NSAIDs for Exercise: Are You Taking a Risk?

Non-steroidal anti-inflammatory drugs (NSAIDs) are a group of drugs designed to reduce pain and inflammation as well as to lower body temperature. Whether you have had a headache or a mild fever, you have probably taken an NSAID before. Many exercisers opt to use NSAIDs in order to provide pain relief. The most common NSAID used by people who exercise is ibuprofen (Motrin or Advil) which provides short-term relief in pain and inflammation. NSAIDs have been shown to help relieve pain and inflammation due to exercise, but there is debate on whether or not the drug should be used to prevent pain due to exercise. To look into this debate, let’s first get an idea of how the drug works.

These drugs work by blocking cyclo-oxygenase (COX) enzymes. These enzymes are involved in producing chemicals called prostaglandins which have various functions in the body. Both the COX-1 and COX-2 enzymes produce prostaglandins that are associated with pain, inflammation, and fever. The common side-effects observed with NSAID use is with the additional effects of blocking the COX-1 enzyme. These enzymes allow for the production of prostaglandins associated with protecting the lining of the gastrointestinal (GI) tract as well as activating blood platelets associated with clotting. By blocking the COX-1 enzyme, complications within the GI tract can potentially occur such as stomach ulcers and temporary intestinal leakage. These side-effects are usually not observed when one occasionally uses NSAIDs, but what if one regularly uses NSAIDs while exercising?

A study published in the 2012 edition of Medicine & Science in Sports & Exercise looked into this potential factor. The study compared nine healthy men at four different time points to see if a combination of high intensity exercise and taking ibuprofen can increase temporary damage to the small intestine. This was after completing a previous study where they concluded that high intensity exercise leads to temporary small intestine injury. The four time points were 1) cycling at high intensity for one hour with 400 mg of ibuprofen in their system, 2) cycling at high intensity for one hour with no ibuprofen in their system, 3) staying at rest with 400 mg of ibuprofen in their system, and 4) staying at rest with no ibuprofen in their system. At the end of each time point, the researchers analyzed the blood of the subjects for levels of intestinal fatty acid binding protein (I-FABP) which is an indicator of injury to the small intestine. They noticed that there was a significantly higher level of I-FABP present in the blood of the subjects who cycled and took ibuprofen compared to the other three groups and that the I-FABP levels were high for as long as 2 hours post exercise. These results show that taking NSAIDs during exercise may be detrimental to the body, especially since many endurance athletes exercise for longer than one hour and may actually consume more than 400 mg of ibuprofen prior to or during their exercise.

Besides the known side-effects, research has shown that there may be a few hidden side-effects by taking NSAIDs with exercise. A paper published in the 2009 edition of the British Journal of Sports Medicine analyzed these potential side-effects. The paper states that taking NSAIDs prior to exercise may negatively impact the musculoskeletal system by masking the pain one feels and potentially causing an injury to inadvertently get worse. The paper also states that prostaglandins are associated with the production of collagen which is an important building block needed for muscle, tendon, ligament, and bone recovery. By blocking the COX enzymes, prostaglandin production decreases causing a decrease in the production of collagen. As the author states, a decrease in the production of collagen may result in adverse effects such as the inability of healthy tissue to adapt to increased loads or a decrease in the rate of collagen regeneration after injury. These effects may lead to an increased risk of injury as well as a delay in recovery after injury.

After reading through these two papers, I found a few limitations. In the first paper, a limitation I found was that they only tested male subjects undertaking endurance exercise. I wonder if there are any adverse effects of taking NSAIDs while performing resistance exercises and if there are any differences between males and females. In both papers, a limitation I found was that they only tested NSAID use prior to exercise. From past experience, I have occasionally used NSAIDs a couple hours after exercise to reduce excruciating pain that had already developed. After taking the drugs, I was pain-free and felt no side-effects. It would be interesting to see whether or not the risks discussed are also associated with taking NSAIDs after exercise if the pain has not already developed.

