Section 2: The Practice
Chapter 8: About DOMS
There is a lot of theories about why we get sore after exercise. And many of them are debunked by modern research. Diving into this subject can be confusing since there are so many factors included in keeping the body in homeostasis (balance). We will consider some of them here.
Chapter 9: How to Remove DOMS – The Protocol
Here you will learn how to remove DOMS with the RecoveryBreathing technique. By day 2 after the exercise all pain from DOMS will be gone when you follow this protocol. Too good to be true you say? Try it out for your self. Its fun to be surprised by something so simple.
Chapter 10: The Breathing Exercise is Simple
The breathing exercise is simple. Do it on the couch while relaxing or watching TV, while stuck in traffic, while waiting for a friend, in bed before going to sleep, or anywhere when you can. There really is no need to close your eyes. Just control the breathing and relax for a short period of time. Here you will learn how.
Chapter 11: Important Guidlines
The breathing exercise is simple. But don´t be fooled. Please read this page carefully. There are some details many people do wrong because they confuse breathing techniques they have learned before with this one. Read on to make sure you do it correctly.
Chapter 12: About Recovery Strategies
Here is a list of the most popular recovery activities and techniques, apart from breathing. Which rarely (never, really) is mentioned. You can add any of these strategies to the RecoveryBreathing protocol, but you will quickly notice that none of them can remove DOMS like RecoveryBreathing can.
Chapter 13: The Spectrum of Breathing Frequencies
Normaly we believe that if we breathe deeper it is better. But actually, deep breathing does very little. It is the change of breathing frequency that gives the results. And different breathing frequencies give different results. Just like different electromagnetic radiation frequency (light) give different colours of the rainbow. Here you will get a complete overview of which breathing frequencies that does what in the body.
Note: The graph are based on the real science but do not show the exact numbers. They are made to portray the relative relationships between factors associated with RecoveryBreathing.
Chapter 8: About DOMS
There is a lot of theories about why we get sore after exercise. And many of them are debunked by modern research. Diving into this subject can be confusing since there are so many factors included in keeping the body in homeostasis (balance). We will consider some of them below.
Lactic acid (lactate)
Lactic theory has been turned on its head. Previously we thought that lactic acid was the major culprit in training. When we experience exhaustion, we call it “the lactic threshold” because the concentration of lactic acid increases significantly in a short time. However, lactate, being lactic acid without acid, has actually been shown to provide new energy to the muscles during long distance training. It passes by the liver and is converted into glucose which is used as energy in the muscles. This is called the Cori cycle.
Lactic acid is associated with exhaustion since it increases significantly when we are exhausted, but is in actuality something positive and something we really want to utilize fully. It is not a cause of fatigue, but a protection from fatigue.
And also, something that might surprise many of you, even though lactic acid give acidosis, it is not a cause of acidosis, but a protection from it. This is explained below.
Even the acid theory has been threatened by science. There is no doubt that excess acid in the muscles is problematic for the nerves and can contribute to pain. But when muscles are exhausted, it is not the excess acid in general which is exhausting the muscles. It is excess acid from specific processes that causes problems.
Lactic acid and CO2 both cause acidosis, but these two have a protective function. Lets repeat this: the acidosis from Lactic acid and CO2 are not damaging, it is protecting.
When we reach exhaustion there is a surplus of K+ ions (potassium) in the extracellular fluid (outside the muscle cells). In a resting muscle cell we find most of the K+ inside the cell. Only during movement does K+ leak out so that Na+ can leak in and generate an action potential big enough to create a contraction. As long as K+ is allowed to be moved back into the cell before the next muscle cell movement we will not experience fatigue. A buildup of extracellular K+ reduces the muscles ability to contract and during exhaustion there is so much accumulated K+ that the muscles are completely unable to contract.
However, the lactic acid and CO2 will have an acidifying effect, but still their function is to protect against exhaustion. They neutralise the surplus of K+. This has been shown in several studies that also mention that increased CO2 in the blood gives a higher lactate threshold.
The green circle shows what happens to muscle strength when lactic acid is injected into a muscle that has been exhausted. Muscle strength returns quickly. (Nielsen et.al. 2001)
The chemical process that is producing lactic acid is protecting us agains acidosis by using two H+ protons (the acid) to produce an end product with one H+.
