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Archive for Exercise

Exercise in the Office

By Peter Fabian · Comments (4)
Tuesday, January 29th, 2013

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The Office Slump

OK, so we all don’t look that bad (or cute) sitting in the office.  But isn’t sitting pretty different from moving?  Of course it is–and this is one of the great problems in sitting.  The side effects of how we sit and and the amount of sitting that many of us at the office do is very detrimental to our health.

Problems with Sitting

First of all we are sitting too much and moving too little.  So one way to deal with this problem is to change positions frequently and go take a break.  (There is an excellent video on how to sit that was posted in the past.  We will not cover that topic here.)

Also sitting often in a slumped position changes our breathing options.  We breathe in a more shallow and irregular manner.  We don’t energize our system with proper deep diaphragmatic breathing like we would if we were moving more.

Sitting in a chair all day or a good number of hours shortens our joints and surrounding tissues so that our body starts to resemble this fairly bent or flexed posture.

Most important here is that our nervous system adapts to this static posture and we actually loose options to move and feel.  This effect bores through many more systems than just the so called musculoskeletal system.

Sounds terrible, yet why don’t we change our behavior?  We naturally resist change.  We really operate and behave based on habits.  Changing habits is not easy as we all know.  Without a good reason and without a practice–we just will continue in our habit.

There is nothing another person can do for us.  We have to make our own assessment of ourselves.  Ask ourselves if we want something different.  If we do, then discover a deeper reason for change and then start a practice that supports these differences.

Office 5 Exercise

You will feel better and be more alert at work if you body, breath and mind are doing their full job.

Here is a video that shows you several simple exercises you can do without leaving your chair.  How easy is that!

Explanation of Some of the Exercises

Are you still sitting while reading–I’m sure sitting while writing.  How long has it been since we changed our position and took a break.

These movements are very effective in creating the difference our system needs to reset itself and receive the benefits of movement (and decrease the negative sitting effects).  Feel free to modify them

  1. The first movement stretches the spine like a cat.  It uses deeper breathing as a focus that follows or leads the movement.  This forward and backward arching of the spine is a primary direction that is strongly embedded in the nervous system.  By altering in a rhythmical way this powerful direction, you will strongly turn up the nervous system while you counteract the forward posturing from sitting.
  2. The second exercise opens up our hips–which is so important in establishing a proper sitting foundation.  These split leg movements done on the chair are very accessible to all (unless there are arm rests, oh well).  The extension and stretching of the rear hip is very helpful to balance out the prolonged hip flexion that is required by sitting.
  3. The third is simple a progression of the second.  You add a bowing of the body to the side.  This sideways direction is quite stimulating as we are often just stuck in a forward direction in sitting.  If you again work with the breath as you expand the lateral/side wall of the chest, you will also expand the breath.  Remember deeper breathing is better breathing.
  4. The fourth exercise uses twisting.  Now we all have heard of the dangers of twisting the spine while it is bent and flexed.  This is very true in overstretching of the lower back or lumbar spine.  Here the split leg position will often counter rotate the pelvis and you should try to work on twisting from the chest and not the waist.
  5. The last exercise is just fun.  If you do it so that you keep your chest (and weight) over your hands and bend your elbow a bit, it will really exercise your trunk and upper body.  In sitting we don’t do anything to express the upper bodies system–keypading and mousing do not count  : o )

Some times you will find yourself just stretching in you chair.  Great idea.  Try just turning in your chair if doesn’t have arm rests and go into that split leg position.

I’m sure you can figure out other variations you could do as well.

Key point here is to do.  So right now try out these movements and see if you don’t feel better.

Comments (4)
Categories : Exercise
Tags : asana, Back Pain, neck pain, Physical Therapy, Sitting

Stop Neck and Back Pain

By Peter Fabian · Comments (4)
Thursday, September 6th, 2012

What is Going On?

Things were much simpler when we were younger–do you know what I mean.  Now days we are looking for the cure of our ailments and troubles of the world.  Well stop right now and open a different book or URL than what you are reading at this moment.

What we can do here?   We can look beyond what we are noticing as far as the pain.  Pain in a chronic area of the neck and/or back is poor prognosticator of the problems location.  Always consider the adjacent body areas in figuring out what to address in correcting and alleviating this common problem.

