Could rowers benefit from Inspiratory Muscle Strength Training ?

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Nomath
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Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Nomath » August 23rd, 2021, 1:55 pm

A few days ago, an interesting article was published in the Journal of the American Heart Association. It showed that 5 minutes daily of high-resistance training of the inspiratory muscles during 6 weeks lowers the systolic blood pressure of midlife/older adults by an average of 9 units (mm Hg). This result is quite spectacular, knowing that above-normal systolic blood pressures (i.e. SBP >120 mm Hg) are quite common in this age group. Hypertension is a serious cause of cardiovascular diseases and deaths. It is known that for people who suffer from hypertension a reduction of 5 mm Hg already reduces the risk of a stroke by 34%. Achieving this without medication and with only 5 minutes of daily training must be a real bounty.
The article is available in open-access on the internet https://www.ahajournals.org/doi/pdf/10. ... 121.020980

What the researchers from the University of Colorado did was to subject one group of 18 persons to a low-resistance training of inspiratory muscles and another group of 18 persons to a high-resistance training. Resistance was defined as a percentage of the maximal inspiratory pressure (MIP). Low-resistance training was done at 15% of MIP ; high-resistance training was done at 65% (2 weeks) - 75% (4 weeks) of MIP. Not many people will know their MIP, because to measure it accurately will require special equipment. However, it may help to know that for the 36 participants aged 67 ± 2 yrs, the MIP was 64 ± 5 mm Hg at the start of the study. So low-resistance was at about 10 mm Hg and high-resistance at about 50 mm Hg. Wikipedia states "Typical maximum inspiratory pressures in adult males can be estimated from the equation, MIP = 142 - (1.03 x Age) cmH2O, where age is in years". Note that 1 cm H2O equals 0.74 mm Hg.

The results after 6 weeks of training were amazing :
  • The systolic blood pressure of the HR group decreased significantly by 9 mm Hg ; the decrease of the LR-group was 3 mm Hg, which was judged insignificant by the authors
  • The decrease in systolic blood pressure for the HR group was still present 6 weeks after the daily training was stopped ; the LR group had a slight increase in SBP
  • The diameter of the brachial artery (the major blood vessel in the upper arm) had increased by 45% for the HR-group and was unchanged for the LR-group
  • Blood serum samples taken from participants before and after the 6-week period showed a significant increase in nitric oxide (NO) generating activity for the HR group and much less for the LR-group. Wikipedia : "The endothelium (inner lining) of blood vessels uses nitric oxide to signal the surrounding smooth muscle to relax, resulting in vasodilation and increasing blood flow"
The device used for the training of inspiratory muscles is an inhaler that opens when the inhaling pressure gets below a set threshold. In the study an expensive registrating inhaler PowerBreathe K3, about €400, was used. The pictures below show some more affordable inhalers, like the PowerBreathe Plus (ca. €60) and the Philips-Respironics Threshold-IMT (ca. €30).
Image

Image

Now, what could be the relevance for rowing ? The study shows that a short, daily, high-resistance breathing excercise has substantial benefits. This is not what in-vogue polarized training schedules do. They typically combine 4 days of low intensity with 1 day of high intensity. Moreover, 75% of MIP is VERY high intensity that you cannot sustain very long in combination with a high power output. So in my view the polarized training should be complimented with a few minutes of separate high-resistance IMST training. You can do it in an armchair while watching television and there is no need for a towel to soak up the sweat.


What motivated this idea is an experience in cycling. I did several cross-country tours in the Rocky Mountains on dirt roads, such as the Great Divide route. At times the gradients and the weight of body+bike+gear is such that you get to the maximum of what you can sustain in speed and power output. The choice is between power pedaling or stepping down. The discipline of controlled, forced, maximal breathing is key. This is not what you do automatically in the first days. It takes a couple of weeks before breathing and pedalling are finely tuned. I observed that the altitude gain per hour hinges on disciplined breathing.

I start with a 6-weeks HR-breathing training today, mainly to reduce my systolic blood pressure (ca. 145 mm Hg). I wonder if there are others who do special trainings for breathing capacity.
Even if a reduction in blood pressure is not a motivator, the observations in the study on the effects on arteries and the production of nitric oxide are inspiring. What was observed for the main arteries in the arm will happen in the leg arteries too.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Tsnor » August 23rd, 2021, 4:04 pm

Neat !

I wonder if most Rowers have already done the equivalent of " high-resistance training of the inspiratory muscles " just by living through 500M, 1K and 2K intervals. I did not see the training level of the people recruited to the study, other than they all already had high systolic BP. Sometimes studies of sedentary people get great results that are not possible for people with more training.

Really neat that the positive effect was additive on top of medication. ".. Participants on antihypertensive or other
prescription medications (eg, statins) were enrolled if their treatment regimen had been stable for >3 months and remained stable throughout the study.."

