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Diaphragmatic Breathing and Why I Care
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There is a lot of talk about core function these days. Whether its chit chat at the hair salon, an article in Fitness magazine, Men's Health or even Readers Digest, information is everywhere about the core. And even though we live in Washington State we aren't talking about apples. It's that often apple shaped middle of our bodies that people are talking about. As a physical therapist and strength and conditioning specialist core function is frequently at the core of what I talk about with my patients, excuse the pun. The purpose of this article is to remind or teach everyone that part of the core is your diaphragm. Yes the thing you breathe with. The problem is not enough of us are breathing with it which is the again, core, of my point here.
To begin, I'd like to review briefly how we all breathe. The diaphragm separates our chest cavity from our abdominal cavity. When relaxed it is shaped like a domed dent rising up into our chest cavity with the center of the tent roof being the tendon. When we inhale to breath it is pulled downward toward the abdominal cavity thereby making the chest cavity bigger and air is essentially sucked down and into the lungs. Like all muscles after contraction comes relaxation. When the spring loaded diaphragm is relaxed the now flattened tent springs back to life back up into the chest cavity making it smaller and pushing air back out. Thus exhaling. So with this spring loaded trampoline of a muscle we take air in almost effortlessly and exhale out almost effortlessly. This is very efficient and is how almost all breathing takes place.
However, in times of need we have additional muscles in the body that can help with inhale and exhale. To feel them just blow air out as far as you can and you'll feel the abdominals help exhale. Next, take the deepest breath in that you can and you'll feel muscles in the body all the way up to the neck that help inhale. These muscles are extra back up support if needed in times of fight or flight. They are a great way to compensate when needed. Unfortunately this primitive survival pattern of breathing under times of high stress such as running from a velociraptor, referred to as "high threshold breathing" is often used in modern times of stress such as running late for work, or the phone won't stop ringing, or traffic is bad or decreased sleep, or empty bank account or…. You get my point. Another way a high threshold pattern will occur is when we are in pain. You suffer an injury the body is under stress and adopts that breathing pattern. Oftentimes after the injury even after the pain is gone or nearly gone the high threshold breathing pattern continues.
This is often when patients end up at my door. They were going along fine, then unexpectedly they fall, get into a car crash, lift something wrong, etc. Time goes by and symptoms haven't resolved so they come and see me or they see their doctor who refers here. In my exam I typically find they don't have effective core stability. The person then often tells me I must be wrong. Because he/she does crunches on a ball, can plank for 5 minutes, takes Pilates, and the list goes on. The problem is even if you can do all those things, if you do them with a high threshold breathing pattern, many of the muscles you need to stabilize your spine will be busy breathing for you since your diaphragm currently isn't. Then randomly during your day when your body needs to choose between taking a breath and stabilizing, breathing wins. Then that unstabilized movement or posture will be the time you say you "tweeked it." Your muscles can't do two things at once. They can breathe or stabilize. Since breathing is more important that's what wins out. Once you re-learn a normal diaphragmatic breathing pattern again you have a chance of being truly and consistently stable so not only will you be able to plank for 5 minutes you will also be able to do all the little things that used to cause tweeks and flare ups.
So in summary, no matter how many planks, sit ups, roman chairs or supermans you can do if you don't have a normal diaphragmatic breathing pattern you can't have a consistently stable core. If you think this applies to you or want to learn more please schedule an appointment. If you don't think it applies to you just remember this when an old injury doesn't seem to want to "heal". You might be surprised.
Dan Swinscoe, MPT, CSCS
Peak Sports and Spine PT Issaquah and Sammamish Plateau
