Thursday, 25 May 2017

Take a breather

Source: my back garden 
A recent study published in the International Journal of Sports Physical Therapy* found a significant relationship between breathing and functional movement.   Participants with normal breathing performed better on the functional movement tests than those with dysfunctional breathing.    The functional movement tests were based on exercises like squats and lunges that involve both mobility and stability.  Normal breathing was defined as diaphragmatic breathing and dysfunctional breathing was breathing that uses just the upper chest, over-using neck and shoulder muscles with less use of the diaphragm.  

Really, the majority of us are somewhere between normal and dysfunctional.    Most of us can improve our breathing and feel many potential benefits from doing so.    These benefits can be better sports performance, improved mobility in the spine and rib-cage, improved core strength (as the diaphragm is a key part of our core (see Getting down to the Core blog)), less pain in neck and shoulder muscles and also decreased stress levels.

I would call this normal breathing optimal breathing as we can work towards it and for many of us it isn't yet normal!

Optimal breathing uses the diaphragm for 75% of effort and the intercostals between the ribs account for the remaining 25%.  This means that neck and shoulder muscles are barely used to breathe with.

Source: Wikimedia Commons
The diaphragm connects to the base of the breastbone, to the lower ribs and to the lumbar vertebrae.   It separates the thorax from the abdomen.   

The diagram above shows, as we inhale, the diaphragm contracts and it's outer edges pull the ribs outward and upward.   The intercostal muscles help by pulling the ribs further apart.  The thoracic cavity expands and air is drawn into the lungs.  

At the same time, the abdominal cavity is compressed and the abdominal and pelvic organs move down meaning the abdominal wall has to expand outwards and forwards to accommodate this.  The transverse abdominus relaxes and the pelvic floor descends as it receives the increased load of abdominal and pelvic organs.

In the optimal exhale the diaphragm elastically recoils back up higher into the rib cage, abs and pelvic floor contract and the intercostals relax.   This sends air back out of the lungs.

It sounds simple, so why don't we all breathe optimally?  Well chances are that we did when we were young.  And then something changed and our breathing changed too.   This might have been a physical change to our body - such as our spine and rib-cage stiffened with a lifestyle of sitting and inactivity or we may have had a baby which can both change our spinal alignment and the position of the diaphragm.   Or it might be that stress and anxiety have changed the optimal breathing to something more rapid and shallow.

The most common breathing dysfunction is chest breathing (referred to as 'thoracic' breathing in the paper).   This type of breathing is short exhalation followed by shallow inhalation.  Muscles in the neck and shoulders overwork to sustain this.  The position of the ribs may well be altered so the front, lower ribs flare upwards.  There is likely to be a lack of mobility in the lower ribs and potentially muscle pain in the neck and shoulders.

So, where to start on retraining your breath?  In many cases it's about re-acclimatising the brain to higher CO2 levels by gradually using longer exhales.   And breathing into the back and the sides of the rib-cage, activating the diaphragm more to encourage fuller inhalation.

The paper concludes that "future research is needed to validate breathing re‐education programs and the role they have in treating pain disorders, preventing injury, and improving movement patterns."   Joseph Pilates understood this many years ago - so perhaps your first call when looking to improve your breathing technique should be your Pilates teacher...

Many thanks to Heather King-Smith for her fantastic Breathing and Alignment training.
*  Bradley H & Esformes J Breathing Pattern Disorders and functional movement.  Int J Sports Phys Ther.  2014 Feb; 9(1): 28–39.

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