August 24, 2020

O2, VO2, and You: Improving Respiratory Fitness for Better Health and Performance

Endurance athletes understand the need for oxygen, but how does your respiratory system and the exchange of gases within your body actually work? Respiratory Therapist and TriDot Coach Ryan Tibball provides an overview of your respiratory system and how you can improve your respiratory fitness. Ryan defines VO2 max and its relationship to training. He also recommends optimal breathing patterns for swimming, biking, and running that can significantly benefit your triathlon performance and offers special considerations for asthmatic athletes.

TriDot Podcast .‌048:‌ ‌ O2,‌ ‌VO2,‌ ‌and‌ ‌You:‌ ‌Improving‌ ‌Respiratory‌ ‌Fitness‌ ‌for‌ ‌Better‌ ‌Health‌ ‌and‌ ‌Performance‌ This is the TriDot podcast. TriDot uses your training data and genetic profile, combined with predictive analytics and artificial intelligence to optimize your training, giving you better results in less time with fewer injuries. Our podcast is here to educate, inspire, and entertain. We’ll talk all things triathlon with expert coaches and special guests. Join the conversation and let’s improve together. Andrew: Hey, folks! Welcome to a new edition of The TriDot Podcast. Hot topic and a brand new TriDot expert on the podcast today to talk about it. Today we’re talking respiratory health.  Breathing in, breathing out, improving cardiovascular fitness, and the ins and outs of getting oxygen through our system as we train and race. Joining us for this conversation is Respiratory Therapist and TriDot Coach Ryan Tibball.  Ryan has a B.S. in Biomedical Sciences from Texas A&M University and Respiratory Care from UT Health Center at San Antonio.  He serves as the LifeTime Cycle Coordinator and the PWR Cycle Coach at LifeTime Fitness and is a certified Crossfit Coach & a Pose Method Certified Run Coach. Ryan is a multiple time Ironman finisher and has been coaching with TriDot since 2015. Ryan! Thanks for joining us today brother. Ryan: Thank you very much, Andrew. Long time no see, brother. Andrew: Yeah, for real. Ryan: Great seeing you. I’m really excited to be here. Andrew: Yeah, man. Also joining us is Pro Triathlete and Coach Elizabeth James. Elizabeth came to the sport from a soccer background and quickly rose through the triathlon ranks using TriDot--from a beginner to top age-grouper to a professional triathlete.  She is a Kona & Boston Marathon Qualifier who has coached triathletes with TriDot since 2014. Elizabeth, thanks for joining us! Elizabeth: It’s always great to be here. Thank you, Andrew. Andrew: And who am I? I am Andrew the average triathlete. Voice of the people and captain of the middle of the pack.  Today we’ll get warmed up and then we’ll dive into our main set covering all the implications of respiratory health for triathletes. We’ll cool down today talking about some of the new tri gear that has gotten our attention. Time to warm up! Let’s get moving. Andrew: Movies can serve as a source of entertainment and inspiration. And sports movies in particular are popular for their mix of action and storytelling. Whether it’s a modern hit or a timeless classic, there are plenty of hit movies out there capturing the stories of a large variety of sports. For today’s warm up question, Ryan, Elizabeth--what would you say is your all-time favorite sports movie? And, listen, there are so many out there that...let’s do it this way. I want each of you to declare a personal favorite, but then add maybe a second one that you really enjoyed that you feel doesn’t really get the love and attention that it should. Ryan, first time on the podcast, let’s start with you. Ryan: Alright, well, this is going to date me a little bit. Obviously an old-time favorite of mine...it goes way back to 1981--Victory. It is, in a nutshell, a story about...it happens during World War II. It’s a German soccer team against POWs from the war. You know, it was all about a propaganda thing in Germany. They were just trying to basically improve morale. Sylvester Stalone and Pele, one of my most favorite soccer players… Andrew: Pele is in the movie? That’s awesome. Ryan: Yes, Pele is in the movie. Elizabeth: Oh, that’s cool. Ryan: I don’t know, Elizabeth, with your soccer background, if you knew about this movie. Elizabeth: No, I didn’t. I’m going to have to go watch it now. Ryan: Yes. Classic, but Sylvester Stalone, this is pre-Rambo, of course. I don’t want to give it all away, but let’s just say the prisoners of war, the whole negotiation thing was...They were going to try to escape at halftime through a man-made built tunnel through the locker room of their locker room. They had it all set up, it was ready to go. At halftime they went in, the tunnel opened up, and they decided they wanted to come back on the field and win the game. They don’t win...but they were down 4-1 and they do tie. But they do make their escape. Andrew: So many spoilers! Ryan: I know… Elizabeth: Hang on, hang on, I want to watch this! Ryan: Okay, fine, I’ll stop right there. Andrew: We still gotta watch and see how it happens. Ryan: You do really need to watch that. So, yeah, I’m going to stop right there with that one. One that doesn’t get the love and attention...I’m going to show my maturity here--Talladega Nights. Andrew: The Ballad of Ricky Bobby. Ryan: The Ballad of Ricky Bobby. Yeah, I said it. Andrew: That’s definitely a Will Ferrell movie with one of the higher laughs per minute metric. There’s certainly lots of comedy gold to that one. I like your style. Elizabeth, what about you? Elizabeth: Okay. Gosh. All-time favorite...Remember the Titans. I could watch that over and over again. Anything football, too, is going to capture my attention. Andrew: The speech at the field in Gettysburg from Denzel Washington, after he ran them through the woods. Lots of golden moments in that movie for sure. Elizabeth: Lots of moments. Tear jerker moments throughout. So inspirational. So that would be my all-time favorite and then the one that doesn’t get the love and attention it deserves I would say is Without Limits. Andrew: I have not seen that one. Elizabeth: Since it doesn’t