Respiratory Muscle Training: Benefits, Methods, and Who Can Benefit

How Do You Exercise Your Respiratory Muscles?

Exercising your respiratory muscles involves specific techniques and devices designed to strengthen the diaphragm and intercostal muscles, along with general aerobic exercise that indirectly enhances their function, leading to improved breathing efficiency and endurance.

Understanding Your Respiratory Muscles

Our ability to breathe, a seemingly automatic process, relies on a sophisticated interplay of specialized muscles. The primary muscle of inspiration (inhaling) is the diaphragm, a dome-shaped muscle located at the base of the lungs. When it contracts, it flattens, increasing the volume of the chest cavity and drawing air in.

Alongside the diaphragm, the external intercostals (muscles between the ribs) also contract, lifting the rib cage upwards and outwards, further expanding lung volume. During forced or strenuous breathing, accessory inspiratory muscles like the scalenes and sternocleidomastoids in the neck assist in elevating the rib cage.

Expiration (exhaling) at rest is largely a passive process, relying on the elastic recoil of the lungs and chest wall as the diaphragm relaxes. However, during forced exhalation (e.g., during exercise, coughing, or blowing), the internal intercostals pull the ribs downwards and inwards, and the abdominal muscles (rectus abdominis, obliques) contract, pushing the diaphragm upwards and forcefully expelling air. These are the muscles targeted in respiratory muscle training (RMT).

Why Train Your Respiratory Muscles?

Training these vital muscles offers a range of benefits, from enhancing athletic performance to improving quality of life for individuals with respiratory conditions:

• Increased Endurance: Stronger respiratory muscles can work more efficiently, delaying fatigue in the diaphragm and intercostals, which can otherwise limit exercise duration.
• Reduced Dyspnea (Breathlessness): For individuals with lung diseases or heart conditions, RMT can decrease the perception of breathlessness, making daily activities easier.
• Enhanced Athletic Performance: Athletes, particularly in endurance sports, can experience improved time trials, power output, and reduced recovery times due to more efficient oxygen uptake and carbon dioxide expulsion.
• Improved Lung Function: RMT can increase inspiratory and expiratory muscle strength, potentially leading to greater lung volumes and airflow.
• Better Posture and Core Stability: The diaphragm is also a key component of the deep core stabilization system, and its optimal function contributes to overall trunk stability.
• Faster Recovery: For patients recovering from surgery or illness, RMT can aid in regaining respiratory strength and function.

Methods of Respiratory Muscle Training (RMT)

RMT involves specific exercises that target the inspiratory or expiratory muscles, often using specialized devices.

Inspiratory Muscle Training (IMT)

IMT focuses on strengthening the muscles involved in inhalation, primarily the diaphragm and external intercostals.

• Threshold Loading Devices: This is the most common and evidence-based form of IMT. Devices like the POWERbreathe or Threshold IMT require you to inhale against a set resistance. The resistance is only overcome when a certain inspiratory pressure (threshold) is achieved, ensuring consistent muscle loading regardless of flow rate.
  • How to do it: Typically involves 30 breaths, twice a day, 5-7 days a week, with the resistance progressively increased as strength improves. You inhale deeply and forcefully through the device.
• Flow Resistive Training: Less common, these devices provide resistance that varies with the speed of inhalation (faster inhalation equals more resistance).
• Volitional Breathing Exercises: While not providing a measurable resistance, conscious, deep breathing exercises can improve inspiratory muscle coordination and recruitment.
  • Diaphragmatic (Belly) Breathing: Lie down or sit comfortably. Place one hand on your chest and the other on your abdomen. Inhale slowly through your nose, feeling your abdomen rise while your chest remains relatively still. Exhale slowly through pursed lips, feeling your abdomen fall. Focus on making your diaphragm do the work.

Expiratory Muscle Training (EMT)

EMT aims to strengthen the muscles involved in forced exhalation, mainly the internal intercostals and abdominal muscles.

