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Respiration Management and Running Performance

– Derek M. Hansen –

As a running coach and conditioning consultant, I get many requests each week to work with different athletes. I do my best to accommodate most of these requests, referring the odd one to other colleagues where appropriate. One of the most recent requests, however, involved a unique problem. It was the parents of a young female athlete that was having significant difficulty preparing for and performing an endurance running test for her sport (an outdoor field sport). The test is commonly known as the “Beep” test or Leger test, involving increasingly faster shuttles over 20 meters. Athletes achieve specific levels within the Beep test, which can involve well over 10 minutes of constant shuttles. This particular athlete needed to achieve Level 10.5 in order to satisfy the testing requirement for her team.

The issue, however, was that this athlete was experiencing chest pains during the upper levels of the Beep test. When I was told about the chest pains, I thought that perhaps this problem was outside of the scope of my professional experience. They wanted me to create a workout plan for her and I was more concerned that I was going to only exacerbate the problem. My last CPR recertification was almost two years ago and I didn’t want to have to fly into action during a workout with a teenage athlete. Worst-case scenario thoughts were flying through my head and I wanted to dissuade the parents from pursuing a “workout” solution.

Through further discussions with the athlete’s parents, it was determined that the necessary specialists had been previously consulted (i.e. cardiologists and respirologists) and all of them concluded that there were no physiological problems and there would be minimal risks associated with continuing with an intensive training program. There were no allergies or asthma diagnosed, and use of inhalers and other medication resulted in no improvements. So what could it be?

A conversation with a soccer coach colleague provided me with greater insight into the possible cause. According to her, she has seen more and more cases of athlete anxiety – particularly among females – that have directly impacted their performance and well-being. She attributed the anxiety to the higher expectations and greater pressure athletes are putting on themselves these days. She confessed that she had been witness to athlete “melt-downs” and nervous breakdowns over issues that were never a problem in the past. Could this current case be an example of “exercise induced anxiety” I wondered to myself?

I agreed to meet with the family and go over some possible options for the athlete. My first plan was to simply assess the athlete by having her run some very simple workouts and observe her in action. I brought my video camera as well as my heart rate monitor. The video camera would help me document key issues with regard to her running mechanics, while the heart rate monitor would allow us to document how hard the athlete was working throughout the workout. This particular heart rate monitor (Suunto T6C) recorded the heart rate information to be later analyzed on my computer via USB connection. It also gave us instant feedback on her heart rate throughout the workout.

I had her run some 400m intervals on a running track at a moderate pace. I gave her three-minute breaks between runs and by the third repetition she was exhausted. The one thing that I picked up on when talking to her after the runs was that she felt like her breathing was forced at the 120-meter mark of the run. At the pace she was running, I thought that maybe she would feel something about 200-250 meters into the run. The fact that she felt significant respiratory stress early in the run led me to believe something was up.

Analysis of her running mechanics revealed that she used her arms in a tight, cradled, cross-body swinging motion. It looked like she was carrying a baby in her arms while running. Such arm mechanics would only exacerbate any existing breathing problems with her shoulders and neck tightening, thereby leading to restrictions in the upper torso. However, this alone could not be the reason for her level of respiratory distress.

We then began to run a series of 100m and 200m intervals at about 70 percent of top velocity on the grass soccer field with me running alongside her. As we got into the latter stages of each run, I would notice her breathing rhythm would shorten and she would be almost be gasping for breaths. It was as though she didn’t know how to breathe properly. At that moment I realized that she needed lessons in how to breathe, particularly during periods of physical exertion.

I quickly fell back on my knowledge of breathing exercises as it relates to battle situations. One of my past clients, Academy Award winning actor, Benicio Del Toro, was kind enough to pass on to me a number of books by author David Grossman including “On Combat” and “On Killing”. In “On Combat”, Grossman covers the topic of “battle breathing” taught to police officers and emergency response team members to deal with the stress of deadly force encounters. Grossman would teach individuals to gradually draw a breath in through their nose over a four second period, hold it in their abdomen for four seconds, then slowly blow the breath out their mouth over four seconds. This would be performed over a period of time in order to stimulate a parasympathetic response (“rest and digest”) in their autonomic nervous system.