get the love and attention it deserves...if you’re listening and you don’t know what that one is...it’s about one of the most gutsy runners, Pre  Prefontaine. Ryan: I haven’t seen that one. Elizabeth: Oh, it’s great. Andrew: I decided to go the nostalgia route. I think my favorite sports movie from growing up as a kid is The Sandlot. Just absolute classic. It’s a story of sports, it’s a story of...takes you back to being a kid and not having a care in the world. One that I’ll say that is a really recent one--I’m a big fan of the Oscars, the Academy Awards. I try to watch them every year. This past year one of the nominated films was Ford vs. Ferrari. It’s Matt Damon and Christian Bale telling the story of when the Ford Motor Company at the time was not really big into racing and decided to step into racing in a big way and take on the juggernaut of Ferrari at one of the premiere races in the world. Just a great artistic movie, beautiful cinematography, beautiful story. Ryan: Great movie. Andrew: Did you see that one? Ryan: Yes, I did. I discovered it just because it flashed on my tv one day as a streaming option. I was like, “I need to watch this! This is about cars? Let’s do it.” Andrew: It’s the more serious version of The Ballad of Ricky Bobby. Folks, we’re going to throw this question out to you on social media so go find us “I Am TriDot” on Facebook, Instagram. We want to hear from you. What is your favorite sports movie? There’s tons of great options. We want to see what you guys have to say. On to the main set. Going in 3…2…1… Andrew: Our main set today is brought to you by TriTats. Whether you’re a seasoned Ironman or gearing up for your first local sprint tri, TriTats will help you make your mark. These tough, stylish, and easy to use race number tattoos make you look and feel like a pro. I, personally, have raced countless local sprint and olympic tris where I showed up thinking I had plenty of time to settle into transition only to find a massive line waiting to be body marked. Switching to TriTats has allowed me to show up on race morning with my focus on the finish line, not the body marking line. If you have an Ironman race this year, their Iron Tats are made especially for you. Iron Tats body mark you for that one key race and include the all-famous M dot logo. Friends don’t let friends race with Sharpied on numbers. So as a friend of the podcast, head to TriTats.com and use promo code TriDot for 10% off your order. Again, that’s TriTats.com promo code TriDot. On a hard race or training day we can only go as fast as our breath can support. Now coincidentally, my last workout before recording this podcast was a 4x5 minute zone 5 interval run at the track that had my lungs absolutely screaming for air by the end. So how does this biological system within our body really work? And what can we do as athletes to maximize our respiratory ability? Ryan, before we get to the respiratory fun, tell us a little bit about Ryan the triathlete. How did you get started in the sport and what are a few of your favorite moments from your tri journey? Ryan: Well, you know, starting off 18 years ago...I’ve actually been in the sport that long, and was a little punch to the 18 years is poorly training for quite some time. Andrew: More than you would like, I’m sure. Ryan: Exactly. I came into the sport with a swimming background, a cross-country running background, but I was a terrible biker. Andrew: I still am a terrible biker. Ryan: Arguably, it is my weakest discipline still. But it is closing in on the others. I like that. Andrew: Thanks to TriDot. Ryan: Yes. Absolutely. So that’s where the journey started. I will have to say even before I go any further--shout out to my wife Monica for tolerating these past 18 years. As we know triathlon is an investment to say the least. She’s like, “Are you seriously buying some more stuff?” Yes, I am. Andrew: I need it! Ryan: Yes, exactly. My first race sprint I think most of us do a sprint on our first race. I remember Benbrook sprint race in Forth Worth, Texas. As soon as I hit that finish line I felt like I did an Ironman, but I was hooked. It was hook, line, and sinker from that very moment. Fast forward about a year later. Actually getting on the podium with an 8th place finish. Yeah! Andrew: Overall? Or age group? Ryan: 8th age group. Andrew: How many podium steps were there? Ryan: There was 10. I was like hey, I’ll take it. I got a little taste of the glory in 8th place with a plaque to show. They were giving plaques for this, so it was legit. That was here in Fort Worth, so I guess things are better and bigger in Forth Worth or at least in Texas. Andrew: Makes sense. Checks out. Ryan: Moving forward, another big pivotal moment was talking with Jeff Booher. I had known Jeff Booher previous to TriDot with Tri4Him. I joined TriDot way back in the day when it was called… Andrew: Free for Feedback. Ryan: Free for Feedback. So I did that and was really hooked there. And then one day Jeff...about a year and a half later calls me up. My phone rings, it shows Jeff Booher on the phone. I was like I better take this. I’m at the hospital working. I step across to the skybridge where I get better reception because I don’t know what Jeff wants. If he’s calling you, I figure I better answer. At that point in time he actually offered me a position as a coach for TriDot. Andrew: Wow. Ryan: That is almost emotional thinking about that, it really is, because it has really been such a journey. It’s been such an enjoyable journey since that phone call. Lastly, I’m going to...this is really where the emotional tear-jerker for me is my second Ironman. Not my first. My first was great, don’t get me wrong. My second is where my parents, my wife, and her parents were there. My family was there. I’m trying to keep it together here. But having my mom there...she had polio, she’s been affected by that and permanently affected by that. So she’s unable to do the things that I’m able to do. It was a special moment with her there. It really was. Andrew: Yeah. Absolutely. Anybody who’s finished an Ironman can relate to the fact that’s an emotional accomplishment anyway. So