Oxygen Delivery vs. Utilization & Breathing To Enhance Performance w/ Andrew Hauser (SSOF Ep 162)

Andrew Hauser2:42

Yeah. But the private side is like, man, now you can really run a model, which the team side there are just so many variables that don't allow that to take place—time, contractual situations, just bodies, how many people there are, what your responsibilities are. There's just a lot that goes into that.

And I do always think there's a piece on the team side, is different in different sports, there's different levels of it, but when you're paid by the club the player knows that. So that is always in the back of their head. They can trust you, but there's a different level of trust that occurs when you go on the private side and like, hey, now I'm working specifically for you, not what's for the organization. And so I think you're able to do a lot more. And that's towards the end of my time in baseball. That's what I was missing.

I feel like running at best a C plan most of the time. There's just like, we're leaving a lot on the table that again for a number of reasons, whatever they may be, it's just not happening. So the private side now it's like, okay, now we can get really deep in the weeds on blood work, on their physiology, how we're going to really guide everything.

And to me, physiology was the big, that was a big turning point for me of really pulling everything together from the weight room, the training room, their blood work, their psychology. To me, physiology is really at the center of all of that.

That was an aha moment for me. And then as I got later into the team stuff, into the private field, like okay, now I can make really good decisions that are objective. They're changing every day, but the body changes every day. So like, hey, if I have a clear intent, there are a lot of different ways I can get that accomplished now that I know, like hey, the technique is good enough where I can see that almost in real time.

And that was the Moxy, but it again, it started tying in more of the breath piece. It started tying in a lot of what I'd been educated on, different systems I've been educated on and different training ideas and modalities. So many roads lead to Rome. So like, hey, you really want to do hypertrophy stuff? Great. We can fit that in to our intent. Even if maybe that's not the road I would go with you, there's a give and take for everything we do when it comes to physiology, but I can drive an adaptation as long as I have an intent.

James de Lacey2:42

This is the perfect place to start podcast. We've been on a physiology kick over the past, I don't know, months, years now on this podcast too. And actually titled this oxygen delivery versus utilization. And obviously you mentioned the Moxy already.

So let's just start with, let's just start bare bones and just see how are you using the Moxy. Just for listeners, maybe just quickly explain it, but how are you using the Moxy and then I know it's very general, but how from that data, how are you then looking to influence a training program? I guess from that, I know it's a very, very general question, but I guess once you come back to me, I can get some follow-ups to that.

Andrew Hauser6:38

Yeah. So a couple different ways if somebody, we're going to go, I'm going to answer this from a healthy athlete perspective. They come in. So I work with a lot of throwing athletes, but a lot of the team sport athletes in general, our body is also getting used in whatever we're doing. So linemen, not offensive lineman, same thing. But we're going to get them on a bike just as our baseline test for everybody, because hey, if somebody's hurt, we can always go back to the bike. So that's our baseline for all healthy athletes.

Moxy on both legs via vastus lateralis in my experience gives the best systemic idea of what's happening. So we'll go both legs. So now we'll see inter and intra muscular coordination. And then we'll also go to the forearm. When I first started, I actually would do the deltoid. That's what a lot of the Moxy users, I started to see this a lot, like when we would do blood flow restriction stuff. And the delt just does not give the information that you're looking for, especially with a throwing athlete. And the forearm, medial forearm tends to give a much better picture of that in my experience.

So we'll test them with three Moxy's on. We'll have a VO2 master mask on, heart rate monitor, and I'll put a core muscle oxygen sensor on as well. Which all these things tell, it's like they're different pieces of the same story in my experience.

So we do a bike test. And the whole, so my mentor, his name's Brian Mackenzie in this space, was the one that put me on to call it the RIP test, the recovery index profile. So every other minute we're going to go 20 second all-out bike sprint. Typically we're going to do this on an echo bike, so upper body and lower body is getting used.

And the whole point of the 20 seconds is one, nobody can coordinate anything past that 20 seconds. So you're going to go into the called a venous occlusion. So you create so much tension on a vein, it's like holding a hose. So blood will fill up, that's when your legs start to burn. So legs get heavier, there's a lot of vasodilation happening. It's actually a good place to recover from, a good place to create a powerful movement, terrible place to consistently perform from, good place to recover from.

But so we're looking like, okay, how long does it take an athlete to create that occlusion? So it's 17 seconds plus or minus 3 seconds is typical, but I mean I tested a professional boxer last week and it was like nine, 10 seconds. Like all right, when that stuff happens, that tells me like this guy's like challenging training is going to beat this guy up. His cost of doing business is just increasing when that stuff happens.

But I want to see like, okay, how well do they utilize oxygen? How well do they recover or deliver it? And that's just our gas in a tank. Okay, each leg is a gas tank. Can they use that gas? And then can they recover it? Heart rate monitor, the heart rate, you start to see like, okay, well, how's heart rate recovery? What's that look like as their heart rate spikes and recovers? What's that look like for the blood flow in their limbs? So you start to get a good systemic picture of stroke volume and how that, what's going on with that.

