Breath To Win- Enhancing Respiratory Muscle Strength And Endurance

In an depth guide to training athletes with pulmonary (respiratory) limitations

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This newsletter is part two of a three part series. If you haven’t already checked out Understanding Bioenergetic Limitations and Enhancing Oxygen Delivery For Maximal Performance I recommend you read those before continuing here.

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🧬 How Do You Improve An Athlete’s Breathing?

As with training delivery limited athletes, we can also sub-categorize respiratory limited athletes training into a handful of classifications including foundations, tier one energy system training interventions, and tier two energy system training interventions. 

When I think about the foundations for improving a respiratory limited athlete's performance, the first thing that comes to mind is structural foundations. The reason when anatomy and physiology are traditionally paired together in higher education curricula is that anatomical structures dictate physiological functions. The four primary structural points I’m concerned with for respiratory limited athletes are the position of the pelvis, the position of the thoracic spine, the orientation of the ribcage, and the width of the infrasternal angle of the ribcage.

Addressing the aforementioned structural foundations need not be overly complicated and there are plenty of resources for navigating this area. However, we do need to consider the fact that there is a ‘chicken or egg’ relationship between said structural limitations and respiratory muscle strength. For example, some athletes who are stuck in thoracic extension may be in that position because they have an expiratory muscle strength limitation. In these cases they present with a hyperinflation pattern, which is a state of excess inhalation with inadequate exhalation. This hyperinflated pattern can be asymmetric or symmetric. In the former scenario it’s common for the left side of the rib-cage to be more flared out than the right side, whereas in the latter scenario both sides of the rib cage are flared out. This is a case where function, specifically strength, impacts structure. On the other hand, we can have a scenario where structure impacts functions, which is the case when a kyphotic athlete presents with an inspiratory muscle weakness. 

After addressing the aforementioned foundational structures, I start to think about how these structures move as well as the capacity of these structures. Collectively, this compromises the structural foundations for respiratory limited athletes. These functional foundations include the strength of inspiratory and expiratory muscles including the diaphragm, external obliques, and abdominal muscles. These functional foundations alone include the fatigue resistance of the respiratory muscles, breathing coordination, as well as the ability to  breath with an optimal depth and frequency in sport specific movement patterns and scenarios. 

Once these structural and functional prerequisites are met a respiratory limited athlete can begin redistributing their training volume to spend more time on tier one and tier two energy system training interventions.  These include methodologies intended to elicit the following adaptations: improved capacity and efficiency of the cardiopulmonary system, improved respiratory muscle strength and endurance, increased VO2max, and increased output at one’s maximum metabolic steady state. 

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🧬 Basic Training Interventions For Respiratory Limited Athletes

The tier one energy system training interventions for respiratory limited athletes can collectively be bucketed together and referred to as balanced delivery and utilization training. In this subsection I am going to lay out general guidelines for balanced delivery and utilization training categories, which include B1 and B2 training respectively.

Classically B1 and B2 training would be referred to as threshold and VO2max style training and would fall under the umbrella of functional endurance training or maximal aerobic endurance training because these categories comprise the highest intensities that can elicited before oxygen utilization begins to outstrip oxygen supply. 

Any time we discuss compartmentalized energy system training categories we are really drawing proverbial lines in the sand. In truth, these different categories lie on different areas of the spectrum between very low intensities when we are delivering oxygen at a much faster rate than it is utilized up to very high intensities where oxygen utilization greatly supersedes oxygen supply. Practically, B1 and B2 training fall somewhere in the middle of this spectrum where oxygen delivery and utilization are closely matched to one another. The difference between said categories is that B2 training is done at the highest output that can be achieved before oxygen utilization begins to outstrio oxygen supply whereas B1 training is done at a slightly lower intensity than that.

Traditionally B1 training is referred to as threshold training. The purpose of B1 training is to decrease the amount of lactate that accumulates above baseline concentrations while working at moderate to high intensities, increase the rate of lactate transport and consumption, as well as increase an individual's power output that can be sustained before they begin to utilize oxygen at a faster rate than it can be supplied to the skeletal muscle. Typically athletes whose sports require them to operate above or near their critical power for an extended period of time, whether that is in one continuous effort or multiple repeated efforts, can benefit from B1 training. This includes field sport athletes, middle to long distance endurance athletes, and mixed sport athletes like Crossfit competitors. My guidelines for performing B1 training are as follows:

1. B1 training is best completed in an interval format using roughly forty second to ten minute long intervals and resting between one fourth as long as the interval duration upto the same length as the interval duration. However, B1 training can also be performed in a continuous format with work bouts lasting between ten to forty five minutes. 