I instructed my female athlete to perform the “battle breathing” method during her recovery periods between runs (i.e. 4 seconds in, 4 seconds hold, 4 seconds out). During the runs themselves, I would instruct her to simply perform a three second inspiration and a three second expiration to manage her breathing. Later in the day when I reviewed her heart rate data throughout the workout, the results were quite dramatic. Before we implemented the breathing management guidelines, her heart rate easily jumped up to 180 beats per minute (bpm) or higher during runs. Additionally, between runs her heart rate would not drop below 135 bpm. Once we implemented the breathing management guidelines, her working heart rate did not rise above 170 bpm for the same running pace and during her recovery periods, her heart rate dropped to as low as 110-115 bpm.

Once I had the opportunity to review all of the heart rate data and the video of her running mechanics, I then provided the athlete with some recommendations for her training as follows:

Practice your breathing exercises on a daily basis to help develop relaxed, efficient breathing patterns for both everyday activities and exercise. The 4+4+4 breathing pattern will teach you to take advantage of full inspiration and expiration without rushing your breaths. When exercising, resist the temptation to take more breaths of shorter duration. Trust that longer, more relaxed breaths will be more than adequate to fuel your body.

Purchase an affordable heart rate monitor to allow for biofeedback training during workouts and recovery periods. Being aware of your working and recovering heart rates during exercise will assist you when implementing your breathing exercises. Because you are in the process of getting back into shape, ensuring that you are not over-exerting yourself and triggering any anxiety during exercise will be critical. Initially, maintaining your heart rate below 160 bpm during interval training will ensure that you are in a safe zone. As you get more accustomed to higher intensity training and more efficient breathing patterns, bringing your heart rate above 170 bpm for short periods of time will be much more tolerable. Once you see you can work at these higher heart rate zones without breathing restrictions, your confidence will build.

When performing your running intervals, as well as your running drills, ensure that your shoulders are relaxed and your arms track smoothly forward and back, as opposed to across your body. Practice easy arm swings in front of a mirror so that you are aware of proper swing mechanics and good shoulder position. During a workout, practice or game, periodically shrug your shoulders ups, then drop them down so that you are aware of the down and relaxed position.

Stay hydrated and drink water or a diluted sport drink regularly to ensure that your throat does not get dry and irritated during workouts and games. Any irritation in the throat can lead to respiratory distress and tightening of the neck and chest.

After I provided these guidelines and we ran a few workouts together, I could see that the athlete and her family were relieved that an appropriate solution was made available to them. For the past few months, they thought that she was experience anything from allergies to a heart condition. I then provided them with a basic interval training program that progressively built her fitness, without excessively stressing her cardio-respiratory system. She has had significantly less respiratory distress and is finally getting back into full game shape. More importantly, she is regaining her confidence in her athletic ability.

After going through this process, it made me wonder if other athletes and recreational fitness participants could be going through similar problems. It seems that more and more individuals are being diagnosed with asthma and respiratory issues. While many experts point to the environment as the main cause of these breathing problems, I often wonder if for many individuals that this is a self-fulfilling prophecy. Stress and anxiety are at all-time highs for society, particularly amongst our youth. I have recently acquired many books on the art of meditation – a practice that heavily relies on the execution of “mindful” breathing habits. Perhaps like the art of running, we need to take a few steps back and spend more time teaching our youth the fundamental mechanics of life. Breathing, eating, sleeping, listening and running all seem like activities that should be carried out easily and automatically, but they are all areas where we could use more attention and direction.





  1. Interesting case, Derek.

    As an avid “meditator” I can’t say enough for the enormous benefits of sitting and watching the breath for as little as 15 minutes a day. It can help to decrease heart rate, lower blood pressure, lengthen attention span, and slow down the mind, which otherwise burns like a raging fire for roughly 16 hours a day, among other benefits. The health benefits alone are reason enough to try meditating or yoga, not to mention deeper benefits of sitting for much longer periods of time.

    It’s good to hear the athlete is gaining confidence in her athletic ability; that will help on and off the field of play.


  2. Yes, I have had to rely on breathing exercises more and more as I get older. When my two young kids are having melt-downs, the “battle breathing” helps me hold it together. Even when I feel run-down and perhaps sickness is imminent, I’ll spend more time working on relaxed breathing and I seem to pull through it unscathed. It definitely makes a difference to my Heart Rate Variability readings, where I can move closer to the parasympathetic zone.

  3. Nice article, Derek.

    This topic seems to have gained considerable interest recently in the blogosphere.

    Have you read “Anatomy of Breathing” by Calais-Germain? Great book and wonderfully illustrated (as are all of her books).

