There’s a reason I am always reminding you to breathe.
Often times when I see people come into the rehab clinic expressing difficulty in movement whether they can’t squat deeply, touch their toes, experience pain etc., the findings simply don’t add up. When we start to break down their movement and their mechanics, very often we can see that there is full and pain-free range of motion in the hips, knees, ankles, and other joints necessary for the movement or task at hand….So why can’t these athletes achieve clean movement patterns?
They have a faux mobility problem… it isn’t actually their MOBILITY. This is where we start to see the influence that respiration has on core stability and motor-control.
Core stability, a buzz word in the fitness and health industry, is the bulk of how you stabilize your spine. Your core isn’t just your washboard or six pack abs. It isn’t even just one muscle. Your core is actually your diaphragm (the muscle that controls breathing) in conjunction with several other muscles including the abdominal wall, pelvic floor, and deep posterior muscles in your back that surround your spine to protect it.
The brain has a dramatic influence on how the core is functioning. The core and the diaphragm are an extremely complex system that work together with the central nervous system signalling to the brain whether or not we are safe. If there are bad signals coming from either direction, things start to become pretty murky. In our overworked, overstagnant culture, it is rare that we have a well-oiled, perfectly functioning core.
How the diaphragm works:
As we inhale the diaphragm contracts and pulls the air into the lungs using negative pressure (roughly 75% of the work). The ribs become slightly elevated but the diaphragm is active here. We see disfunction when the ribs and sternum excessively elevate and the diaphragm contracts too little or incorrectly. The diaphragm can basically shift into a “bad position”… more on this later. We should be able to maintain a neutral spine as we inhale and exhale. During exhalation, the diaphragm pushes the air out as it returns to its natural, relaxed domed shape. During normal breathing, this exhalation is passive and much slower than inhalation.
With perfect breathing, we want to achieve whats called the Zone of Apposition, or ZOA, which is basically a normal, dome shaped curvature and normal movement of the diaphragm. The ZOA allows our muscles to be in the most optimal position to accept gas exchange (respiration) which is controlled and balanced. If we start to look at what a sub-optimal or poor ZOA looks like, we can see a change in posture: the ribs are flared out, the curvature of the lumbar and cervical spine becomes overly extended, the scapula is shifted out of position, and the head becomes more forward on the spine due to the change in it’s curvature. Check out the picture below and see if you can notice a difference in the skeletal alignment. These postural changes can become problematic quickly.
*It is important to note that our body also has natural asymmetries that are not due to postural compensations (ie. three lobes in the right lung, two on the left, the right diaphragm is higher and has more muscular attachments, the left side has a heart to accomodate, etc.) Large amounts of research has been done by the Postural Restoration Institute (PRI) to study the effects of these imbalances and specifically the respiratory influence on asymmetry and posture. Respiratory dysfunction can have resounding effects on this delicate system if persistent and consistent.
So what are we doing that’s leaving us with a sub-optimal ZOA?
There are several reasons we can develop dysfunctional breathing, some of them include:
- Chronic sitting/slouching
- Over-use of “core” exercises (read: Hypertonicity of the abdominals and Pelvic floor)
- Mouth breathing/ hyper- ventilation, or shallow breathing
- Chronic Pain (read: stress)
- Sleeping on the belly
- Abdominal surgeries/ Pregnancy
- Poor posture
- Movement patterns (read: unilateral sports, sport specificity)
We know that most of us are exposed to at least one or two of those causes quite frequently. When we start to examine the effects of a sub-optimal ZOA we find several different functional and pathological conditions and mechanical issues associated with this dysfunction. Some of those include:
- Pelvic pain
- Incontinence/pelvic floor dysfunction (Do you pee when you do double unders??)
- Functional intestinal disorders (ie. IBS)
- Hip impingement/pain/instability
- Shoulder impingement/pain/instability
- Sports hernias
- Groin/hamstring Strains
- Low back pain
- SI pain/dysfunction
- Plantar fasciitis
Now that we know the basic fundamentals of breathing and what can go wrong, let’s look at some very simple qualities of optimal breathing, and what we can do to get us there.
Qualities of Normal Breathing
- Abdomen rises first, then the chest rises slightly.
- Little to no accessory movement in the neck muscles, slight elevation of the ribs.
- Inhalation through the nose, exhalation through the mouth.
- The exhalation phase lasts twice as long as the inhalation phase of breathing.
Are you doing this? Or do you find that you are in the dysfunctional category?
Let’s think about it. We breathe on average 12-14 breaths per minute. There are 60 minutes in an hour, 24 hours in a day…
That’s around 20,000 breaths a day.
That’s 20,000 repetitions a day… in a poor position
That’s 20,000 “bad reps”… a day.
There are several different ways we can start to address resetting the diaphragm and breath. The following two exercises are the very first go-to drills I put my clients through to start the process and are usually quite effective.
Super easy exercises to practice:
Lying Belly Breathing
- Lay down with your feet up. Hips and knees at 90 degrees.
- Place your left hand on the belly, right hand on the chest.
- Focus on breathing in through the nose and out through the mouth.
- As you inhale, fill the belly as much as you can rising the left hand. The right hand should only rise minimally at the very end of the inhalation, if at all.
4-7-8 Belly Breathing
Once the first drill becomes smooth and natural practice 4-7-8 breathing.
- Inhale deeply for 4 seconds into the belly
- hold the breath for 7 seconds
- exhale for 8 seconds.
Repeat these for 4-5 breath cycles at a time throughout the day, and soon enough they will become natural.
Below is a client who had complaints of hip pain/ impingement referred to the rehab clinic for mobility prescription.This picture is showing progress, each 2 weeks apart. Roughly 90% of the work put in across all 4 weeks consists of breathing, motor control drills, and nervous system down-regulation (read: brain-breath connection). As you can see in the picture, hip flexion, knee flexion, ankle dorsiflexion and easy of movement has improved. The athlete is now pain-free with movement.
Keep in mind, this athlete had full passive range of motion in all of these joints (I could move the joints freely), but when given gravity and active movement, the athlete could not achieve an optimal position.
Are you breathing correctly??
“If you can’t breathe in a position, you don’t own that position. You can’t survive in that position.” -Gray Cook
Cook, G., Burton, L., Kiesel, K., Rose, G., Bryant, M. (2010). Movement: Functional Movement Systems: Screening Assessment, Corrective Strategies. Lotus Publishing.
Mullin, M.(2014, July 16). Respiratory Influences on Core Stability. Online Webinar. https://www.nata.org.
Hruska,R. (2005). Zone of Apposition (ZOA). Postural Restoration Institute. https://www.posturalrestoration.com/resources/dyn/files/1051512z69443dbe/_fn/ZOA.pdf
Swanson, A. (2016, March 24). Understanding the Difference Between Low and High Threshold Strategies. Retrieved April 10, 2016, from http://www.functionalmovement.com/articles/Fitness/712/understanding_the_difference_between_low_and_high_threshold_strategies