And then the VO2 at this point, all right, now I got an idea that how much air is that person able to move in a minute. Because if I can consume 100 liters of oxygen in a minute, that's not very efficient for a professional athlete. So the more we can build that, and there's a sweet spot too with a VO2 max, VO2 mask where you get to see like, all right, my, how fast I'm breathing.

What's this? I can peak at one point, but where am I breathing pretty fast? My tidal volume of my breath is at its highest, and then also my air I'm moving is at its highest.

I'm looking for that sweet spot because then it's like, okay, these are all trainable qualities. Now we can really, we have our test retest, but we can drive all these things. So each of these systems has a limiter, and each and every person has a limiter of those limiters. And so that's what we're trying to identify because then that, all those factors start to push us. Hey, this is how we're going to train this, this is how we're going to train that. And how it all bring it all together, obviously is the important thing.

But it's the breath stuff alone is interesting because I do a static spirometry test as well. And so there's certain things in there that, all right, if this is my static testing, how much of that can I actually even use? Or FEV1, which is that has become a very important metric for me over time, which is how much air you're moving out in 1 second. But it's like, okay, how powerful is my diaphragm? How much force can I deliver, more or less?

So what I've started to see with very explosive athletes, that number is very high. I always think of Maria Sharapova when serve and she had that big run, but that's what's happening. When you throw, when you punch, when you do that, well, that is happening. That's your FEV1.

So, different ways I can influence that in the weight room. I mean, that's what kettlebell swings really do when you get the breathing right with, I use something called the Breathe Way Better that we do a lot of those things with. But athletes that are powerful but are hurt a lot, that number is typically low, which is interesting as well.

And we look at carbon dioxide levels systemically. This would be an interesting thing for your fighters. I do it intranasally with a capnometer. And this was, I originally started looking at that to get a better picture of, all right, where does, athletes that have a lot of anxiety or performance anxiety, where are they on this bell curve? Most pro athletes are in a very specific part of a bell curve.

And then guys that have been concussed, usually there's a big asymmetry right to left. Now, there's outliers to that. They've broken their nose a number of times, that starts to create asymmetries as well. So usually see downstream effects of that from your orthopedic testing, which is interesting.

James de Lacey12:51

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There's a lot to go through there. I've got a couple of, well I want to go through some of those limiters.

But first you talked about this venous occlusion and about the pro boxer had a very quick venous occlusion and basically potentially means he can't go through harder training without the cost of having a lot of fatigue. So do you want to just go through that a bit? Why is it that the shorter occlusion is a problem? And then how are you looking to address something like that?

Andrew Hauser15:24

No, good question. Because we had some hockey players this off season that the exact same thing came up. I'm starting to see a mental piece with those individuals as well where those are usually your grinders. They're going to train, they're going to want to train every day. They're the ones that want to go hard all the time, which I think is just an interesting, again it's where physiology and psychology are really complementing each other.

But I think when you start to have those fast occlusions, so creatine phosphate gets used up way faster. So that's again, if you're not recovering that and the Moxy, there's good research behind that. I don't remember if Andre Feldman did it, but you might be able to find it on the probably could find it on the Moxy website. There is good research behind creatine phosphate following the SMO2 or the oxygen on the curve.

And so you start to see the people that don't really recover, they create those occlusions fast, they don't typically recover as fast, reoxygenate their oxygen. And so you just see kind of a downward trend. So power output will typically go down with those athletes. And that's not to say you can't perform like that. There's a lot of athletes that are going through this. So it's not an unusual finding. But again, it beats those guys up a lot more.

And so those guys do typically they miss more games. They get extremely fatigued from outings and whatnot. So a lot of, there's two things we typically start with those athletes. One we do, we just call it optimal, again this is a term I took from my mentor Brian Kak, but we call optimal coordination.

So we're going to, let's say we're using the bike, we're going to bike sprint right before they hit that occlusion. And so they're going to get right on the edge, but they're not going to hit it. So, they're going to recover. So, really, your ability to do more work starts to increase. They get, they're not going to get as sore from their training. It's just not going to beat them up as much.

These are when you have high output work you do in the gym or, they're going to spar or something. This is when they leave usually feeling better or kind of jazzed up. And again, occlusions are necessary. So there's certain, a roundhouse kick, you better bet there's an occlusion that's creating that kind of whip. And throwing's the same way.

I know this isn't specific to throwers right now, but there's so much that comes from the forearm when they throw. There's a massive occlusion that almost creates an elastic catapult for that throw, an elastic catapult for throwing. That's why I also think the pitch clock in baseball is a challenge for guys because you create that occlusion, but then we looked at our test, okay you got to release that occlusion.

And then oxygen, when that happens, usually oxygen spikes back up. So when guys are just not repeatable, and I think this is any sport, your coach's eye usually tells you when somebody's in that occlusion. Everything just looks a little off or, I know, they just had the World Championships and track. If you watch the 400, everybody falls apart because it's really just can you grind through it.

It goes back to that mental thing. That's probably the most challenging event in track, I think, just from a mental component. It's literally, it's just a grind. Because everybody, the difference between a very smooth and beautiful athlete and the ones just all over the place, it just looks like everything looks like they have to muscle up and do everything. That's your occlusion and then that's your coordination, the difference between occlusion and coordination.

