On this episode of ADVENTing, Dr. Madan Kandula and Dr. Ethan Handler discuss that no matter what sport, athlete or way to train, they all require proper breathing to be at their very best.
Dr. Kandula: Yeah. All right, talking about athletes and we've been talking about sort of the breathing impact of athletic performance. And I think for us, we see patients all the time, athletes, non-athletes. But I think sometimes the story, sometimes for me when I'm in clinic and seeing patients, or on the back end of procedures for folks and we get somebody who was sub-optimal/optimal in their stories, those are really to point at. As far as athletes that you've seen any particular ones that come to mind that sort of were like, "Wow, this person really needed the change that we're able to deliver."
Dr. Handler: Yeah, I mean I can think of one in particular that was a collegiate power-lifter. And, big kid, you know probably 6'6". And you know I don't know a lot about power-lifting per se, but I can imagine it requires a lot of strength, obviously. But he complained primarily of not getting good sleep, at all, and not being able to breathe through his nose. And, obviously two essential qualities I would think to performing your best especially in that kind of setting where, a pound difference apparently can make a world of difference for what you accomplish in that world of power-lifting. So anyway, we did a scan, and his history was obviously very specific for not being able to breathe well through his nose. And then I was worried about sleep apnea, big kid, you know that kind of thing. But that scan, I mean his nose was like, shut down. Like, shut down. And of course he never breathed through his nose anyway, and so it made a profound difference for him. Didn't end up having sleep apnea which was good but sleep quality improved just by virtue of getting his nose opened.
Dr. Kandula: Right.
Dr. Handler: And I asked him to give ADVENT of course a shout-out you know, if he won a world title. Kidding, never heard back from him.
Dr. Kandula: What's your excuse for not being the world champion power-lifter? If his nose was jacked up and he still was able to crush it, why can't you crush it with your nose that's working right?
Dr. Handler: It's cause' of my 140 pound frame, I don't think that's gonna' be happening.
Dr. Kandula: Exactly.
Dr. Kandula: Yeah. Athletes who have issues breathing through their nose, is that genetics, is that environment?
Dr. Handler: That's a good question. So I think that it's multi-factorial, you know? Lot's of things can play a role, genetics can hurt you especially from aligning, right, cause' we always talk about there's two problems in the nose, it's anatomy, it's lining, genetics play a role of aligning. The way you react to the world around you is inherent in your DNA.
Dr. Kandula: Correct.
Dr. Handler: Right? But the anatomy is a large factor in that story and if your anatomy is unfavorable in your nose, meaning it's shutting you down, like, you're kinda' screwed.
Dr. Kandula: Although, humans are resilient and so one can assume if you're a competitive power-lifter that your genetics are favorable to do such a thing.
Dr. Handler: Correct.
Dr. Kandula: But that's good and go with the flow there but then it doesn't mean that your nose is genetically on your side either, and in fact most the athletes we see are compromised that way. And to me it's almost remarkable that they can do what they can do with a nose that's hurting them every breathe they take, every single breathe they take. You know meaning if you're gonna' start two athletes off and genetics are gonna' really play a role in a lot of that but breathing plays a crucial role into much of that. And so it's amazing how resilient human beings can be in the face of struggle and challenge kind of a thing. And it's almost like, and then again to me it's almost analogous to training at an altitude.
Dr. Handler: So why do athletes train at altitudes, what's the whole purpose there?
Dr. Kandula: The purpose there is to get an edge on the rest of the competition. So when you're training at altitude you are basically restricting your breathing capacity in a way, because there's less oxygen in the air at altitude so you're forcing your body to fight against a situation where it's harder. So that, you do that, you go to altitude so that when you come out of altitude that you're stronger than where you were, lets say when you left off. The opposite is true too, there is a reason why playing in Denver has always been through the years really hard, because you take somebody whose living on the ground here and you take em' up and put them on a mountain and decrease their oxygen capacity, it's gonna' hurt them.
Dr. Handler: Right.
Dr. Kandula: Because it takes a while to become strong through that, and so here on the ground we see folks all the time who are basically struggling through life where their intake valve is partially shut down or completely shut down and they're fighting it, they don't get the benefit of kind of taking the chains off that way. They can't do it on their own I guess is what I'm saying, and so they need our help to both identify that there's an issue there and correct that issue so that we can send them back out in the world as stronger. But it's absolutely part in parcel with that, I mean again there's a reason why people go to great lengths to challenge themselves from a aerobic capability standpoint, but there is not a reason to do that unless the tools that you have are causing you to do that on a constant basis, that's not helping you.
