The Importance of Breathing

How obvious, right? We need to breathe to live. But did you ever think about "how" you breathe? Or, an even deeper question, how does your breathing pattern affect the rest of your body, your muscles, posture, core stability, and mental well being? Do you get a lot of headaches? Let's look at this a little closer.

First things first. Let's get to know a few of the muscles involved, this is by no means a comprehensive list:

The diaphragm is the most obvious one to start with. It is our primary breathing muscle, responsible for filling our lungs with air.

Diaphragm

Pectoralis minor- It attaches to our shoulder blade and our rib cage. It assists with breathing by helping elevate the rib cage. It also pulls the shoulder blade forward.

Pectoralis Minor

 Scalenes- These muscles attach to our first and second rib and our cervical spine (neck), assist with breathing by elevating the ribs, and move our head.

Scalenes

Psoas- This muscle may seem unrelated at first. I am including it because it shares an attachment with the diaphragm and because of this, the two muscles influence one another. 

Psoas

The Quadratus Lumborum, or QL as it is affectionately known, is a muscle in our lower back that attaches to our lower ribs, our lumbar spine, and our pelvis. it also shares an attachment with the diaphragm.

Quadratus Lumborum (QL)

Now let's discuss breathing patterns. I am going to break it down into two groups- belly breathers and upper chest breathers. How do you know which group you fall into? Well, put one hand on your tummy and the other on your sternum or breast bone. Now breathe normally and see which hand moves first when you inhale. If your lower hand moves first you are a belly breather and if your upper hand moves first, you guessed it, you are an upper chest breather. We are going to talk about what changes can potentially occur in your body if you are an upper chest breather.

Upper chest breathers are also called hyperventilators. According to Garland (1994) hyperventilation leads to reduced diaphragmatic efficiency and restriction in the lower rib cage which results in the accessory breathing muscles being excessively used (they get painful and tight). A series of changes then begins to evolve. Muscles in the back become tight, upper ribs become elevated, normal motion of the ribs and spine of the mid-back is disturbed, the Scalenes and other muscles in the same area become tight leading to myofascial trigger points, the neck becomes progressively more rigid, and functional tone of the diaphragm and core stabilizing muscles begins to diminish (they get weak). It doesn't sound too good does it? But that's not all.

Hyperventilation also leads to reduced oxygen in tissues (including the brain), smooth muscle constriction (arteries, respiratory structures, gastric-intestinal), heightened pain perception, and encouragement of the development of myofascial trigger points- all or any of which are capable of altering normal motor control of skeletal musculature according to research done by Nixon and Andrews 1996, Mogyoros 1997, Seyal 1998, and Chaitow 2004.

So what does it all mean and what can we do about it? As these changes occur, we move further and further along a vicious cycle. The abnormal function or use of these muscles alters normal structure which makes returning to normal function very difficult, and so it goes. If the muscles around our head, neck, and shoulders get tight, it can lead to headaches, disc issues, shoulder pain, and rotator cuff issues. If the muscles below our ribs get tight (Psoas, QL) it can contribute to low back pain and altered movement. So let's do some breathing exercises and see if we can't get some control back!

First, let's set our shoulders. Think about bringing your shoulder blades down and back- as though you are putting them in your back pockets. Now let's bring our chin back so it's not poking out- think about pushing the back of your head into the wall behind you while you keep your chin level. Sit up straight as though there is a cable attached to the top of your head pulling you upright. Put one hand on your belly and the other on your chest and breathe deeply in through your nose. Make sure your bottom hand starts to move first, filling up your belly first and then your chest. Exhale through your mouth and repeat. 

No time limits or sets and reps here, just do it until you don't want to do it anymore, and try to fit it in at least once a day. I think you might notice a feeling of relaxation coming on. Close your eyes and get into it. Remember the words of Sting..." every breath you take, every move you make..." is contributing to how you feel on a daily basis. OK, maybe that was a bit cheesy :)

References:

Chaitow L 2004 Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine 7(1): 34-41

Garland W 1994 Presentation to Respiratory Function Congress, Paris, 1994

Mogyoros I, Kiernan K, Burke D et al 1997 Excitability changes in human sensory and motor axons during hyperventilation and ischaemia. Brain 120(2): 317-325

Nixon P, Andrews J 1996 A study of anaerobic threshold in chronic fatigue syndrome (CFS). Biological Psychology 43(3): 264

Seyal M, Mull B, Gage B 1998 Increased excitability of the human corticospinal system with hyperventilation. Electroencephalography and Clinical Neurophysiology/ Electromyography and Motor Control 109(3): 263-267

Images are screen captures from iPad2 app The Muscle System Pro 3
3D4Medical.com

   

Specificity

What is specificity and how does it apply to training? To youth sport? To development? The National Strength and Conditioning Association (NSCA) describes specificity as "...the method whereby an athlete is trained in a specific manner to produce a specific adaptation or training outcome." It applies to ligaments, joints, nerves, and all other tissue in the body too, not just muscle. This is also known as the "S.A.I.D." principle- Specific Adaptations to Imposed Demand. Common practice for athletes wanting to excel at a sport. It would follow then that training for a sport by actually doing the sport would be the most efficient use of your time then, yeah? Maybe.