Overall, it may seem tempting to take NSAIDs to prevent pain due to exercise, but it may not be the ideal thing to do. Although NSAIDs can help you relieve pain, research shows that there are a number of additional risks you may be taking by using these drugs to prevent pain either prior to or during your exercise. If you want to manage pain during exercise, I would recommend just dealing with the pain or maybe looking into non-NSAID drugs such as acetaminophen (Tylenol) which provides pain relief through a different mechanism. If you want to take NSAIDs after exercise, it would be best to use the drugs only when pain has already developed instead of using it to prevent potential pain. It would also be best to use the drugs occasionally in order to prevent an additive effect of the side-effects on your body. But remember, it is always best to talk to a health care professional prior to making decisions regarding your health.

Recommended Further Reading:

Nonsteroidal anti-inflammatory agents

Cyclooxygenase: COX-1 and COX-2 Explained

Aggravation of Exercise-Induced Intestinal Injury by Ibuprofen in Athletes

Exercise-induced splanchnic hypoperfusion results in gut dysfunction in healthy men

Prophylactic misuse and recommended use of nonsteroidal anti-inflammatory drugs by athletes

Questions to Consider:

1.) Have you ever used NSAIDs before? If so, when and/or why did you take them?

2.) If you have taken NSAIDs before, did you use them as a preventive measure or as a way to reduce any discomfort?

How It Works: Isokinetic Dynamometry

Recommended Further Reading:

Isokinetic Dynamometer – Role in sports rehabilitation

Isokinetic Dynamometry Applications and Limitations

Isokinetic dynamometry. Applications and limitations. 

Isokinetic Training

Physiological Adaptations to Velocity-Controlled Resistance Training

How Is Isokinetic Resistance Created?

Endurance Training & Skeletal Muscle Adaptation

DC Motor, How it works?

Usefulness of measuring isokinetic torque and balance ability for exercise rehabilitation

A new method for gravity correction of dynamometer data and determining passive elastic moments at the joint

Video Sources:

How to do a proper leg extension

Eccentric Quadriceps on Biodex Isokinetic Dynamometer Passive Mode

Biodex Isokinetic Testing

Louisiana Tech University: How to use a Biodex Isokinetic Dynamometer

Isokinetic Dynamometers Easytech

Epsom Salts: The Inconvenient Truth

Do you suffer from insomnia, muscle cramps, delayed-onset muscles soreness? If so, then your physical or massage therapist may recommend Epsom salt without even knowing why. In its multitude of benefits, Epsom salts are said to improve sleep, reduce inflammation, improve muscles cramps, wound healing and much more. Epsom comes from the name of the English town that the mineral compound, magnesium sulfate, was first discovered. It was extracted by boiling water from a bitter saline spring that people would soak in for great health benefits. The medicinal properties are said to be established by a chemist Nehemiah Grew in 1695, who acquired a royal patent for exclusive manufacturing rights. Today, Epsom salts are a main ingredient in most bath salts and soaks and can be found at almost any pharmacy or bath specialty stores. Before you go take a soak, what does the science say?

Figure one is a molecular model of magnesium sulfate

Well the inconvenient truth is that there is little to no research on the effects of bathing in an Epsom salt bath. There are endless blogs out there with endless claims about the health benefits of Epsom with nothing to back it up. For example, there’s a claim that it’s good for people who are magnesium deficient, but there’s no evidence the magnesium is absorbed through the skin. After searching for articles for magnesium sulfate, bath salts, Epsom salts, I have found not a single article that even investigates Epsom salt baths. The closest thing I found was a patent for methods of different bath soaks, which just boil down to saying put salt in warm water and soak for 15 minutes. Other bloggers seem to have the same problem when trying to find the proof, (in the references below is a link to another similar article.)
I did however find articles about other medical uses for magnesium sulfate. In the study from Maternal-Fetal Medicine Units Network, they wanted to test if magnesium sulfate could help prevent cerebral palsy in preterm babies. 2241 women at imminent risk for delivery between 24 and 31 weeks of gestation, were randomized into experimental (magnesium sulfate) and placebo (control) groups. Each group receive magnesium sulfate, administered intravenously as a 6-g bolus followed by a constant infusion of 2 g per hour, or matching placebo. After a follow up analysis, the rate of the primary outcome was not significantly different in the magnesium sulfate group and the placebo group. However, in a secondary analysis, moderate or severe cerebral palsy occurred significantly less frequently in the magnesium sulfate group. The risk of death did not differ significantly between the groups.