you tack on the family being there and your mom, that’s great. And for you, we’ve talked before. So your first Ironman you weren’t training with TriDot. Ryan: Correct. Andrew: And your second Ironman you were training with TriDot. So can you share quickly the experience of both worlds at the Ironman level. Ryan: Right...so that first one without TriDot--looking to finish and I did finish well enough. I had plenty of spare time in the end, but coming in to now TriDot and training with TriDot, I actually shaved off 90 minutes. So the first Ironman was at Arizona. Arguably, a nice flatter course. Then my second one was in Chattanooga where I shaved off over 90 minutes. Andrew: On a harder course. Ryan: On a harder course. Not that I needed anymore justification for staying with TriDot or anything, but, boy, I tell ya...that’s the way to go. Andrew: I feel lucky that I’m training for my first Ironman with TriDot and not making the mistake that you did and not miss out on that time hopefully. Anyway, now that we’ve walked through the highlights of the Ryan Tibball triathlon career reel. So you go to Texas A&M University, which, again, talk about the comparisons between you and TriDot founder Jeff Booher, you’re both A&M Aggie guys. You both used to race against each other back in the day. So there’s a lot of relationship there. Just walk us through your educational background and what made respiratory therapy the industry you wanted to pursue. My educational background with A&M and then I actually went to UT Health Science Center San Antonio and received a Bachelor’s degree there in respiratory care. With that education I’ve worked in many aspects and facets of the hospital, adults and pediatrics, ICUs, ERs, Labor & Delivery, and some pulmonary clinics. So I had the opportunity to do pulmonary function testing, which is very intriguing in itself, too. But currently working in surgery now as a respiratory therapist. The autonomy there that I get is just fantastic being able to truly practice as a respiratory therapist. Andrew: So you went to school for years to learn all this stuff in the field of respiratory health care so I don’t expect us, Ryan, to get on your level of knowledge in just a few minutes. But can you give us the essential overview of our respiratory system and what it is and what it does? Ryan: Deep question, but yes. Our respiratory system is fairly simple and yet obviously extremely important. Obviously. The primary thing is exchanging of gases--oxygen and CO2. We take in oxygen, remove CO2. The homeostasis, the balance, the equilibrium that the body tries to maintain utilizing the lungs in order to do that with those gases. In a nutshell, as far as the respiratory tract goes, meaning the upper part of the airway, the nose, the mouth, etc. all the way down to your vocal cords or voice box. Below that is where the lower and the really, really important part of your respiratory tract begins, going from the trachea to the bronchus, mainstem bronchus bronchioles. I know this is getting that science-y part, but getting down to the workhorses of the lungs--the alveoli. The ones that are truly responsible for exchanging gases, the Oxygen for the CO2 and the water. Alveoli are the workhorses of the lungs, along with the pulmonary vessels. So now we’re talking cardiovascular part, as well. Andrew: So those are the blood vessels that connect into your lungs? Ryan: Right. So the capillaries are responsible for transporting, along with the arteries, arterials, veins, and venules. They come all the way down to the capillaries in between all of that. So those are the ones that are actually exchanging with the lungs and the alveoli. So that is essentially...I’d like to say nutshell, but we got a little deep. Andrew: We’re in question one about our system, Elizabeth, and we’re already hearing so many terms. Elizabeth: Are you still following? Ryan: Alveoli, guys. Remember that. Workhorses. There you go. Andrew: Definitely not a word we’ve heard before, but obviously helpful in keeping us alive every day. Ryan: Tiny little sacks responsible for so much. Elizabeth: You had mentioned in that overview the importance of oxygen and that exchange of gas. For us triathletes, we know that breathing and getting in the oxygen to the lungs and our muscles is important. But biologically what is the oxygen doing inside of our bodies that’s helping us perform? Ryan: Elizabeth throwing another deep question at me. But, hey, I’ll try to give the important parts of it. Our atmosphere is made up of a lot of different gases, but in particular, the most important for us is Oxygen. That’s 21% of our atmosphere. Anywhere you go, no matter how high you go or low you go, it doesn’t matter. It’s still 21%. The rest of it...78% of that is Nitrogen. If you do the math there, where’s the other 1%? That’s CO2 and a couple of other different gases. As far as what Oxygen does in our body--it is responsible for energy production. Coming down all the way to those mighty mitochondria. Those powerhouse cells of the body. As athletes we try to develop our mitochondria whether we know it or not. Some people get real sciency understand I work out, I get stronger, I develop more powerful mitochondria, more mitochondria. So oxygen is important in cellular respiration. So combining Oxygen with a great diet is important. Oxygen combined with fat, sugars, proteins, amino acids--those things there can end up...what they do is your mitochondria takes that and puts everything together with the Oxygen and says okay, make some ATP--Adenosine Triphosphate. Let’s make the power blocks so you can function as an athlete. Andrew: So our diet has an impact on our body’s ability to do that? Ryan: Absolutely. Andrew: Wow. Elizabeth: Another reason to eat healthy. Andrew: We literally just had two episodes with Dr. Austin. One targeting men’s health and one targeting women’s health, talking about a lot of different things our diet can impact. Here we are finding out another one. It impacts our body’s ability to produce those mitochondria. Ryan: Yeah, and Oxygen...every cell in our body needs it. Every cell in our body needs it. Talking