Also, scientists have see that the metabolic acidosis usually is fully recovered already within 20 minutes after ending the exercise. The acidosis might be a reason for the burning sensation in the muscles during exercise, but it is certainly not a cause for increased muscle soreness 2-4 days after the exercise. (Street et.al. 2001)
The Muscle Spasm Theory
After eccentric exercise there is an increased level of muscle activity. Even at rest. This has been proposed to indicate local spasm in muscle motor units that lead to a compression of local blood vessels, ischemis (low oxygen delivery) and accumulation of metabolic waste products. The problems that arise from this spasm may lead to a vicous cycle where pain leads to more spams leading to prolonged ischemic conditions leading to more pain, etc. (Chung et.al. 2003)
But science has not yet found any clear indication of this. In some studies the elecromyography (EMG) show increased muscle spasm, but it others there is no muscle spasm. The Delayed Onset Muscle Soreness is still there though. So there is no direct relationship between muscle spasm and pain after exercersise.
Anyways, in the situations where muscle spasm actually play a sentral role, Recovery Breathing will be a very efficient recovery strategy. The relaxation that happens during the breathing session, and the accompanying vasodilation that happens when the pause is included, will be the antidote for the muscle spasm theory.
The Enzyme Efflux Theory
The cell membrane of muscle cells is called sarcolemma. As with all cell membranes the sarcolemmas function is to protect the cell. But the sarcolemma also serves another function. It stores calsium used in the contraction of muscles. When the sarcolemma is damaged during exercise there is a leakge of calsium to the inside of the muscle cells. When the calsium accumulates we experience muscle weakness.
Accumulation of calsium is also thought to lead to an inhibition of cellular respiration at the mithochondrial level. When this happens adenosine triphosphate (ATP) regeneration is also slowed down. ATP is nessecary for the active transport of calsium back to the sarcolemma.
The accumulated calsium causes a cascade of molecular function that lead to more inflammation, more muscle damage and chemical sensitation to nociceptive nerve endings contributing to the painful experience of DOMS. (Chung et.al. 2003)
With RecoveryBreathing (increased CO2) you will quickly regain cellular respiration at the mitochondrial level after exercise because of increased blood circulaton happening in a situation of decreased metabolic demand. Calsium is safely transported back to the sarcolemma without any unnessecary activation of inflammatory functions.
Inflammation theory has also been scrutinized. It was earlier believed that the soreness comes from micro tears in the muscles that activate immune and inflammatory mechanisms. But this does not seem to be entirely true either.
There are many inflammation factors in the body but there are not many that correlate to pain progression during muscle soreness.
The main inflammatory marker in studies of the immune system response is CRP, and it does not change after training. Various other inflammation factors increase and decrease at different times after training, so one can not really say that inflammation is a direct cause of the pain. (Peake et.al. 2006)
During exercise-induced muscle damagen there is an infiltration of immune cells and edema in the muscle tissue. The breakdown of proteins and lipids during exercise attracts monocytes and phagocytes (immune cells) which is followed by an influx of protein-rich fluid into the muscle. The resulting edema stimulates sensory neurons that are associated with the pain experience. (Chung et.al. 2003,Peake et.al. 2005,Hirose et.al. 2004)
But even with this fact accepted by all scientists and exercise physiologists, it is still very difficult for scientists to actually find any inflammatory marker that clarely corresponds to DOMS. The immunsystem is very irratic compared to the established pattern of DOMS. Most inflammatory markers peak at 3 h after the exercise.And some cytokines sems to increase more on day 4, when the DOMS normally is going down.
The one factor that does seem to correlate to both the progression of DOMS and its accompanying pain sensitivity is Creatin Kinase (CK). CK is an enzyme that control the conversion of ATP to phosphcreatine (PCr). It is important in all cells that use a lot of energy (ATP), like heart, muscles and brain. It is closely associated with cell damage, muscle disruption or muscle diseases. These cellular disruptions cause CK, which is a natural part of the molecular process of muscle contraction, to leak into the blood. (Baird et.al. 2012)
By analyzing serum CK activity in the days after exercise we can see that it more or less perfectly overlaps that of DOMS. It peaks around day 2-4, just like the intensity of muscle soreness.
