. Do we understand the muscle involved when doing a core exercise?  I'm not goin to rewrite the following article as I don't think I can do it justice.  The summary is that traditional core exercises has its place for developing certain areas but a athlete can activates his core muscles more positively and directly with a simple squat, or dead lift exercise.  Here to read: rethinking-core-training-is-it-fad.

Also on FaCT Canada is a very long discussion that shifts away a bit from the above topic but from 9 post down the subject becomes of interest to the core topic and looks at it from a different angle, discussing the involvement of the diaphragm  as a major core stabilizer and follows to a interesting subject on its own on muscle activation during weight training.   (There is mention on a device called a SpiroTiger which I will discuss in a upcoming blog with my own experiences on the device which also has a effect on the core).