In my references, there is also another article about using magnesium sulfate to treat polymorphic ventricular tachycardia. Long story short is there is no evidence to support the claims people make about Epsom salt baths. I’m surprised there isn’t any actual science considering a folk remedy that been around for hundreds of years. We can only go by What other people say. I can see some merit to the muscle relaxation benefit because magnesium sulfate can be used as a laxative and magnesium chloride is a common ingredient in rescue inhalers, in both cases it relaxes muscles. But again, there is no research on it. The best thing to do is try it and see if it works for you.


Questions to consider

Do you use Epsom salt? If so, Why?

Do you feel it helps?

Any thoughts why there is no research?



Dwight J. Rouse, M.D., Deborah G. Hirtz, M.D., for the Eunice Kennedy Shriver NICHD Maternal–Fetal Medicine Units Network*

N Engl J Med 2008; 359:895-905 August 28, 2008 DOI: 10.1056/NEJMoa0801187


Treatment of torsade de pointes with magnesium sulfate.

D Tzivoni, S Banai, C Schuger, J Benhorin, A Keren, S Gottlieb and S Stern

Circulation. 1988;77:392-397, originally published February 1, 1988






Calories and Power in Exercise Equipment



Recommended Reading:

Calculating caloric expenditure with ACSM equations

How the Peloton bike calculates power output (watts)

Lesson plan on bike ergonometry

The accuracy of the ACSM cycle ergonometry equation

Watts calculator for Concept 2 rower

Making sense of calorie-burning claims

Exercise Physiology for Health, Fitness, and Performance


Traditional and Functional Workouts – Are They Really That Different?

As exercise  trends changed over recent years, the kinds of workouts individuals do have also changed. Trends like circuit workouts, high intensity interval training (HIIT), or most recently Crossfit have influenced the types of workouts people do because of the results each claim to give.Essentially these workouts can be put into two categories: Traditional or Functional workouts.

Traditional workouts or traditional strength workouts are those that use resistance training principles. These workouts are what typical gym-goers think of as “leg day” or “arm day”. They include isolating a specific group of muscles and lifting weights to maximize muscle strength usually including exercises like arm curls, leg presses, dip machines, etc. On the other hand, Functional workouts include a wide variety of exercises that mimic movements that the individual experiences in activities for daily living. A typical functional workout is harder to define since it is so subjective to the individual. For example, a functional workout for a softball player is going to be completely different from  a functional workout for a dancer.

Intuitively you would think that each type of workout out would produce different results. A traditional strength workout would increase a person’s strength while not really affecting other systems. While a functional workout would not increase a person’s strength as much and would increase their efficiency for activities faster. But what does the research really say?

First let’s look at how each workout affects aspects of the other. The article “The Effects of Resistance Training on Endurance Distance Running Performance Among Highly Trained Runners” looked to study how traditional strength workouts affects the functional running performance in runners. After a systematic review of articles, they found that resistance training has a positive effect on running pefromance [1]. This means that resistance training can be beneficial for functional activities. Another study looked at the adaptations of resistance circuit training compared to traditional strength training in resistance-trained men. It could be argued that circuit training is a form of functional training for this population and thus the study is looking at how a functional workout affects strength performance. The study found that the one rep max (1RM) increased equally for both training protocols and that circuit training was as effective as traditional strength training in improving weight lifting [2]. Interestingly each type of workout has positive effects on each other. A functional workout can improve strength abilities while traditional strength workouts can help with functional activities.

