Respiratory dysfunction in Swimmers
…It’s bubble, bubble, breath, right…?
Competitive swimming training and racing places a huge demand on the respiratory system to deliver oxygen to the blood so it can be transported to the working muscles, and to remove carbon dioxide waste from our lungs at a rate that allows us to perform competitively.
Even though you may not notice it, you do spend energy on breathing when you’re swimming, and you will spend more energy on breathing when you are under physical load, stress or fatigue. This is because more breathing muscles are required to work to help inflate and deflate your lungs at the rate and volume that is required for you to work hard.
The main factors that influence how much energy you spend on breathing during exercise are:
- How hard you are exercising
- How efficient your breathing is
The efficiency of your breathing can be influenced by:
- Your pattern of respiratory muscle use while swimming
- How stiff you are around your ribs and thoracic spine
- Your breathing pattern and habits while swimming
The respiratory muscles are divided into primary and accessory muscles:
- Primary muscles of breathing:
- Diaphragm (muscle under your lungs)
- Intercostals (muscles between the ribs)
- Accessory muscles of breathing:
- Sternomastoid & scalenes (neck muscles)
- Pectorals (chest muscles)
- Latissimus dorsi & Serratus anterior (shoulder muscles)
- Abdominals & Quadratus lumborum (core muscles)
Resting (Quiet) breathing:
Breathing at rest is called quiet breathing. It is the most efficient pattern of breathing and it occurs involuntarily (controlled by your brainstem). Your diaphragm is the muscle responsible for the inflation of your lungs when it contracts, before a passive expiration occurs by the elastic recoil of the rib cage and diaphragm.
Breathing while swimming:
When you need to increase the rate and depth of your breathing to keep up with the demands of exercise such as swimming, the accessory muscles of breathing need to start working with the diaphragm to help inflate and deflate the lungs by pulling the ribs up and out (inspiration) or down and in (expiration). These muscles are less efficient than the diaphragm and result in a higher energy cost of breathing.
[flat_box icon=”icon-lamp” background=”” image=”” title=”” link=”” target=”” animate=””]The unfortunate thing for swimmers, is that the accessory muscles of breathing are also the muscles that are required to swim, and stabilize your body position!
So, you are trying to use the same muscles, for two different purposes, at the same time![/flat_box]
This means that the accessory muscles of breathing are under a lot of stress in swimming.
Many swimmers suffer a combination of respiratory muscle overload plus thoracic stiffness, causing them to become over-reliant on the upper chest component of breathing, with overuse of the upper trapezius and scalene muscles. This can often be the cause of musculoskeletal discomfort, pain or injury around the neck, shoulders or thoracic region, as well as increased fatigue and poor performance.
Improving a swimmer’s breathing mechanics to increase diaphragm activity, increase thoracic mobility and reduce accessory muscle use (tension/spasm in and around the shoulder and neck muscles) has been shown to be effective in reducing respiratory stress and improving performance in swimmers.
Therefore, it is important for coaches and their swimming athletes to understand how to breathe efficiently during training and racing, to minimise the amount of energy spent on breathing.
Breath stacking in swimming occurs when a swimmer does not exhale adequately before taking another breath in, resulting in a residual volume of air staying in the lungs. This is common in cases where the swimmer utilizes an upper chest pattern of breathing because of over-reliance on the accessory muscles, thoracic stiffness and reduced diaphragm use.
When breath stacking occurs, the swimmer does not refresh their entire lung volume, effectively starving the working muscles of fresh oxygen. They may try to compensate through increased respiratory rate, but ultimately breath stacking results in poor performance and accessory muscle stress.
Other things to consider: Breathing dysfunction and respiratory illness in swimmers
Obstructed airways can lead to altered breathing patterns, with an increased tendency to mouth breathe, particularly during sleep. This leads to the swimmer inhaling dry, unfiltered air which may be one cause of reported increased upper respiratory tract infection rates.
Swimmers should be encouraged to utilize nasal breathing at rest and for exhalation during swim training in order to maintain a clear nasal passage and reduce the frequency of mouth breathing.
Inspiratory muscle training:
There are products available that help to improve the strength and endurance of your accessory muscles of breathing, and they have been shown to improve swimming performance. These products provide a measurable resistance to inspiration, forcing the respiratory muscles to work hard to achieve inspiration. The dosage is usually 2×30 breaths performed twice daily at the maximum resistance that can be performed well. It is generally recommended that athletes should consolidate good breathing function before undertaking inspiratory muscle training.
Tips for improving breathing efficiency in swimming:
Know your breathing habits – Be able to answer the following:
How many strokes do you take before you breathe in each of your events and during training? How consistent is this number?
Do you hold your breath when your face is in the water, or exhale?
Do you exhale through your nose or mouth when your face is in the water?
At rest and during sleep do you breathe through your nose or mouth?
Practice using your diaphragm to breathe – first at rest, then during dryland exercise, then during swimming. Your Physiotherapist can teach you how.
Use a regular breathing pattern (get into a rhythm).
Don’t hold your breath during free-swim unless you are sprinting 50m or less.
Use consistent, controlled exhalation, primarily out of the nose, when your face in the water (called ‘trickle breathing’).
Exhale adequately before your next breath (avoid breath stacking).
Practice diaphragmatic breathing during rest intervals. Breathe through your nose where possible.
Maintain good thoracic and rib mobility to minimize resistance to thoracic cage breathing motion.
How can Physiotherapists help you breathe better?
Physiotherapists are experts in movement. We can:
Assess your thoracic and rib cage mobility to determine if you have enough mobility to breathe efficiently
Assess your breathing strategies and pattern of muscle use and correct dysfunctional breathing patterns by teaching you how to breathe correctly at rest and while exercising
Prescribe exercises to train your breathing muscles for performance under pressure