Glad you are trying this "..I start with a 6-weeks HR-breathing training today, mainly to reduce my systolic blood pressure (ca. 145 mm Hg)...." Hope you are on the high end of beneficial impact.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Cyclist2 » August 24th, 2021, 12:35 pm

I have a PowerBreathe. There are old threads on here that discuss it, so I decided to give it a try, seemed logical and it wouldn't hurt anything. I used it pretty regularly for quite a while, but saw no real benefits. I don't have all the specialized equipment to measure BP to that accuracy, or blood chemistry, however, so I had no empirical data. I was only going on how I felt and whether my perception of erg performance was affected. I could see no significant, if any, difference. I wasn't concerned with blood pressure effects (which I don't recall being discussed way back then) but if it helps with that, then there is one reason to use it.

I'd be interested in your results. I am back from shoulder surgery and about to start a dedicated training program (probably the Pete Plan) to try to regain months of lost fitness. If 5 minutes with the PowerBreathe would help, it's easy enough to do.
Mark Underwood. Rower first, cyclist too.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Dutch » August 24th, 2021, 1:16 pm

Sorry to be the downer here, but the fact the people are average age 67 and have been picked by a study means they are probably physically knackered anyway and even walking would benefit them and show improvement to bp.

The fact that Wikipedia is being quoted more than once here is a bit worrying if this study is to be taken seriously.

I have seen countless studies done on all sorts of old people, in their last days done in weightlifting and they can practically show what they want in a study. Any activity will show improvement they are that unfit and it rarely replicates to trained individuals.
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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by ampire » August 24th, 2021, 4:46 pm

I'm pretty skeptical because I think the respiratory system is already receiving maximum stimulus from a typical training program on the erg.
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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Cyclist2 » August 24th, 2021, 5:25 pm

ampire wrote:
August 24th, 2021, 4:46 pm
I'm pretty skeptical because I think the respiratory system is already receiving maximum stimulus from a typical training program on the erg.
As I recall, the gains quoted in sources from those long ago threads were on the order of 2%, which isn't a whole lot but still, 8 seconds over a 7 minute 2K. I agree that the muscles are already getting a hefty workout during an erg session. I think the PowerBreathe is more about "teaching" the muscles how to breathe properly; from the diaphragm, full breaths, etc. The increased efficiency may be where any improvement comes from.

Don't know, but it sure doesn't hurt anything, so go for it and see what happens, is my thought.
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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Nomath » August 24th, 2021, 5:57 pm

Tsnor wrote:
August 23rd, 2021, 4:04 pm
I wonder if most Rowers have already done the equivalent of " high-resistance training of the inspiratory muscles " just by living through 500M, 1K and 2K intervals. I did not see the training level of the people recruited to the study, other than they all already had high systolic BP.
...
The study was indeed done with aged people (avg 67 yrs) with above-normal systolic blood pressure. It showed a spectacular improvement in systolic BP after only 6 weeks of deep-breathing training. It also found effects on the main blood vessels, such as an enlarged diameter and increased production of NO, the messenger substance for the dilation of the vessels.

I am not sure that high-intensity 500m - 2K intervals on an erg have a similar effect. Remember that the participants of the study did their training almost daily. It is not common to do high-intensity sprints on the erg daily. Moreover, I made some effort to understand what 5 minutes of forced breathing at 75% of the Maximal Inspiratory Pressure (MIP) means. The equation that I found in Wikipedia, which has a linear decrease with age, appears to simplistic. The table below is taken from a paper in the Canadian Respiratory Journal (2014), which combined many previous studies of MIP. It shows that the MIP is fairly stable up to about age 40 and then declines by about 10 cm H2O over 10 years. There is also a strong difference in MIP between male and female.
Image

According to the table, at my age my MIP should be about 75. I have a Philips Threshold IMT (Inspiratory Muscle Trainer) that has a maximum setting of 41 cm H2O, so about 55% of my expected MIP. I have to say that at this setting breathing becomes much heavier than I remember from 500K sprinting on the erg. I can do 30 deep breathes at 55%, but I wonder if I could finish 30 breathes at a setting of 75% of MIP. I would probably need a week or so to get adapted to that high resistance. It not only involves the chest but also taxes the abdominal muscles. So do not underestimate the intensity of the daily IMS-training !

I clearly need a PowerBreathe device that has a wider range of settings to do the 6-weeks program. In their Plus line they have 3 models : Light, Medium and Heavy. Light has a range from 17-98 cm H2O ; Medium has a range from 23 - 186 cm H2O. Heavy goes from 29 - 274 cm H2O. For my age, Light seems perfect, but for the under-60's Medium is probably the best choice. I am not sure who is targeted by the Heavy model ; its range far exceeds human abilities.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Baraboobiker » August 24th, 2021, 6:40 pm

Wonderful post, Nomath. I also became aware of this study and purchased a Powerbreathe Plus not so much to improve my rowing but to hopefully benefit from the BP lowering effects. Too early to comment right now, as I'm sure diet and beer consumption also are important variables.

