In part one of this article we looked at the anatomy of breathing, the biomechanics of correct breathing, and benefits offered simply by breathing correctly. Here in the conclusion to the article we will review the faulty manner in which most people breathe today. We will uncover how the modernization of the world we live in can cause faulty breathing. We will explore the effects of incorrect respiration on the body, as well as exercises that you can apply toward your clientele to get them on the right track when it comes to breathing.
Breathing incorrectly seems to be a fad today. Everyone seems to be doing it. Though it may not be a conscious fad, nonetheless it is happening in many people. The vast majority of clients I see have faulty breathing patterns. I even take note of people’s breathing just walking around. When someone is not using their diaphragm it is fairly easy to detect. Walk along the beach and you’ll see many people wearing there bodies down one breath at a time.
The most common type of faulty breathing is chest breathing. Chest breathers underutilize their diaphragm and over utilize their accessory respiratory muscles. It is said that the most important fault in respiration is lifting the thorax by means of the cervical accessory musculature instead of widening it in the horizontal plane, which requires normal diaphragmatic function. Though it is by no means a comprehensive respiratory assessment, you can often identify a chest breather by the way their chest rises throughout the majority of the inspiration phase. In healthy breathing, you should only see the chest rising during the last third of the inspiration phase. Chest breathers also commonly breathe predominantly with their mouths.
Breathing predominantly with your chest does not permit you to get an optimal amount of oxygen as easily as diaphragmatic breathing does. The greatest diffusion of oxygen and carbon dioxide takes place in the lower lungs due to the higher density of blood capillaries surrounding the alveoli. Therefore, chest breathing results in a less efficient oxygen exchange. When there is a decrease in oxygen the rate of breathing increases.
The respiratory control center is found in the medulla oblongata of the lower brain stem. It is quite sensitive to changes in the levels of carbon dioxide in the blood, making it a chemosensitive area. This respiratory control center is part of the nervous system and controls the rhythm of breathing. If there is either a slight increase or decrease of carbon dioxide, the chemosensitive area will respond by either increasing or decreasing the rate of respiration. This enables someone to keep enough oxygen in the lungs by increasing the quantity of breaths, not the quality.
Faulty breathing can ultimately be caused by a variety of reasons, many of which stem from living in our modern day world. Observe an infant breathing, and chances are very good that the he/she will be breathing diaphragmatically. The worldly factors that can inhibit optimal breathing have not yet reached the infant.
Some of the modern world factors that can effect respiration include:
- Walking surfaces
- Poor nutrition
Certainly the modernization of the world is not the only way breathing can be changed for the worse, but it will be the focus of this section.
As you know much of the ground we walk on today is hard. Whether you are on a concrete sidewalk, a paved road, a basketball court or a tile floor, much of what you walk on throughout the day is an unnatural hardened surface.
When someone with a functional inner unit walks on a hard surface their deep abdominal wall will contract as a mechanism to stabilize the back from the forces that travel up through the leg into the lumbopelvic region. This is a very necessary function to protect the back. The transverse abdominis and the internal obliques are key stabilizers of the lower back. In this instance they stabilize the back through the intra abdominal pressure mechanism, as mentioned earlier, and via the thoracolumbar fascia gain mechanism. (These two mechanisms of support will not be covered in detail in this article, but references 4 and 5 cover the topics in extreme detail.)
If you refer to Table 2 in Part 1 of this series, you will see that the transverse abdominis and the internal oblique are listed as expiratory muscles. When expiratory muscles are contracted they can obviously inhibit the effect that the inspiratory muscles have on respiration. In this case both of the abdominal muscles at hand act to draw the belly button inward toward the spine in an effort to preserve the lower back. In doing so they play an antagonistic roll to the diaphragm, as it wants to displace the abdominal viscera outwards. It cannot effectively do so due to the resistance encountered by the transverse abdominis and internal obliques, which are essentially holding the viscera in.
