Preface

Back in 2008 before a career change led me to become a personal trainer, teach Chi Running and Oxygen Advantage Breathing technique, I worked with Robin McNelis. Robin is the running coach who first introduced me to total nasal breathing. At the time I was putting together a blog on ‘natural running’. I’ve just re-read an article Robin wrote for this blog and thought it would be a great idea to share this again.

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Many people over-breathe when they run, either deliberately as they wrongly think it will give them an advantage, or unintentionally due to the multiple trigger factors that come along during heavy exertion. A normal breathing pattern is an essential foundation to achieving your running potential yet many people do not even breathe properly at rest, so they have little chance of succeeding during their training or races.

Most people don’t think about breathing, it’s just something they do naturally to stay alive and yet an inefficient breathing pattern leads to an inefficient body. Breathing is a sub-conscious activity that we have an element of control over so it is possible to retrain your body and to “breathe easy”. Often people are not aware that they have a problem with their breathing and yet some surveys show that about 40% of us are breathing incorrectly at any given time for a variety of reasons.

Poor breathing techniques divide into two broad categories which can often co-exist:

  • Hyperventilation literally means that someone is breathing more than they physically require. It can be acute or chronic (long-lasting and ongoing) and is often subtle rather than the panic attack type of situation that hyperventilation is usually associated with. It results in a lowering of carbon dioxide levels within the body, which alters the acidity of the body making it work less efficiently and producing some horrible symptoms.
  • Dysfunctional breathing covers problems where there is an issue with the mechanics of breathing without an accompanying lowering of carbon dioxide. It often comes down to breathing with the wrong muscles and ventilating the wrong parts of the lungs.

During heavy exertion, runners are exposed to many factors that will increase their desire to breathe and of course it is completely natural that breathing should increase during any form of exercise. The problem occurs when the lungs are ventilated at a higher level than is appropriate for that level of exertion. This can occur due to a poor breathing pattern at rest, meaning the individual is closer to maximal breathing at their exercise start point or can occur purely during heavy exertion due to factors that come into play transiently. Often it is not one factor that causes the breathing issue but multiple triggers, one of which may be the obvious one that tips individuals over the edge and causes symptoms for the first or subsequent occurrences.

Common factors that can cause the various types of breathing dysfunction can be grouped into three broad categories to cover the hundreds of potential triggers that affect different people in different ways:

  • Physical, e.g. pain, asthma, foods, medications, caffeine, unstable blood sugars, temperature
  • Emotional, e.g. anxiety, stress, fear, depression, frustration
  • Mental, unhelpful and often inaccurate thought processes as to what is happening and why

The trigger factors combine to form a stimulus that makes the individual lose control of their breathing and produce symptoms that are often not obviously attributable to the breathing.

Common symptoms include:

  • Shortness of breath, unreasonably fast breathing, unable to take a deep breath
  • Unexplained high heart rate, chest pain, tightness across the chest, regular sighing
  • Visual disturbance, confusion/disorientation, numbness/tingling, mouth tightness
  • Feeling faint or dizzy, stomach bloating, cramping/muscle stiffness
  • Anxiety, feeling tense or wound up, unusually cold hands/feet

Obviously many changes occur to your body during exercise as a normal, natural reaction but it is when these reactions are disproportionate to the level of exertion that a problem may be occurring. Although these symptoms are common to many health problems, if you have several of these without a diagnosed medical condition then you should consider breathing retraining. Indeed, even if you do have a medical condition like asthma and are having many of these symptoms, the British Thoracic Society recommends that a visit to a Respiratory Physiotherapist is part of the optimisation of your treatment.

If you think you may have some breathing problems then it is worth taking the Nijmegen Questionnaire which is a useful screening tool that the above symptoms are taken from. A score of above 23 is positive for hyperventilation syndrome but scoring highly in other areas with no reasonable explanation can also indicate there is a problem.

So how can things improve?

The first step to improvement is identifying the nature of your problem after excluding any underlying health problem. Although self-analysis is possible, it is often more accurate to have a breathing assessment carried out by a Respiratory Physiotherapist, who should also be able to help you to identify any triggers that could be managed better or excluded. Understanding what is happening to your body is a key element to regaining control of the problem.

Once this process has identified what the source of the problem is, breathing retraining should be performed regularly at rest in a supported position, preferably lying flat to begin with.

Normal, relaxed breathing at rest should consist of:

  • Nose breathing rather than breathing through the mouth
  • Relaxed breathing should be quiet rather than noisy
  • The shoulders and upper chest should be relaxed and barely move
  • The diaphragm and lower intercostal muscles should be doing the work meaning that the abdomen swells by 1- 2” during inspiration
  • Expiration should be relaxed and effortless
  • Breathing should be in a smooth, equal rhythm and at a rate of about 12 breaths per minute
  • Emphasis should be on slow rather than deep breathing

Remember, this is breathing at rest in a relaxed position and your breathing will change if you are exercising, under stress or excited. Although this seems a fairly basic thing to practice when all you want to do is go out and run faster or further, it will give you a good breathing foundation to work from and mean that your breathing should be better controlled during running, with your body performing more efficiently and you will be able to regain your breath quicker and easier.

When running it is easy to over-analyse your breathing and try to breathe the same way as you perfected at rest, which is not appropriate as breathing should increase as there is an increase the level of exertion. The key element is focusing on maintaining control of breathing. If you are doing an aerobic run i.e. not a speed or hills session, you may find breathing in and out through your nose a useful technique, although be warned that it may slow you down a little at first and it’s a good idea to take some tissues with you as your nose will tend to run a lot. Nose breathing technique will limit you to running at the top level of your aerobic zone which is about 80% of your maximum heart rate and the most efficient level to do most of your training at for distance running.

One other common problem is that of hyperinflation which is due to too much air being trapped in your lungs and prevents you from taking in as much air as you would like or need. This is caused by an overpowering desire to breathe making you breathe in again before you have fully exhaled the previous breath. This is not a problem over one or two breathes but when it is repeated 25 or 30 times in a minute, a discrepancy of 100mls per breath can lead to a hyper-inflation of 3 litres, making breathing very difficult and causing the loss of breathing control and a panic reaction.

To help overcome this problem it is important to practice breathing control at rest and lower levels of training before trying to employ techniques at higher intensities. It is common for some runners to try to combat this problem by making sure they exhale fully once every minute whilst maintaining breath control to the best of their abilities the rest of the time.

As you can now tell, breathing is a little more complex than moving air in and out of your lungs any old way. There are multiple influences on breathing and this often means people get into bad habits which lead to inefficiency, underperformance and occasionally ill-health. With the identification of the nature of the dysfunction, trigger modification and breathing retraining, health, performance and enjoyment of exercise can improve greatly.

Robin McNelis
Respiratory Physiotherapist and England Athletics Running Coach
twitter @runrobinrun73