James de Lacey18:48

What are you seeing on the SMO2 graph for that? Are you just seeing the bottom of the desaturation slope and that is what you're?

Andrew Hauser18:48

And again this is different for everybody, but you'll see, I still think Parapedal, you don't see it as well on the Moxy app to be honest right now. I think that's going to be improved. You see it if you get on their portal after the fact, but with Parapedal you still see it pretty clearly which is just a computer program.

But the actual, there's an orange, it says THB, and there's green, which is your oxygen. You'll see those lines cross. And you generally, if you have on a Watt bike or an Echo or something like an Aerodyne, you'll hear the power decrease. That's kind of, that's why I actually like having those auditory things where they're a little louder because you'll hear that change.

I do a lot of explosive step-ups at different box heights. It's kind of why I use that, one of the reasons I use that as well, because then you hear it when it's right or when it's wrong. But regardless, you'll see those lines cross and that's when things slow down. Again, their legs start burning. Everything just becomes more challenging. Your heart, it's like your heart's beating faster trying to push more blood through, but those legs are just filling up with blood or the arm or, and so your respiratory system.

That's the other thing I said, we do that optimal coordination training and you can do that with any implement. I use bike sprints as an example. We could do that squatting, we could do that sprints, we could do that whatever. A lot of breath stuff we do. We use something called a Breathe Way Better and that is more specific to, to me the breath is kind of the barometer for where all our systems are at.

You put on a V2 mask and you're really looking for that breaking point of where your breath can no longer keep up with oxygen demand. And so your breath typically gets faster but you're moving less air, so you just become less efficient. So if we can, and you could see this with a Moxy, once somebody's warm we could do certain breath things and we can create an occlusion, we can get out of an occlusion, we can use oxygen, we can recover it.

So that's how, that's usually a big light bulb moment for a lot of athletes. Oh, I can delay the cost of doing business just by getting better coordination through my breath. So we do a lot and we tag team that with, we'll use different warm-ups, we'll do specific just breath things. We use it in a lot of different ways, but I mean there's, we use it within every workout for sure.

James de Lacey22:52

Interesting. We'll definitely—we're going to dive into that as well, especially with the limiters. I think which will be interesting for the audience too. Obviously you mentioned athletes will be kind of limited in certain areas. You can address those through some of the testing you're doing.

So are you looking at limiters just like oxygen delivery, oxygen use, and then the breath as your three, or you kind of just lumping two of them together?

Andrew Hauser22:52

We break down the muscular system. So can you deliver oxygen or recover it, and or can you utilize it? So usually it's can you work on the low end of your gas tank, or do we need to work more on refilling your gas tank? And then I—the occlusion stuff kind of falls into some of that thing. But those two things are very, very important because the more we can use—the more of our tank we can use on a whole, I mean, the better.

So a lot of athletes, if they've had an injury, a previous injury, you see big, big differences side to side. And usually we do a lot with the—I mean, if a lot of your listeners probably use a lot of force plates, I've gotten more away from a lot of my force plate use to do actually more Kaiser testing. But doing it single limb where, if you do a single limb seated or single leg seated calf on a Kaiser with their testing, it's like you find kind of where they're at on the force velocity curve and then that usually backs up into the physiology.

If I need more—let's say I need more elasticity on a side per my force velocity finding with the Kaiser—typically those sides are going to have a larger blood profile. Their gas tank's bigger, but then they can't utilize quite as much, or they can't—it's they're not as bouncy. So they use that to load everything. And then the other side maybe they need more just pure force development.

That's usually almost their gas pedal, where that's the side they jump off of or whatever. So, and the Moxy—their blood or their gas tank might be a little smaller on that side. Not dramatic, but usually you start to see those carryovers.

So looking at those things for oxygen delivery, utilization, and then the heart—you know, heart rate, stroke volume. Stroke volume you see that really with again the THB or the gas tank of these different limbs. It's going to be larger in your—usually you're going to have a higher number in your upper body, particularly if it's your writing hand. Whereas your lower body, higher we can get that—it's bigger gas tank just means more opportunity for more gas. So it's performance potential.

And then from the breath we're looking at frequency and volume. So we see that very clearly with the mask. But again, if you're occluding quickly on a test, those are typically over-inhalers. They're grinders, but they hold their breath a lot and you do those things and it just creates more tension.

But it's funny because a lot of this stuff goes back to stuff Verkhoshansky was even doing back in the day. He started most of his athletes—they were just going to try to create more angiogenesis or more a bigger plumbing system, and that's what a lot of work in an occlusion does. Now we try to take the heart rate out of that some of our days and do more sustained isometrics where we can create an occlusion for a while, but essentially just having to move more blood. So create this big peripheral adaptation without it just having to be your heart rate responding to everything.

So if somebody really struggles with heart rate recovery, we do a lot of that.

James de Lacey22:52

So within the limiters, do you find that most athletes are limited by a certain—or essentially by peripheral or central—or do you find it's kind of a mixed bunch depending on the sport?