about the diet, I’m jealous sometimes with EJ posting her foods and I’m like, “If I could only force myself to eat that. Such good stuff.” Andrew: Her daily salmon salad? Elizabeth: Now we can talk about the impact of those salads on our mitochondria, as well. Andrew: Yeah, I had no idea it was doing that for us. Ryan: You’re fueling the system. I call it fueling the machine, I suppose. Elizabeth: Absolutely. Yeah. So we’ve talked about Oxygen and the importance of that. As athletes I think another thing that comes up a lot is VO2 max. So, Ryan, could you give us an overview--what is VO2 max? How does that impact our performance as athletes? Ryan: Oh, VO2 max. That sexy number we all see on our Garmin watches. Andrew: New VO2 max. Superior! Ryan: Love it. By definition, the VO2 max is the maximum amount of Oxygen consumed measured in milliliters per kilogram per minute. Obviously you see your Garmin doing that for you. There’s other ways of measuring that. But that’s our good old Z5, our zone 5, we see. As far as its impact on our performance, it’s really interesting because how often do we really work in our Z5 versus, say, our Z4? Andrew: I worked 20 minutes on my zone 5 last night. When you talk cumulatively over the course of a month, not too often. Ryan: Not too often. So speaking to that, I spent some time with the UNT Kinesiology Department… Andrew: UNT--University of North Texas. Ryan: Yes, sir. Their kinesiology department is some of the tops in the nation. So spending a lot of time with them...it’s not as important as zone 4. So it’s nice to see it, that VO2 max on your watch. It is a great measure of your cardiovascular capacity, for sure. Andrew: But if you’re not working at that capacity, it doesn’t matter as much. Ryan: Right. So, again, it’s just about do you want to spend as much time there as your other zones? Arguably, no. Not necessarily because there’s some limitations with it. In particular, genetics is about 50% of your predicted VO2 max. So I like to say choose your parents wisely. Andrew: If only we could. Ryan: Age. So don’t get old. Andrew: Got it. Ryan: You’re looking at two of those factors that you really can’t control. And the other factors are training and body composition and weight, which obviously we can control doing the right training right. Heard that once or twice, right? TriDot! So, again, you have your genetic limitations and that is 50% of it as far as your VO2 max. Do most of us reach that? Probably not. There’s nothing wrong with striving to get better all the time, absolutely. Andrew: Does our VO2 max mainly come into play when we’re racing in that zone 5, maybe a sprint triathlon toward the end? If I’m in zone 3 or 4 in a workout, does it even matter what my zone...what my VO2 max is? If my VO2 max improves will it also improve my ability to perform in the lower zones? Ryan: It certainly can, yes. I can get into that. Again, with the time I spent at UNT and talking and really spending a ton of time with the kinesiology folks and the doctors there, you could have two athletes. For example, athlete A has this phenomenal VO2 max, let’s say 80, which is really off the charts almost. Meanwhile, their lactic threshold is 40% of that. Versus an athlete who has a VO2 max of 65 and they’re utilizing 85% of that with their lactic threshold. I’m going to pick athlete B every single time to win. That’s because of...it’s important to develop that zone 4 over that zone 5. Andrew: Because zone 4 is how much of your zone...your ability you can… Ryan: Right. So it gets real sciency in this part, but, again, you notice our training is predominantly zoned for zone 2 for very good reasons. We have a hard time reaching our maximum potential on our VO2 max, but if we keep working at our zone 4 and we do some zone 5 work it will happen. When I used to train, I think I was probably in zone 5 half the time and that explains why I never got a whole lot better. Andrew: Zone 5 or zone 1. Ryan: Zone 5 or zone 1! Yeah, exactly. That doesn’t mean it’s not important to work on. Absolutely it is. You see it in our TriDot programming. We do touch on that zone 5 and zone 6. Andrew: Interval runs. 30-30s. 30-90s. Ryan: The most impactful zone will be your zone 4 overall. Andrew: So for folks who are at least monitoring their VO2 max and they do enjoy seeing the new numbers pop up on the Garmin device, how accurate...I’ve always wondered this personally...how accurate are those readings when it’s just my watch or something? Essentially, educated guessing, educated estimating my VO2 max, I’m assuming. Are those numbers pretty accurate? Ryan: Yeah...so you see me pause there. It’s interesting you ask. The algorithms and the way that Garmin measures it...again, I don’t know their algorithms, but certainly they’re not taking into account some of the important factors of measuring your true VO2 max. Andrew: So they only have so much of the data basically? Ryan: Correct. But what’s nice about having that on the Garmin is it can be hopefully motivating when you see it moving up. When it goes down, you kind of...eh. Alright. We’ll see you later. But you see a lot of times in the summer (at least I have seen this trending) is that my VO2 max drops. Obviously temperature doesn’t seem to be playing a role in Garmin’s algorithms because I’m dropping in the summer. At least that part is my opinion. To answer the question, like you said--is it super accurate? Really it gets you in the ballpark, sure. And you can trend it. And you can watch it. If you start off at 50 and drop to 30, you might want to question why. But if you’re like going 50 - 48 - 51 - 52, you’re still in the ballpark of probably what it truly is. It’s pretty close. Andrew: So they’re doing the best they can with the data they have available? Ryan: Right. Andrew: What would be the actual way to tell you what your VO2 max is? Ryan: The actual way would be to go (like I’ve done several times) is going in and doing the active metabolic assessment. Finding a facility and I had the opportunity several times at the University of North Texas to do that. What they do is actually measure the inspiratory and expiratory gases that