As an aside, I also read the book Breath by James Nestor and became interested in the Wim Hof breathing exercises. He is an interesting guy, having accomplished some amazing physical feats. His website has a nice protocol for breathing, cold challenge (which I really enjoy), and meditation. The book is definitely worth a read.

Thanks again for the informative post.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Tsnor » August 25th, 2021, 6:25 pm

Nomath wrote:
August 24th, 2021, 5:57 pm
... I am not sure that high-intensity 500m - 2K intervals on an erg have a similar effect...
I'm hoping you do a follow-up with your results so we can find out. Either you can get training gains in MIP using the PowerBreathe device, or you are already trained for MIP by rowing/running/etc.

What is the relationship between VO2max and Maximal Inspiratory Pressure (MIP) ? Are they correlated ? VO2max is maximum o2 you can use during exercise. That o2 has to get into your lungs somehow. Rowers have high VO2max, so rowers may have high MIP??

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by rowingdude » August 25th, 2021, 11:25 pm

Erg a 4x2k at your normal 2k + 5 pace and you won't need this contrivance.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Nomath » August 26th, 2021, 12:11 pm

Tsnor wrote:
August 25th, 2021, 6:25 pm
What is the relationship between VO2max and Maximal Inspiratory Pressure (MIP) ? Are they correlated ? VO2max is maximum o2 you can use during exercise. That o2 has to get into your lungs somehow. Rowers have high VO2max, so rowers may have high MIP??
Many questions can be answered, not perfectly but approximately, by searching the internet with a few keywords.
Here is a pertinent figure taken from a paper published in Respiratory Physiology & Neurobiology 248 (2018) 25-30
Image

I guess that the correlation is weak because MIP only measures the strength of the inspiratory muscles, whereas VO2max includes cardiovascular transport and metabolic processes. The MIP data in the graph suggest that we are dealing with many outliers in the ranges listed in my previous table. Interesting to see that runners appear to score higher on VO2max than cyclists, but if you view the participants characteristics in this study, there were also significant differences in age and body mass involved. I would say that the regression line is mathematical bogus.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Tsnor » September 11th, 2021, 3:32 pm

@Nomath: 2 week bump. Any early results? You trying it daily?

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Nomath » September 12th, 2021, 2:33 pm

Tsnor wrote:
September 11th, 2021, 3:32 pm
Any early results? You trying it daily?
I am now in week 3, but no significant results yet.

I bought a PowerBreathe Plus, model Light. The resistance pressure can be set between 17 and 98 cm H2O, in 10 steps of 8 cm, which should cover my Maximum Inspiratory Pressure. From the age table listed above, my expected MIP is 75-80 cm H2O. I started in week-1 at 49 cm, which is at about 60%. I increased the set pressure in weeks 2-3 to 57 cm. I expect to be able to increase the resistance one more step to 65 cm for weeks 4-6. I guess my true MIP is about 85 cm H2O
Doing 30 deep breathes takes about 2 mins. The daily effort (2x30) is less than 5 minutes. However, the breathing effort is much harder than anytime during a high-intensity row.

I didn't see a significant change in the systolic blood presssure yet, which is not surprising because the blood pressure is notoriously variable from day-to-day and from events all over the day. Probably only the statistics of daily measurements over a course of several weeks does show the effect of this training.

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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by johnlvs2run » September 13th, 2021, 12:18 am

Only a 9 mm change in BP is not significant. The only way to change BP in a significant healthy manner is with diet. The power breathe device is a scam. I made a similar device out of PVC and a ball valve a couple of decades ago which works great, but rarely gets any use. In addition to regular exercise, breath holding practice can be quite beneficial for increasing lung function and capacity, provided it's done the right way.
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Re: Could rowers benefit from Inspiratory Muscle Strength Training ?

Post by Tsnor » September 13th, 2021, 9:08 am

johnlvs2run wrote:
September 13th, 2021, 12:18 am
.. The only way to change BP in a significant healthy manner is with diet.
Maybe post a few references. Many sources seem to think EXERCISE can lower blood pressure. Example: Mayo clinic "How exercise can lower your blood pressure: Regular physical activity makes your heart stronger. A stronger heart can pump more blood with less effort. As a result, the force on your arteries decreases, lowering your blood pressure."
https://www.mayoclinic.org/diseases-con ... t-20045206

My take on Nomath's post is that he is checking to see if specific breathing exercises have an impact. I tend to doubt it for well trained rowers, but think it is an excellent thing to try given the study he cited. Also, hard to see any possible negative impact with the approach he's taking.

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