But what if the two workouts are compared to each other?

In “Functional vs. Strength Training in Adults” 101 middle aged subjects were divided into two groups (functional and strength training) that each performed 24 sessions of a training protocol twice a week. Each subject was assessed pre- and post-intervention using  Y-balance test and a Functional Movement Screen. The results showed that there were no differences in improvement between the training protocols, however functional training was less effective for women compared to men in the same group [3]. when looking at the anthropometric and motor effects of functional vs. traditional resistance training in the Tomlijanovic et al. study, there was no statistical difference between either of the anthropometric measures or the motor status variables after a five week training program [4]. There were only minor improvements in each training program that did not affect the overall results, this could have been due to the short amount of training time. Even when comparing the two workouts to each other in a non-exercise application a similar trend appears. In the study Christine Stutz-Doyle, a traditional strength workout and a functional workout were compared to study their effects on pain, strength, and functional mobility in elderly subjects with Knee osteoarthritis in hopes to improve the subjects quality of life. Interestingly there was no statistical difference in muscle strength, pain and stiffness between the two groups Although the functional workout group did increases gait velocity by the end of the study which could be attributed to the task specific training [5].

In conclusion, the gathered research states that there is no statistical difference between functional and traditional strength workouts. The results that you are going to experience from doing either are going to be relatively the same, which is rather interesting. So it is really up to personal preference of which workout you would prefer doing. Of course, it is incredibly difficult to standardize functional workouts across studies and even within studies it is difficult to control for the types of movements. A more expansive review of research studies might prove these results otherwise.


Further Readings:

  1. Yamamoto LM, Lopez RM, Klau JF, et al. “The Effects of Resistance Training on Endurance Distance Running Performance Among Highly Trained Runners: A Systematic Review”. Journal of Strength and Conditioning Research. 2008; 22(6): 2036-2044. DOI: 10.1519/JSC.0b013e318185f2f0. 
  2.  Alcaraz PE, Perez-Gomez J, Chavarrias M, et al. “Similarity in Adaptations to High-Resistance Circuit vs. Traditional Strength Training in Resistance-Trained Men”. Journal of Strength and Conditioning Research. 2011; 25(9):2519-27. 
  3. Matheus Pacheco, Luis Teixeira, Emerson Franchini, et al. “Functional vs. Strength Training in Adults: Specific Needs Define the Best Intervention”. International Journal of Sports Physical Therapy. 2013; 8(1): 34-43. 
  4. Tomljanovic M, Spasic M, Gabrilo G, et al. “Effects of Five Weeks of Functional vs. Traditional Resistance Training on Anthropometric and Motor Performance Variables”. Kinesiology. 2011; 43(2): 145-154.
  5.  Stutz-Doyle, Christine. “The Effects of Traditional Strengthening Exercises Versus Functional Task Training on Pain, Strength, and Functional Mobility in the 45-65 Year Old Adult with Knee Osteoarthritis”. Seton Hall University Dissertations and Thesis (ETDs). Paper 98. 2011. 

Is massage really helpful?

The Issue:

Massage is a popular method for relaxing and fatigue recovery around the world. Most people find that massage is comfortable and enjoyable, but why and how is it beneficial to your body? The idea behind massage is “myofasical release”, which is often used as a alternative medicine thearpy for myofascial pain. To understand how it works; first of all, we need to know what fasica is. Fasica is a tissue surround and  support muscle throughout the body[1]. Since the thread of fasica is connected and tightened, when the body get injured at one spot, the effect spreads to other place of the body. Thus sometimes patients experience pain at one spot, but the pain originates from other spot in the body. When one spot in the body get injured, the body react to protect the itself by reduce blood flow and contract muscle around that injured area. However, the initial good thing can create pain because more reduced blood contracted muscle at the restricted area. The myofasical release therapy which in form of various type of massage is focus on smoothing out the contracted area, and let fasica tissue return to its original flexible fluid self[2]. However, there are also voice claims that myofasical release therapy lack of evidence and is a quackery. So will myofasical like massage really help patients release myofasical pain? let’s check some research result and find out.

