The first assumption that most people, including doctors, make, when someone complains of breathlessness during exertion is- heart or lungs.

I’m talking about breathlessness that has always been there. When you’re huffing and puffing your way up a flight of stairs. Or if you need to take a big breath occasionally because you feel like you’re getting enough air. A feeling of tightness around your upper chest and neck that you’ve had for a long time and no one has been able to explain.

A sudden onset, uncharacteristic episode of breathlessness, needs to looked at seriously. It might well be cardiac or lung related. *But* breathlessness the way I’ve described in the above paragraph, which has been investigated and never been fixed satisfactorily, might be just a lack of conditioning.

The lack of conditioning can be
1. A lack of respiratory muscle strength and endurance
2. A lack of skeletal muscle strength and endurance
3. Faulty usage of the respiratory muscles
4. Over breathing
5. An over sensitivity to carbon dioxide levels

Lack of respiratory muscle conditioning
A body that is unused to breathing hard, will set the alarm bells ringing at the first sign of effort. And, in the fear driven, comfort seeking culture of our times, the discomfort of breathing hard is avoided like the plague. This makes them weaker and weaker as time passes, and the level of activity is reduced as the capacity to breathe effectively shrinks. This vicious cycle once set in motion is difficult to break out of, without conscious, persistent hard work.

Lack of skeletal muscle strength and endurance
A body that is weak and has a relatively low peak strength, will need to work harder to perform the same day to day physical activities that a stronger one breezes through. As an example- consider a Nano car that has a top speed of 100odd kmph vs a V8 engined car that can touch 250kmph without struggling. Run them both continuously at 100kmph and see which one breaks down first. Because the Nano is working closer to it’s limit of performance, it will burn through it’s reserves quicker. A V8 or a V6 will able to run at 100kmph all day, for months together because the large engine is barely stressed at that level of power demand. Skeletal muscle is like those large engines. Big and thirsty engines will be able to run at lower stress levels. At some point larger engines will becomea liability, but, finding a happy medium that lets you have a large reserve capacity while running unstressed through daily life is what one should be aiming for. Also depending on the lifestyle that you live or plan to live in the future, you’ll need to decide what sort of reserve capacity you need to hold. Skeletal muscle that works extra hard all day, burns out and breaks down. Skeletal muscle that is trained systematically near it’s peak and allowed to rest and repair itself during the rest of the day, gets stronger with use. Skeletal muscle that works closer to it’s peak strength all day consumes more fuel, more oxygen, breaks down faster and produces more metabolic end products that need to be carried away and processed to prevent local damage. The truck therefore is to gradually train it’s peak strength higher, and make it’s regular day to day demands effortless, so that it may recover during day to day life.

Faulty usage of the respiratory muscles
I’ve talked about this in detail in earlier posts. Most modern humans are incapable of breathing using the diaphragm or the intercostal muscles. This is due to posture, lack of core strength, psychological reasons that cause one to retain a flexed, crouched posture(the prey/victim posture). It can also be due to the modern penchant for the 6 pack/flat washboard abs. Trying to keep the abdomen immobile while breathing in, will require the breath to fill the upper part of the chest, rather than the lower. This reduces utilisation of the diaphragm and shifts the load to the small muscles of the neck and upper chest. This is inefficient and leads to the feeling of tightness around your chest and neck. The chronically over worked muscles in that area will give you recurrent neck, shoulder chest issues and headaches that get frequently misdiagnosed as migraine.

Over breathing
Like gears in a car, which let you choose the right cogs for the load and speed required, breathing has the same ability to make things easy for your body. Provided, you select the right gear. Regular breathing should occur in the lower chest. Chest expansion should be horizontal and circumferential. Modern lifestyles have made most of us expand vertically and immobile in the horizontal plane, during inhalation. This results in having to breathe faster and shallower to obtain the same amount of oxygen. This over breathing changes your blood chemistry to a more unfavorable alkaline pH, that causes your red blood cells to hold on to more of the oxygen they’re carrying, instead of releasing it to the tissues that need it. A second effect of over breathing is that it constricts the small blood vessels of your body and further reduces oxygen supply to the periphery. Yes, an optimum level of carbon dioxide is essential to keep your blood vessels nice and open. An optimum level of carbon dioxide is required to keep your red blood cells generous with the oxygen they carry, instead of hoarding it all for themselves

Chronic over breathing leads to chronically low carbon dioxide levels and your body starts to think of those lower levels as “normal” and it now starts to defend those low levels by perpetuating the over breathing. This sets up another vicious cycle.

Correcting the above requires getting out of your comfort zone. This would mean, choosing exercises that make you breathe hard.

It also requires you to take an honest look at your breathing style and fixing it as a matter of priority, during your exercise sessions instead of focusing just on the exercise. This would include breathing exclusively through your nose during exercise and consciously trying to slow down and controlling your breath during hard efforts. It isn’t easy.

Posted below are some links you might find useful.

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