Andrew Hauser27:25

Depending on the sport, the training history—I would say more often than not, most team sport athletes as an example, they usually struggle more with stroke volume. They usually struggle more with the top end. So oxygen delivery, not utilization as much. That's most—what happens in the weight room is usually more delivery dependent. And then tidal volume as well. Most guys can breathe fast, but they're just not moving a lot of air. And then coordinating all those things.

So I would say those are probably the three most common you see in a team sport perspective. I think you have different nuances to different sports. I mean, some distance runners I'll see, and those are different profiles. They have different compensatory things they do, particularly with their cardiac system and their vascular system. But most team sport athletes fall within that.

And the nice thing about Moxy is we put it on, we use it within our training every day. So if I know—it kind of tells me where a guy needs to be for his warm-up, or what—can he—is this the right training modality for him today?

There's an athlete we work with that—if you look at the oxygen dissociation curve, but to simplify, if you're to the right on that graph, you usually unload oxygen well. If you're to the—and you get really hot, those are going to be your heavy sweaters. Those are—yeah, I mean it—those are they use oxygen well. The others deliver oxygen better if they're on the other side. But they're the ones that really—they're tight usually. Just they—those are people that usually love getting stretched. They love getting in the sauna. It's just giving them what they're craving.

Interestingly, I'm so—I've started to see some of these psychological qualities or characteristics that are saying, oh, what this oxygen dissociation curve that we learned about in college that I didn't think about for 20 years was saying. But those athletes, you do a super challenging workout—if we did a bunch of circuits, that person will feel good, but that will also crush them.

So it's—you have to almost put them on a totally different split. If we have two more higher intensity days a week within a 7-day period, they may not recover, or they may not be able to handle it neurologically or physiologically. So had to kind of change our thought process on that of, okay, we may just need to put these people in a totally different group altogether and be like, hey, we're going to hit maybe once every week or once every five, six, seven days, and we're just going to have to see how you do with that.

You just have to get way more creative with how you go about training some of those individuals.

James de Lacey30:54

Interesting. Interesting. How are you—maybe it'll be good for the audience as well—some examples of how you're addressing or how you're training essentially or targeting oxygen delivery in terms of maybe just exercise modalities, et cetera, and then how you're doing that for oxygen use as well.

Andrew Hauser31:10

Yeah. Oxygen use is the easy one because that's usually what most of us have done in the weight room. Your hypertrophy work will help—that pump that you get—that's going to help with oxygen delivery.

James de Lacey31:25

I'm sorry—oxygen use.

Andrew Hauser31:27

I use a lot of sustained isometrics, especially early on, 30 plus seconds. We built out a lot—just now we have those Isofit.

Which I don't know if you've used those.

James de Lacey31:42

I haven't used those now. I've seen them around.

Andrew Hauser31:44

Yeah. So we build that into a lot because it's—for us it's a way—it was a way to start building work capacity in kind of a low-threat environment for athletes. But again, that stuff will start to increase oxygen utilization. The sauna will help with that. Traditional sauna will help with that. Again, it's really most things you're seeing in the weight room. If we're doing some breathing stuff, more hypoxic or hypercapnic specific work will start to enhance that as well.

When we start looking at oxygen delivery, we do a lot on the bike for that, where we take a lot of their resistance away, but we're moving fast. And I think it was Seluyanov that—I learned about it from a guy named Aaron Davis down in Austin. I don't know if you know Aaron at all—super sharp, one of the sharper people I know.

Seluyanov, the Russian sport scientist who has since bounced away—he was doing that and he'd talk about it from opening up calcium channels and stuff. But you have to be moving at essentially right around 90 RPMs or higher on a bike, but it's way less resistance than people crank, and it's more sustained time.

So you start getting more of an elastic cardiac response. Your heart rate definitely does not get up as high or typically isn't going to get as high, but you can go for a long time. It's actually a weird experience for a lot of athletes when they first—if they don't do those things a lot—because they think they should be pushing it. And then they also—my legs are moving fast. I'm not really getting tired though. But again, that'll drive oxygen up.

A lot of nasal breathing stuff. I'm sure a lot of your listeners have done the Oxygen Advantage type work or like Buteyko, a lot of the breathing stuff. We try to—I mean, we're trying to coordinate things, but if, let's say I'm an over-inhaler, I'm going to over-exhale and it's going to drive oxygen up. So we do that with our breathing bags.

Walks, just leisurely walks help with that. I'll do some Indian club stuff for if we're talking about the upper body. The pool, we use the pool a ton. I wish we had one on site because we'd use it a lot more.

But that, depending on what you do in there, but if I tempo run in the pool, I mean, accomplish that. Tempo running outside, I mean, you're going to use oxygen, but then you should recover it pretty well. But you can also deliver that with short explosive bursts of energy, too. Like if I do a 3-second bike sprint, if I fully recover repto, I can overshoot. I can drive oxygen delivery. It's just, you know, I'm getting a little bit different cardiac response where if I have continuous, I know my heart's essentially growing outwards. I can do the short quick burst, but that's growing inward.