When the diaphragm’s movement is limited in such a way, it cannot create the space in the thorax that is needed for air to flow into the lungs. The accessory respiratory muscles now go into overdrive to ensure that the lungs do indeed get the air that they so desperately need. With this aberrant workload comes consequences. As you read on you will find out exactly what those consequences are.
Chest breathing can be the result of stress. In order to better understand stress, we must first understand stress’s connection to the sympathetic nervous system.
The sympathetic side of the autonomic nervous system has a lot to do with our “fight or flight” response. When you encounter a stressful situation you evoke a sympathetic response. Imagine that you are at a gas station paying at the counter and in comes a man with a ski mask waving around a gun demanding money. You would surely experience a sympathetic response. You would probably have an overwhelming urge to do one of two things. One, sprint out the door, run home and change your shorts. Or two, kick some serious butt!
This is an example of a very stressful situation evoking a sympathetic response. Very few of us encounter stresses of this magnitude on a regular basis, but we do experience more subtle stresses frequently, which still warrant a sympathetic response. Examples include worrying about bills, driving in traffic, feeling pressed for time or encountering a difficult business or personal relationship. These types of stresses can stay with us day in and day out, and even carry over to our sleep.
One of the first things that happens in a stressful situation is our respiration increases, and generally we breathe more from the chest. Returning to our extreme example from above, ask yourself if you would experience a faster respiration rate. You most certainly would. Going back to the smaller everyday stresses, when you are under a constant “fight or flight” response you do not experience any time between stressful situations to recover from them. This is all too common today. People over-stress themselves and do not do enough to relieve the stresses that they experience. So they live in a constant state of increased respiration relative to what is optimal for good health.
There is sufficient evidence out there to conclude that the human body is not meant to be under a constant “fight or flight” response. What really seems to be likely is that our sympathetic nervous system is meant to function for survival reasons and then be less active when the body is not being threatened. Primitive man most likely lived an extremely healthy life compared to what people do today. They most likely ate the best food around, got the right amount and type of exercise through their everyday living, and had little stress in their lives. They would have had the occasional stress back then, but not to the frequency that people experience today. A stressful situation in the primitive days would be the caveman going behind a bush, doing his business and coming out and to see the occasional tiger looking him in the eye. Anyone would get a sympathetic response from this, but once the acute situation was over the primitive man would go back to living a peaceful life. The human body is equipped to effectively handle this because the body has a chance to recover from the stress. What it does not seem to be equipped to handle is the chronic type of stress that so many people in the modern world now experience.
Society has evolved a great deal faster than the human body. The result is that the system – that is the human body – wears down from having to function in an environment that it has not yet evolved to effectively manage. I’m not suggesting that we pack up and move to the Amazon rain forest (or what is left of it), but we do need to realize that we and our clients live in a stressful world. We can combat stresses that do us harm. Addressing breathing is a powerful weapon we can easily use.
Optimal breathing capabilities are derived from an optimal posture. Good posture is not only important for respiration, but also for the health of joints, visceral functions, muscle balance, energy efficiency, and aesthetics. In any client that has postural faults, correcting them needs to be a high priority. (Assessing and correcting posture is a very important and broad topic, and it is beyond the scope of this article, but the reader is referred to PTontheNET.com article search function under keyword “Posture.”) Ultimately, correcting postural discrepancies is essential if someone is aiming to have normal respiration.
The type of posture that is most common today is forward head, rounded shoulders, with an increased thoracic kyphosis, and either an increased or decreased lumbar curvature. If you have not assessed your clients’ posture, I would be willing to bet that the vast majority of them have the above postural faults, and most likely are breathing incorrectly.
Poor posture can be a result of many different circumstances. Among these are sedentary lifestyles, work related issues such as sitting at a desk all day, and poor respiration. Faulty respiration can be either the cause or the effect of poor posture.