2. Performed at high, but tolerable, intensities. This style of training is hard, but should be sustainable for extended durations. For individuals recording biometric data we should expect to see heart rate values between ~85-90% of an individual's maximum heart rate, small to moderate blood lactate accumulation above baseline concentrations, and muscle oxygen saturation levels stabilized between roughly thirty to forty percent. For those without biometric data, B1 training should be done at ~85-90% effort and if asked an athlete should be able to speak three to four words without gasping for breath afterwards.

3. B1 training is much more demanding than any of the basic delivery training categories, and as a result roughly forty eight hours are needed for optimal recovery between B1 training sessions.

4. As with D3 training, B1 training can be performed equally well using both cyclical and mixed modalities. However, this assumes an individual can maintain a high cycle rate and turnover while employing mixed movements and that they can tolerate high contraction volumes of these movements without accruing meaningful muscle damage. The majority of global movements can elicit an appropriate training response during B1 sessions, but the loads will need to be scaled appropriately to ensure that local tissues are not overloaded. Regional movements, like kipping pull ups or push presses, can also be used during B1 training sessions as long as they are combined with a cyclic modality to ensure local muscular endurance limitations do not occur. 

Sample B1 Training Sessions

Additional considerations when prescribing B1 training for athletes are as follows:

1. The goal is B1 training to increase the power output or pace that an athlete can sustain before their oxygen demand supersedes their oxygen supply. Many athletes will have a tendency to push this type of training too hard to the extent that they ‘spillover’ into an unsustainable intensity domain. As a result, monitoring biometric data can be extremely useful for helping athletes regulate their work rates.

2. As athletes become more advanced, and accustomed to this form of work, you can decrease the rest times below ½ their work time to further challenge their ability to match their rate of lactate transport and consumption with lactate production. Elite swimmers are able to perform thirty to sixty minute B1 training sessions with no more than twenty second rest periods interspersed throughout the workout.

3. The amount of fatigue generated per unit of stimulus for B1 training is quite high, and as a result this style of training needs to be used sparingly. Additionally, this form of training has a tendency to lower active muscle tension, so it must be implemented in a strategic manner when working with mixed sport athletes who are not only trying to train their energetic limiters, but are also required to perform resistance training throughout the training week.

The second, and final, tier one training category for respiratory limited athletes is B2 training, which is often referred to as maximal aerobic endurance training or VO2max style training. This type of training can be utilized for a wide range of athletes including track and field competitors, field sport athletes, mixed martial artists, and crossfit competitors. In fact, this training quality will be one of the primary ceilings for performance in 1,600m to 5,000m running specialists as well as open level Crossfit athletes. My guidelines for performing B2 training are as follows:

1. B2 training is best done in an interval format with set durations lasting between thirty seconds to ten minutes. The rest intervals between intervals should be complete, and approximately matched to the previous sets work time. 

2. B2 training should be done at a very high, to near maximal, intensity for the interval duration. This style of training is very challenging, and uncomfortable to sustain for the interval duration.  For individuals recording biometric data we should expect to see heart rate values between ~90-95% of an individual's maximum heart rate, moderate blood lactate accumulation above baseline concentrations later into the workout, and muscle oxygen saturation levels stabilized between roughly twenty to forty percent. For those without biometric data, B1 training should be done at ~90-95% effort and if asked an athlete should be able to speak two to three words without gasping for breath afterwards.

3. While B2 training is not performed at a maximal effort, it is quite taxing on athletes both physically and mentally. As a result, it is advised that athletes do not complete this form of training more than once every seventy two hours. However, there are times of the year when this may not be avoidable as is the case during a pre competition phase for a Crossfit athlete or during championship racing season for a middle distance training and field competitor.

4. ​B2 training is most effective when performed in a cyclical modality, however advanced athletes may be able to combine cyclical and mixed elements effectively and still get the appropriate training response. Most global movements can elicit an appropriate training response as long as an athlete can maintain a very movement cycle rate with a high relative power output. If the load gets too heavy or if an athlete is forced to rest due to a local muscular endurance limitation then the relative intensity will drop too low to be effective.

Sample B2 Training Sessions

Additional considerations when prescribing B2 training for athletes are as follows:

1. This style of training is extremely potent. Most athletes will see benefits from 1-2 exposure per week at most, and this style of training should not be performed year round.

2. Rest intervals should be held close to 1:1 or 2:1 work to rest. It’s important to rest enough such that power output can be sustained from set to set without meaningful deterioration.

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🧬 Advanced Training Interventions For Respiratory Limited Athletes