So, a lot of your faster athletes will be better at that and you have to be patient with a long-term adaptation for the continuous work. Which is a nice thing with Moxy because if I want to drive up oxygen as kind of my first thing I do in the weight room or for a training session, some athletes have done so little continuous work. And they're just those elastic fast twitch guys. That's a slow build that you're going to get that response.

So it's okay, identifying I need jump rope or I need, you know, those short fast bike sprints or skipping whatever. Sometimes you need those twitchier things to then drive up oxygen, but you don't know that until you start seeing it.

James de Lacey34:22

Interesting. Interesting. You've obviously talked a lot about breathing as well on your Instagram. I saw you doing breathing sizes with isometrics, breathing sizes while doing various lunges and things like that. Do you want to maybe go through some of the kind of what you're trying to achieve from doing that stuff?

Andrew Hauser36:10

Yeah. Yeah. So, taking positional specific stuff out of it. For me, it's I want to restore coordination, which we've talked a lot about, but breathing coordination. And I want to restore that with essentially their diaphragm, their pelvic and thoracic diaphragm in a good spot. So on top of each other that goes back into some DNS or dynamic neuromuscular stabilization things.

That's actually where we start a lot of people in a position to do that whether it's prone or we'll do back up against the wall. But then we're looking at, okay, how do we open the right chest wall or left chest wall? We get them into more specific positions to then drive a bigger adaptation.

If I can create an orthopedic change just from breath, then I want to take full advantage of that. But we want to drive a lot of these things from an endurance perspective. I mean most of the diaphragm is that means pretty much all slow twitch fiber. So it's time under tension. And then kind of incidental finding for me at least, started to see even with our endurance breath, that starts to restore some elasticity within their system.

Which is a guy has surgery or has an injury that's usually what they're looking for and lacking. Things like that and then rhythm and tempo are the big things I think that people lose after a procedure.

So we'll do endurance breathing and then we'll do strength breathing or tidal volume breathing. So how much air can we move in one breath? We do that a number of different ways. Again position specific. I start those two right away. Tidal volume especially guys usually really like that because of what they feel. You feel when you get a full exhalation, a resisted exhalation, your low abs really kick on. That's what guys with low back, people, they're craving that typically.

At some point we'll get to more speed breathing. And so that will really start to increase some of that FEV1 we talked about. It'll ramp up their nervous system. So game days or higher intensity days, I try to use that if they're in season. That is the most tiring and fatiguing. But those are the three big qualities.

The speed breathing is fascinating because I'm, you're starting to have to relax the diaphragm faster. So it goes back to if I'm getting that systemic relaxation fast then I'm going to get that other play, I'm going to have downstream effects of that. So it goes back to what we talked about with occlusions. I think that's pro sport at in every pro sport at the top level, who can relax the fastest, contract and relax the fastest? They're the most explosive and best athletes. You watch Mayweather, you know, that is a fast relaxation.

And then we'll start to build it out into again a lot of different positions. A lot of, you brought up something I put on Instagram, the isometric. So that's one specific, I think restoring the reflexive ability of the diaphragm but coordinating that with, you know, my low abs and my hip on that side. You start doing that then you get again huge downstream effects.

So we, there's some hypoxic stuff we'll do on a bike where for me I want the athlete to feel, they need to feel their anxiety with that and then understand that they can control that and they can start to get out of that depending on what their legs are doing on the bike. So they're coordinating it by what their legs are doing, but the speed of their legs is also controlling and it goes back to that CO2 curve. The faster your legs moving, the more heat you're starting to produce. So carbon dioxide starts to increase and you start to see panic ensue.

But the first time they do it, I want them to feel that. After that they need to identify it and be able to stay out of it.

James de Lacey41:00

So you are you making them breathe fast to get to that state? Is that what's happening there? And then timing that with fast legs?

Andrew Hauser41:07

They're actually just breathing normal but they've got the bag. They've got their nose plugged.

They've got an SPO2 or a pull socks on as well in that. We'll do that a lot of time as a prep for our isometric work because you're just increasing oxygen utilization a lot. You're getting a ton of vasodilation systemically. So we'll do that for 8 minutes to start. I don't know what reflex occurs at 8 minutes, but whatever is coming out of my mouth from a chemical perspective at that point, it's happening everywhere.

So when I drop below 95% using a pulse socks, you'll see that on a moxy. I could have a moxy on my leg and they'll go into that occlusion actually then but I'm just doing it all for my breath. So again now I'm increasing peripheral angiogenesis. And I'm starting to move again. It's funny to watch people that have never done it before.

But we can simulate altitude with that. Research is pretty good when you can, it's 90 to 94%. You can usually it's 12,500 ft or so that you can kind of stimulate for, you know, for bouts. But we go from that to an isometric. It's like the isometric is way easier. And then if it go back to the bike after all that, they can get way lower. Not that that's our intent, but they can get way lower before that anxiety feeling starts to kick in. Usually your grinders can get lower than that 90 to 94%. But just for safety reasons...