you are producing while putting you through that active metabolic testing. There they can analyze that and see where you start burning more sugars over fat, etc. They can get you all your values, get your zone 4, get your VO2 max, your zone 5, and find out where those are at. Because it’s so much more accurate utilizing the machine that can analyze your gases. Andrew: When we think of training, we think of swim, bike, run, and probably strength training. But anyone who has simply run out of breath time trialing a 5K knows that there’s fitness implications from our lung strength. Can we train the strength and efficiency of our lungs like we can our muscles? Ryan: Absolutely. The lungs themselves are not muscles, but the diaphragm, the main breathing muscle of your body...that diaphragm is a nice dome shaped muscle that you can actually control because if you tell somebody to take a deep breath they do it. They’re using their diaphragm to do so. Andrew: Any singer is well versed in the diaphragm muscle and controlling it. Ryan: Singers...Some of your best athletes in regards to VO2 max is your cross-country skiers, rowers, and people like that. They’ve certainly definitely learned how to use their diaphragms really well. Yes, you can work that muscle out. The only difference is that it’s hard to quantify how strong is your diaphragm. You can’t hook your diaphragm up to a stack of weights and see what it can do. Andrew: You’re not curling 25 pounds vs. 20 pounds. Ryan: Right. But there are ways to measure and quantify lung capacities, though. So it gives you an indirect measurement by doing a pulmonary function test. Those pulmonary function tests are done in a lab and actually measure lung volumes. So if you really had the money to spend and wanted to really know a whole heck of a lot about yourself, go get yourself some pulmonary function testing done. Andrew: That sounds like a great ice breaker at a party. Sit down and break the ice with somebody. “Just so you know, my lung capacity is…” What’s the metric for lung capacity? Ryan: Liters. Andrew: “My lung capacity is 10 liters of air.” Ryan: That’s fantastic. Elizabeth: Here we are mentioning lung capacity. Is that something that biologically we are born with a certain size lung? Is that also something that can be improved? You said it was measured in liters. Can you elaborate a little bit more? Ryan: As I sit here across from professional triathlete Elizabeth James… Andrew: Who probably has the best lung capacity out of the three of us at the table. Ryan: Funny story--I’ve raced some races, I wouldn’t call it ‘with’ her, but been at the same race. Meanwhile, I think she probably went home and showered and everything after she finished… Andrew: And you were still on the run course? Ryan: And I finally finished up. Always with a smile on her face. Yes, factors such as age, yes. As you get older your lung capacities do have the tendency to go down. That’s a lot with lung strength as well--sex. Male or female. Males typically have larger lung capacities for the same height male and same height female you’ll find that the male will have a larger lung capacity. So those certainly play a role. Body build. As far as height, for those of us that are vertically challenged like myself, I won’t have as large a lung capacity as a guy who is 6 foot 2. Andrew: Makes sense. Ryan: Lung capacities...some are hereditary. I guess we’re going back to genetics. Andrew: Again, thanks, Mom and Dad. Ryan: Thank you, Mom and Dad. To be more specific, most males anywhere about 5 to 6 liters on average. I’m giving you average numbers here. Females, marginally less, about 4 ½ to 5 ½ liters total lung capacity. Andrew: So when we talk about...you mentioned a little bit ago that lung strength, diaphragm muscle strength is something we can improve, is that something that just kind of happens naturally with our training? Or are there separate things we can be doing on the side to work our diaphragm and improve that strength? Ryan: Right, so yes, exercise...I like to point out to athletes--exercise, diet, etc. Those kinds of things will certainly help strengthen that diaphragm. Routine exercise. And you can actually practice...I think we might talk about that a little later...is how to breathe. As far as...yes, you can strengthen that in order to get better, absolutely. Andrew: So one of the more well-known breathing conditions is asthma. What considerations need to be made for an asthmatic athlete and their training? Ryan: I love talking asthma. Those with asthma are some of my main clients so to speak. Especially when I wasn’t working in surgery. And no offense to any asthmatics out there. Hopefully y’all aren’t asthmatics. They can be some of the stubbornest people. Andrew: Really? Ryan: Yeah. I don’t want to use the word “embrace,” but they certainly...slight denial, you know? Sometimes they’re like, “I don’t have problems breathing. I don’t want to have problems.” I get it. Nobody wants that problem. It’s important to breathe, of course. But you have to realize as an asthmatic...and I do have a few athletes I do coach that do have asthma...I have to really harp on them and say, “Listen, part of being an asthmatic is you have to maintain health. Just like eating a good diet and exercise, but if you have asthma, that’s another component to work on.” So making sure you keep your asthma in check. Understanding...as far as when you should be giving yourself a treatment. Are you doing maintenance as well? So longer acting medications that will help keep you at a healthy level of lung health, basically. Our all time favorite: caffeine. That can help. Andrew: Really? Ryan: Yeah. I think I turned y’all’s heads, didn’t I? Elizabeth: Yeah! Coffee? What? Andrew: I think I found a new reason to use caffeine. Ryan: Coffee. Theophylline…yeah, absolutely. it’s actually a bronchodilator so something that helps open up the lungs essentially, in a nutshell, is what that means. Going back to asthmatics….recognizing your triggers. It could be environment. Cold or hot weather. It could be seasonal. Living here in Texas, everybody with those allergies. Some are allergy-driven