• Threshold Loading Devices: Similar to IMT, devices like the EMST 150 require you to exhale forcefully against a set resistance. The resistance is only overcome when a specific expiratory pressure is met.
  • How to do it: Typically involves exhaling forcefully through the device for a set number of repetitions, several times a week. The resistance is increased over time.
• Pursed-Lip Breathing: A simple technique often used to manage shortness of breath, it can also provide mild resistance for expiratory muscles.
  • How to do it: Inhale slowly through your nose for a count of two. Pucker your lips as if you're going to whistle. Exhale slowly and gently through pursed lips for a count of four, making the exhale twice as long as the inhale.
• Forced Exhalation Exercises: Coughing or "huffing" (taking a deep breath and exhaling quickly and forcefully like fogging a mirror) can engage expiratory muscles.

Whole-Body Aerobic Exercise

While not specific RMT, regular aerobic exercise (e.g., running, cycling, swimming, brisk walking) is crucial for overall cardiorespiratory fitness. During intense aerobic activity, your respiratory muscles are challenged significantly, working harder and faster to meet the body's increased oxygen demands and remove carbon dioxide. Over time, this consistent demand leads to adaptations that improve the endurance and efficiency of your breathing muscles.

Who Can Benefit from RMT?

A wide range of individuals can benefit from incorporating respiratory muscle training:

• Athletes: Especially endurance athletes (runners, swimmers, cyclists) and those in high-intensity sports (e.g., CrossFit, martial arts) to improve performance and delay fatigue.
• Individuals with Chronic Respiratory Conditions: Patients with COPD, asthma, cystic fibrosis, or post-COVID lung issues can experience reduced breathlessness and improved exercise tolerance.
• Heart Failure Patients: RMT can improve respiratory muscle strength and functional capacity.
• Older Adults: To maintain respiratory function, improve balance, and reduce the risk of falls.
• Individuals Recovering from Surgery: Especially thoracic or abdominal surgeries, to prevent complications and aid recovery.
• Sedentary Individuals: To improve baseline respiratory fitness.

Considerations and Cautions

Before starting any new exercise program, especially RMT, it is highly recommended to:

• Consult a Healthcare Professional: Discuss RMT with your doctor, a pulmonologist, or a physical therapist, particularly if you have underlying health conditions. They can advise on the appropriate type, intensity, and duration of training for your specific needs.
• Start Low, Go Slow: Begin with lower resistance levels and gradually increase as your strength improves. Overtraining can lead to muscle fatigue or discomfort.
• Proper Technique is Key: Incorrect technique can be ineffective or even harmful. Follow the device instructions carefully and consider guidance from a qualified professional.
• Not a Substitute for Medical Treatment: RMT is a complementary therapy and should not replace prescribed medications or other medical treatments for respiratory conditions.

Integrating RMT into Your Routine

RMT is typically easy to integrate into a daily schedule due to the short duration of sessions.

• Consistency is Crucial: Like any strength training, regular practice yields the best results. Aim for daily or near-daily sessions.
• Warm-up and Cool-down: While not strictly necessary for RMT, it's good practice to incorporate it into your overall fitness routine.
• Alongside Aerobic Exercise: RMT complements aerobic training, providing specific strength benefits that enhance the overall efficiency gained from cardiovascular workouts.
• Listen to Your Body: If you experience pain, dizziness, or excessive fatigue, stop and consult a professional.

Conclusion

Exercising your respiratory muscles is a targeted approach to enhancing breathing efficiency, endurance, and overall well-being. By strengthening the diaphragm, intercostals, and abdominal muscles through specific devices and volitional techniques, individuals can unlock significant improvements in athletic performance, manage respiratory conditions more effectively, and simply breathe easier in daily life. When approached thoughtfully and with professional guidance, RMT is a powerful tool in the arsenal of comprehensive fitness and health.