And guys, if they start, a lot of guys when they first do it, they just want to go out too hard. It's, hey, stop your legs. Just try to breathe back on the bag. We'll shorten the bag up so they can. We may even take the nasal, the nose plug out. Because they do, they typically just get too low and that's a whole other conversation.

But when we can stimulate those things and not get panicky, the research is pretty good here, too. Hey, we're increasing cerebral blood flow. So, I always look at that carbon dioxide, it's two sides of the same coin. True hypoxia, you know, you're going to get that sympathetic response. They get a little more panicky. They're not thinking as clearly, you know, in a fight. It's when they, most guys get punched in the mouth. In team sport, it's the guys that do not perform well under pressure or in intense situations. They can be great performers, but they're just terrible in the postseason.

Whereas I think hypercapnia, you get a big increase in cerebral blood flow, but even though they're creating this occlusion, carbon dioxide levels are rising, they're still able to stay calm. And that's what, if you want to lower a resting heart rate. If somebody gets good at that, that's what free divers are doing really. They're able to get very hypercapnic. They can sustain these huge levels of CO2 and think very calmly. And you get, that's a trainable quality. There's, of course we're all kind of wired one way or the other, but that is a trainable quality.

James de Lacey44:50

What's your take on the I guess commercial breath trainers then? Does that fit anywhere within I guess your philosophy around this?

Andrew Hauser45:00

Yeah, so most, I personally, that's why I always like something with a bag. So before it was the Spyro Tiger. Spyro Tiger was great because it would tell you if you were over inhaling, overexhaling. Now I use a breathway better. And they've got a great app that is easy for me to work with athletes on and it's harder to break than the Spyro Tiger ever was.

But I like the bag because now we can control, what can you even control with the bag? Just because I have this five or six liter bag, odds are you can't breathe in or out that full bag. It's we'll shorten it up, we'll do different things, but I like the bag because now you're getting, you're getting some resistance. It's a reference for your lungs and your diaphragm.

And I think our body needs that. Neurologically needs that. And that's why I think the bag for me at least typically tends to be the best. And again, I can make it as hard or as easy as I want depending on where I'm at on the bag. I won't use hand gestures for that. That'll look odd.

So how are you then assessing maybe if we just go even just, I think most people be familiar kind of diaphragm and diaphragmatic breathing and strength and stuff like that. How are you assessing changes to I guess diaphragm strength? I'm assuming something to do to it with some kind of maybe even tidal volumes, but I guess how you, how you seeing change then? How are you seeing or looking at transfer to the actual sporting movements or performance?

Yeah. Good question. So a couple things. Spirometer is obviously the easiest way to continue to assess that when we do our retest with the breathing with the VO2 mask and with the Moxy. So I see better coordination with the Moxy. Should see these are the objective things: how many liters of air per minute they're moving, what's their tidal volume. Really, you should see a little bit of a decrease in their breathing, or you'll see just that level of that sweet spot I talked about where it's your tidal volume, your frequency, and your movement per minute. That should all be going up.

So the recovery, the oxygen recovery should be better with the Moxy. No matter where you have the Moxy, that should be improved. So those are all the objective things. I always tell athletes when they first start, hey, give it a couple weeks. You got to get just good at the skill because it is a skill.

And typically without fail, they all come back, they're like, "Hey, I felt like I'm just not breathing as hard, or I feel like I'm able to do more reps on the ice or on the field or whatever." I had a soccer player last week that was like, "Yeah, I mean, I felt like I was deconditioned going into what I was doing on the field, but they're telling me I'm running faster than I was right now, and it's, but he's like, I'm not feeling as tired."

So it's in his head, he should have been way more fatigued just because of the lack of exercise. And that's where I think from an injured perspective, we can kind of throw out all these fancy things and terms and different and what we're doing, but if an athlete breaks an ankle and he can't, he's a football player as an example or a fighter, whatever, if I have any data before, all the better.

But if we can stimulate that physiologically what his respiratory system and cardiac system has to go through, think how much more high quality work we're actually able to do without having to put them through the load of, okay, they can't use their foot and ankle right now. Great. We can simulate that by how fast we're breathing, how much air we're breathing.

I'm actually using, there's a new breathing strap. It's kind of like the old Zephyr bio harness. I don't know if you remember those. But they would give you kind of a breath wave. There's something called a Timewear that just came out that I literally just started playing with this. So I was using it the last few days and seeing, okay, if I get in different positions, I do different breath protocols, oh, I can drive more air in these certain ways, which I think is going to be really advantageous especially with injured athletes.

James de Lacey50:04

Interesting. I guess another one that would be interesting for I think for most listeners as well is kind of this nose versus mouth breathing.

Is there, are you specifically instructing either or during maybe certain tasks?

Andrew Hauser50:19

Couple things. And again, I try to, I know I'm kind of using a lot of big terms, but I try to then keep things more simple for the athletes. Hey, your nose breathing, you're pretty much, that's your parasympathetic. Your mouth breathing, now we're getting sympathetic. And that's another thing, when we're using a breathing bag, that's almost all through our mouth. So we're trying to coordinate a sympathetic response.

