Breathing complaints

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To date, there has been very little attention paid to breathing in sports. This is likely due to the belief that, in healthy athletes, breathing is not the limiting factor for oxygen uptake capacity and exercise performance.

However, recent literature shows that this is not the case. In a significant portion of healthy athletes without respiratory complaints, breathing does limit both oxygen uptake capacity and exercise performance. For example, in some athletes, we observe reduced oxygen transport from the lungs to the blood vessels during intense exercise (EIAH). Additionally, narrowing of the central airways (EIB), dysfunctional breathing patterns (BPD), and closure of the vocal cords during exercise (EILO) are very common among athletes (Dempsey A.J.).

Retrain Your Breath
Dysfunctional breathing pattern during exercise (DBP) Shortness of breath during exercise Exercise-Induced Bronchoconstriction (EIB) Closure of the vocal cords (EILO) Arteriële hypoxemie (EIAH)

Dysfunctional breathing pattern during exercise (DBP)

A dysfunctional breathing pattern can also lead to excessive exhalation of carbon dioxide (CO2). A decrease in CO2 concentration in the blood causes red blood cells to retain oxygen longer, reducing oxygen availability to the muscles (Bohr effect). Besides the respiratory metabolic response, the Bohr effect has a significant negative impact on sports performance.

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Shortness of breath during exercise

What is shortness of breath?

Shortness of breath is a subjective, complex, and difficult-to-measure breathing discomfort. This experience can be unpleasant or stressful, and its intensity varies (Parshall AJRCCM 2012; Demoule ERJ 2024).

During physical exertion, a certain degree of shortness of breath is normal. The key question is whether the perceived shortness of breath is normal or abnormal and disproportionate. At rest, shortness of breath can occur in both healthy individuals and those with a lung condition. In healthy individuals, this sensation is often caused by a dysfunctional breathing pattern or hyperventilation.

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Exercise-Induced Bronchoconstriction (EIB)

Asthma and exercise-induced narrowing of the airways (EIB) is very common among high-level endurance athletes. Performing endurance sports in cold, polluted air or in warm, humid swimming pools with chronic exposure to chlorine are clear triggering factors. More than 50% of cross-country skiers report EIB or asthma.

EIB is less commonly seen in younger athletes. The first symptoms often manifest after the age of 20 or 25. The fact that elite endurance athletes ventilate a lot of air per minute can also contribute to the development of EIB.

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Closure of the vocal cords (EILO)

What is EILO?

EILO, or Exercise Induced Laryngeal Obstruction, refers to airway obstruction triggered by the adduction or closure of the vocal cords during inhalation. This condition was previously known as vocal cord dysfunction.

EILO typically manifests within 1 to 5 minutes after beginning high-intensity exercise. The symptoms resolve within 5 minutes after stopping the activity.

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Arteriële hypoxemie (EIAH)

Inspanning gebonden afname van de gasuitwisseling tussen longblaasjes en bloedvaatjes (EIAH):
EIAH draagt in belangrijke mate bij te het ontstaan van vermoeidheid in de armen en de benen en kan tot 15% bijdragen in het verlies van VO2max.

Bij 30 tot 70% van de uithoudingssporters zien we dat de zuurstofconcentratie tijdens zware inspanningen daalt.

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