Basic Anatomy

Our spine is an interesting and integrated structure composed of three primary curves.  Most people who have neck (cervical) pain or lower back (lumbar) pain do not think of the thoracic spine.  This thoracic spine is conveniently “surrounded” by the neck and lower back spine.  This arrangement of the anatomy is a key in addressing these pains.

Remember the spine operates as an integrated structure.  This means that each area is functionally related to the others.  You must not just think that the anatomical structure as the cause of the pain–follow the connections.

Advice for Stopping Chronic Neck and Lower Back Pain

Let’s be practical here.  First you should have had a thorough medical and movement assessment.  This means that if you are having chronic pain (longer than 3 months) you should get medically cleared by your doctor.  Next it would be great to have a qualified Physical Therapist or movement expert screen and assess how your structure is moving and working.

Often in my practice I find that the thoracic area is really neglected.  It becomes stiff and a poor transmitter of spinal forces.  The areas of the cervical and lumbar are performing way too much work (many times this is in one or two directions though).  Remember the place that is complaining is certainly not the only place that should be looked at.  A myopic view of pain often distorts the larger view of functional relationships of important adjacent regions.

Exercise Approach

One simple set of exercise you can immediately start is shown below.  Here you are using sidelying to work on moving and mobilizing the thoracic spine in a variety of directions.  During these movements you are learning much more than might be evident.  A primary direction of movement is in rotation or twisting.  During this twisting of the chest you are learning to stabilize the lumbar area.  Over time you will get a very good sense of how much we over rotate the thoraco-lumbar to lumbar area.  Therefore you can appreciate how under used the thoracic are becomes.

Also you can use a foam roller very nicely for this thoracic area.  The below video emphasizes thoracic extension.  There are many variations.  One not shown is just to use the roller to massage the back muscles here.  Most people find it very useful.

 

 

There You Have It

Try these ideas for a chronic problem with your neck or lower back.  Go slowly as with anything different or new.  Don’t try to perform the exercise.  Rather use these as movements to explore your own body and what you are noticing.  Your job here (should you accept this “Mission”) is to make a change by feeling something you haven’t felt before.  This work should be in the direction of making you more comfortable and more freely moving.  So use these movements as guidelines and not just a prescription of “exactly” what to do.  That being said, please try it out this way for several weeks before you become too creative.

Remember to work with your breath once you have the basic movements.  Stay in this sidelying position for awhile–you will be greatly benefited by putting in 15-30 minutes.  These longer times really benefit from proper diaphragmatic breathing–this type of breath is not the belly expansion but the sides and all around the lower rib cage.  There is an extremely important relationship with the breathing and the thoracic spine.  It is a much more detailed topic than will be covered here.  It is one of the keys to unlocking chronic pain.

 

Train and practice daily.  Go and try out these movements.  Write to me what you have learned.

Comments (4)
Categories : Exercise
Tags : ageing and exercise, awareness, Cervical spine dysfunction, exercise, fitness, low back pain, movement learning, neck pain, Physical Therapy, training

Ouch! My Back

By Peter Fabian · Comments (0)
Tuesday, May 22nd, 2012

Geez My Back Hurts (again)

Low back pain can be very frustrating.  Make sure you rule out any medical condition that may be underlying these symptoms.  The next issue is to get a proper mechanical evaluation.  Sounds practical but a lot of us are not getting the proper evaluation.  So the help offered becomes anecdotal and lucky at best.  Does this treatment or that treatment work best?  What should I do to get better?  Nothing seems to work, Egads!

Evaluate the problem

We often start with some type of complaint.  In this case–my low back is hurting.  If it is a chronic problem make sure you have looked at more than just mechanical problems.  As said before, get clearance from your medical practitioner at some point.  Also life style plays an enormous role here.  Do not under value things like proper sleep and nutrition.  Much more could be said on this but it will have to wait till later.

Mechanical evaluation

Here I am thinking about movement of the body through space.  Specifically we pay attention to the pain most of the time (and sometime all the time).  We need to also look at what movements and/or postures worsen and lessen the symptoms.  This question of what (movements) make it worse and better are critical to evaluating and then re-evaluating this type of condition.

Simple categories can give practically anyone some guidelines to finding ways to change this condition.  One of the most popular underlying reasons for Low Back Pain is related to flexion problems of the spine.  I will try to keep it fairly simple here or make it as easy for myself to explain one of the popular scenarios we see today.