asthmatics so when all those pollens come in, pre-medicate. You know...you watch the weather. You see it coming. Pre-medicate. I always advise on that. Exercise. Even diet can actually be a trigger, as well. So knowing your triggers as an asthmatic is extremely important. Again, making sure you are staying on top of your own self maintenance, as well. Andrew: So, Ryan, as I was researching a bit for this conversation a funny thing happened with the Google searches I was doing to learn a little bit. I started getting social media ads for all these different breathing aids marketed toward athletes. I’ve gotten ads for the altitude simulating masks, for the nasal strips that are supposed to open up your nasal passages for increased airflow. It’s always a picture of Chris Froome with one of those on his nose. They’re trying to market it as this guy uses it. Some other breathing devices you put into your mouth and breathe into it to exercise your lungs. Are any of these products the real deal and worth our attention? Ryan: Great question, too, because it’s funny you ask about that breathing mask. I’ll back up one second so I can address the nasal strips. I think the nasal strips really can help. Some things can be hard to quantify, of course. But having those nasal strips opening up your passages the air flows through is certainly...yeah...could be very, very beneficial if you already have a narrow upper airway. Andrew: I think Oakley even has some sunglasses they market that has a little piece on the nose that is supposed to do the same thing. Ryan: If you can...and this can come down not just to a physical benefit, but maybe mentally, hey I feel better with all these strips on my face--wear them! Why not? But I think in the end if you’re opening up your nasal passages and improving airflow, that’s the bottom line. Going over to the mask...I actually had the opportunity...this is where I was a real guinea pig...wearing that elevation training mask. I did a study at UNT several years ago. They were testing does it really work? Does it do what they tout it to do? Andrew: I saw it...NFL players were using it pre-game to get themselves warmed up. They would challenge their lungs by wearing this elevation mask then take it off for the game. Ryan: Right...I will tell you what UNT found. I did speak extensively with their kinesiology guys about this. I wanted to know the results. They said, “No. There was no significant improvement in any sort of way.” But...here’s the big but part...well, is it good for lungs? Or not lung strengthening, but diaphragmatic strengthening? Your diaphragm. Your main breathing muscle. Could it help there? Sure. But, again...something...how could you quantify that? That would be pulmonary function testing. Are you improving your lung volumes? So then you have to question--I’m wearing the mask while exercising. I’m wearing a mask here or there. Is it the exercise that helped? Or is it the mask that helped? So, again, according to UNT they say no, not really. Andrew: They didn’t find a difference. Ryan: Sorry, elevation mask. There wasn’t anything to see any significant improvement. Elizabeth: Good to know. One of the things...I want to go back here for a second. Ryan, one of the things earlier you were talking about potentially specific breathing patterns for each of the disciplines in our sport. Are there optimal breathing patterns for swimming, biking, and running, that we can be leveraging for our triathlon performance? Ryan: That’s a great question. I would certainly say at the very least, just breathe. Elizabeth: That’s a good idea. Ryan: Just breathe, right? As far as swimming goes, even coming from a swimming background I didn’t really have that good old sink down drill that we have prescribed for ourselves at times. Andrew: And no matter how good your swim dot is, those will still get prescribed from time to time. Ryan: Yes, that’s exactly right. Andrew: It’s a good reminder. It’s a good thing to do. Ryan: I love that drill. Even as a swimmer with a swimming background. Why? Because in swimming it’s important that you have a constant flow of air. Meaning breathing in and breathing out. Of course there’s a lot of other drills that we do. For example, that facilitate body rotation. So you improve rotation, extension out front, gives you that opportunity to breathe even better. So it comes down to always having constant air flow, but how can you optimize, as well, to get to even start that process of constant air flow? So breathing in, blowing air out, and always...I see this a lot with some of the athletes I coach. They hold their breath. Don’t hold your breath. Don’t hold your breath. I promise, you want that constant...even I with my background work on it all the time. When I do I just feel better. I breathe better. In fact, I just got out of the pool earlier today really focusing on that. A lot of my drills had to do with body rotation, which was fantastic. It gave me an opportunity to keep that constant air flow. Andrew: To think about that. Ryan: Right. Moving on to the bike, we talk about this often--is bike fit. What does that have to do with breathing? For those of you who might feel a little crunched up on your bikes, you’ll understand. I don’t like being in aero. If you don’t like being in aero, chances are you’re probably having a hard time breathing there. So maybe we need to reinvestigate your bike fit. Andrew: That was something a few episodes ago, we did an interview with Jesse Frank, an engineer with Specialized Win Tunnel. One of the things he talked about was when they take an athlete through a bike fit in the Win Tunnel at Specialized. Before they even put them in the tunnel, they do a study. They hook them up to a machine and they see in a variety of positions how much oxygen is getting through their system. Because if a position is more aero, but less efficient for your breathing, in the long run it’s not a good position for you. So they find that mix of what’s a position that is nice and aero, but is also efficient in the breathing before they even take you to the Win Tunnel? So that reinforces exactly what you’re talking about and making sure