For now we will examine how poor respiration can cause bad posture. First off, if you believe that there is some sort of respiratory obstruction in your client, you should refer them to a skilled therapist or physician for evaluation. A person with an obstructed airway will commonly develop a forward head posture very quickly in order to improve her respiration. Assuming there is no presence of an airway obstruction, we will now explore how faulty respiration can contribute to poor posture.
A person that breathes predominantly with his chest, whether it is a result of stress or something else, will be over working his accessory respiratory muscles. The majority of the accessory respiratory muscles that assist with inspiration are predominantly tonic in nature. It can be understood that when the accessory muscles are doing the majority of the work, they are being overworked. Typically, when tonic muscles are over worked or under worked they have a tendency to shorten and tighten. When the accessory inspirators become short and tight they have the potential to pull the head forward, round the shoulders, and increase the thoracic kyphosis. There is often concomitant lengthening and weakening of the thoracic erectors, middle and lower trapezius, and the rhomboids. If there was any movement of the diaphragm before, there is most likely to be less movement now.
On the other hand, if you have a person who has great respiration and you put her at a desk for eight hours a day, in the car for another hour, and on the couch for four additional hours per day, you will most likely see this person start to develop the postural faults listed above. Hand in hand with these faults most likely will become faults in this person’s breathing.
When someone is in the faulty forward head, rounded shoulder posture that has been described, they exist in a position of constant forced expiration. Next time you are at a child’s birthday party watch as the child blows out the candles on the cake. If a good effort is made his head will go forward, the shoulders will round, and the thoracic curve will increase. That is because the child is creating forced expiration. When someone is in the position of forced expiration, optimal inspiration will be inhibited.
In this faulty posture the diaphragm cannot properly descend and effectively create a negative pressure in the thorax. This is where the accessory inspirators have to work overtime. Since we have established earlier that the brain will do anything it must in order to preserve respiration, it will sacrifice the well being of the accessory inspiratory musculature. When these predominantly tonic muscles pick up the slack, they will most likely keep getting progressively tighter and tighter. Often their aberrant function can lead to trigger points and headaches.
As already stated, the accessory inspirators pick up the rib cage to create a negative pressure within the thorax. The quadratus lumborum, which is an accessory expiratory muscle, is a depressor of the rib cage (4). This muscle can now become chronically overworked trying to depress the rib cage, possibly leading to back pain. This is just another potential side effect of poor posture and poor breathing.
If you are currently working with a client to improve her structural alignment without addressing breathing, you and the client are very likely taking part in a steep up hill climb. With every breath a chest breather takes, the work you do with her is being slowly erased. On the other hand if you are trying to improve someone’s life by teaching her to breathe correctly, you would experience much better results by simultaneously addressing any postural faults that the client may have.
By now you should have an appreciation for the downward spiral that people can get stuck in if posture and breathing are not addressed together.
Today the dietary habits of people are atrocious to say the very least. Many people make processed foods, pesticide and hormone ridden foods a staple in their daily meals and snacks. These types of foods are unfit for human consumption, or for consumption by other animals, for that matter. These so- called “foods” are often the cause of dysfunction within the body. (for more information on this topic, please refer to my PTontheNET.com article titled Why Our Health and Vitality Are Being Damaged By Our Present Food Supply.
Paul Chek says that food allergies can affect respiration. It also seems very likely that the hormones, pesticides, food additives and preservatives that litter our food can affect respiration. The liver, along with the stomach, intestines, appendix, pancreas and kidney are all capable of reflexing into the diaphragm. When any of the viscera listed above becomes inflamed as a result of the consumption of food that is of poor quality, the diaphragm, which is innervated by the phrenic nerve out of the spinal levels C3, 4, and 5, receives a viscero-somatic reflex impulse and can become inhibited. Particularly the costal portion of the diaphragm can become inhibited.
Whenever the diaphragm is inhibited, the accessory inspiratory muscles have to come into play to a much greater degree than what they should, resulting in chest breathing.