Flexion problems mean forward bending and sitting that causes an increase in the low back symptoms.  In this post, that means that the opposite direction of extension or straightening of the spine does not cause pain and/or alleviates it.  So one will usually notice that they are worse during or after sitting or when they lean forward to write/shave/clip toe nails, etc.  Often they are better if they walk around or lie down flat.  There are many variations to this problem and a good evaluation will figure it all out.

A good test that I include in my evaluation is a standing flexion and extension test (among many others).  For this example, let’s say that in standing, you try to bend forward keeping your knees straight.  Notice how far you bend before you first feel an aggravation of your symptoms.  Note the distance down the leg you are able to reach and remember it.  Repeat it a few times just to see if movement and symptoms  improve, worsen or stay the same.

Again to keep it simple, let’s say that when you bent forward you were limited to reaching 4 inches below your knees before you said, “Ouch” (meaning it worsened your symptoms and you didn’t want to reach any farther).  Now you have a movement paired with your symptoms.  This is very important.  This will become your simple re-test when you decide on a treatment.

A proper evaluation will include more movements to better determine what to do and what to not do.  Again the evaluation is critical and the first step.

Strategic Perspective

Now if you find yourself seeking treatment before you have done a proper evaluation, you will do yourself a disservice.  Do not ask what exercise should I be doing until you have enough information related to movement.  Exercise is not magic.  It is movement based to help alleviate the stresses and strains of both pre-existing and current problems.

It is interesting to note that many pre-existing conditions (i.e. in this case a movement dysfunction) can go undetected for years without seemingly causing any problems.  Once you have symptoms, especially chronic ones, you need to deal with many of these pre-existing conditions and patterns.  That’s why it is so important to have a regular program of practice where you are always working with yourself and making discoveries and changes along this route of your movement in life.  Otherwise we get caught at these stressful times of our lives without the proper tools or even the time to work on these multi-layered problems and movement dysfunctions.

Treatment

So if in this case let us say we have someone who is flexion intolerant.  This means as said above, that bending forward activities or postures aggravate their symptoms.  So one approach would be to do backward bending activities.  This makes a lot of sense.  This simple advise would also include to stop doing or curtail/lessen the flexion activities and postures.  Also one would find it very difficult to stop sitting all together.  Then another strategy would be to do things that neutralized the effects of the flexion pattern many times throughout the day.  One can use a combination of many of these strategies.  They don’t all have to be used all the time.  Many of us find a limited amount of time and focus for these practices.  So be practical.  Some days rotate in the things you were not able to get to on the previous day.  Always do something everyday.  Just modify it.  Your retesting will show you if you are doing enough, too much or something needs to change.

Now in this case the evaluation showed some adjacent areas of mechanical dysfunction in the chest or thoracic spine.  Also there were movement dysfunctions in the frontal plane (side to side movements vs the sagittal plane–forward/backward movement as described previously) of the hips and lumbar through thoracic spine.

An interesting note is that sometimes you do not want to start movement exercises  in the place of the reported symptoms.  It could be that a person is too irritable.   It could be that greater movement dysfunctions exist in adjacent areas.  It could be that through experience in certain cases one has found it better to start in these non-traditional areas.  For a variety of reasons, we will be starting at increasing mobility of the adjacent areas (i.e. the thoracic/chest spine) and increasing the stability in the local and symptomatic area (i.e. the lumbar to hip area).

We will work at the start in the sagittal/front to back plane.

Here in the below video we start with prone lying on the belly/chest area first.  In asana work this position is called Makarasana (crocodile pose).  It is an excellent rest/restore and recovery position.  The position in this case eases the symptoms and the diaphragmatic breath is just an excellent support for healing.

Next when one props up on the elbows, there is a further exaggeration of the backward bending nature of the spine.  Remember that this position of backward bending does not aggravate the symptoms.  But look in the video and note that the person finds it a bit uncomfortable.  We do not eliminate the posture but just modify it with supportive pillows based on his symptoms.  We always have to be ready to listen and modify based on movement and symptoms.

Next we work in the  frontal and transverse (rotational)  plane (exercises shown in side lying).  Quickly we will using all the planes as it will be part of the demands of some of the movement re-education patterns/exercises.