in our bike position we’re able to breathe well. Ryan: Right. And when you have that you’re able to breathe better. Going back to that good old word “oxygen.” Getting it into your cells, getting your body to produce the ATP that you need for that energy. Moving on into the run, as well, we talk about different efforts require essentially different breathing patterns almost. I don’t want to use the word “require,” but certainly they’re beneficial to practice. When I talk about the bike fit, it’s about your diaphragm being able to do its job. So getting crunched up...imagine being balled up and trying to breathe deep. It’s almost impossible. So now moving to that run part, talking about breathing patterns as far as...put your hand on your belly, put your hand on your chest, and then breathe in through your nose. Your chest and belly should rise at the same time. For us guys, our beer belly sticks out. Andrew: We’re all doing this right now. Me and Elizabeth are over here doing it. Ryan: Watch your chest and your belly rise at the same time. They should. Instead you will see some people sometimes go like this. Their belly doesn’t move out, they just inflate their chest. So they’re not taking advantage of their diaphragm as much. So practicing this drill of hand on chest, hand on the belly, breathe in through your nose, out through your mouth. Practice that for five minutes sitting on the couch. Andrew: Be aware of where is the air coming from. Ryan: Where is the air coming from? Allowing that diaphragm to pull down, push the abdominal contents (your belly) out. it gives you a sign that you’re using your diaphragm to breathe. That comes into play in all the sports, not just biking and running, but and swimming. The more you train...I mean, we gotta do drills. Do them, do them, keep doing them. That is one of them. Add diaphragmatic breathing to your exercises. You’re sitting on the couch watching Ford vs. Ferrari, right? Practice that belly breathing is what we call it. Chest, belly, rise at the same time. Breathe in through your nose nice and slow and you can blow it out. When it comes to running and high exertions, at some point you will start breathing through your mouth and trying to bring in the air as fast and as hard as you can. So, again, things change. Your body pretty much naturally adapts when out there running, but I think a lot of newer athletes make that mistake of I have a hard time breathing when I just take off and run. Chances are part of that equation there is maybe you’re running too fast already and you’re not training right. So let’s slow you down a little bit. That way you’d practice efficiency. Andrew: I’ve seen them suggest before, if you don’t have a heart rate monitor on or don’t have a watch to tell you your pace, so you’re just going off RPE the way to tell what zone you’re in--in zone 2 you should be easy breathing, able to have a full-on conversation with somebody. In zone 3, you’re breathing a little bit, but still able to form sentences and conversation. In zone 4, you’re getting out words, but you’re struggling to get out words. In zone 5 you’re not talking. If you’re out of breath, you’re not in that zone 2 easy running. Ryan: Exactly. Elizabeth: You’re going to have to edit out all of my deep breathing as I’ve been practicing. I’ve been breathing into the microphone here. Andrew: Ryan, there’s probably a different podcast where we talk about this a little bit more. But a very serious breathing issue that I wanted to touch on is SIPE--Swimming Induced Pulmonary Edema. It can be a very serious condition occurring mostly during open water swim race events. What is SIPE and what do we need to be aware of in regards to this on race day? Ryan: Yes, SIPE. Swimming Induced Pulmonary Edema, just like you said, Andrew. Pulmonary Edema in general can be attributed to other things, as well. I see that, unfortunately, sometimes in the recovery room at the hospital. It is essentially by definition is leaky capillaries in your lungs. Your lungs are essentially giant sponges. Those capillaries leak into those giant sponges in your chest. A lot of things can happen...the cascade of problems can happen after that starts to occur. Specifically, this is something that is...kind of...more recently discovered over the last 10 to 15 years is this SIPE in athletes and triathletes who jump in wearing a wetsuit in cold water. You’ve got this...for the most part...kind of a tight thing on--your wetsuit. It’s squeezing the peripheries so, essentially, your body is trying to push the blood to the muscles because, hey, you’re going through high exertion. You just started a race, your heart rate is pumping. It’s going hard. Everything is going hard, so what they’re finding is in the athletes who have experienced SIPE is that, yes, they were in a race, they were going harder. What happens is the blood pressure in their lungs goes up, which causes the leaky capillaries. Now, I don’t want to scare our listeners by saying, “Okay, I’m never going to wetsuit swim again.” Andrew: It’s very, very rare. Ryan: Right. It is rare. But it is important to recognize if you’re experiencing… Andrew: Or if another swimmer around you is experiencing… Ryan: Yeah. It’s super important to...I think most of us, all of us at this table have worn the wetsuit and swam in probably some cold water. I remember Arizona being frigidly cold. In fact, I got out of the water a little hypothermic, in fact. Nonetheless, thankfully no SIPE. That just shows you how rare it is. It really is. I don’t recall anyone having any issues that day even though the water temp is 62. You Northerners, that’s cold, I’m gonna tell you that right now. Signs and symptoms...I have difficulty breathing anyway when I’m working out. Signs and symptoms begin with a cough, a very persistent cough. When I say persistent I mean something you almost can’t even control. Andrew: You can’t stop coughing. Can’t hold it back. Ryan: Right. You’ll notice associated with that is difficulty breathing. It’s almost unexplainable. You’re like, “What in the world is going on? I’ve never had problems before.” That’s something that should start immediately