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Breathing Pattern Disorders Sports

Breathing pattern disorders including chronic hyperventilation may result in additional musculoskeletal pain. The incidence of musculoskeletal injury is quite high amongst athletes with Hootman reporting that 13.79 collegiate athletes are injured per 1000 athletes during competitive season. Breathing patterns play an important role in mechanical stability and mobility of the spine and trunk. Therefore, athletes with breathing pattern disorders may experience health and musculoskeletal conditions with poorer motor control patterns. The ideal breathing pattern is driven by the diaphragm with expansion of the lower ribs.

The International Journal of Sports Physical Therapy | Volume 11, Number 6 | December 2016 | Page 971

Dysfunctional breathing patterns including chronic hyperventilation may result in additional musculoskeletal pain. The incidence of musculoskeletal injury is quite high amongst athletes with Hootman reporting that 13.79 collegiate athletes are injured per 1000 athletes during competitive season. Breathing patterns play an important role in mechanical stability and mobility of the spine and trunk. Therefore, athletes with dysfunctional breathing patterns may experience health and musculoskeletal conditions with poorer motor control patterns. The ideal breathing pattern is driven by the diaphragm with expansion of the lower ribs.

The International Journal of Sports Physical Therapy | Volume 11, Number 6 | December 2016 | Page 971

Dysfunctional breathing patterns are linked to a number of health conditions including lower back and neck pain. There is no single screen to identify dysfunctional breathing patterns, which includes biochemical, biomechanical, and psychophysiological components. The purpose of this study is to create a breathing screening tool to be used by coaches, instructors and healthcare professionals to help determine dysfunctional breathing patterns.

  • 51 subjects
  • Biochemical (ETCO2)
  • Biomechanical using Hi-Lo
  • Psychophysiological using SEBQ and Nijmegen questionnaires

5 subjects had functional breathing. 14 subjects failed at least one measure, 20 failed at least two and 12 individuals failed all 3. The researchers concluded that a breath hold time measure of 25 seconds along with answers to four questions below can be used to screen for the presence of dysfunctional breathing patterns.
The four questions are:

  • Do you feel tense?
  • Do you feel cold sensation in your hands or feet?
  • Do you notice yourself yawning?
  • Do you notice yourself breathing through your mouth at night?

If the screen is passed (BHT greater than 25 seconds and assessment of answers to questions), there is an 89% chance that dysfunctional breathing is not present.

Kiesel K, Rhodes T, Mueller J, Waninger A, Butler R. Development of a screening protocol to identify individuals with dysfunctional breathing. The International Journal of Sports Physical Therapy, Volume 12, Number 5, October 2017, Page 774.

Dysfunctional breathing patterns including hyperventilation syndrome and fast breathing produces respiratory alkalosis which results in an array of symptoms including headache, dizziness, chest pain, trouble sleeping, breathlessness, light sensitivities, exhaustion, and cramps. Athletes with abnormal breathing can experience muscle fatigue and excessive breathlessness during physical exercise.

Chapman E et al. A clinical guide to the assessment and treatment of breathing pattern disorders in the physically active: part 1. The International Journal of Sports Physical Therapy, Volume 11, Number 5, October 2016, Page 803.

Normal breathing mechanics are very important for posture and spinal stabilization. Abnormal or dysfunctional breathing patterns contribute to pain and reduced motor control, which can result in dysfunctional movement patterns. For functional movement, functional breathing is necessary. Breathing from the upper chest during rest causes a decrease in the level of arterial carbon dioxide. This increases blood pH to cause respiratory alkalosis. Respiratory alkalosis can trigger changes in physiological, psychological, and neuronal states within the body that may negatively affect health, performance, and the musculoskeletal system. Breath holding is commonly less than 20 seconds in individuals with dysfunctional breathing patterns or poor lung function. (Test your breathing using the Body Oxygen level Test BOLT)

In a study of 34 healthy men and women, over 70% had disordered results. Resting end tidal carbon dioxide were significantly different between diaphragmatic and thoracic breathers. Individuals with poor breathing patterns scored worse on the FMS (Functional Movement Screen) compared to those with normal breathing patterns. The FMS is used to help predict risk of injury in athletes. The results show a relationship between dysfunctional breathing patterns and dysfunctional movement patterns. Finally, 87.5% of individuals who passed the FMS exhibited abdominal or diaphragmatic breathing.

Bradley H, Esformes J. Breathing pattern disorders and functional Movement. The International Journal of Sports Physical Therapy, Volume 9, Number 1, February 2014.

Correction or re-education of Dysfunctional breathing patterns can result in new neural connections and restoration of normal motor control patterns in the central nervous system.

Chapman E et al. A clinical guide to the assessment and treatment of breathing pattern disorders in the physically active: part 1. The International Journal of Sports Physical Therapy, Volume 11, Number 5, October 2016, Page 803.

Breathing slowly enhances ventilation efficiency and arterial oxygenation via alveolar recruitment, and distension and reduction of alveolar dead space.

Bilo G, Revera M, Bussotti M, et al. Effects of slow deep breathing at high altitude on oxygen saturation, pulmonary and systemic hemodynamics. PloS one 2012; 7: e49074

Training aimed at a permanently slow breathing rate reduces dyspnoea and improves exercise performance.

Bernardi L, Spadacini G, Bellwon J, Hajiric R, Roskamm H, Frey AW. Effect of breathing rate on oxygen saturation and exercise performance in chronic heart failure. Lancet 1998; 351:1308±1311

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