    Proper breathing is indeed important but, conversely, have you looked into inspiratory muscle training (IMT) as a method to increase tolerance to the discomfort of very high respiratory rates? I’ve used the PowerLung and have noticed my perception of effort to be greatly diminished during my sprint and rowing intervals.

    Anyway, keep up the great work.


  4. Derek, what a great article on such an important but not very popular topic! People take for granted their breathing habits and rarely even consider that the way your breath could affect performance so much.

    I spend quite a bit of time observing the breathing patterns of a new client, and it so obvious the connection between anxiety, pain, general thoracic and neck stifness, and the lack of a deep, healthy breath cycle.

    The short, upper chest breathing pattern is so typical these days, even in high-level athletes, that is practically an epidemic. Getting people to learn how to get out of the sympathetic or “fight or flight’ style of breathing and back towards the parasympathetic (or “relax and restore”) mode is one of the best things fitness and sport coaches could do for their clients/athletes..

    Keats Snideman

  5. Hi Steve.

    Thanks for the feedback. I’ve looked at some of the Intermittent Hypoxic Training devices over the last year with some interest. Obviously the cost is still pretty high. For specific cases like the one I documented in my article, perhaps the PowerLung is a good short-term option for building tolerance as you say. Thanks for the heads up!

    Have you had any direct experience with the Intermittent Hypoxic systems on the market – such as GO2Altitude or AltoLab?

    I know the topic has been covered a good deal recently. My concern would be that people may not look for the simple solution, but rather look at more expensive and complex solutions that could do more harm than good. On the positive side, at least the internet allows us to share case-by-case experiences and uncover what works and what doesn’t.

    Best regards!


  6. Hi Keats,

    Funny you should say… I just viewed a great presentation on http://www.Ted.com. It was by Behavioral economist Dan Ariely, the author of Predictably Irrational. He uses classic visual illusions and his own counterintuitive research findings to show how we’re not as rational as we think when we make decisions. The link is at:


    I thought it was a great presentation because it shows how we can see obvious solutions right in front of us, but then behave irrationally and not remember these solutions in future decision making. I believe this directly applies with things like breathing, diet and other human behaviors. We know what the answer is (or what the correct behavior should be – like focusing on proper breathing habits) but we still behave irrationally.

    Best regards,


  7. No, no experience with intermittent hypoxic systems. Way out of my budget.

    By the way, I’m “following” you now on Twitter. I hope you can find time to tweet more often. I find your information and insight extremely valuable. Speaking of which, I am about to re-watch your “Forty Yard Dash Fundamentals” DVD. Seeing if I can salvage a little bit of speed before I get too old. Thanks Derek.


  8. Steve,

    I’ll get on the twitter thing right away. I’m always witness to bizarre issues with regard to training (as well as a lot of good stuff that I see) that I can’t write a full article on, but would like to put the word out.

    Talk soon,


  9. Just found this. Shane will like it.

    Diaphragmatic Breathing Reduces Exercise-induced Oxidative Stress.
    Martarelli D, Cocchioni M, Scuri S, Pompei P.
    Evid Based Complement Alternat Med. 2009 Oct 29. [Epub ahead of print]

    Diaphragmatic breathing is relaxing and therapeutic, reduces stress, and is a fundamental procedure of Pranayama Yoga, Zen, transcendental meditation and other meditation practices. Analysis of oxidative stress levels in people who meditate indicated that meditation correlates with lower oxidative stress levels, lower cortisol levels and higher melatonin levels. It is known that cortisol inhibits enzymes responsible for the antioxidant activity of cells and that melatonin is a strong antioxidant; therefore, in this study, we investigated the effects of diaphragmatic breathing on exercise-induced oxidative stress and the putative role of cortisol and melatonin hormones in this stress pathway. We monitored 16 athletes during an exhaustive training session. After the exercise, athletes were divided in two equivalent groups of eight subjects. Subjects of the studied group spent 1 h relaxing performing diaphragmatic breathing and concentrating on their breath in a quiet place. The other eight subjects, representing the control group, spent the same time sitting in an equivalent quite place. Results demonstrate that relaxation induced by diaphragmatic breathing increases the antioxidant defense status in athletes after exhaustive exercise. These effects correlate with the concomitant decrease in cortisol and the increase in melatonin. The consequence is a lower level of oxidative stress, which suggests that an appropriate diaphragmatic breathing could protect athletes from long-term adverse effects of free radicals.

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