Dr. Handler: Right. I mean imagine an athlete trying to, let's say it's you know, a NBA player, and they're playing their basketball game and imagine them playing a game with like a clip on their nose, right? So nose ain't working at all.
Dr. Kandula: Yeah, absolutely.
Dr. Handler: Then they play a game with a clip off their nose, and still, they're not optimized. Right? They're still breathing what their normal baseline is. And then imagine like, a level up from there so I mean it would give people perspective and I think people can relate to that, like hey, if I'm not breathing through my nose and then I take that clip off and I'm getting just my normal baseline and it's that much better, think about what it could mean for you performance-wise if you actually get your nose working.
Dr. Kandula: Absolutely, yeah. I mean it's a big deal. I mean another way to look at it too is if, everybody has had a cold, if you're an athlete and you have a cold and you got out and perform, think about your performance on those days. And part of that is just the overall effect of your body fighting a virus, but part of that is the fact that the cold is causing your nose to get shut down and you're just not breathing properly and you're struggling.
Dr. Handler: Right, and maybe these players wouldn't have to take so much game management and take a day off on a double header you know. They can actually play all 82 games.
Dr. Kandula: Maybe Kawhi would be like, able to hit every game?
Dr. Handler: Right? You know I remember when Kobe Bryant and Michael Jordan they used to play every game, flu or no flu.
Dr. Kandula: So maybe we need to check their noses out.
Dr. Handler: We probably should.
Dr. Kandula: Maybe Kawhi needs a personal intervention with us.
Dr. Handler: Yes.
Dr. Kandula: Yes, although now that I think about it Michael Jordan his famous thing and move was tongue out when his was jamming. Was he signaling to the World that he needs some help or was he...
Dr. Handler: Or just, in your face, in your grill. It's a good question.
Dr. Kandula: Yeah, no, but it really is, it's important, because it's important doesn't mean you can't make light of it though, and then on the flip side because--
Dr. Handler: Right.
Dr. Kandula: But yeah I mean I think it's certainly something to consider, certainly something that, you don't have to be a professional athlete, you don't have to be Kawhi Leonard. You could be, Joe Smith who just wants to be their best self. And you like to workout, whatever it is, you like to run, whatever it is that starts with breathing properly through your nose, and if you're not doing that, that's hurting you. And I think for non-professional athletes, non-peak performing athletes, I would venture to bet that it is a barrier to entry for a lot of folks, meaning if your nose isn't working and therefore every time you hit the treadmill, hit the road, hit your bike, you're just struggling to breathe because you gotta' drop your mouth open your mouth breathing the whole time, that's gonna' condition you, that's a punishment to exercise. So it's gonna' condition your brain to say, "Man, when I go to exercise, it sucks. "I cannot breathe properly." And you might not connect the dots here like consciously, but sub-conscious your brain is gonna' say, "Dude. Take a day off. It's too hard for us to continue on like this." And so, I would venture to bet there's a lot of folks that are shortchanged because their nose doesn't work properly from an athletic standpoint that they haven't really connected the dots yet.
Dr. Handler: Right.
Dr. Kandula: Cause' it can only hurt you, it can only be something that is going to make it harder to do what you're trying to do.
Dr. Handler: Yeah. It's an unnecessary barrier, like it doesn't need to be there and be a problem for someone who wants to get into exercise.
Dr. Kandula: Well I guess that's back to sort of like, what do you do with that? What you do with it is identified as a possible problem, and the good news is nowadays there's really easy ways to get better, to push through that, to get it out of the equation. And so it's just a matter of really, creating that awareness which I think is important because what's the point of talking about all this is all the people out there who are suffering, you know athlete or non-athlete with issues that are easily correctable, why suffer? And there's no reason, I mean like there's not really an existential crisis, it's just there's no reason. Like, there's no reason, there's no reason. It's just a matter of, you know getting it out of somebodies way which is powerful. So I think, again, for all the professional athletes out there down the ladder to really the eight-year-old kid who's on the soccer field who's trying to do their best, it starts with the nose from a breathing standpoint. And it's crucial, it's powerful when you can breathe properly and it's deflating when you can't. And so I would say it's absolutely time to do something, so.