Breathing: We all do it without thinking much about the process.
But the way we breathe can have a big impact our life. According to a 2014 study, an inappropriate breathing technique “could result in muscular imbalance, motor control alterations and physiological adaptations.”
But chiropractors can be instrumental in correcting bad habits and restoring balance for clients whose breathing is out of sync.
Differentiating the breath
This study distinguishes between “normal” breathing, (diaphragmatic breathing), and “abnormal” breathing, (thoracic breathing). Normal breathing is similar to yoga breathing in which the breath originates in the abdomen, pushing the belly out as you inhale, then pulling it back in upon exhale. The authors define abnormal as breathing from the upper chest, which destabilizes the lumbar spine, decreases carbon dioxide (CO2) in the blood and may cause neck, hip and back pain. Breathing pattern disorders (BPD), such as thoracic breathing, are “persistent enough to cause symptoms with no organic cause.” This study finds a connection between BPD and the inability to properly control movement.
So how can a chiropractor re-educate patients who exhibit an abnormal breathing pattern? Most importantly, a chiropractor must understand the role of the diaphragm in spinal mechanics, according to Robert “Skip” George, DC, owner of La Jolla Sport and Spine and instructor at the Postural Restoration Institute. “You have to have a system to assess breathing and its effects on biomechanics,” he says. “The diaphragm is the core of your core. It dictates how you position yourself, how you move and breathe.”
Exercises for change
Once you’ve determined that dysfunctional breathing might be contributing to pain issues, there are some basic exercises to address the problem. George recommends the 90-90 hip lift as a starting point. The patient lies down on the exam table or the floor and places their feet on a wall with a ball in between their knees, knees bent to 90 degrees. They then inhale easily through the nose, filling the belly and low back with air. Upon exhaling forcefully, the patient pulls the belly in and raises their hips slowly, pushing their feet against the wall to activate the hamstrings. The patient then lowers their hips and repeats the process four or five more times.
George notes that there are some variations to this exercise. For instance, the patient can press alternating feet against the wall to create balance in the pelvis and spine. Any of the variations can be performed in the office or at home.
Beyond the appointment
Speaking of homework, it’s important for the patient to continue working on restoring balanced breathing on a regular basis once it has been determined as the root case of dysfunctional movement. “You should prescribe exercise based on your findings in the functional exam. You want to help the patient reposition the pelvis and the entire spine with specific exercises, including breathing,” he says. “The patient should do homework three times a day. You have to get patient participation. They need to take responsibility for their health.”
Natural asymmetry and bad habits can contribute to dysfunctional breathing, according to George. “Western society tends to breath with the back and neck. We don’t get the breath out before we are trying to get air in,” he says. Restoring balance in the entire body is the ultimate goal. “You should be a teacher and help your patient become skilled at body awareness until it becomes automatic. You need to help them stay in a more neutral or centralized position, no matter what activity they are doing,” says George.