Here in the below video is an interesting way that seems to be very helpful for a variety of mobility problems in the thoracic area.  I have used this position for neck, shoulder and back symptomatic problems as they relate to movement dysfunctions of this chest/thoracic area.

As you watch the example of the below video keep in mind some of the above information.  It is only one approach.  There are many ways to start.  My point here is that they should be based on an appropriate evaluation and constant retesting.

Sagittal Plane and Frontal/Transverse Plane Movement Training Video

The next two video are dealing with hip flexion (forward movement) and hip abduction (outward movement).  Here the emphasis is on creating activation of the leg in the direction of limitation while the spine remains extended and stable.  Quite a bit of stabilization training of the trunk, pelvis and lower extremity are emphasized in these next two videos.

Hip Flexion with 40 inch Band Video

Hip Abduction with 40 inch Band Video

Conclusion

The “ouch” of the pain usually cannot exist when you improve dysfunctional movement patterns.  Remember one of the keys is to identify what movements and postures have set us up for these problems.  Have a way of noting a movement or movements that correlate with worsening and improving your symptoms.  Then use these as a way of retesting as you explore better ways of moving through life.

Moving in these ways described above is a good start.  Let it be only a start.  Start identifying lifestyle issues that mirror the same problems.  All of this takes us on a journey deeper within ourselves.  You can stop at any time or continue.  A continued journey becomes an expanded practice.  Discoveries that lead us to ourselves at deeper levels become an awakening of the richness of our true lives.

Good luck in wherever you practice leads you.

Comments (0)
Categories : Exercise
Tags : awareness, diaphragmatic breathing, exercise, fitness, low back pain, mobility and stability, movement learning, Physical Therapy

Strong Back and Improved Posture

By Peter Fabian · Comments (2)
Friday, April 20th, 2012

Proper Posture and Strength

You need to have sufficient strength in order to have good posture.  Many people put the cart before the horse.  Here I am referring to thinking that you just need to work on your posture.  How many times have you seen people (most of us) just try to sit better and in seconds to minutes find ourselves back to a comfortable slouch.  Ouch!  On the other end of the spectrum there are many who are really strong and their posture is abysmal.

We need to work on this from many perspectives.  Here we will start with assuming that you want to improve your ability to sit better and longer (with less pain and discomfort–looking beautiful, etc).  Alright, once you have a goal that will allow you to train this aspect, we can start.

Problems

  • We complain of back pain when sitting
  • We often do not have the muscular strength and endurance to sit properly.
  • We often over correct at the thoraco-lumbar region (the area where the rib spine meets the lower back)
  • We don’t have the proper guidance for proper sitting
  • We do not practice regularly

One of the biggest problems and complaints that I hear regularly about sitting–is the discomfort one gets from trying to maintain the proper position.  This is certainly true for those doing sitting meditations.  This group of folks usually know that proper sitting will allow them to breath properly with the diaphragm.  Good, deep diaphragmatic breaths will allow the body and mind to begin to settle down.  Good posture definitely facilitates this diaphragmatic style of  breathing.

Those not meditating can still benefit greatly by taking a very similar approach.  If the spine is erect and the shoulder and pelvic girdles and associated limbs are positioned well, it is much easier to have a sense of ease in this position.  You will find that the better that your body alignment is the better and more comfortably you can sit.

We can find out how to sit better.  There are many pictures of the ideal out there.  But sitting is a very dynamic activity.  The body that cannot sustain the activity returns back to it’s default posture of usually being slumped.  Then we often try to correct our sitting by straightening our spine from the mid to low back region.  This over activates the back extensor muscles that many complain of during their good intended corrections.

Strengthening the Upper Back

There is a video below that will go into a bit of the detail to help with strengthening this upper back area.  I often teach someone to work with a pivot prone or candelabra position or simple called the New York position.

This exercise with a mini-band is quite helpful.  The one thing that is good here, is that the mini-band can travel easily with you in a pocket, bag or purse.  Frequent use of it is helpful in retraining the movement pattern.  What I have found is that people still are way too weak in the upper back area to help in postural retraining.  The following video is another way.  I also have been using these 40 inch long and 1/2 inch wide cords for a pretty good test of the upper back.  It allows me to standardize what I expect now with most people.