But again, even this cannot be used as a way to monitor or reflect muscle soreness or muscle damage. Some individuals have a higher level of CK in their blood compared to other individuals, even though they are exposed to the same exercise protocols. The base levels of serum CK in the general population can range from 20 to 16,000 U/L.
So some people can have high levels of CK, and still experience less DOMS than those with lower levels of CK. We are left, again, with no correlation of phyiological markers and DOMS.
But there is no doubt about one thing when it comes to muscle soreness: it hurts and it hurts the most during day 2 and 3.
The best theory of pain related to DOMS is that it is a kind of central sensitization, ie an increase in the pain sensitivity in the brain and the central nervous system. (Hosseinzadeh et.al. 2013,Minnett and Duffield 2014)
Therefore, even small movements or the slightest pressure on the sore muscles is painful. The causes of central sensitization are often complex, and may include acidity, inflammation, micro injuries to muscles, oxidative stress, etc.
This is also the reason why we experience less pain and become less stiff from the workout if we continue with it. The nervous system adapts to (read: becomes confident in) the challenge and thereby we do not experience so much pain. But if we do a new workout or increase the amount of exercise, we get DOMS again, because the nervous system needs time to accept this new challenge.
There are large individual differences in how intensely central sensitization appears. Everything from genetic differences to childhood challenges play their part. When talking about pain, it is always very individual and relative. Sometimes you can get increased DOMS after exercise simply because you have a stressful work situation, problems in your relationships, or other things that make you more susceptible to pain conditions and sensitization of the nervous system.
But no matter what is your ground zero, it is possible to prevent aches and pains if you take care of some basic needs: proper nutrition, a proper amount of pure water, good sleep and a proper amount of exercise (avoid overtraining).
And proper breathing. Using recovery breathing daily will result in an obvious boost in your recovery.
Chapter 9: How to remove DOMS – the protocol
In order to avoid DOMS after a hard workout the breathing technique must be used extensively and frequently in the days following exercise. Of course, in addition to eating real food, drinking lots of water and getting enough sleep. But I´m assuming you allready do that. The breathing protocol comes on top of that.
After the workout when the body is calm and you are no longer out of breath, you should do a 20 minute session with the breathing technique. Repeat at 2-3 hour intervals with the last session right before you fall asleep.
You will probably feel the onset of soreness during the day. Use the breathing technique as often as you can. At least 3 x 20 minutes, but also on occasion during the day. Eg. when sitting on the bus in rush hour traffic, perhaps at work, while watching the TV, etc. The more you do the breathing technique, the more likely is it that the DOMS disappears completely in the morning.
Typically, the DOMS is much worse on day 2, but if you have done the breathing technique enough you will know that it is leaving your body now. When you use your muscles, there is almost no pain left. Continue using the breathing technique a lot on this day too. 2 – 3x 20 minutes and as much as you can at every opportunity during the day.
This is the day when the soreness usually reaches its peak, but since you have used the breathing technique, it is almost completely gone now. Use your breathing technique 1 – 2x that day also to be absolutely sure that it will not flare up again.
Previously you would have still had DOMS that day too, and maybe even a few more days, but now you can rest assured that your breathing technique has cleared the muscle soreness after exercise and increased your recovery significantly. Consider what other health or pain situations it may be helpful for when you use this way of breathing.
“Over the oxygen supply of the body carbon dioxide spreads its protecting wings.” – Friedrich Miescher, Swiss physiologist, 1885
Chapter 10: The Breathing Exercise is Simple
The breathing exercise is simple: inhale for 5 seconds, exhale for 5 seconds, then a comfortable pause of 10 seconds before you breathe in again. Repeat for 20 minutes.
Do it on the couch while relaxing or watching TV, while stuck in traffic, while waiting for a friend, in bed before going to sleep, or anywhere when you can. There really is no need to close your eyes. Just control the breathing and relax for a short period of time.
