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To Exhale or To NOT Exhale?

4
May

To Exhale or To NOT Exhale?

GREAT Write-up from Dr. Daniel, M.D. David and him were having a conversation about exhaling during lifts. Here is Dr. Daniel’s take on it……

David and I were discussing how exhaling during the strenuous part of heavy lifting works. This got me thinking and I did a quick literature review on the evidence behind this. Quickly typed it up, maybe the fellow CrossFitters would enjoy.

Exhale more weight.
19:52 May 3, 2012; By Daniel D
“Breath out….Exhale”, this suggestion is commonly heard throughout fitness communities everywhere. It is well assumed that when pushing/pulling/moving heavy weight, maximum effort is achieved when one exhales during the peak of exertion; many times emphasized as we tend to naturally hold our breaths. Coach David and I discussed this the other day after an enjoyable exhausting workout of the day where submaximal bench press was the strength/skill portion of the WOD.
Going back to the basics I decided to open up some of my textbooks on exercise physiology and strength and conditioning. In most power exercises such as deadlift, squat, press, etc. the most strenuous portion of an exercise is from the transition of eccentric to concentric phase. This is where experts in the field of strength and conditioning as well as exercise physiologist suggest one should begin exhaling to change pressures from the intrathoracic cavity to intraabdominal. Done in a continuum naturally breathing effort rather than static holding our breath effort, reduces stress on your heart and allows for greater recruitment of core muscles. This also anatomically and physiologically adds support to the spine and helps maintain alignment (1, 2).
Intuitively this makes since but has it been proven?
Like most health professionals I take everything with a grain of salt and look at the evidence behind the madness. Unfortunately, not much research has been done on this subject and the concept is taught based on anecdotal evidence; expert’s recommendations and theoretical physiological concepts. A quick literature search on the subject revealed only a hand full of studies on the subject. These studies had low power enrolling anywhere from only 11 to 20 participants and all having slightly different aims such as looking at the breathing effects on vertebral support or looking at its effects on isometric exercises not concentric. Most concluded benefits in one way or another. I do not want to draw this out and make it into a journal article analysis but just want to give you my conclusions and answers to the question of whether exhaling during heavy lifting makes a difference (3,4,5).
My take home point from this: Continue to exhale during the most strenuous portions of sub-to-maximal heavy lifting. You will reduce stress on your heart and add vertebral alignment and core support.

-Daniel D. fellow All Sport CrossFitter
D.D. background Bachelors of Science in Kinesiology with concentration in Exercise Physiology and Doctor of Medicine currently in residency, Emergency Medicine
References
1. Baechle T.R and R.W. Earle. Essentials of strength training and conditioning. National strength and conditioning assosication. 2nd edition. Human Kinetics, IL 2000.
2. Powers S.K. and E.T. Howley. Exercise physiology theory and Application to fitness and performance. 5th edition. McGraw, NY 2004.
3. Hagins M and EM Lamberg. Natural breath control during lifting tasks: effect of load. Eur J Appl Physiol. Mar 2006; 96:453-8.
4. Hagins M, Pietrek M, Sheikhzadeh A. and M. Nordin. The effects of breath control on maximum force and IAP during a maximum isometric lifting task. Clin Biomech. Oct 2006;21:775-80.
5. Hagins M, Pietrek M, Sheikhzadeh A, Nordin M, and K. Axen. The effects of breath control on intra-abdominal pressure during lifting tasks. Spine. 2004 Feb 15;29:464-9.

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