James de Lacey50:44

Yeah. That's what kind of brought my question on was the was that bag with the nose shut.

Andrew Hauser50:44

Yeah. Yeah. For sure. But I do love, a lot of the Buteyko stuff is, it's all nasal driven. A lot of Patrick McKeown's work, but you get a two in, two out, hold for time, you can build up massive amounts of carbon dioxide in my experience. So you're going to build more nitric oxide.

And that's where, okay, I've got a graph of a guy post, it was a postsurgical case, and so he just could, it was a couple days after the surgery. It was an arm surgery. He's got a Moxy on his leg and he's just sitting down. I was like, "Hey, man." Again, I want you to do it just all through your nose.

Two in, two seconds in, just comfortable breath. 2 seconds out. When you get your air out, hold. We'll start at 10 seconds. If you can go longer, great. But don't worry about it. Start at 10 seconds. And then you just have to repeat that for at least 15 minutes.

And this guy went 35 minutes, which actually was good for me to see because 30 minutes is about the sweet spot if you can do it. 15 plays, but oxygen delivery and utilization both increased dramatically as he was doing it, which makes a lot of sense when you start talking about carbon dioxide and nitric oxide. Injuries use those substances to help heal themselves. Your body is using those to heal.

And that's something I was seeing on the team side. A guy gets hurt, you see oxygen actually goes way up in that hemoglobin, or—

James de Lacey52:36

Almost overcompensates, right?

Andrew Hauser52:38

Yeah. It all drops because your body is using those things up. So it's almost like there's a local hyperventilation occur. There's a systemic and a local hyperventilation that's occurring where, hey, the oxygen's there, but you don't have anything that can use it, which I also think goes back to, all right, well, you strain a hamstring. Why is everybody just talking about the muscle? Why is no one talking about how's it getting fed? That's our vascular system.

So you better get that going. And I think, BFR, that's why people get good results with BFR post injury. There's some different modalities that help that, but isometrics are huge for just rebuilding that, plus just changing the proliferation of, or what the scarring is doing.

James de Lacey52:38

Interesting. So you're then using in a rehab setting a lot of that breathing to help offset that, I guess that lack of oxygen used in an injured muscle, to then start bringing some of those, what, substances in to the muscle to have it kind of desaturate, resaturate, just from some what, two and two out hold for 10 seconds for 30 minutes?

Andrew Hauser54:00

Yeah. And you don't need the bag for that. Well, and you get such a good systemic response. And again, there's, I talked about that 8 minute reflex. So something occurs at that point and then something also occurs at 15. It's almost like your body's primed. Again, there's 8 minutes plus or minus a minute, 15 minutes, maybe plus five minutes for some guys that may need a little bit longer. But those are, yeah, I don't know what those reflexes are, but you consistently see them over and over.

But that is such a low-hanging fruit thing for any athlete to do, especially, when I first started using it, I would do it before bed. So I would do that and then I'd tape my mouth and I'd go to bed. So it's like I built this large CO2 level and then I taped my mouth. I did a lot of, played with a lot of hypercapnic stuff on my own first, and that's what I, I use everything on myself for long periods of time before I'm going to start using it with an athlete typically.

But I would do hypercapnic work, which I would do that with a bag, trying to get my CO2 level to a certain place, or if I have a pulse ox, I use that kind of interchangeably. That was more of a 5-second inhale, 5-second exhale, but it was just repeated with a bag. I got the idea from someplace on the time for the inhale and exhale because there's interesting yoga research actually. It's like your all your systems coordinate at almost that breath pace.

Interesting. There's, again, there's a lot, that's the trouble I, or the challenge with physiology as a whole, is there's so much research out there for the last 120 years, but it's all over the place. So then pulling it together and pulling it in and then being able to make it work, and again, you work with athletes. Athletes are different than the lay person. So, again, my mentor was very good about, hey, this is maybe what the research says, but you go play with it and see, prove it right or wrong, especially with an athlete.

It's like athletes at the top level respond, at least neurologically, they respond different than everybody else. I mean, it's like going out and buying a new MacBook compared to buying a Macintosh from 1993. I don't need a floppy disc anymore.

James de Lacey57:00

Most your listeners probably don't even know what a floppy disc is now, right?

Andrew Hauser57:05

No, I think a few there should know. I've got a few questions in the chat actually in the live chat from Dr. Andrew Asha, I think, around some of the Moxy stuff. So asking what you mean by coordination with the Moxy. I think this is about the first part of the conversation we had.

Yeah. So the coordination, you'll see in a Moxy, the essentially the green or the SMO2, it will stay above the orange. And you'll see a decrease in oxygen as they're like a bike sprint. You'll see the graph will start to go straight down. And those lines, they're coordinated until all of a sudden they crossed. So that's when they fall out of coordination.

Your occlusal state, and then it should pop right back out of that. But the athlete themselves typically feel that as well of when, oh, we talked about hearing it if you're on a Watt bike or something. But they'll also feel, oh, their legs all of a sudden just got slower, heavier, or that's when their legs started to burn.

