"Take a deep breath!" Advice we have all heard a million times. But is it good advice?
Breathing is obviously very important - It's how we live and get oxygen to our cells - but did you know that how you breathe affects both your nervous system responses and your core stability?
First, we have to look at how the breathing system works to understand how to use it more efficiently. During inhalation the diaphragm, the biggest breathing muscle, 'domes' down and expands to draw air in, which in turn creates pressure that pushes down the abdominals and the pelvic floor muscles.
These structures rebound up upon exhale, creating a piston system which contributes to core stability. Here is a great video from Julie Wieb, a women's sports medicine Physical therapist explaining this. (1) 360 degree breathing, expansion in all directions of the ribs, is needed for this to work appropriately. In other words, during inhalation the chest expands up but the ribs should also expand out to the side and the back and return on exhale. When used effectively, this system disperses the pressures created by breathing efficiently and, in turn ,uses that pressure to create core stability.
Now let's explore three breathing strategies that may be inefficient and contribute to pain and injury as well as overall core weakness: shallow or chest breathing, belly breathing and breath holding.
Chest breathing is a shallow breathing pattern limiting dispersion of the pressure into the abdomen. Two major contributing factors for this are slumped sitting and drawing in of the navel. When slumped, the diaphragm struggles to expand which causes the pressure of the inhale to stay up in the chest. This stimulates the accessory neck and chest muscles to work too much and contribute to pain. The diaphragm also stimulates the vagus nerve, responsible for control of the sympathetic nervous system. This is the part of the fight-or-flight system that winds us down. Altered stimulation of this nerve may wind up the nervous system to keep us in a more tight, anxious or stressed state. Secondly, some people will draw in or squeeze their abdominals either consciously to "work" them or subconsciously to create stability at the core. This drawing in at the navel, again, limits the ability of the piston mechanism described above. This strategy contributes to a more shallow breath and creates increased pressure on the pelvic floor. Think of a balloon, if you squeeze the middle of it the top and bottom will bulge with pressure. (2) This bulge of pressure on the pelvic floor may be problematic. Excessive pressure on the pelvic floor may contribute to pelvic floor, hip and back pain or dysfunction. Unfortunately, the drawing in method has been taught in exercise for years as "core building" exercises and may be contributing to some dysfunction. Our society also bombards us with cues to "suck it in", further encouraging faulty core strategies. Pay attention to your abs, are you squeezing them in throughout the day? Try to let them relax and feel your breath when you inhale get all the way down to the pelvis.
The second dysfunctional pattern is belly breathing with a lack of 360 degree expansion. During belly breath, the pressure is shifted fully down into the abdominals and away from the ribs. This creates too much pressure on the abdominals and pelvic floor, and can be particularly troublesome for a postpartum woman dealing with a diastasis. For some people, the cue "take a deep breath" may be synonymous with belly breathing and may not be the best advice for them. Stiffness and tightness in the upper back may be limiting rib expansion. Adding thoracic spine mobility exercises to your workout may be the first step to gaining 360 degree expansion and can really help with upper back pain.
Lastly, breath-holding is an inefficient strategy used to create core stability. Many of us hold our breath during simple every day activities. Now, during maximal heavy lift, breath-holding may be appropriate to create pressure to protect the spine from the heavy load. But holding this much pressure in the abdomen too often throughout the day may overload our pressure system and contribute to pain and dysfunction. Breath-holding may be seen during simple daily activities such as getting out of a chair, pushing up on stairs, reaching for dishes in the cabinet, etc. The diaphragm has fascial connections to several of the abdominal muscles, the hip flexors, and some back and rib muscles. Because of this, the diaphragm contributes to connecting the upper body and lower body as well a creating the piston pressure system for core stability. Rendering the diaphragm inefficient with breath-holding may increase extra stress on many other structures in the body. It is incredibly important to not hold your breath and this may be the first thing to be aware of when working on breathing or recovering from injury. Pay attention throughout the day - are you holding your breath during your daily activities? If you catch yourself holding even for just a second, start blowing out before you initiate that activity. For example, if you catch yourself breath-holding when standing up, start blowing out before you begin to stand and keep blowing out until you are all the way up. You may be surprised by how often you catch yourself holding. Start with this and stay tuned next week for part 2 with tips to improve your breathing and core system, and Part 3 with strategies for runners.
References
Diaphragm, T., Pressure, I., & System, P. (2014, January 21). The Diaphragm And Our Internal Pressure System. Julie Wiebe YouTube. Retrieved November 12, 2019, from https://youtu.be/cW9mwfy-6-I
Fit, T., 1:, P., & Training, 1: (2011, December 24). The Fit Floor Part 1: Training The Pelvic Floor For Fitness. Julue Wiebe YouTube. Retrieved November 12, 2019, from https://youtu.be/2Egyo34omQU
Disclaimer:
This program, videos and content is not intended to diagnose or treat any illness or injury. It is for educational purposes only. If you chose to try any of the exercises presented here do so at your own risk. Please consult a physician before you start any new program.
Not every exercise is safe for everybody. Correct execution of all exercises is imperative to prevent injury. Please consult a healthcare professional if you have any questions about your exercise execution or if an exercise is right for you.
You are responsible for yourself and will not hold Kelly Kuhn or Kelly Kuhn Physical Therapy liable for any injury or illness.