throwing up the red flag on yourself. And then if you start something frothy. Frothy sputum. I hate that word, sputum. It sounds gross. Andrew: You’re actually coughing up something. Ryan: Some red tinged...It could be red-tinged. If that’s the case, if you ever see somebody experience that--you, yourself, or anyone else, stop immediately. Get some help immediately. Because it can...going to the extreme here--very extreme--it can be fatal. But it also can be reversed, as well. So once you recognize it and being able to treat it as quickly as possible. Andrew: So, Ryan, before we shut it down today...we can’t end our conversation talking about SIPE deaths. Before we move on to the cool down, just for a second I want to give you the chance to be coach Ryan and not respiratory therapist Ryan. What is your top triathlon tip or training wisdom, if you will, that you’d like to share with the audience to close us out for the main set here today? Ryan: Yeah. Hm...consistency. My athletes would certainly agree because I preach the heck out of that. Shout out to Jenna who...consistency, I would put her picture, along with several of my athletes next to that word. Without sounding cliche about it, but consistency with a positive attitude. Nothing beats a positive attitude every single time. I tell you what, I like to say smile big. Smile big in the face of adversity. Great set everyone! Let’s cool down. Andrew: With fewer races happening currently, triathletes have never before seen an opportunity to try different pieces of gear, components, nutrition, etc. without it impacting race day. So in this unique, non-race season that we’re in at the time of this recording, Elizabeth, Ryan, what are one or two new things that you have tried recently that have really gotten your attention? Elizabeth: I honestly haven’t tried any new gear. I was thinking so much about this… Andrew: Elizabeth is so consistent with what she knows works. Elizabeth: I’m sure my husband would swear that something has to be new with the number of Amazon packages that have arrived at our doorstep. Truth be told, it’s just been a restock of everything that I’ve been using previously. Andrew: UCAN. Nike Vaporflys. Elizabeth: Yeah, same ol’, same ol’. So I guess I’m going to have to pay attention to your guys’s answers here to see what I’m missing that I need to put another order in for. Andrew: I know Ryan and I both, even in race season we like trying new things and are kind of junkies in that way. Ryan, I trust you have an answer here? Ryan: I do. Like Elizabeth said my wife is always like, “Hey, you got another package at the door.” Andrew: I have an allowance now. Ryan: Don’t tell my wife that. It’s either an Amazon package or a TriDot package, it’s one or the other. I will admit to that for sure. But seriously, though. My Garmin 945--I’m wearing it right now. I actually just recently got this about 4 or 5 weeks ago. I’m absolutely loving it. Andrew: What is it telling you your VO2 max is? Ryan: I think it said 54 or something like that. Andrew: Superior? Ryan: It does say superior for my age, thank you. Hey, listeners, 54 if you beat me, don’t pick on me, alright? I have a printout here from UNT that says differently, though, which is interesting. But I love my Garmin 945. It’s a fantastic watch. All the metrics for us data geeks. Andrew: You had the 920 before. Because I still have that. So you’ve upgraded and seen some impact with the new features? Ryan: Yeah, somewhat. It’s data. It’s fun data. I don’t like to let Garmin dictate my feelings so I can tell you that. A lot of times when it says something I don’t like, I just smile at it. Remember that. But my Kickr. I love my Wahoo Kickr. I got it a year ago. At the time I wasn’t on Zwift with everyone. With this whole Covid thing I fired that up back 6 months ago and started Zwifting more. I love that Kickr. I tell you what, talk about nailing workouts. That’ll help you. Andrew: The indoor trainer with the automated workout in Erg mode is dynamite. Ryan: Non-forgiving. Andrew: Yeah. Those 2x18 at threshold, you have to hold all 18 of them. Long-time listeners of the podcast will have heard me talk about my preparations for Ironman Texas this year that didn’t happen. But getting ready for that race, I was starting to try some new things and figure out what nutrition I wanted to use on race day. What saddle I wanted to sit on. What gear I wanted to wear all day long on course. So in that I was trying some things. A company called Dash Saddles, it’s a local company out of Boulder, Colorado, that puts out super lightweight carbon high-end saddles. I had read good things about them, heard good things about them. I never wanted to pay the price tag for one. I found one on eBay. It was at a time when I was playing saddle roulette to find something that would make my butt happy-ish for 112 miles. So I eBay purchased this Dash Saddle and it’s been hopefully the winner. I’ve been more happy on it than any other saddle I’ve tried and I’ve tried a lot of saddles. If you’re in that place where you’re looking at different saddles thinking that it might be time to date a new one and move on from your old one, I highly recommend giving Dash Saddles a look. Well that’s it for today, folks. I want to thank Coaches Ryan Tibball and Elizabeth James for talking all things respiratory health. Shout out to TriTats for partnering with us on today’s episode. Head to TriTats.com to show up to your next race styling like a pro. Enjoying the podcast? Have any triathlon questions or topics you want to hear us talk about? Head to TriDot.com/podcast and click on “Submit Feedback” to shoot us a message or leave us a voicemail to get your voice on the show. We’ll do it again soon. Until then, happy training. Thanks for joining us. Make sure to subscribe and share the TriDot podcast with your triathlon crew. For more great tri content and community, connect with us on Facebook, YouTube, and Instagram. Ready to optimize your training? Head to TriDot.com and start your free trial today! TriDot – the obvious and automatic choice for triathlon training. 
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