You'll or you'll see it, if you have an athlete run. I remember watching this is when I was still in the team setting, and I remember watching this guy run. And he was running from the right field line to center field, and he was a good athlete and it looked super smooth. And then he hits left center or right center field, and it's like all of a sudden his arms just started flailing. It was like, that is the perfect example of they coordinated, lines crossed, not coordinated. And 400s perfect for that too.

James de Lacey58:48

I think that's the best example of it, to be honest. I think everyone remembers how 400 feels from their school days. We had to run 400s and 800. To the school questions on, I think we answered this one around the 9-second equation for the box. So is that referring to the time to desaturation or just seeing on the slope, and that's the crossover, right, that you were mentioning just then?

Andrew Hauser59:12

That's the crossover. And you'll hear, that's why I like things with good auditory feedback. You'll hear their power will go down if you're watching it, but you'll hear, you'll hear the decrease in output on a, a lot of your guys use probably a Dyne and Echo bikes. So they'll hear it go.

James de Lacey59:32

And then just to finish us off. It's already been an hour for you, but are you able to explain how the nasal breathing affects diffusion across the capillary to the muscle?

Andrew Hauser59:43

Okay. So what's your question specific about that?

James de Lacey59:46

Are you able to explain how nasal breathing affects the diffusion of oxygen across the capillary to the muscle?

Andrew Hauser59:56

And I think this would be my opinion. I think you're getting such a major desaturation or not desaturation, vasocclusion dilation. I'm using too many words. I think you're getting such a big vasodilation and you're getting more hemoglobin move now instead of just myoglobin locally in the area. So I think now it's almost you've activated myoglobin to really spread out.

So I think it's at that point it becomes an opportunity for, you're shifting them to the right a little bit, but you're also when you do that, just because of the nasal effect, you're driving more oxygen along with it. Again, that's just something I've seen consistently happen now.

So the vasodilations are for sure. As far as opening up capillary, your capillary network oxygen's, I do think you lose, as we're talking through this, I do think you decrease dead space in your throat, which is something we didn't talk a lot about. But you lose a quarter of your air that you breathe. A quarter of the oxygen you breathe, you lose, it's just non-usable and it stays in your trachea. So from a nasal perspective, and this is a slower breath rate, when you're doing that, you should really be losing less of that to dead space. So more usable.

James de Lacey1:01:37

Gotcha. And then final one on the measuring of, I think it's measure of CO2, but the VO2 Master doesn't have a CO2 sensor. I think you mentioned what you use to measure CO2.

Andrew Hauser1:01:46

Yep. So I use a capnometer to measure CO2, like they in hospitals. I do it intranasally always. You know what's actually a good, what originally got me to even get the capnometer. I wanted to actually call out, I remember going through some of Buteyko's work, and he's got these great charts, CO2 charts that they would do off of where Patrick McKeown took his bolt score from. They would do something similar, and it's like, hey, you wanted to get up to a certain time and then that would equate to this CO2 level.

And I was like, I didn't buy it. So I was like, all right, I'm going to see. It's pretty accurate honestly, once I got him. But that's when I started using, oh, okay, I want to see how high can I comfortably drive this when I do some of this hypercapnic work or hypoxic work.

But I will say that bolt score or they call it a control pause, that may be next to an Omega Wave, that may be the most sensitive, probably more so even than the Omega Wave, but the most sensitive marker I've seen for stress is that control pause, which again equates to your CO2 level. So I started doing it a lot when I was, I mean, Major League Baseball, it's you're home a week, gone a week for most of the year.

James de Lacey1:03:15

Yeah. Playing.

Andrew Hauser1:03:16

Almost every day.

So I would, and I'm not playing, but I would measure it when I'd get up in the morning. I do that every morning. And then early on I would compare that with a capnometer and see. But that was very eye opening. That will respond to what you eat a lot, and it's just all these stressors that we're not necessarily thinking about.

So it's like, oh, I did not, I didn't respond well to whatever I just ate, or that jumped my CO2 level up. Is that is a highly reactive marker that getting the bolt score or the pause, the technique of it isn't easy because everybody just, it's either I'm going to hold until a maximum hold, and it's not that. So that is a challenge, but once you get it, it's awesome. I do love the Omega Wave still, particularly the DC potential.

James de Lacey1:04:24

Perfect. I think that's a great way to end the podcast. Andrew, where can people find and follow you, keep up with what you're doing?

Andrew Hauser1:04:29

So I mean, I run a facility in Scottsdale called Continuum High Performance, which, one, you can just email me if you have questions. I love to talk through this stuff. That's andrew@continuumhp.com. I couldn't tell you my handle on Instagram, but—

James de Lacey1:04:48

We'll put that in the description.

Andrew Hauser1:04:50

But you can definitely reach out through there. I'm getting a little better about starting to put stuff out, kind of go through spurts, where I, some upcoming educational stuff that's going to be coming down the pipe, which will kind of go through that and the website, which is continuumhp.com. But yeah.

James de Lacey1:05:10

Perfect. No, I appreciate you coming on and sharing everything.

Andrew Hauser1:05:13

Yeah, thanks for having me.