Figure 1: this picture shows where the fascia is.


Scientific evidence:

The first article, “Modeled Osteopathic Manipulative Treatments: A Review of their in Vitro Effects on Fibroblast Tissue Preparations.” published by The Journal of the American Osteopathic Association (JAOA) suggests the possibility of myofasical release (MFR) aiding in the strengthening of the area. The research look into the magnitude and duration of the MFR therapy in order to find out the effectiveness of MFR therapy. Researchers hold strain magnitude constant at 6% and try different magnitude (3%, 6%, 9%, and 12%) and duration(0.5, 1, 2, 3, 4, and 5 minutes) of MFR. The result suggests production of extracellular matrix proteins such as collagen may be up regulated with  greater-magnitude (12%) treatment.

Another article “Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial” also support the evidence that myofascial release make a positive effect on fibromyalgia syndrome like pain, postural stability and physical function by comparing random assigned experimental group and a placebo group. After 20 weeks of myofasical therapy, there is a great improvement in painful tender points, McGill Pain Score, physical function, and clinical severity. Also, according to the six month late post intervention, the experimental group had a significant lower mean number of painful points, pain score, physcial function, and clinical severity. One limitation of this research is the lack of postural stability text with a higher level of difficulty, another limitation is that the therapist who administered both intervention protocols and the patients themselves could not be blinded.



According to the research above, it seems MFR therapy has a positive effect on myofasial pain. The MFR itself is safe and does not have side effect. Thus, lots of people might consider it as a alternative therapy especially those who don’t want surgery. Both research offer scientific evidence to support the benefits of MFR therapy. However, there also could be limitation for those research so they could also sometimes be inaccurate. Overall, MFR therapy is recommended since it does not have side effect, and it is indeed a comfortable method to relax.



The Sports Gene- Chapter 14 Reflection

Class Make Up Blog 4/13 – Focus on Chapter 14

As the title of Chapter 14 suggests, “Sled Dogs Ultrarunner, and Couch Potato Genes”, David Epstein continued to explore the genetic influences on the worlds top athletes- and the role these genes play in the average person’s lifelong health journey. This chapter specifically looked at a person’s genetic predisposition to physical activity levels

Epstein starts off the chapter with the story of Lance Mackey. A dog sled racer and breeder, Mackey had great success because he bred dogs for the will to run rather than their speed.  WHile his hand was somewhat forced because he could not afford the expensive racing dogs, he looked for th dogs that simply wanted to run. Zorro, his pride an joy, was one of his first dogs and the beginning of his winning lineage.

Mackey used Zorro (above) to breed the first generations of racing dogs.

After Mackey’s crazy success, Heather Huson began to look extensively at the genetics of sled racing dogs.  In her 201 dissection of  breed composition and performance she showed Alaskan Huskies to be there own distinct breed and supported Mackey’s opinion that he won because his dogs wanted to run not because they were forced to.

While sled racing is exciting, what does winning a thousand-mile dog race mean for our athletes? Well, a lot apparently. It is easy to understand the role genetics play in athletic success in terms of body structure and muscle type, but it is not as blatant the role it plays is in drive and passion to train.  After discussing the genetics of huskies, Epstein turns to lab rodents bred to be runners.  They have also shown, that like the huskies, mice can be bred for work ethic.  In  Theodore Garland’s voluntary-runner breeding program he showed that while the bodies changes physically, the brain changed as well.  Mice who ran more than the average mice were bred together and resulted in “high-runner” mice who ran excessively. This genetic drive for physical activity can be seen in Pam Reed, an ultrarunner. She believes that running more than three hours a day may make some people ill, but not doing it would certainly make her ill. She has difficulty sitting still and is believed to be the human version of the mice bred to run. Taking the study a step farther, Garland dosed the mice with Ritalin and found that the levels of dopamine in the medicated mice matched the levels in the “high-runner” mice. Particular dopamine receptor genes have been linked to higher levels of physical activity, and can be further linked to attention deficit hyperactivity disorder (ADHD).  Ritalin, used on the mice in Garland’s study, is a common medication for those with ADHD to calm them and increase their focus.  Tim Lightfoot has studied the connection between ADHD, exercise and dopamine levels and believes that although Ritalin may be beneficial to keep students focused in class, it may be blunting their strong drive to be active.