In the video you will see this pulling apart motion of the band.  Watch carefully the testing protocol.  It is simple, but do not re-grab the band in a different way.  It is the wrapping of the band around the thumb and hand that really asks for a lot of external rotation and scapular stabilization.  This position is with the arms away from the body.  I am finding so many people are extremely weak in this pulling motion.  They all are so much stronger in the pulling motions that mimic a row.  Rowing strength does not seem to be a correlate for proper upper back strength in posture.  Remember the the lats are internal rotators of the arm.  If you row, you get better at rowing type movements.  Proper posture of the upper back requires external rotation of the upper arm and strong and enduring scapular stabilization.  This means the mid and lower trapezius fibers and rotator cuff must be activated in a particular manner and direction.

Also for you folks who do mainly asanas for your exercise, you really lack pulling strength.  There is an overabundance of forward pressure with the upper body in asanas.  There is an absolute lack of pulling strength in asanas.  (so much for balance, heh)

Of course proper mobilization of the thoracic or rib spine into extension is quite helpful.  Also evaluating for an improper head and neck position is critical.  There is much work to be done.  Remember that strengthening has to be coupled with proper retraining of ones postural habits.  Postural habits can be influence by a large number of other factors to include:  psycho-social, cultural, medical and other biomechanical issues.  Our work has just begun.

Video of Strengthening the Upper Back and Improving Posture

Conclusion

Go have some fun training this upper back area.

I have used many companies to purchase bands from–below is a listing of the three most popular ones I use:

  1. PerformBetter.com—-You should see the Superbands listed–I’d buy 1/2 and 1 inch sizes
  2. ResistanceBandTraining.com
  3. IronWoodyFitness.com

Start your training and let me know how strong you get.  Now if you practice your posture, do you find it much easier to sustain it?   Now that’s skillful training.

Best of efforts–peter

Comments (2)
Categories : Exercise
Tags : asana, back exercise, exercise, fitness, meditation, mobility and stability, Physical Therapy, posture, practice, strength, strength and conditioning

Shoulder Rehabilitation

By Peter Fabian · Comments (2)
Tuesday, April 10th, 2012

Shoulder Rehabilitation

Recently I had the opportunity while in India to work with a variety of people.  In the video that follows, this person was well recovered from a fracture of the proximal humerus.  They were still experiencing pain upon end range movement.  Here we will look at only one of the functions that proved bothersome–overhead movements with the left arm.  Their range of motion in this direction (shoulder flexion) was fairly good, though lacked the last 10 degrees–which were also a bit painful.

One thing to check is to see if the shoulder blade is participating sufficiently in these movements.  Since stretching of the arm overhead proved painful and since her prior rehabilitation had taken her in this direction, I thought we would explore more approximation or pressure into the shoulder joint.  (and this compressive movement was not painful and helped her to improve)

This concept of compressing the joint in these weight bearing positions that you will see in the video is a very good alternative for improving pain free terminal flexion.  Often in hatha yoga where there is today and emphasis in stretching, the stability work that is needed is often marginalized.  (This post is not about yoga but focuses on a case example of rehabilitation).

Another important aspect here is the emphasis on testing before and after exercises.  This testing can be accomplished quickly and easily before and after your session.  You will see it at the beginning of the video.  It would be wonderful if people found out things that they could not do easily and then determine the exercises that would help them function better (i.e. less pain and more gain).  In other words don’t just perform a bunch of exercises without seeing if they are appropriate and giving you the results that you want and need.

Also this is not a complete program, it is a first example of where one might start out in their journey of recovery.

Lets take a look at the video:

 Mobility

You can see there is not an emphasis on stretching out the shoulder at this point.  The place that we try to increase mobility is at the thoracic spine or rib spine.  This associated area of the middle back is often left out with rehabilitation of the shoulder.  Of course one should test the ability of rotation to take place here before prescribing the exercise.  Do note how much shoulder mobility is asked for in the down shoulder.  For some people you will need to support the space between their armpit/rib area and the floor.  For some people, without using the support–they will have too much stress on the bottom shoulder in flexion and abduction–they will not be able to relax or benefit from the spinal rotation.

It is interesting to note that in the side lying movement of reaching and rolling of the upper body–this person had difficulty in stabilizing the pelvis and lower trunk while accessing the middle spine area.  Again this difficulty is fairly typical.  We often over move from the lumbar and pelvic area especially in the side lying position.

There are many variations in sidelying that can be very helpful here.  This is only one of them.

