By Mark Yanai

My Morning Routine: Listening to My Heart

What’s HRV and why should I care?

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I’ve written about my morning routine in previous blogs and why it’s important to my wellbeing and me. Meditation and breathing exercises are key components of that routine and so is a movement practice that sets the tone of my day. But how do I know that this routine is effective? I did quite a bit of research to find some way to quantify my day-to-day improvement since I knew that using just my “gut feeling” wasn’t enough. Having a scientific background led me to look at measuring my heart rate, blood pressure and sleep cycles and I concluded that the best measurement of effectiveness was to look at Heart Rate Variability (HRV).

I first heard of HRV while listening to Ben Greenfield’s fitness podcast. He spoke about it often and wrote about it in his book, Beyond Training. He even has his own app to use for an iPhone. Unfortunately, I’m more of a Android guy and needed to look elsewhere. After an extensive search and multiple trials, I found one that I’ve used for the past year: Elite HRV.

So what is HRV? According to Elite HRV’s website, “Basic Heart Rate Variability (HRV) is the measured changes of the time intervals between successive heart beats. Unlike Heart Rate (HR) that averages the number of heart beats per minute, HRV looks much closer at the small fluctuations of the heart that occur in response to internal and external events. “

For those of you with the propeller hats, there’s a more scientific explanation. This one is from Polar.com:

Heart rate varies with every heartbeat. Heart rate variability (HRV) is the variation of beat to beat intervals, also known as R-R intervals. Electrocardiogram (ECG) is the electric signal originating from heart. The most distinct feature of the ECG is the QRS complex, which consists of the Q, R and S waves and originates from the electrical activation of the heart ventricles. Figure 1 illustrates the variation of time between R-R intervals.

HRV indicates the fluctuations of heart rate around an average heart rate. An average heart rate of 60 beats per minute (bpm) does not mean that the interval between successive heartbeats would be exactly 1.0 sec., instead they may fluctuate/vary from 0.5 sec up to 2.0 sec.

HRV is affected by aerobic fitness. HRV of a well-conditioned heart is generally large at rest. Other factors that affect HRV are age, genetics, body position, time of day, and health status. During exercise, HRV decreases as heart rate and exercise intensity increase. HRV also decreases during periods of mental stress. HRV is regulated by the autonomic nervous system. Parasympathetic activity decreases heart rate and increases HRV, whereas sympathetic activity increases heart rate and decreases HRV.

If you didn’t quite comprehend what was stated above, don’t worry. The takeaway is that HRV measures the balance of your nervous system. It lets you know if you’re more in the “fight or flight” or “rest and relaxation” mode. By measuring my HRV daily, I’m able to know if my morning routine, physical training, and sleep are being optimized.

Without fail, my readings have given me instant feedback about how my body is reacting. After hard training days, my HRV is usually lower and it gives me an idea about how I’m going to attack the day. It also gives me excellent feedback on when I’m over-reaching or over-training. It was interesting that after last month’s Spartan Race, my morning readings reflected the effects on my HRV:

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My HRV the morning of the race:

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My HRV the following morning:

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Due to the information and knowledge that I’ve gained by measuring HRV, I decided to use it as a tool for treating patients. For our Work Hardening patients, we’ve collected six months of measurements to track the effectiveness of the program as well as looking for trends in patients. It’s been interesting to note that patients who’ve come in with low readings often struggle with the program and exhibit weak cardiovascular systems. I believe monitoring HRV during our patient exercise routines will become an integral part of their therapy treatment program and in the future, I hope to be involved with a medical model that is specific to patients in this capacity.

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If you are interested in monitoring your HRV, you’ll need a heart rate monitor. I’ve tried several and so far we’ve had the best results with Polar’s H7. Also, there are several apps that are compatible with the Polar H7 (and other bluetooth HR monitors) and can be easily found on the internet. We use the Elite HRV app (compatible with Google Play and App Store devices) and you can download it here.  Start by taking a reading as soon as you wake up and then several more during your exercise routine. If you have any questions regarding this topic, feel free to email me or stop by our WORC site.