The whole secret of the breathing exercise is the pause you do after the exhalation. This is where the cells are pouring out the CO2, thereby initiating all the good effects we want in our recovery. CO2 is not a waste product, but one of the most important protective molecules in the body. And it is readily accessible with this simple breathing technique.
And the whole secret to the pause is to keep it comfortable and relaxing. If you have to breathe deeper or tense your chest or muscles in any way you are overdoing it. The deeper breathing will remove more CO2 and you will miss out on the vasodilatory effect we want to achieve with this breathing method. Please be sure to take this point to heart: it is not about deep breathing. It is about comfortable paused breathing.
Please read the Important Guidelines carefully to get a clear view of how to do it correctly.
The first graph below show how much the CO2 may increase during the pause after exhalation. (Sasse et.al. 1996)
The next graph below show how the CO2 level in the blood stabilizes on a higher level as the paused breathing stabilizes the breathing frequency on a lower level. During the RecoveryBreathing guided practice we keep it at 3 breaths/minute. (Wolburg et.al. 2009,Fu et.al. 2004)
Chapter 11: Important Guidelines
The breathing exercise is simple. But don´t be fooled. There are some details many people do wrong because they confuse breathing techniques they have learned before with this one. Read the guidlines carefully to make sure you do it correctly.
Always breathe effortlessly. If you feel the muscles tensing up or you feel out of breath, the process becomes counterproductive. Relaxation is an important factor in the effectiveness of this breathing technique.
Please bear in mind that this is not about deep breathing. It is about paused breathing. If you need to take deep and forceful inhalations you are probably pushing your limits too much. Just inhale and exhale normal, slow, gentle and smooth. And keep a long, comfortable and relaxed pause after the exhalation. A 10 second pause is what we do in the guided practice, but you can do a longer pause if it is within your comfortable limits.
Be patient when it comes to progress. If it becomes too tiring to do a 10 second pause between each breath, just do as many as you can and be careful not to strain anything. Tolerance for CO2 is gradually trained. If you do the exercise daily you will notice that lengthening the pause gradually will become easier and easier.
Breathe with your stomach. Let your stomach gently and effortlessly inflate like a balloon when you breathe. This is the most relaxing way to breathe.
Mentally and gently count the seconds. This is a way to maintain mental presence (mindfulness ) in the breathing exercise. Every time your mind starts to fly, just turn your attention back to the counting and the effortless breathing.
When you are doing the breathing exercise, do the breathing exercise. When you are not doing the breathing exercise, do not do the breathing exercise. The breath must also be able to do its thing without being controlled. Being in able to not control the breath is as important as being able to control your breathing.
Look for sensations such as heat, flowing or tingling sensations, increased sense of heaviness etc. These are some signs that tell you that your blood circulation is increasing and that you are doing the breathing technique correctly. If you do not notice any of these sensations, pay more attention to the relaxation while doing the exercise, and then they will appear when the nervous system and the blood vessels relax.
Each day is different. Some days it may feel okay to have a 10 second break and you may perhaps have a 20 second pause without problems. On other days, it may be challenging with just a 3 seconds pause. Respect such fluctuations in your daily body state and do not challenge your body too much. Remember to constantly stay within what your body can tolerate without tensing or straining.
Chapter 12: About Recovery Strategies
Most athletes know how important recovery is for their performance. But often recovery only includes time spent on relaxation with playstation or TV, and sleep. And more often than not, when I have asked athletes how they actually sleep, they respond: “not so good, really”.
Even though most people know that recovery is important, the reality is that many don´t really know much about it so it don´t get the attention it deserves.
Recovery can be defined as “techniques and actions taken to maximize your body´s repair and return to homeostais“.
Recovery is multifaceted and encompassens a lot more than just muscle repair and glucose refueling. Blood circulation, blood chemistry, cellular repair, oxidative stress, peripheral nerves, brain chemistry, hormones, mental state, and much more. All this is part of what we need to include when we choose smarter strategies for recovery. Maybe you already notice that the breathing function touches on almost ALL these aspects?
It is important to note that hydration, nutrition and sleep does not remove DOMS. It is only by adding the RecoveryBreathing protocol that DOMS can be completely removed during day 2.