Stability

From the above instability of the pelvis and lower trunk, you can see that this area will need to be addressed in follow up routines.

Notice the weight bearing aspect of being on hands and knees and prone on elbows (supported cobra asana).  These are just excellent positions to stimulate the shoulder complex and begin teaching stability.  Always consider there to be 3-5 ways to regress and progress any exercise.  That gives you a much wider appreciation of the functional relationships that are involved in rehabilitation.  It is also quite a challenge to come up with this range of movement possibilities.  This challenge is mainly for those who are teachers, trainers and therapists.

Conclusion

Do try out some of these movements.  You will find out that working with the mini-bands in the prone on elbow position can be fairly challenging.  Many people are quite weak in external rotation when the elbows are away from the body.  This variation opens up so many more ways to activate the rotator cuff musculature and the scapular stabilizers than just the standard “cuff” exercises with the elbow fixed to ones side.

This routine is only a beginning.  I hope it will be a continuation of the progress that has been made.

Best in Training–peter

 

Comments (2)
Categories : Exercise
Tags : exercise, Physical Therapy, Rehabilitation, shoulder pain, stability, stretching

Restoring Movement to the Neck

By Peter Fabian · Comments (2)
Thursday, February 2nd, 2012

The Neck

The neck is about one of our most used connections of the spine (and well used in our lexicon)  It is designed to be mobile and capable of great feats of movement and stability.  Just remember the days you’ve arisen out of bed–even before getting up–you notice how stiff you became over night.   Sometimes we say life is a pain in the neck.  Some folks even still neck around a little.

The neck is just not an anatomical structure to be described of bones and soft tissues.  It is a highly functioning arm of the nervous system and ourselves.  Here I am concerned with looking at how to restore movement in the lower neck (in a particular direction).

Mechanical problems

In my practice of Physical Therapy, many people who come in with shoulder and neck problems usually have a problem in moving their lower neck and upper back spine.  This area seems to become easily rigid.  We often see degenerative changes of the spinal segments at the segments just above this juncture of neck and upper back.  We often label seven neck segments with the top one starting as number one.  So the fifth and sixth segment are very popular in showing these degenerative changes.  To me this means that the area below is not participating in allowing movement to continue through these lower segments.  By the way, we don’t just move our necks.  Our bodies don’t move the neck.  Our movements take place in the spine.  Our patho-anatomical  medical approach (getting a diagnosis of a problem based soley on the anatomy that has a dis-ease vs including a functional evaluation or how it is working in daily usage) can distort our perspective of how we look at how what is going on ie the problem.

Of course, the  direction of mobility problem can be different for different causes and different people.  Here I wish to share my observations of the problem at moving through this juncture of the neck (cervical spine) and upper back (upper thoracic spine).  This junction is easily referred to as the cervical-thoracic junction or C/T junction.

What I find is that many people do not have very good side bending of the lower neck.  They often over move in the segments above.  Also when you observe those with pain and dysfunction of the neck and shoulder complex, it is worth evaluating how well they are side bending at this lower neck to C/T area.

Of course there are problems of stability in the mid neck and also upper neck.  There are sometimes mobility problems of the upper cervical region as well.  Note the junctional areas of the spine are very important in transmitting forces THROUGH the area (versus into the area).

Example of Moving the Lower Neck Spine

Here is a short video I did in working with someone.  I hope it will explain a bit about how you might start to work on learning to move this area.  Note it spends most of the time trying to coach one to move the lower area while learning to stabilize the above area.  It seems un-natural for many who have a movement deficit in this area.

Remember the learning is not just about correcting and moving better.  Ideally one must spend a good amount of time feeling and practicing these directions.  Often it takes some coaching.  A mirror can be invaluable in this type of training.

Conclusion

Enjoy the practice.  Those who don’t move this lower neck area well will be rewarded with proper practice.  You will find that once you can create some movement here sometimes your shoulder and neck problems become less.

Try it out and let me know what you find.

Comments (2)
Categories : Exercise
Tags : awareness, exercise, fitness, movement learning, Neck, Physical Therapy, Spine

Popular Misconceptions of Breathing

By Peter Fabian · Comments (7)
Thursday, June 30th, 2011

Breathing

We breathe and we live (or is it the other way around).  There are many excellent resources on breathing.  This article will focus on some of the popular misconceptions of the diaphragm in breathing.