I found the genetics of work ethic to be fascinating because you do not hear about it often. For example, during the NFL draft they tell you about players height, weight and other physical stats, but there is no category to quantify “drive” or “passion”.  The connection towards the end of the chapter to the treatment of ADHD also caught my attention. In 2008 when Michael Phelps had his incredible 8 gold medal run I was his biggest fan. I have read (maybe embarrassingly) read his autobiography multiple times. In No Limits, Phelps speaks to his experience with ADHD and his experiences with medications.  In this article in Psychology today, “From ADHD Kid to Olympic Gold Medalist” they explain how swimming became his medication by allowing him to release his nervous energy and increase his structure and focus.

While Phelps has the perfect body for a swimmer with freakishly large feet and hands and an abnormally long torso makes him a force to be reckoned with, his brain may also be home to perfect genetics we do not understand yet. I believe this chapter is eye opening and important because as a society we continue to over-medicate children with ADHD. These children may not all be olympians but these studies show that they may just need a physical outlet rather than Rtalin.

Near-Infrared Spectroscopy- How It Works


















No Whey? No Problem!

In today’s world of social media “fitspo” blogs and fad diets are at our fingertips more than ever.  The “recommended page” on Instagram, for example, is full of fitness bloggers telling you exactly what to eat and what work outs to do for the best results.  And while their advice is often based on some truth, it is also can be blown out of proportion or can be easily misconstrued.   It is important to remember that diet is based on individual needs and that what works for one person may not work for you- therefore, the best way to choose new meal plans is through education. First off, why are proteins so important?

Figure 1: 9 essential amino acids we must ingest.

Proteins have four layers of structures that all play a role in how they work and  how they interact. The primary structure, is simply the sequence of amino acids (AAs) in a polypeptide chain.  There are essential AAs that we must ingest, non-essential AAs that our body can produce, and conditional AAs that are pertinent in times of stress and illness. Protein is extremely beneficial and unarguably critical to our diets, we excrete excess amino acids, so over eating protein poses to additional benefit.

So knowing this, how do you decide how much protein you should eat? Maybe to some surprise, science have shown that athletes actually require the same general range of protein intake when compared to sedentary persons of the same sex. According to the U.S. and Canadian Daily Reference Intakes,  0.8 g·kg−1 of protein is enough to meet the needs of 98% of healthy adults. “There is not a strong body of evidence documenting that additional dietary protein is needed by healthy adults who undertake endurance or resistance exercise, the current DRI for protein and amino acids does not specifically recognize the unique needs of routinely active individuals and competitive athletes.” They also suggest that for adults 18 years and older,  10%-35% of total caloric intake should be comprised of protein. This supports the accepted ideal that the recommended intake levels can be met through regular diet and without supplementation.

What does this mean for those trying to lose or gain weight? Whilst, in both of these cases, it may be easy to fall victim to one of the fad diets, you should take the time to understand them and to find the truth behind them.  CrossFit is currently one of the most popular fitness plans and many of their athletes use meal templates to guide them in fueling their bodies. The Paleo Diet and Zone Diet are two of the most common choices for these athletes, or a combination of the two.  Paleo (sometimes called the caveman diet) is bases on eliminating processed food and eating a high fat, moderate protein and low carb diet. The Zone Diet is based on “blocks” where you eat a specific number of daily servings of proteins, carbohydrates, and fats.  The “blocks” are structured throughout the day rather than in the normal 3 meals a day.  The diets claim to increase metabolism and when tailored to specific goals, can result in significant weight loss and muscle development.

