I was asked by a blog reader to do this post and it is a great topic. I will be absolutely honest though, other than reviewing literature on breathing, Chaitow's text, and 2 PRI Courses under my belt, I am by no means an expert on this topic. Here are tidbits I have picked up the past few years on breathing.
I have made some big changes with MDT, Pain Science education and working on breathing. People have come in with 10/10 HA, not respond to any manual therapy, or be adverse to touch, and leave with 0/10 after some reassurance, a positive, relaxing atmosphere and breathing techniques. Part 1 of this post is why you should be looking at breathing, part 2 next week will be 5 ways I address it.
1) Breathing pattern disorders have been associated with both cervical and lumbar conditions
- sternal breathers are using muscles normally reserved for fight or flight modes or in times of greater oxygen demands
- this has been associated with chronic cervical pain and/or headaches
- been working on those SCMs and tonic scalenes, but not focusing on breathing? That tone is likely not changing if they continuously using accessory muscles of respiration
2) Sternal breathing may enhance perceived threat
- the nervous system associates this breathing pattern with fight or flight, not a relaxed state
- before the research associated breathing pattern disorders with cervical, headache, and lumbopelvic conditions, breathing was being instructed by everyone from pilates and yoga instructors or even marriage counselors
- why? Because proper breathing is key to relaxation and decrease in stress
- any decrease in stress decreases the CNS alarm, which raises the pain thresholds
- I explain low pain thresholds (when the CNS alarm is going off) as not being able to "bank" as much movement, activity, or certain positions the CNS finds threatening
- once we decrease perceived threat, the alarm does not fire as readily and the pain threshold raises, requiring more stimulus to perceive pain
- the more stimulus allows patients to "bank" more prior to perceiving pain, if at all
3) Diaphragmatic breathing is essential for core stability
- You want distal mobility? Work on core stability - and not by planks unless your patient can breath properly in that position
- if they're not breathing properly over a heat pack in hooklying, it's doubtful they will in a plank!
- the diaphragm is a dome, proper contraction causes the dome to descend, creating a piston like effect of pressure on the pelvic floor
- this is essential and I explain the core to patients as having a front, back, ceiling and floor
- it is surprising to patients and clinicians upon first seeing how well an ASLR movement pattern can improve with some diaphragmatic breathing
4) Diaphragmatic breathing cuts off the state of "active inhalation"
- Dr. Andrew Weil, a holistic wellness expert describes sternal breathing as "active inhalation"
- getting the diaphragm to fire and descend actively makes it passively elevate, then drawing in air passively rather than actively
- this breaks the cycle of using sternal elevators during inhalation
- PRI's founder, Ron Hruska, calls the active inhalation a state of "perpetual inhalation"
- this perpetual inhalation increases tone not only in the scalenes, and SCM, but many of the usual culprits seen in your typical upper crossed syndrome
- teaching diaphragmatic breathing gets the patient in a state of exhalation, thus decreasing tone, especially in the upper quarter
5) Diaphragmatic breathing assists thoracic mobility
- I wrote last week on why thoracic mobility is important
- since this is often a dysfunctional non-painful area, diaphragmatic breathing should get the ribcage moving well, and thus the thoracic spine
- if a patient is having difficulty with this, that's where manual therapy comes in, which will be the focus of part 2 next week!
Take a deep, non sternal breath, let out all your air (all of it!) in a nice big sigh... feel the tone melt away and Keep it Eclectic...