Lone Tree Physical Therapy

“Diaphragmatic Breathing / Belly Breathing”

What is it, and why would it help?

You may have heard of the term “belly breathing”, as a relaxation technique. I often teach this to patients who have excessive “tightness” feelings or muscle tension, as a way to relax, and often patients find it helpful.

The general technique: you can be in any position, but for starters, lie on your back, with knees bent and feet resting on the floor.

Place your hands on your abdomen, and as you slowly breathe in/out, monitor how much your belly “inflates” with each breath in, and “deflates” with each breath out. Also pay attention to how much your chest/ribs elevate as you breath in, near your sternum.

To emphasize “diaphragmatic” breathing, try to breath in deeply and pull the air into your belly, having your belly maximally “balloon out” or “inflate” as you breath in (like a Buddha belly). As you exhale, have your belly deflate. Try to focus on ONLY moving from your belly as you breathe, and NOT your chest, sternum, or upper ribs.

The Science:
The Diaphragm is a muscle, that attaches to your lungs and is situated below your lungs and a under your lower ribs (if you follow your sternum down to its’ point, and grip inward as if digging fingers under the ribs above your belly button, you may hit a tender spot which is likely the diaphragm). As you breathe, the diaphragm contracts and pulls downward, pulling the lungs downward with it allowing more air to enter the lungs. It is a more efficient, and better way of breathing, and doesn't involved the excessive activity of neck muscles and chest muscles as the more shallow chest breathing does.

The “Deeper” Science:
Our nervous system involves “parasympathetic” and a “sympathetic” activity, at all times. You may remember from bio or physiology class that the parasympathetic is the “rest and digest”, while the sympathetic is the “fight or flight” system of the body. When we are involved in a threatening situation (a man is charging you with a knife, with a wild look in his eye), our body kicks into “sympathetic overdrive” and we have very shallow breathing, increase in muscle tone, perspiration and are “ready to escape”. Our nerves are on high alert and are telling our brain everything that is going on inside, to an excessive degree, as a means to be better at removing that dangerous situation.

This is actually the SAME thing often going on when you are in pain, as your brain sees the situation as threatening (your muscles tighten up, protect, guard, and you have excessive response to all stimulus). Your nerves are being way too active, and getting way too much info to the brain. This facilitates more and more protection, and often more tightness and pain, which often isn’t helpful. This mechanism DOES help us survive (we need to KNOW if we get bit by a poisonous spider, or have a fractured femur), but unfortunately we can get stuck in this “sympathetic” state, while in reality the “threat” or “issue in the tissue” is long gone (google CRPS or complex regional pain syndrome). Pain is PROTECTION produced by the brain, sent to a vague, general area, based on the information the brain is getting from the nerves (which can be way too much information at times). The pain experienced is and OUTPUT, from the brain downward to the tissue (but happens so fast it feels like it is coming from the tissue). Interestingly, the tissue doesn’t even need to be there to feel pain (if a person steps on a landmine and blows off their foot, and later has the leg amputated, they will often feel pain in where their foot WAS), as we actually register and “feel” things, within the tissue of our brain (more on this later).

GETTING OFF TRACK a little, but belly breathing can help us shift from a more “ready to fight or flee” body mode, to the more chill sister mode “rest and just maintain the vital things in my body” mode. This is a better place to reside. Although you can’t flip off the nerves like a switch, attempts should be slowly made to get them to quiet down (and this may be a component that can help).

-Tal Blair, DPT

Does your pain involve inflammation or ischemia? Knowing the answer may guide you towards improving your treatment strategy:

Examples of inflammatory pains may include acute sprains, muscle strains, post-activity muscle pain, or a "flare up" of arthritic pain. Cardinal signs of acute inflammation include redness, heat, usually irritable tissue surrounding the site (hurts to push on the muscles, or load the joint), a diurnal pattern of pain and stiffness may exist (worse in AM, and overnight), and the pain often responds well to NSAID medication (ibuprofen).

Ischemic pain, on the other hand, is pain due to a lack of blood flow. When you sit on a hard seat, and your bottom begins to hurt, you subconsciously shift and in your chair to unload the tissue. This brings blood flow to the area and ends the prolonged compressive force that was causing lack of blood flow, and you forget that the area was hurting… This type of pain is more associated with symptoms after prolonged or unusual postures, a decrease in symptoms with moving into the opposite direction to which you are in prolonged, symptoms more toward the end of the day and often no evidence of actual trauma.

If you feel your pain pattern falls more toward the inflammatory side, and has been persisting for months, it may be useful to talk to your doctor about a cortisone injection (a strong anti-inflammatory) or course of oral anti-inflammatories per recommendation of your MD. Shorter term inflammatory conditions should be assisted with ICE and elevating the area. A physical therapist may also help you identify why the area is prone to inflammation (is there a corresponding weakness or restriction that causes increase in stress at a particular area).

If you feel your pain is more ischemic, frequent movement may be beneficial. Simple aerobic exercise such as walking, cycling or swimming can often be of help. Try to pay attention to the positions you are in daily, then ask yourself how you may be able to frequently move in the opposite direction (i.e. if you are always slouched, every 30 minutes try to slowly move in the opposite direction 20 times, allowing the tissues and joints of your body experience some loading in the opposite spectrum of what they are always in). A physical therapist may help you determine ergonomic changes to assist with this, or assist you in strengthening muscles that may offer improved postural endurance and support.

-Tal Blair, DPT

Welcome to Physical Therapy Blog Welcome to Physical Therapy BlogFebruary 17, 2014UncategorizedtalblairShare this:TwitterFacebookGoogleLike this:LikeLoading...