Figure 2: The 40/30/30 breakdown of the Zone Diet.

Samuel N. Cheuvront found that the Zone Diet does not result in the promised outcomes. He found that any significant contribution of active muscle oxidation was not even found in skeletal muscle.  In another investigation by Tipton, et al,  they looked at the differences between ingesting protein (such as whey protein supplements) before weight training versus after. Their results allowed them to conclude that the timing of supplementation does not matter but that having protein in your system consistently does have positive impacts.

Based on the review of the current literature, the biggest conclusion that can be made is that protein does play a large role in diet and in over all health.  What cannot be confirmed is the benefits of protein supplements or high protein diets. According to daily recommended intakes,  it is much more important to have a balanced diet, and the main benefit of a high protein diet may actually be limiting sugar and carb intake.


Further Reading

Orders of Protein Structure

Nutrition and Athletic Performance

Role of Protein in Diet

A Review of Protein Recommendations for Athletes


Questions to Consider

  1. How cognizant are you of your protein intake? Do you stagger it throughout the day?
  2. Have you tried any high or low protein diets? Did you notice any difference in your workouts?
  3. What, if any, do these conclusions have on vegetarians?

Breathe In, Breathe Out… Breathing during Exercise

In today’s society, exercise is a part of everyday life. From high school sports and professional sports teams to recreational running and yoga classes, exercise is everywhere. However, many people struggle with breathing during exercise. Gym-goers pant on the treadmill, weight-lifters have trouble lifting their weights, and yoga classes struggle to stay balanced. And, if you’re anything like me, you’ve heard every saying about “breathing in through your nose and out through your mouth” or breathing at certain times while exercising, which can be confusing or overwhelming to do. So, many people ignore their breathing while they exercise and do not regulate their breathing patterns at all. But, many of the exercise difficulties that people experience can be improved by learning to breathe properly while exercising. So, how does this work? And, how does breathing differ between exercises?

The Science Behind Breathing

The process of breathing involves several chest muscles, most notably the diaphragm. The diaphragm is a dome-shaped, sheet-like muscle that lies underneath the lungs. Not only does the diaphragm separate the chest from the abdomen, it is also the primary respiratory muscle. When we inhale, our lungs expand and the diaphragm contracts, or moves downward, as it flattens. At the same time, the intercostal muscles of the rib cage expand. This expansion of the diaphragm and intercostals and the addition of air in the lungs creates a great deal of pressure inside the body, which will play a large role in breath regulation as we will see later. While inside the body, oxygen is absorbed to create energy in the form of ATP. Then, as we exhale, our lungs return to their resting state and the diaphragm returns to a dome shape. As this happens, the pressure built up during inhalation is relieved through the release of gas as carbon dioxide. But what does all this mean for your exercise routine?

The In’s and Out’s of Breathing For All Exercises

Breathing patterns and the timing of breathing differs from exercise to exercise. Many breathing patterns in sports are based on regulating the build-up of pressure that occurs during inhalation, as mentioned above. Other breathing patterns are meant to maximize oxygen-uptake by the body. But, it’s important to note that each sport or type of exercise requires different breathing patterns.


Running is one sport with no singular convention on breathing. Some people say “breathe in through your nose, out through your mouth.” Others say to breathe in-tune to your running, so inhale on one step, exhale on the next. Still others claim that you should breathe however best suits you to finish a run. So, is there no singular optimal way to breathe when running?