Popular misconceptions (taught world wide and in current anatomy texts)

  1. Some people speak of chest breathing versus diaphragm breathing.  Does this mean that if you breathe with your chest you are not using the diaphragm?  If you are moving air into and out of your lungs and still alert for longer than 30 seconds, then your diaphragm is moving.  You will use your diaphragm essentially all the time you move air, whether you see your chest or belly primarily moving.
  2. Only the central portion of the diaphragm moves in breathing.  Really?
  3. The diaphragm is only active on inspiration.  Expiration is essentially passive.  Hmm-mm.

We will be primarily addressing the second and third misconception listed above.

Brief Anatomy of the Diaphragm

It is a dome shaped muscle when at rest or after the expiration/exhalation phase of breathing.

Here are it’s distal (furthest away from the center-line of the body) attachments:

  • Costal or ribs number 7-12
  • Lumbar vertabrae number 1-3
  • Xypho-Sternal aspect

Here is the proximal (close to center-line of the body) attachment:

  • Central tendon

Now there are more complete descriptions of these attachments in most anatomy texts that you can review in the library and on the web.  For now I want you to think about this division of distal and proximal attachments for the diaphragm.

Muscular attachments and directions of contraction

The diaphragm is one of the few muscles that does not attach one bone to another.  The face is another exception to this popular occurrence of muscular anatomy.  Keep in mind that contraction of the diaphragm is occurring between the proximal and distal attachments.  It is not occurring between the ribs and the spine.  Please keep this picture in your mind.  That means that when it contracts in inspiration it is shortening the distance between the proximal attachment (central tendon) and distal attachments.  Therefore in simple terms one end is coming closer to the other end.  (Although in reality they are both moving to different degrees)

Here in inspiration as the diaphragm contracts you could see that the central tendon would be pulled down.  This downward movement of the central tendon causes the lungs to fill with air.  Some people only describe the movement of the central tendon in inspiration.  This is only partially complete.

Let’s deviate for a moment to looking at the action of your bicep muscles in isolation.  Here the biceps connects the forearm bone to the upper arm bone (essentially).  The action is to bend the elbow.  (Only partially true).  So if you bring your hand (distal part) to your shoulder (proximal part), the bicep is moving them closer.  This is true only if the shoulder is fixed in space and the hand is free to move (like when you lift up a gallon of milk).  If your hand (distal) is fixed to an overhead bar or tree limb and you contract the bicep muscle it brings your shoulder (proximal) closer to the fixed hand (the ole pullup).  Similar actions but different parts (attachments) are moving while other parts (attachments) are fixed.

Also notice that the bicep muscle is active in lifting AND lowering in both cases.  Let’s take the example of the lifting glass gallon of milk up with you hand.  As the milk/hand comes closer to the shoulder the bicep is actively shortening in it’s (concentric) contraction.  If the bicep muscle were essentially passive in returning the hand away from the shoulder (in this case the act of lifting), then the glass gallon would possible slam into the table below.  This may be a bit laborious for some to read, but stay with it if you can keep your mind focused here.  Lowering of that gallon of milk can be observed with the bulging of the bicep muscle seen in both directions.  The opposing tricep muscle here is essentially inactive.  This is true also in the pullup example.  The same muscle is active in raising and lowering.  (This dual action will be the same in the diaphragm)

The bicep is actually active in lifting and lowering of the milk/hand.  This is respectively the concentric (shortening activity) and the eccentric (lengthening activity) of the muscle.  Let me labor this point further.  There are still authors and teachers who teach that muscles can only contract in one direction (often stated about the diaphragm).  They say it takes a second muscle or force to activate the second direction.  Of course the force of gravity is always present.  But to say that the diaphragm is passive in exhalation is an error.

Diaphragmatic function in inspiration and expiration

The central nervous system sends a signal via the phrenic nerve (the anatomical origin exits through the neck via the chest cavity to the diaphragm) to activate the diaphragm.  The diaphragm is involved in both concentric contraction and eccentric contraction.  The latter has been poorly described if at all.  I feel that this error is due to very poor functional knowledge of the way things actually work.  These explanations of contraction and then relaxation lead one to speak of one phase being active and the other passive.  This idea becomes erroneous and the propagated to the detriment of proper functional training of the diaphragm.

