Experiencing pain is a fundamental biopsychosocial phenomenon. However, practitioners typically treat pain in isolation with little emphasis on psychological influence. Carl Bescoby explores the psychological impact of pain and discusses how psychologically informed practice may offer benefits to managing the whole pain experience throughout rehabilitation. Introduction It is common for athletes to experience pain when... MORE
Deep breathe in, better performance out: can breathing and mindfulness influence athletic performance?
Athletes may experience fear avoidance when exposed to an unpleasant physical or cognitive experience. The perception of their experience may lead to anxiety and stress dysfunctions. Breathing and mindfulness techniques can minimize an athletes’ psychological perceptions, but can these components enhance sports performance? Tracy Ward looks at using breathwork and mindfulness to improve performance.
Cleveland Browns defensive end Myles Garrett takes a deep breath as he leaves the field after a win against the Tennessee Titans at Nissan Stadium. Mandatory Credit: Christopher Hanewinckel-USA TODAY Sports
Successful elite athletic performance requires the harmony of physical and psychological capacities(1). Sports such as golf or archery benefit from mindfulness with improved mental focus and levels of fine motor control(2). Whereas endurance sports such as cycling and long-distance running benefit from an improved mental attitude(3).
Influencing breathing can impact muscle activation, respiratory function, and physiological performance(1). It can also direct the mind and reduce emotion-based reactive behavior. Pilates and yoga include the synchronizing of movement and breathwork, which brings a state of stillness. Creating stillness in thought helps us to be more mindful of our energy and manage negative emotions. Mental clarity and decisive action improve performance. Therefore, the purposeful practice of breathwork and mindfulness may provide athletes with enhanced performance outcomes.
Pilates adopts a pattern of exhaling on the exertion and inhaling on the return. Contraction of the core muscles on exhalation creates better recruitment of type I, slow-twitch muscle fibers(4). The transverse abdominis muscle is primarily composed of type 1 fibers which are well oxygenated and fatigue resistant. This core support provides local spine stability and muscle endurance and thus could reduce injury risk. Focused breathing throughout exercise ensures the maintenance of a steady breath, even during high-intensity training. During periods of anxiety, a conscious reduction in breathing rate stimulates the parasympathetic nervous system.
Pranayama is the fourth limb of yoga and means ‘breath control’. It is practiced independently or combined with yoga poses. Pranayama encourages rhythmic diaphragmatic breathing, which controls the intake and outflow of breath through the sustained, and subtle flow of inhaling, exhaling, and retention. Pranayama has significant positive effects on the respiratory, circulatory, and endocrine systems (see image 1)(5,6). For example, lung function measures improve exponentially with just two, four, and six weeks of pranayama practice(6,7,8).
Image 1: Pranayama mechanisms of improvement on lung function(6).
Mindfulness is a distinct form of awareness. It is the process of paying open-minded attention to the present moment(9). Mindfulness provides a wealth of physical and mental health benefits with profound positive cognitive and interpersonal outcomes(10). Deliberate mindfulness interventions can be effective at overcoming stressful situations and equip athletes with a heightened sense of self-regulation. Athletes who practice mindfulness are more likely to be conscious of their goals, detect threats, and be less emotive in response to situations(9).
Mindfulness interventions reduce stress and improve endurance performance through longer exhaustion times, allowing athletes to go longer before fatiguing(1,11,12). Executive functions are higher-order cognitive capabilities that enable an athlete to control their behavior(13,14). Enhanced executive functions are characteristics associated with success in elite sports and are affected by stress. Improved information processing and inhibition of external distractions during attention-based tasks is the foundation of behavior performance(15,16,17). Mindfulness cultivates a way for athletes to enhance their focus and concentration and ignore negative thoughts and other interferences that may impact decision-making(14).
Clinical intervention strategies
Athletes may have limited time to include new and adjunctive training sessions into their busy schedules. Convincing an athlete to include breathing and mindfulness exercises may be difficult, but incorporation into their existing schedules and education on the benefits may assist. There are several different strategies that clinicians can rely on to guide their athletes through the process (see table 1).
Table 1: Clinical strategies (simple to complex) to introduce breath work and mindfulness into athletic training schedules.
|Identify situations of anxiety or fear||Athletes are encouraged to observe their behaviors and identify the impact of their emotions and thoughts. It may be helpful for athletes to note this relationship and identify coping strategies before an adverse effect on performance.|
|Focus on regular breaths||The simple process of observing each breath. Attention on the breath can direct the mind away from distractions and negative thoughts. As athletes progress, they can incorporate breath control into movement programs such as Pilates or resisted training. While this is difficult to implement in fast-paced environments, the principles provide a good framework for athletes to revert during sports-specific training.|
|Breath retention (Kumbakha)||The conscious elongation of the inhale and exhale with a pause. With each breath, athletes hold the sensation of fullness after inhalation or emptiness after exhalation. This improves respiratory function through diaphragmatic breathing and to increases the breathing challenge. The duration of the pause is at the discretion of the guiding practitioner and athlete.|
|Breathing in stages (Viloma pranayama)||A breathing pattern where inhaling and exhaling is not a continuous process but is interrupted by several pauses. This works through a three-interval breath pattern to focus on the breath (e.g., inhale from the lower belly and pause to hold, inhale from naval to ribs and pause, and inhale from ribs to collar bones and pause). Exhalation is the reverse.|
Breathing and mindfulness practices can have powerful effects on athletic performance. Breath control can influence core muscle activation instantly and improve respiratory function in as little as two weeks, with benefits increasing exponentially with pranayama training. Mindfulness enhances endurance, behavior performance, and executive functions within five weeks. Breathing and mindfulness promote relaxation and better cognitive function reflected with enhanced performance. Clinicians and athletes should select an invention according to the individual needs of each athlete, but even simple, time-efficient practices will provide benefits.
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