Heart Rate Variability (HRV) Biofeedback and Athletic Performance: Part One

Rationale and background

While part Four of this guide is mainly focused on athletic performance, Parts One, Two, and Three are generic and cover aspects applicable to any other population in terms of the benefits of improved emotional self-regulation

But let’s start with the basics.

What’s HRV biofeedback?

Life can be demanding, from both a physical and psychological point of view. Our health and performance can be affected by how we are able to effectively cope with stressful situations and deal with anxiety, or in broader terms, our ability to emotionally self-regulate can be very important.

With this series of posts, I will try to provide a critical overview of the effects of HRV biofeedback practice for athletic performance enhancement, as well as to discuss implications for future research and for practitioners.

Scientific rationale

HRV Biofeedback is a technique that consists of providing an individual with real-time feedback on instantaneous heart rate and respiration changes while being instructed to breathe at low frequencies (Lehrer and Gevirtz, 2014).

Strengthening the parasympathetic nervous system could also motivate using HRV Biofeedback in athletes, with the potential of improving emotional self-regulation, coping mechanisms, and performance (Khazan, 2016; Pusenjak et al., 2015)

Facing stress

Stressors such as negative life events and intense physical training can result in negative physiological responses such as stress hormone perturbation, immunosuppression, and impaired skeletal muscle repair (Williams and Andersen, 2007; Appaneal and Perna, 2014). All of these aspects can act as mediators for negative outcomes such as increased injury risk or training maladaptation, in both cases resulting in reduced health and performance (Prinsloo, Rauch, and Derman, 2014).

Given the physiological and psychological factors just discussed, HRV Biofeedback is an ideal strategy to help us self-regulate and better cope with stressful situations. HRV Biofeedback can directly affect ANS activity through deep breathing exercises that stimulate parasympathetic activity. Therefore, HRV Biofeedback might directly provide a positive impact on the physiological and psychological factors that mediate health and performance


The scientific literature on HRV Biofeedback has shown positive outcomes on a variety of applications outside of sports, from chronic obstructive pulmonary disease (COPD) to depression, cardiac rehabilitation, and post-traumatic stress disorder (PTSD).

Wrap up

Combining insights from biopsychosocial models and basic physiology, we can see how HRV Biofeedback has been proposed as a technique that can help athletes to improve emotional self-regulation and coping mechanisms via a strengthening of homeostasis, with the potential of resulting in better health and performance.

Such changes in psychological and physiological factors could then affect other health and performance-related outcomes such as injury risk and recovery

In the next parts of this guide, we’ll learn more about common metrics that can be used to quantify HRV Biofeedback sessions and the impact of such sessions on our physiology, as well as common protocols and expected changes in physiological, psychological and performance outcomes.

Founder HRV4Training.com, Data Science @ouraring Lecturer @VUamsterdam. PhD in Machine Learning, 2x MSc: Sport Science, Computer Science Engineering. Runner

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