Here is a list of the most popular recovery activities and techniques, apart from breathing. Which rarely (never, really) is mentioned.
1. Hydration – Drink lots of water. A well hydrated body has better delivery of nutrients and removal of metabolic waste products. You can see if you are well hydrated on the colour of your urine. If its a clear shade of yellow, you are good. If its a darker shade of yellow, you are dehydrated. (Website,Moreno et.al. 2013,Hilman et.al. 2011,Pross et.al. 2013)
2. Nutrition – Sugar and wheat are often considered recovery-food, but for many people these substances will only create other problems. Eat real food. Meat, vegetables, fruit, nuts, unprocessed fats. The body needs real food. Not fake or damaged food. Especially berries with high antioxidant contentseems to be particularly useful in fighting DOMS. (Sousa et.al. 2014,Bell et.al. 2014,McLay et.al. 2012)
3. Sleep – Aim for at least 8 hours of good quality sleep. (Halson 2014)
(4. Breathing – this is where Recovery Breathing should find its place on the list. After water, food and sleep, and before all the rest (no pun intended).)
4. Rest – Spend a lot of time during the day to relax
5. Heat, ice, compression, electrical stimulation – there are many special activities that can help boost recovery. (Kovacs and Baker 2014)
6. Stretching – A good stretch feels real good. Even though science has not proven any relation between stretching and sport-related injuries or recovery, it no doubt feels good. And that alone has great value on your recovery process. (Herbert and de Noronah 2007)
7. Massage – A good massage feels real good! And it might reduce DOMS by approximately 30%. (Zainuddin et.al. 2005)
8. Dietary supplements – Protein, Vitamin D, Tart Cherry, Tomato juice, Chocolate milk, recovery drinks, herbs, mushrooms, etc. There are so many products that is commercially related to recovery. Don’t by into any hype, but try different products and see what works for you. (Pasiakos et.al. 2014,Barker et.al. 2013,Kuehi et.al. 2010,Tsitsimpikou et.al. 2013,Pritchett and Pritchett 2012,Goh et.al. 2012,Roengrit et.al. 2014,Yan et.al. 2014)
9. Spend time with friends and family – This is really important. Not only for recovery, but for quality of life.
Aside from sleep, nutrition and hydration, the breathing is the one recovery action we can take that no doubt includes most (if not all) of the physiological aspects of recovery: increasing blood circulation in the capillaries (the smallest arteries) by increasing CO2. This gives more bloodflow and optimizes nutritional delivery and metabolic waste removal in both nerves and muscle cells. It also increases oxygen availability while at the same time decreasing oxygen intake. This means there is less oxidative stress and more recovery and repair. The increased CO2 also acts as antioxidants directly in the mitochondria where they are produced. Keeping your mitochondria protected. The slow breathing also removes stress hormones and calms our mind. What more do you need for recovery?
Using breathing impacts blood chemistry, hormones, peripheral nerves, central nerves (brain), cellular repair, and much more. It is the missing piece in effective recovery.
Chapter 13: The Spectrum of Breathing Frequencies
Breathing is an autonomic function in the body. That means it happens without our voluntary control. It happens even though we don’t pay attention to it. When we sleep, when we exercise, when we are at work, when we watch TV. The breathing goes on and on. It has been going on since we where a foetus in the womb and will continue until we die.
You don’t ever have to think about it all and you can still be happy and healthy your whole life.
But when you start to pay attention to your breathing you will notice that it is affected by many things. Including physiological demand as in stress or exercise and emotional sensations and states of mind. When you feel safe you may notice the breathing is slower than when you feel unsafe. There is a lot to discover just by observing your breathing. This is what the Buddha did. And just that, observing the breathing, took him all the way to enlightenment.
That said, please pay attention to the next sentence. Breathing is also a somatic function, meaning that you actually can control it voluntarily. By controlling the breathing you get access to many of the other autonomic functions in the body that the breathing function is directly or indirectly connected to.
Disclaimer: I recommend doing breath-control only as an exercise, for a limited period of time (10-20 minutes). When the exercise is over, let the breathing happen naturally without any control.
There are many breathing exercises out there. And a lot of confusing and contradictory theories. But no matter what exercise you are doing, there are only a few simple and basic functions you can change by controlling the breathing.