If you have a case where no matter what the client tries he cannot breathe diaphragmatically, you may want to explore the possibilities of a viscero-somatic reflex inhibiting the diaphragm. A good first thing to do with the client is to clean up his/her diet. Get them off processed foods, switch them to organic foods whenever possible, and eliminate alcohol from daily diets. Not only will that give the viscera listed above a much-deserved break, but it may improve their breathing.
Exercises for Optimal Breathing
There are things in which we can do, and have our clients do that will improve breathing, and in turn, enhance the quality of life. It has already been established that helping clients to improve their posture is a priceless asset to improving their breathing.
It should also be understood that getting people to breathe correctly in general everyday life is not an extremely easy task. The way you breathe is probably one of the most heavily ingrained motor patterns that exists. Every time someone breathes incorrectly he is making that motor pattern stronger and stronger. Therefore a dedication to breathing exercises along with a consciousness in everyday life is very important to correcting breathing.
Below you will find two breathing exercises. The first is meant to help establish normal breathing patterns. The second exercise is an alternate nostril breathing exercise intended to help balance out the psychophysiology of a person.
Diaphragmatic Breathing Exercise
For this exercise start in a supine position. This is the easiest position in which to breathe diaphragmatically. As with other exercises, this breathing exercise should be progressed to a functional position. Once clients reach proficiency in the supine position progress them to a seated position, and finally standing.
- Assume the starting position (supine, seated or standing).
- Place your hands on your abdomen, or hold a water bottle on it so you can see or feel its movement.
- Slowly inhale through your nose. Concentrate on using your diaphragm. Think about trying to push your abdominals out. With your hands feel the abdomen bulge out beneath them, or see the water bottle rise.
- Exhale slowly through your nose or mouth.
Note: While inhaling, if your hands or water bottle are not rising, your diaphragm most likely is not descending as it should.
Start with at least 10 minutes per day. The more you can get a client to do this exercise, the better. Encourage them to do it several times per day, for as many minutes as they can.
Alternate Nostril Breathing Exercise
While the aim of this exercise is to help balance one’s psychophysiology, the breathing in this exercise should still be done diaphragmatically.
- Assume the starting position (supine, seated or standing - depending on your ability to breathe diaphragmatically).
- Close off one nostril with your index finger.
- Using only the open nostril, inhale slowly. You can place your other hand on your abdomen to ensure that you are breathing diaphragmatically.
- Exhale slowly through the same nostril.
- Complete 20 repetitions, then switch nostrils and complete 20 more repetitions.
Note: When switching nostrils, if there is difficulty breathing through the nostril you can lie on your side with the plugged nostril’s side up. This will help open that nostril.
Complete one to three sets with 20 repetitions done with each nostril per set.
When doing both of these exercises it is very beneficial to be as relaxed as possible. As we have discussed previously, stress excites the sympathetic nervous system. When this part of the autonomic nervous system is excited it makes it difficult to breathe without over recruitment of the accessory inspiratory musculature. So try to create a relaxing, quiet environment for yourself or client when doing the above exercises. It can also be helpful to imagine that with every breath taken you are drawing vitalizing energy into your body.
The diaphragmatic breathing exercise is of particular importance, and should receive the majority of the attention initially. It is meant to re-educate the client on how to breathe diaphragmatically, which is a prerequisite to the alternate nostril breathing exercise.
If you see the same clients on a regular basis you can devote the first five or 10 minutes of each training session to doing the diaphragmatic breathing exercise. This will help with a few things. One, it will help to facilitate a correct breathing pattern that can be carried over to the rest of the session’s exercises. The correct breathing pattern will be fresh in your client’s mind. As you know, during exercise people will breathe harder, and if you can teach the client to breathe correctly while exercising they will benefit much more. Two, if you devote some time to breathing exercises each time you see the client they will begin to appreciate the importance of the exercises, and not just think of them as another useless fad exercise. Three, if you do not think that the client will adhere to your advice to do the exercise on his or her own, then this will give you an opportunity to make sure that some work does go into improving his/her breathing.
