Breathwork

The importance of rib cage mechanics and the domino effect of posture

For a very long time, respiration and breathing mechanics have been widely used as an assessment tool in both mainstream medical and allied health settings to determine motion restriction and underlying pathology. In particular, this last decade, breathwork as an individual practice has boomed as an intervention to improve health and wellbeing. When we consider mindfulness being taught widely, and yoga and meditative practice (that has survived thousands of years) growing very popular as society grows more health conscious, it is no surprise. Yet, even allied health professionals are only recently beginning to understand the deeply interconnected relationship between the mechanics of breathing and the domino effect on virtually all other systems within the body - not just those most evidently affected. The results are in too! When paired with manual therapy interventions and exercise prescription, breathwork is improving prognoses for patients.

First, let's quickly recap how we breathe. The diaphragm is our primary respiratory muscle. It flattens when it contracts to increase the size of our thorax and decrease the size of our abdomen. This allows air to passively flow from outside our body into our lungs with the pressure change that occurs. This is also what allows for air in our lungs (containing carbon dioxide to be expelled) to be expired, after reaching the peak of inhalation. Air passively leaves our lungs as the diaphragm relaxes, the size of our thorax decreases and our abdomen size relatively increases again (returns to its size prior to inhalation). Did you know that there is a precursor to this entire process that influences its efficacy? It's our posture; to be specific, it is the position of our pelvis in relation to our rib cage. It is this positioning that allows for optimal length–tension relationship within the diaphragm. The length–tension property of a whole muscle is the relationship between muscle length and the force the muscle can produce at that length. The area the diaphragm can work in (with optimal position of rib cage and pelvis) is called the 'zone of apposition'. Essentially, it's the position of the pelvis with relation to the rib cage that reduces length–tension relationship, producing reduced efficacy of the diaphragm. We can still breathe because the brain places respiration at the top of the list for its survival, it's just that the mechanics are not that great. This is where compensation patterns can be seen within multiple systems. In osteopathy, excessive use of accessory musculature of respiration is common. These muscles assist to increase the size of the thorax during respiration (they aren't the prime mover). They become tight and sore from overuse because, normally, they should not have to help out that much! Accessory musculature hypertonicity is seen in chronic neck, thoracic and shoulder girdle presentations. They are often those presentations where they just 'started one day' for no particular reason. It can be the body's way of finally calling out that enough is enough of the less-than-ideal mechanics.

The diaphragm also acts as a centralised vacuum. Many lymphatic vessels and nodes (including the main important vessels) are located deep within the abdominal cavity. This mechanism is a huge factor in lymphatic system flow. The consistent pressure changes of the abdominal cavity and thorax enable the diaphragm to assert suction-type forces on the lymphatic vessels, promoting fluid movement. Stagnation of the lymphatics has been directly linked to several chronic health disorders and reduced immunity. Good lymph circulation is necessary to transport waste products from cellular processes around the body to be eradicated and filtered. Without good zone of apposition (rib cage and pelvic alignment that allows for optimal diaphragmatic length tension), the innate vacuum action of the diaphragm can be reduced.

A particular approach can assist you to learn to locate good zone of apposition for yourself and practice breathwork there.

This is called the 90–90 breathing method. It can be used prior to training sessions to ensure the following:

• reduced sympathetic (fight/flight/freeze) tone prior to exercise that can be detrimental when excessive

• reduced muscle tension of accessory respiratory musculature and lumbar spine proprioceptive musculature. When these are hypertonic/tight prior to exercise, they can influence activity and increase risk of soreness/injury post exercise.

• increased oxygen supply to peripheral tissues prior to exercise

• activation of musculature of the deep front line that is responsible for providing endurance-type stability to our movements during exercise, so that our musculature used for explosive and strength movements can function well

• increased parasympathetic (rest/digest) system activation, which promotes good recovery post exercise and general sense of wellbeing.

Sound good? Ready to practice optimal breathing mechanics? Here's how you get started!

1. Lie on the floor with your heels resting on a dining chair or bench at appropriate height (to allow for 90 degrees flexion at the hips and the knees).

2. Place a foam roller or a rolled up towel between your knees and apply 3/10 pressure to it with your knees inward to compress it. Note: not 10/10 pressure, only 3/10

3. Gently flatten your lower back into the floor beneath you.

4. Maintaining this position, inhale through your nose deeply and completely fill your lungs

5. Exhale through your mouth as if through a straw, very gradually. Aim for the length of your exhale to be longer than your inhale.

6. Complete 5 cycles (inhale–exhale), before breathing in a less focused manner for 30 seconds, and repeat for 2 more sets.

Try this prior to each of your exercise sessions – even prior to the start of each day. I would love to hear any feedback as to how this has made you feel. You won't be sorry! Take care everyone. Happy breathwork! Lenore