Jens Tummeleer Osteopaat IO

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1 Jens Tummeleer Osteopaat IO Hoe de metaboreflex een beperkende factor is bij wielrenners in maximale inspanning, en hoe dit te beïnvloeden door ademhalingstechnieken Literatuurstudie

2 Over mezelf! Jens Tummeleer 37 jaar " Kinesitherapeut (2000) " Manueel Therapeut (2008) " Osteopaat IO (juni 2016)

3 Over mezelf! 4 jaar staff A elftal Waasland Beveren (voetbal)! 12 jaar actief in het wielrennen " 10 jaar op Pro Tour niveau " Lotto, Saxo Bank, HTC, " Omega Pharma Quick Step sinds 2012

4 Over mezelf

5 Inleiding! Wat te doen als renners je zeggen dat hun benen werden afgesneden?! Wat te doen aan plotse vermoeidheid! Ik voelde me supergoed en de volgende klim had ik niks meer in de benen

6 Inleiding

7 Literatuur! St. Croix, 2000 " High resistance, prolongues duty cycle breathing at rest results in clear respiratory muscle fatigue.

8 Literatuur! J.A. Dempsey, 2001 " Manipulation of breathing work during maximal performance results in a marked change in the blood flow of the working muscles, as well as a change in cardiac output and the uptake of oxygen in the whole body. (breathing techniques)

9 Literatuur! The metaboreflex origins in the respiratory muscles and has as its fundamental goal the protection of the oxygen delivery to the respiratory muscles, thus ensuring the ability to mainatin pulmonary ventilation, proper regulation of arterial blood gasses and ph and overall organismic homeostasis. (D.R. Seals, 2001)

10 Metaboreflex Verhoogde bloodflow Verhoogde opname van zuurstof Verhoogde capillaire ventilatie Verhoogde activiteit van ademhalings spieren Verhoogde cardiac output Fysieke activiteit Overload

11 Metaboreflex! Overload " Vitale organen worden beschermd tijdens submaximale en maximale inspanning, waar duidelijk voorrang wordt gegeven aan deze vitale organen tov de locomotorische spieren. " Immuunsysteem

12 Metaboreflex

13 Literatuur! Factoren die maximale inspanning beinvloeden " Diaphragmatic fatigue Occurs during sustained exercise of high intensities (>80% maximal oxygen consumption (VO2max)) " Babock et al, 1995

14 Literatuur! Factoren die maximale inspanning beinvloeden " Accumulation of metabolites in the inspiratory and expiratory muscles when respiratory muscles are fatigued activates unmylenated type IV phrenic afferents, which in turn increases sympathic vasoconstrictor activity via a supra-spinal reflex Hill, 2000

15 Chris Froome?! Wat heeft dit te maken met Chris Froome?

16 Chris Froome! Exp Physiol 2012; 97: " The cost of breathing for top-level athletes can be up to 15-16% of VO2max when engaged in an intense effort

17 Chris Froome! Med Sci Sports Exerc 2000, 32: " Cyclists, even top-level ones, do not breathe efficiently especially under intense effort " The study observes how often cyclists under effort instinctively tend to gasp and generally breathe in a not very efficient way, in particular by not emptying the lungs completely during exhalation.

18 Chris Froome! This means that residual air, low in O2 and rich CO2, mixes with fresh air rich in oxygen, consequently "impoverishing" alveolar pulmonary gas exchange.

19 Chris Froome Tour de France 2013 (Mont Ventoux)

20 Chris Froome! Breathing technique (G. Obree The Obree Way) " Full exhalation to empty the lungs from residual air " Deep inspiration to fill up with fresh air " Respiratory cycle with a depth half of the first " Third cycle will have a further lower depth " Resume the sequence again with a full exhalation and deep inspiration

21 Inspiratory Muscle Training (IMT)! Try to increase respiratory muscle strength and presumably reduce or delay respiratory muscle fatigue, and so reduce the increase in heart rate and arterial pressure (Witt et al, 2007)! Respiratory muscle metaboreflex is a key player in increased sympathetic tone and blood flow redistriction during heavy exercise (Sheel et al, 2001)

22 Inspiratory Muscle Training (IMT)! There seems to be a threshold for activation of this reflex that does not occur during exercises of low to moderate intensities or non fatigueing inspiratory efforts (Rodman et al, 2003) " IMT may have raised the threshold required to elicit significant increases in main arterial pressure.

23 Anatomie Nervus phrenicus (C3-C5) Lumbar connection (L1-L3) Diaphragma Connection to lungs and heart (ligaments) * Giles et al, 2013 Vital importance fot lymphatic and vascular systems Connection to occipital bone *

24 Anatomie! Deep Front Line (Myers) " Fascia prevertebralis " Fascia pretrachialis " Infrahyoidale musculatuur " Suprahyoidale musculatuur " Mm. Scaleni

25 Breathing techniques Chris Froome Tour de France 2015 Paula Radcliffe Chicago Marathon 2002 (World Record)

26 Samenvatting! Metaboreflex is een limiting factor bij sub maximale tot maximale inspanningen! IMT kan de threshold voor deze reflex gaan uitstellen! Breathing techniques tijdens inspanning kunnen de expiratie fasciliteren zodat de inspiratie een groter volume O2 kan omvatten

27 Contact