An important part of improving respiration in your clients is to improve their own consciousness of their respiration. One effective way to do this is to build triggers of awareness into their every day life. You can tell them every time they hear a phone ring to let it serve as a reminder to think about how they are breathing. You can tell them that while driving in their car to take the opportunity to pay attention to their breathing. These are just two examples, and I am sure that you can think of many more.
An Underestimated Medicine
As you now know, breathing plays a critical role in achieving and maintaining optimal health. A role which is widely under-appreciated by the western medical world. If the average physician taught patients how to breathe correctly, there probably would be a big drop in the number of office visits, surgeries, and prescriptions written for pharmaceuticals every year. You may be thinking to yourself, “If breathing correctly is so essential for optimal health, then why is it that doctors don’t pay much attention to people’s breathing patterns?“ One possible answer is the way that the traditional western medical world often functions – if there is no financial interest in a method or a procedure, it is not really emphasized by the medical schools. Because there are no companies out there that sell a drug or make a machine that will make you breathe diaphragmatically, the benefits that come from breathing correctly are not widely promoted to the medical community in the western part of the world.
There is a wealth of medical knowledge out there. Unfortunately some of the most valuable knowledge available is often ignored by the traditional western medical world, and confined to the less visible world of alternative health practitioners. As you read this, and other sources keep your eyes open, and your brain on high alert.
We have covered the anatomy of breathing, the biomechanics of correct respiration along with the benefits of it, breathing pathology and its causes and effects. We also have discussed corrective breathing exercises.
In short, our world is not very conducive to optimal breathing and good health. It is not very likely that anytime soon our food, walking surfaces, posture, and stress levels will automatically change for the better. So we need to do what we can to improve things ourselves. We need to seek out better sources of food. We need to minimize stresses and do activities that will relieve stress. It is very possible to live a healthy life in the world today, but most people will have to make certain adjustments to their lifestyle in order to get on track with their health. These breathing exercises are just a couple of the activities that will help to improve the overall quality of life.
As trainers, we need to take advantage of our jobs working so closely with people. Be a breathing pioneer in your gym or clinic. Start taking a more holistic view of your life and your clients’ lives. You and they will experience a higher quality of life by utilizing extremely simple concepts, such as breathing correctly.
- Chek, Paul. Nutrition & Lifestyle Coaching Course, Level 1. C.H.E.K Institute. Encinitas, CA. 2002. Go to www.chekinstitute.com or call 1-800-552-8789 for information on this course.
- Farhi, Donna. The Breathing Book. Henry Holt and Company Inc. 1996.
- Steindler, Arthur. Kinesiology: Of the Human Body. Charles C Thomas Publisher. 1955.
- Chek, Paul. Scientific Core Conditioning (Correspondence course). C.H.E.K Institute. Encinitas, CA. 1998. Go to www.chekinstitute.com or call 1-800-552-8789 for information on this course.
- Chek, Paul. Scientific Back Training (Correspondence course). C.H.E.K Institute. Encinitas, CA. 1993. Go to www.chekinstitute.com or call 1-800-552-8789 for information on this course.
- Jahnke, Roger O.M.D. “Breathing exercises and Self Healing.” September 1, 2002. Internet. www.mercola.com/2001/feb/20/breathing.htm
- Kendall, Florence., Kendall McCreary, Elizabeth., Provance, Patricia. Muscles: Testing and Function. Fourth edition. Williams & Wilkins. 1993.
- Chek, Paul. “Scientific Balance Training Part 3.” www.PTontheNet.com
- Pottenger, Francis M. Symptoms of Visceral Disease. Fifth edition. Mosby. 1938.
- Yuefang, Cen. Chinese Qigong Essentials. New World Press. 1996.
- Chek, Paul. Posture and Craniofacial Pain. Chapter in Chiropractic Approach to Head Pain. Wilkins & Williams.