One of the most powerful inbuilt tools humans have is also one of the most underappreciated and underutilised.
Of course, most of us don’t have to think twice about the automatic process that occurs between 17000 and 30000 times a day, causing our diaphragm to contract, creating space for oxygen to expand our lungs. All in the space of a single breath, the oxygen is pumped through the blood around our bodies and the excess carbon dioxide is released to maintain a delicate balance.
James Fletcher is an exercise physiologist and physiotherapist who has spent the past six years working with athletes, people with respiratory illnesses and former smokers.
He recently worked with top big wave surfer, Ryan Hipwood, using breath techniques to help him calm anxiety, increase his volume of breath and hold his breath for longer while competing. Breath training has helped Hipwood become a two-time finalist at the Big Wave Awards.
Fletcher is also working with Olympic swimming sprinter Cameron McEvoy in the lead up to the 2018 Commonwealth Games.
“By making the breathing muscles stronger, we reduce their fatigability,” Fletcher explains of how such training can improve performance. “If your breathing muscles don’t become so fatigued, we see less shortness of breath which allows them to go faster and we see an increase in performance.”
Nearly 15 per cent of Australian adults smoke and it is associated with an increased risk of a wide range of health conditions, including heart disease, diabetes, stroke, cancer, renal disease, eye disease and respiratory conditions such as asthma, emphysema and bronchitis.
“The single biggest step they can in their health journey is using nicotine replacement therapy and quitting smoking,” Fletcher says.
But, even after people quit, shortness of breath is common.
Fletcher has just finished working with a group after they used Nicorette to take the first step in quitting for good.
“We looked at how they breathe, so we try to get more air into the lungs and use parts of the lungs that maybe haven’t been used in the last few years,” he says. “They have habits of short, shallow breath, not exercising and not taking their respiratory system beyond every day activities. These breathing techniques allow these patients to reduce their shortness of breath levels very quickly which enables them to do things like play with their kids again.”
How does it work exactly?
Using a pressure threshold device (the same device he uses with the athletes) they work on strengthening the inspiratory muscles.
“There’s a valve which I set at a certain pressure,” Fletcher explains. “When I turn that up, the pressure to open that valve becomes higher. So if the patient breathes in and they’re not very strong, the valve won’t open so I’ll know they’re not at that strength level. I’ll turn it down and when it opens I’ll know this is where the patient is regarding their inspiratory muscle strength,” Fletcher explains. “These patients are used to taking these short, shallow, sucking motion breaths like sucking on a cigarette and we change that and put a load on the breath and say this is how you should breathe.”
As their muscles strengthen, he adds more ‘weight’.
The strength of these muscles has a “direct result” in reducing shortness of breath and, interestingly, anxiety.
“People get really anxious at quitting smoking and some of the techniques look at reducing anxiety and give them control of their breath,” he says. “[With anxiety] the chest becomes tight and it becomes harder to breathe. If these guys have got a stronger diaphragm and a stronger respiratory system then they can overcome that tightness.”
During their ‘training’ patients also work with their volume of breath – how much oxygen they can take in, by using a “one-two technique”.
“However long it takes you to breathe in, it’s double the breathe out,” Fletcher says. “A common one is 5 and 10 technique – so five seconds to breathe in and 10 seconds to breathe out with proprioceptive feedback, so your hands on your belly and breathing into the hands.”
We do not all necessarily need to exercise our breath, unless we have specific goals, but breath techniques, like the “one-two” are tools any of us can use to calm anxiety, self-soothe, breathe better and enhance our sporting performance.
“Shortness of breath does limit us,” Fletcher says. “Less than five minutes of training a day can make a big difference.”