I see many kids in the community that are focusing on one sport very early in their development (for whatever reason). Soccer, hockey, distance running, golf to name a few. It begs the question: Is there a downside to early specialization? I would argue that there is, especially if the adaptations that are occurring are altering an athletes ability to move functionally.  How do we know if our kids are developing in a way that may leave them with muscle imbalances due to early specialization? What kind of motor patterns (see previous post below) are they reinforcing? Are we creating young adults that are going to have chronic issues later in life?

I bring this up because of an article that was brought to me from Stop Sports Injuries via the Twitterverse. The author writes about the importance of the "ready" or "athletic" position and it's role in reducing injuries in young athletes. For the record, I totally agree with the points made in the article, I just want to take the idea a few steps further.

In order to avoid the downside of early specialization there needs to be a measuring stick, a way to monitor balanced development, a way to gauge how an athlete's training regimen is affecting their movement. Only then can a focused, specific approach to that particular athlete's movement deficits be implemented.

Getting into the ready position is great, but; I suggest that it is most important to train an athlete to move into and out of that position effectively and with proper form. If an athlete has trouble maintaining the ready position, which is essentially a semi-squat, find out why. Is it a limitation of ankle flexibility? Is it a hip stability issue? What about hip mobility? Find the weaknesses that limit the movement and train those weaknesses specifically. That, to me, is an effective use of FMS, the S.A.I.D. principle, and a way to build balanced athletes that are resistant to injury.

Lower crossed (sore back) syndrome

Do you sit at a desk? Me too. For more time than I care to admit. How much time do you spend re-setting your posture or changing position or getting up for a stretch? Yeah, me neither. And I wonder why my back hurts. One thing that may be contributing to our discomfort is called lower crossed syndrome. Now, I'm not saying this is the only contributor, or even that it is contributing, for that you would need to be assessed properly. What I am saying is that this is a common issue with all us desk jockeys out there and it can be combatted with some simple moves that don't require a gym membership.

Let's first talk about what we are dealing with. Think of muscles like guy wires. Each joint has guy wires on each side of it that control how it moves (or doesn't move). In this case we are talking about the joints above and below your pelvis (lumbar spine and hips). Sitting in a typical "desk" posture can cause muscles in the lower back and others that flex your hips to become shortened and tight (sore). The muscles (guy wires) opposite them (abs and glutes) become long and weak. Over time, this imbalance can lead to whats called an anterior pelvic tilt; it just means your pelvis is tilted forward. It doesn't happen overnight, but it happens.

So, what to do? Well, we need to strengthen (shorten) the weak, long muscles and lengthen (stretch) the tight, short, grumpy muscles so we can be balanced again. Here are some exercises to get you started. 

Remember: these should not hurt. Feel the stretch, not pain. Only do what you can with proper form, the sets/reps given are a guideline only. Focus on your breathing and feeling the proper muscles involved. Quality of movement not quantity. Listen to your body.

Modified child's pose gets at the muscles affecting the lower back (erectors, quadratus lumborum, latissimus dorsi). Really reach across and try and feel/ create separation between your ribs and hip! 

This hip flexor stretch is awesome! Not only does it stretch a hard to get at muscle (ilio-psoas), it improves your hip and ankle mobility and gets your core stabilizers working. Feel like there is a cable attached to your belt above your down leg. It's pulling you forward while you maintain a vertical spine. The ilio-psoas pulls your knee toward your chest (hip-flexor) and is attached to your lumbar spine so when it is tight, lower back pain is often the symptom. 

Ahhh...glute bridges, everyones favourite. If you haven't figured it out, the gluteals are the muscles that make up your butt. Sitting for long periods can "de-activate" them. Let's get them firing again! If you are getting cramps in your hamstrings when you do these then you aren't concentrating on squeezing your butt hard enough. If they are too easy, try lifting one foot off the ground, bringing your knee toward your chest while keeping your pelvis level and your hip, knee, foot inline. Yeah, I thought so.