- Rythm (Pauses)
All breathing exercises ever invented since the beginning of human history are a combination of these 4.
The one factor that affects our organism the most is not deep breathing or forceful breathing. It is the speed and pauses, that together make up the frequency. With Recovery Breathing we want to keep the depth and force to a minimum, only adjusted enough to keep the breathing relaxed and comfortable while controlling the speed and the pauses.
After studying the research available on different breathing frequencies I have come up with a simple and clear overview of what benefits we can tap into by regulating our breathing frequency.
The Spectrum of Breathing Frequencies:
Normal Breathing: 15-25 breaths/min – no special benefits
Meditation / Deep Relaxation: 10-15 breaths/min
Calming, nice, good feelings. Meditation has benefits beyond just slower breathing. I encourage everybody to meditate and especially Mindfulness of Breathing meditation, even while doing the RecoveryBreathing exercise. (Martarelli et.al 2011, Zeldan et. al. 2011, Kerr et.al. 2013, Goyal et.al. 2014)
Autonomic Regulation: 5-6 breaths/min (no pause).
Increases vagal tone (social engagement) which includes physiological, psychological and emotional results. The Vagus Nerve is called the Compassion Nerve because when it is strong we are happy, compassionate and socially engaged human beings. It also stabilize heart rate, lower blood pressure, better digestion, lower inflammation, reduce oxidative stress, just to name a few effects of a strong vagus nerve. Using breathing to strengthen the vagus nerve is also called Resonant, Coherent or HRV Breathing. (Porges 2006, Eckberg et.al. 1980, Mason et.al. 2013, Bernadi et.al. 2001,Couck et.al. 2012)
Metabolic Regulation: 2-3 breaths/min.
Recovery Breathing makes an efficient entrance to this with pause after exhalation). Increasing CO2 (mild hypercapnia) to access all the protective effects of CO2: vasodilation, lactate removal, pH-buffering, oxygen uptake, antioxidant, lower inflammation gene expression, to name a few. (For references, see all the previous chapters)
Advanced Breath-hold: 0 breaths/min (breath-hold).
Intermediate hypoxia (controlled apnea): “Breath-hold divers have shown reduced blood acidosis, oxidative stress and basal metabolic rate, and increased hematocrit, erythropoietin concentration, hemoglobin mass and lung volumes.” (Lemaitre et.al. 2003)
Breath-hold with Intraabdominal Pressure is what the tibetan monks have been using to ignite the inner heat and human potential from breathing for the last thousands of years. Read this very interesting piece of research on how the tibetan monks increase their core temperature during breath-holds. (Kozhevnikov 2013)
Nielsen et.al. 2001. Protective effects of lactic acid on force production in rat skeletal muscle
Chung et.al. 2003. Delayed onset muscle soreness : treatment strategies and performance factors
Peake et.al. 2005. Characterization of inflammatory responses to eccentric exercise in humans.
Hosseinzadeh et.al. 2013. Pain sensitivity is normalized after a repeated bout of eccentric exercise
The Breathing Exercise
Moreno et.al. 2013. Cardiorespiratory effects of water ingestion during and after exercise
Sousa et.al. 2014. Dietary strategies to recover from exercise-induced muscle damage
Bell et.al. 2014. The role of cherries in exercise and health
Kovacs and Baker 2014. Recovery interventions and strategies for improved tennis performance
Herbert and de Noronah 2007. Stretching to prevent or reduce muscle soreness after exercise
Pritchett and Pritchett 2012. Chocolate milk: a post-exercise recovery beverage for endurance sports
The spectrum of Breathing Frequencies
Martarelli et.al 2011 Diaphragmatic Breathing Reduces Exercise-Induced Oxidative Stress
Zeldan et. al. 2011. Brain Mechanisms Supporting the Modulation of Pain by Mindfulness Meditation
Porges 2006. The Polyvagal Perspective
Eckberg et.al. 1980. Phase relationship between normal human respiration and baroreflex responsiveness
Bernadi et.al. 2001. Modulatory effects of respiration
Lemaitre et.al. 2003. Apnea: a new training method in sport?