This post is by Mitch Stanley, DPT, Pivot Physical Therapy. He can be reached at mstanley@pivotphysicaltherapy.com
As humans, we breathe on average 12 times per minute, 17,280 times per day, and 6,307,200 times per year. To say that we take the action of breathing for granted would be an incredible understatement. Breathing is initiated from the very moment we are brought into the world via the autonomic nervous system. Through the initial activation of the diaphragm, inhalation and exhalation are made possible. This should give insight as to how important breathing truly is.
Most of us may find ourselves asking, what is the diaphragm? The diaphragm is a broad-based, crescent-shaped muscle that sits just below the lungs and just above the stomach. More importantly, it is where and what the muscle attaches to. Its action is to aide in respiratory function and provide stabilization to the lumbar spine via its attachments through connective tissue. Now that we know the basics and the importance of its main function, why don’t we find ourselves actively using it? Our bodies are incredible compensators, and those objects that we love so much called chairs do a great job of shutting this muscle down. Take a moment and think of how much sitting you truly do throughout your day. It is incredible! We sit in a chair to drive, to eat, to go to the bathroom, to work, and the list goes on. When we sit, we slouch forward. When we slouch forward we eliminate the opportunity for the muscles along the front of our spine and abdomen to engage including that wonderful diaphragm and all of its integral connections in the trunk.
The body loves finding the easiest way of completing a task or movement. In this case, our bodies realize that by utilizing the chest and neck muscles, we can perform the necessary breathing required to survive, but not necessarily thrive. This is what is termed apical breathing and is characterized by the use of accessory muscles for breathing. Does it work? Of course. Then, why not allow the body to continue the task of breathing in this manner? It all comes down to two words: functional efficiency.
Many of us can relate to increased chronic tension in our neck and shoulders. This is in large part due to apical breathing. In this fashion, the typical muscles of the neck and mid-back that are put on our bodies for mobility and stability purposes compensate to become muscles of respiration. This creates increased activation and an unnecessary overuse. In turn, stiffness of muscles and joints are the end results. When we say that “we carry a lot of stress in our shoulders,” let’s rethink our breathing and positioning situation. Let`s create a functionally efficient breathing pattern through the use of the diaphragm and relax those accessory muscles for a change. You just may feel and see the difference in comfort and ability to move.
How do we breathe using our diaphragm? First and foremost, watch a few home movies and take a look at how you are breathing. Now, dust off the old home movies of when you were a baby/toddler and watch that belly of yours go in and out as you were at play. Very different than the up and down nature of your shoulders and chest that you use in the mirror today. You once had the ability to subconsciously breathe functionally and efficiently, and go figure, through the diaphragm. You were the best mover ever! So, what happened?
In American society, we love our comfort. In particular, we love our chairs; our comfy chairs. Unfortunately, this starts at all too young of an age in elementary school as we sit bottled up at desks for prolonged periods of time with less and less physical education and recess. It only gets worse as we grow older. By allowing the external support of the chair to hold us in a position, we are no longer actively utilize our spinal stabilizing muscles to support our trunk. The only option they have is to shutdown–diaphragm included. The forward or rounded postural nature that we all gradually come to adore, further shortens and relaxes the diaphragm. This essentially tells the muscles to stay on break. Dare we be so bold to say that chairs are the biggest contributing factor in the roughly 100 billion dollars per year that Americans spend on low back pain? Yes, indeed. So instead, let`s return to those glory days of being a kid again when we moved so well.
Diaphragmatic breathing is best re-learned when lying on your back or stomach just as you first learned to do it when you were an infant. Once you achieve fundamental breathing in a lying down position, you may progress by incorporating it into your daily upright activity. Let`s discuss how to perform this simple and essential task. As you inhale, send your air into the lower lobes of your lungs by actively pushing your belly out and filling your belly with air. Do not worry, you are not actually putting air into your belly. As you exhale, use your diaphragm to force the air out of your lungs by pulling your belly in. Counterintuitive yes, but this just goes to show how incredible the human body is at compensating for quantity of breathing rather than quality of breathing. As you exhaust your breath completely, you will feel your stomach muscles gradually get tighter and tighter. You should see and feel undulating wave of activation; first, in the movement of your belly with gradual transition into your chest on the inhalation. This pattern should then be reversed on the exhalation. Welcome to diaphragmatic breathing. Welcome to true “core stability”.
The human brain and our central nervous system is the most intricate and complex structure that never loses its ability to recall former actions or abilities. As a result, reactivating that diaphragm is possible. Breathing functionally gives us life not only in terms of evident exchange of oxygen to live, but on a deeper, more subconscious level, allowing for the ability to move well in all other areas of the body. By breathing well, we will move well. By moving well, we will be well.