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Mark's Blog
By Mark Yanai

The Most Important Exercise

I’m often asked by patients “What’s THE most important exercise I should do?” My answer changes as my experience as a physical therapist evolves throughout the years. I would normally tell my patients to do some form of stretching or strengthening, until recently, when I started doing deep, abdominal breathing exercises as part of my morning routine. I now tell my patients that abdominal breathing is one of the most important exercises they can do.

There are a number of contributing factors that make abdominal breathing so important. A couple of years ago, I began focusing on abdominal or diaphragmatic breathing after studying Heart Rate Variability (HRV) which is a measurement of the balance between your sympathetic and parasympathetic nervous systems. By measuring your HRV, you are able to assess your body’s response to stress. The body reacts to stress by changing breathing patterns, which leads to physiological changes including hormonal responses and neurological patterning.

In normal breathing patterns, we SHOULD use abdominal breathing, which is focused on using the diaphragm, a muscle located below the lungs. This muscle is controlled by our parasympathetic nervous system via the Vagus nerve. Because of the daily stresses of life, we’ve adapted our body’s most vital need: to breathe. Abdominal breathing has such profound effects on our ability to handle stress, anxiety and physical activity. However, some of us have changed our breathing patterns and use more of a thoracic breathing pattern. This pattern is shallow, shorter and typically used when we are reacting to a “fight or flight” situation and triggers the production of cortisol leading to a weakened immune system.

“Habitual chest breathing not only reflects physical and mental problems. It creates them. It mildly but chronically over-stimulates the sympathetic nervous system, keeping the heart rate and blood pressure too high, precipitating difficulties with digestion and elimination, and causing cold and clammy hands and feet.” – David Coulter, The Anatomy of Hatha Yoga

I often see this shallow breathing pattern in my patients. Pain is a factor in changing the way we breathe and we unconsciously respond to pain by holding or shortening our breath. When I see this response, I spend time educating the patient on focused abdominal breathing exercises which helps moderate pain.

One of my favorite references on how to breath correctly is Jill Miller’s The Role Model. Her book is excellent in explaining how the body breathes, the anatomy involved, and how to correct your breathing pattern. I incorporate her “Breathing Primer” into my breathing exercise routine each morning and it has positively affected everything that I do.

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After learning about the importance of breathing correctly, I discovered Breath Reset, a type of meditative breathing that helps me to focus my thoughts, settle my body, and allow me to get in touch with my body. This breathing practice has been performed by many for centuries and has been the foundation of Buddhism.

 

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Chapter 4 of The Breath of Life

One who has gradually practiced,
Developed and brought to perfection
Mindfulness of the in-and-out breath
As taught by the Enlightened One,
Illuminates the entire world
Like the moon when freed from clouds.  

(Theragatha 548)

Each morning, I perform a routine of meditation, yoga, body weight exercises and reading while drinking my Bulletproof Coffee. This routine usually takes about an hour which is why my alarm goes off every morning at 5 A.M., even on the weekends. But the most important part of my routine, is my “belly breathing”.

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I start by walking out to my backyard deck, a place that is quiet and peaceful. A regular spot in your home will help your routine become permanent. I usually sit with my back supported and with my legs crossed. With my eyes closed, I begin by taking a long inhale through my nostrils and exhale through pursed lips. I focus on my abdomen drawing in and out, trying to feel as if my diaphragm is elevating and depressing. My thoughts usually wander which is normal. I think it’s impossible to expect my brain to stop having random thoughts or emotions, so I don’t put pressure on myself to suppress them. Instead, I try to focus on feeling my body breathing.

During my breathing exercises, I am able to quiet my mind, induce a relaxed feeling, and trigger the hormones in my body that create an improved level of function. I start every morning this way so that I can control my thoughts and emotions throughout the day. The value of this ten minute practice is more valuable to me than an extra hour of sleep. It has helped me become more focused, productive, and clear about what my life’s journey is about. It has also improved my posture, breathing capacity and has taught me how to reduce my stress level at any time. No other exercise has had as much profound affect on my life as meditation and breathing. It is a simple practice that anyone can learn to improve your life immediately.

 

References:

Wikipedia contributors. “Heart rate variability.” Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 4 Jul. 2015. Web. 5 Jul. 2015.

 

 

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