Focused Breathing
The other day I had a client speak to me about some back pain that she had been experiencing. After talking about it for a bit, we did some correctives and I gave her some suggestions on what to do that night, the next day etc. She had been gardening quite a bit, and tomorrow was going to be an intense day for her, she needed to plant over 50 plants. Needless to say, our training session was less intense than usual, and a bit more technical. We set a game plan to avoid further injury/pain tomorrow and ended with a bit of stretching. The next day I taught a group class and had previously planned to end it with some breath work instead of stretching. As I was coaching them on the breath work I noticed that they started dropping their shoulders, and relaxing their necks, as the bodies started melt into the ground. I thought about how interesting it is to see what the body is doing externally just from breathing, and how it can affect the human body as a whole. Reflecting back on the previous client with the back issues, I wanted to put an emphasis on breath work while doing certain exercises to help her keep that solid foundation, especially while doing something as dynamic as gardening. So I did a bit of research to see what the benefits were to see if it could help her in our next session.
One of the benefits of manipulating breathing patterns is that it can increase core stability, which in turn can alter movement so that we can increase function and performance. (4) When one leading expert was asked “How important is breath work?” he half-jokingly replied “It’s so important, that if you stop, you die.” Breathing frequencies/patterns can work towards building better structure and integrity in the deeper muscles of the core, i.e. the diaphragm, internal intercostal muscles, multifidi, ect. (6) General training programs primarily focus on spinal flexion, thinking that it’ll promote hypertrophy of the rectus abdominus. However there is some evidence showing that there may be case specific opportunities to train the rectus abdominus without the use of flexion and build better function within the core. (3) Using the muscles previously mentioned in a static versus dynamic state might provide us with better integrity through not only our exercises but also any movement that we do on a day to day basis. From walking to the car, to picking up keys from the ground, our body can benefit from having increased core activation throughout the day. One of the simplest cases to help bring this to light is when we look down at our phones, although the neck muscles are still “on” we’re putting our vertebrae in a vulnerable position with a lot of weight at the end not being supported. Afterwards we might feel tension or pain in our neck, similarly, our lower back/upper back can go through similar stress if we don’t pay attention to how we use it throughout the length of a day. Breathing to strengthen and lengthen can help reduce that stress, and increase core integrity for optimal function.
In my experience working at a physical therapy clinic, there was an increased amount of stress placed on the breath, and how to utilize it to treat not only acute/chronic pain, but to make physiological adaptations on the body. I was able to witness how the Schroth Method, which is a treatment for scoliosis that doesn’t involve surgery, but does rely on breathing techniques to slow down the rate of the curvature in the spine. (5) After looking at the remarkable progress that can be made from manipulating our breathing patterns, it’s almost impossible to reject its importance. Ironically, it’s still difficult to show value in breathing as an exercise strategy today.
Focused inhalation and exhalation produces adaptions to our body’s neurological state as well. Breath exercises such as diaphragmic/belly breathing can help us manage our autonomic nervous system to increase attentional capacity (7), a key factor in sports and performance. The sympathetic system is our “fight or flight” and our parasympathetic system is our “rest and digest”. There has been a tendency for us to stay in this “fight or flight” state ; which can have some really detrimental effects on the body. Conversely, if we can take control of this and train to move from one into the other when necessary by use of breathing techniques, we can promote a more positive impact on the body’s systems. Some studies have shown that one of the benefits of which include lowering blood pressure (2), which has been noted to be an underlying cause of greater cardiovascular diseases.
If interested in learning more about techniques, I’ll list a few that are a good start. Some common breathing exercises include Belly Breathing, Box Breathing, Alternate Nostril Breating, and 2:1 Breathing. Guidance on these exercise prescriptions should be administered and monitored by a licensed DPT or a specialist that can coach you through each section and monitor your body’s response to it by focusing on external cues. Progressive Muscle Relaxation can also prove to be a valuable
Depending on the reason for the breath work, the placement can vary. For example, if you’re trying to shift the CNS from a sympathetic tone to a parasympathetic tone, then maybe placing belly breathing exercises at the end of the training session can help. If the goal is the prep the muscles of the core for movement, then maybe practicing that during the first portion of the exercise program (i.e. corrective movement, or movement prep) might be a better placement. As a facilitator, it’s important to see where the breathing is occurring in the client. I’ve asked my clients to place their hand on their stomach to help me differentiate where their breath is going (this helps a ton with virtual sessions). Furthermore, there may be a place for analyzing breathing in the initial client assessment, that way when it’s used in a training session it doesn’t seem like something new that the client isn’t used to.
Whether your client is trying to get through the stress from adapting on how to work from home, or having some back pain from planting in their new garden, I believe there is a place on the exercise program for breath work. It might not be an everyday application, but it has helped me and my clients work through tough work weeks or stressful days. Hopefully this helps with your own programming.
Resources
1. Tayashiki, Kota; Kanehisa, Hiroaki; Miyamoto, Naokazu Does Intra-abdominal Pressure Have a Causal Effect on Muscle Strength of Hip and Knee Joints?, Journal of Strength and Conditioning Research: June 25, 2018 - Volume Publish Ahead of Print - Issue -doi: 10.1519/JSC.0000000000002649
2. Mori, H., Yamamoto, H., Kuwashima, M. et al. How Does Deep Breathing Affect Office Blood Pressure and Pulse Rate?. Hypertens Res 28, 499–504 (2005). https://doi.org/10.1291/hypres.28.499
3. McGill, Stuart PhD Core Training: Evidence Translating to Better Performance and Injury Prevention, Strength and Conditioning Journal: June 2010 - Volume 32 - Issue 3 - p 33-46 doi: 10.1519/SSC.0b013e3181df4521
4. Nelson, Nicole MS, LMT Diaphragmatic Breathing: The Foundation of Core Stability, Strength and Conditioning Journal: October 2012 - Volume 34 - Issue 5 - p 34-40 doi: 10.1519/SSC.0b013e31826ddc07
5. Weiss H. R. (2011). The method of Katharina Schroth - history, principles and current development. Scoliosis, 6, 17. https://doi.org/10.1186/1748-7161-6-17
6. American College of Sports Medicine. (2013). ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription (ASCMS Resource Manual for Guidlies for Exercise Testing and Prescription). In D. Swain (Ed.), ACSM’s Resource Manual for Guidelines for Exercise Testing and Prescription (Seventh ed., pp. 112–113). Baltimore, Maryland: LWW.
7. Floyd, ..R., & Thompson, C. (2008). Manual of Structural Kinesiology. In Manual of Structural Kinesiology (17th ed., pp. 344–347). New York, New York: McGraw-Hill Humanities/Social Sciences/Languages.
8. National Strength and Conditioning Association. (2008). Essentials of Strength Training and Conditioning - 3rd Edition. In T. Baechle & R. Earle (Eds.), Essentials of Strength Training and Conditioning (3rd ed., pp. 174–175). Champaign, Illinois: Human Kinetics.