Studies have shown that this is false – there are certain ways of breathing that are less energetically costly and more comfortable for runners. One study supporting this was conducted by McDermott, et al. to analyze the connection between breathing pattern and stride rhythm. In this study, ten subjects ran at various paces while measurements of heel strike and inhalation were recorded. The results showed that runners have a tendency to breathe in a 2:1 or 3:2 pattern most often, meaning inhaling for 2 steps and exhaling for 1 (2:1) or inhaling for 3 steps and exhaling for 2 (3:2).

This seems to be a logical pattern of breathing when running. First of all, it is good practice to breathe in sync with your footfalls. When breathing with your footfalls, you time the movement of your body and internal organs with the movement of your diaphragm during respiration. This prevents the development of odd, uncomfortable areas of pressure on the diaphragm which can impede breathing. In terms of the speed of breathing, the more quickly you breathe, the less time your body has to fully absorb the O2 you’re bringing in through respiration. When your body doesn’t have enough oxygen to energize itself, anaerobic metabolism kicks in, which causes lactate to accumulate and decreases the body’s ability to perform endurance tasks. However, when you breathe slowly, more oxygen is drawn into the body, and the body has enough time to absorb the oxygen in your lungs to create energy and keep you energized when running.

Therefore, by slowly breathing in a 3:2 or 2:1 pattern in sync to your footfalls when you run, you have the potential to run more smoothly and for a longer period of time before fatiguing by maximizing oxygen uptake.

Weight Lifting

While there is no standard convention for breathing when running, there is one near-universally accepted standard of breathing for weight lifting exercises. Convention says that while performing weight lifting tasks, one should exhale on exertion and inhale during reset. Easy enough to remember, right? But, is this the best way to breathe when lifting weights?

Studies point to yes. In one study by Hagins, et al. subjects were asked to perform three different breathing patterns while lifting objects:

  1. Inhaling before lift, holding during lift
  2. Exhaling before lift and holding during lift
  3. Inhaling before lift and exhaling during lift

While subjects were doing this, measurements were being taken of change in abdominal pressure and maximum force exerted. These measurements showed that abdominal pressure was lowest during breathing patterns 2 and 3, both of which involved exhalation.

Another study by Lamberg and Hagins looked at breathing patterns when lifting different loads. Subjects were asked to lift milk crates multiple times while a pneumotachograph recorded airflow. This study found that the most consistent natural breathing pattern among individuals was to inhale right before lifting an object, which is consistent with the results of the previous study.

Based on these two studies, it is clear that exhalation is an important part of breathing during weight lifting. By reducing the amount of pressure in the abdomen, exhaling during lifting decreases the chances of sustaining internal injuries such as hernias and vessel strains which can be caused by excessive internal pressure. Exhaling relieves that pressure by releasing some of the accumulated air from the abdomen, ensuring that the abdominal pressure does not reach an unsafe level. So, next time you go to the gym to bench press, remember to exhale when pressing and inhale before letting the weight down onto your chest to regulate pressure build-up in your chest and abdomen.

Other Exercises

The studies viewed in the cases of running and weight-lifting were limited in that they consider only two very rigidly structured types of exercise. The running study had subjects running at specifically selected speeds. And, the weight-lifting studies only looked at subjects lifting specific weights in an up-down direction. But, what about sports where running speed and timing can vary, such as soccer or football? Or exercises where full-body balance is the goal, such as yoga? Is there an optimal breathing pattern for these sports and exercises?

More testing needs to be done to determine optimal breathing for these sports. But, based on the results of existing studies and on common practice in sports, it’s likely that the best breathing pattern for your sport will involve a balance between maximizing oxygen uptake and regulating abdominal pressure.

Recommended Further Reading

For more information about breathing during exercise, explore:

Questions to Consider

  1. Are you aware of your breathing when you exercise? Do you make it a point to breathe a certain way when you exercise?
  2. When you run, what step-breath pattern do you follow most often?
  3. If you lift weights, how do you breathe when you lift? When do you inhale and exhale?
  4. How do you think the breathing patterns covered in this article can be applied to sports/exercises like soccer, football, or yoga?