The diaphragm can fix either the proximal or distal end and move it’s opposite.

  1. In inspiration, if the rib and sternal attachments are fixed (by the action of the abdominal and costal muscles), the action of contraction of the diaphragm will lower the central tendon.  We then see the belly protrude forward.  Often this type of inspiration/inhalation is referred to as belly breathing.
  2. Another style of inspiration is when the central tendon is held in a static position (often by an increase in intra-abdominal pressure, which impedes the central tendon from descending).  Then the action of diaphragmatic contraction will cause the ribs to elevate and expand the interior dimension.  Often this style of three dimensional costal breathing of the lower rib cage is referred to as diaphragmatic breathing.
  3. Another style would be a combination of these proximal and distal attachments being held in part and allowed to move in part also.
  4. In expiration, the diaphragm is returning to it’s resting/starting position of a dome like appearance.  The diaphragm is just not flaccid during this phase, as often suggested by the word passive exhalation.

Eccentric phase of the diaphragm

When (in expiration/exhalation) the diaphragm returns, it is still contracting (in it’s lengthening return to rest).   Let’s look at setu bandasana.  This is the bridge pose in yoga where you lie on your back with your knees bend with feet standing on the ground.

When you inspire, you can see that the diaphragm must push against the weight of the abdominal contents.  Literally the diaphragm muscle is lifting this weight of the internal organs in this pose.  It actually is quite strengthening for the diaphragm, as are all inverted postures/asanas.  Now when you exhale, often slowly, the return of the diaphragm muscle if it was passive, would be a rapid release of the abdomen.  This erroneous belief of a passive diaphragm in this case would create a dramatic “whoosh” of exhaled air.  We know this is not what regularly happens, but quite the opposite.  This slow release is because the diaphragm is actively lowering the belly contents as it returns back to it’s starting position higher up in the chest cavity.

This eccentric phase of the diaphragm is occurring on all positions.  It can be more easily appreciated in inverted postures.

Orchestration of breathing

There are many styles and names of various ways we inhale and exhale.  We can orchestrate the different patterns of breathing through our positions and activations/inhibitions of all the muscles involved.  There are many other important muscles of breathing.  The internal and external intercostals will not be discussed in any detail.  They are extremely important along with the abdominal muscles, especially the obliques in helping to choreograph the visible expansion and contraction of the chest and belly volumes.

Just realize that in breathing the diaphragm is always involved in moving the air (if we are conscious for more that 30 sec).  Even in upper chest breathing (vs just saying chest breathing), the diaphragm is responsible for the intake of air.  In paradoxical breathing, where the chest expands and the belly is pulled up and inward, the diaphragm is still the prime mover.  In this style of breathing, radiography has shown even an elevation of the diaphragm.  Realize that the distal costal attachments are pulling outwards to such an extreme extent that the diaphragm is still contracting even though it is slightly doming up in the chest cavity.

Functional Training

So what!  Literally if you are still reading you may be wondering something similar.  If not OK!  Either way at this time we should look at the so what factor.  Knowing that the diaphragm is active in both phases of breathing will definitely affect your training of breathing.  Breathing for most people is inefficient.  So many people are suffering unnecessarily because they are not breathing well.

Also people are not re-training their breathing patterns properly.  We must include this eccentric phase of the diaphragm in our training.  I think we do in some ways now when we prescribe for people to breath slowly.  The exhalation phase that is active can lead to greater awareness of the breath flow.  Knowing that you are actively working both phases of the breath from the diaphragm will translate into better training regimens.  Adding resistance to the eccentric phase of breathing is very important.  Many people have a very weak diaphragm.  So the use of an abdominal sandbag or using inverted positions becomes very important.  Also I really like the Makarasana position or crocodile pose to help here.  The Himalayan Tradition in teaching proper diaphragmatic breathing commonly uses this asana.

Conclusion

Now when you train your breathing patterns include this active exhalation model of the diaphragm.  See if this concept helps focus and enhances your training.  Let me know what you find out.

The best in your training efforts.

Please contact me if I can be of further assistance.

Peter

Comments (7)
Categories : Breathing, Exercise
Tags : asana, breath, breathing, diaphragm, diaphragmatic breathing, eccentric contraction, eccentric contraction of the diaphragm, Himalayn Tradition, posture, pranayama, training, yoga
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