Dead bugs. Don't underestimate this one. Get into a rhythm with your breathing. You'll feel it. If you use a ball like I am in the picture, squeeze it between your hand and knee while you are reaching with the opposite hand and foot. "Bracing" means feel your core muscles engaged/ activated. If you need to reset your core between each rep, do it!

You can think of these in terms of sets and reps or you can do them for time, say 30s each set to start. I like to think in terms of breaths, 5 breaths is about 20s, you get the idea. When you can do them easily with proper form, add more time.

You can do these everyday- roll out of bed onto your yoga matt and give them a try, it won't hurt you and it just might reduce your low back pain. 

Enjoy! No really!

The spine

Where do you start with a training program? Do you want to build strong legs to improve your skating speed? How about shoulders and forearms to add power to your tennis stroke? Better yet, let's go after the often talked about "core" with some crunches or sit-ups. Will this help you generate more power and improve at your sport? It will if you start with the most important part first- the spine. The spine needs to be flexible and stable in order to adapt to the many different movements we are capable of (mobility) and to support the body and transfer power (stability) that we generate. There is no doubt that sit-ups and crunches develop our abdominals but it is important to remember that spine stability cannot be trained when the spine is moving. Spinal stability is trained by keeping the spine stable in the presence of movement around it by the limbs. So if you are say...a golfer, the next time you see someone in the gym doing "bird dogs" or "dead bugs" while focusing on not moving their spine, pay attention. They might be able to out drive you.

Walk before you run

Walk before you run is a great metaphor for FMS based exercise protocols. Traditionally it was thought that if you train someone, their movement will improve at the same time. This is not really the case. All you are doing is reinforcing the faulty movement patterns that exist, increasing the already imbalanced stress on your joints, ligaments, and muscles, and potentially increasing your chance of sustaining an injury. How many times have you heard this old gem; practice makes perfect. Let's blow this one up right now. If you are repeating the same faulty movements over and over while you train/practice and expect something to change or improve you are going to be disappointed. In fact, that is the very definition of insanity; repeating the same thing, expecting different results. So try this mantra on for size; practicing perfect makes perfect. Thanks to the person that thought this one up! Think about it, or better yet, think about it during your workout. Now it is about quality of movement, not quantity of movement. Being able to do a bunch of pushups is meaningless and a waste of your time if you aren't reinforcing the proper movement patterns and muscle recruitment. Who has time to waste? Sometimes you have to go back, re-learn the fundamentals, before you can move forward efficiently and effectively. FMS can help you do that.

Energy Leaks

Energy leaks are performance robbing, energy sapping inefficiencies in your movement. If you are a runner, you are losing energy that is supposed to be propelling you forward. A golfer looses yardage on a drive. A hockey player can't skate as fast. you get the idea. Often, energy leaks occur where the body transfers energy from bottom to top; your core A.K.A. your transmission. Energy leaks also occur when areas that are supposed to be stable are mobile or vice versa. Example: your need mobility in your hips to run well but, for some reason, it is lacking. That mobility has to come from somewhere so it comes from, let's say, your lumbar region which is supposed to be playing a stable role. Now energy is "leaking" as it tries to transfer between your upper and lower body. How do you plug the leak? A Functional Movement Screen (FMS) can help reveal where your leaks are. Properly prescribed exercises can then be used to address them. Voila! Energy conserved.
Here is a real life example: A client who is a rec. hockey player comes to me, we run through the screen, see the issues and prescribe targeted exercises focused on improving his recruitment patterns (fundamental motor patterns). After doing his homework for 2 weeks he emails me to comment on how he felt a noticeable difference in his energy levels both during and after his last hockey game. Did he do any cardio work? No. Is he using the energy available to him more efficiently because he is moving better? No doubt. Has he improved his fitness? I guess it depends how you define "fitness"

Motor patterns

Ever wonder how we can repeat something like a golf swing over and over with the same results (hopefully)? How do all those muscles know how to fire in the correct sequence? Motor patterns. Instead of having to coordinate individual muscles every time, our brain saves the info like an app. When we have to hit a shot, we already have the basic software programmed. All we have to do is make slight adjustments based on lie, wind, etc... and swing the club. But what if a past injury or unhealthy posture has made us re-write the program in order to avoid pain, putting us out of sequence? Where do those motor programs come from anyway? The motor programs for higher level activities, like golf, are built on the fundamental functional patterns that we establish as babies when we are flexible, have unrestricted joints, and can achieve authentic movement. If our primitive functional patterns have flaws, how can we expect to run our high level patterns effectively? Fix/train the fundamental pattern (foundation) and the advanced patterns can be executed without compensation.

That means better golf shots!!