Tuesday, October 20, 2015

The Core: Week 3. Diaphragmatic breathing and Letting Go

The Core: Week 3. Diaphragmatic breathing and what Queen Elsa got right

Take a really nice deep breath…ahhhh

Not only does a deep belly breath slow your heart rate and calm your nervous system, it is also a key component of your core. Why is the diaphragm important? It is one of 4 sides of a canister. When all 4 sides of the canister contract, pressure builds up and stabilizes the spine. If you only do crunches, you build up only one of the 4 sides.

 If you tried several core “exercises” and still are not getting results, first check your alignment, then check your diaphragm function. Correcting faulty diaphragm function has improved problems ranging from back pain to leaking urine while running.

How does it work? 
The diaphragm is a muscle and fibrous tissue that separates the thoracic cavity (heart and lungs) from the abdominal cavity. It is an upside down muscle that is shaped like a dome located at the bottom of your ribs. When it contracts, it moves down towards your abdomen and becomes flat.

The diaphragm is at rest on the left. This is what it looks like when you exhale. Your abdomen will feel hollow. The diaphragm is contracted on the right. This is what it looks like when you inhale, feel your lower ribs open like an umbrella, feel your abdomen rise, and feel your pelvic floor drop.  The red arrows show where pressure is moving.

This downward motion of the diaphragm increases pressure inside of the abdomen. But you still need activation of the other core muscles to maintain pressure for spinal stability. And preferably the diaphragm and pelvic floor muscles need to activate first.

How to breathe with your diaphragm, the basics:
1.     Lie down and relax. Place one hand on your chest and one hand on your stomach just under your ribs.
2.     Inhale through your nose slowly and feel your abdomen rise and the lower part of your ribs slightly expand like an umbrella. Now repeat this and feel the rise all the way to your lower abdomen and even down into your pelvic floor muscles. You should feel them stretch or expand slightly just like your stomach does. (more on the pelvic floor next week)
3.     Exhale slowly and observe the return of your stomach and pelvic floor like a balloon that has deflated
Use the hand on your chest to make sure you aren't breathing with the top of your ribs. You should have twice as much abdominal movement as upper chest movement. 
*Always check alignment first. Are your ribs lifted up, causing chest breath? Are they facing down,  causing an exclusive belly breath?
*When you get good at this, progress to sitting or standing
*Take about 5 min a day for practice with breath work. Get really good at this so that in a few weeks when it’s time to tie this all together you have a diaphragm that is ready to pull it’s weight!

-You’ll learn how to coordinate the diaphragm with the rest of the core muscles in a future post. For now, just learn how to do a diaphragmatic breath
-No need to hyperventilate, breathe slowly, and take some regular breaths in between the deep ones.
-Postpartum ladies may need some extra time or assistance getting their diaphragm back into shape thanks to a wiggly little human squishing the diaphragm for many months of the pregnancy. This squishing often also causes the ribcage to expand resulting in an overstretched and therefore weak diaphragm.
-Please stop sucking in your stomach all day! Go ahead and pull it in for that summer vacation photo, but like Queen Elsa said, “Let it GO,” the rest of the time! Where do your guts go when you suck in? They can go up into the diaphragm stopping it from dropping and therefore making it unable to help out with correct pressures. Or, they can go down into your pelvic floor contributing to pelvic organ prolapse for women and hernias for men. This constant pressure on your guts can also add to GI dysfunction such as irritable bowel syndrome, constipation, bladder pain, and bladder urgency. So, give your abdomen a break. Relax your belly more than you contract it. And when it is time to correctly activate your core, make sure all parts of the abdominal core are simultaneously contracted.
---And while we are on topic, sucking in makes your muscles tight and short. Remember last week when I said a short and tight muscle is a weak muscle? So, walking around “activating your core” all day long can actually make it weaker.
A quote from Katy Bowman, one of my favorite biomechanical authors, in her recent book, Move Your DNA:
            “Rather than stretching or adding exercises to address our chronic stress, we will focus on releasing areas of the body most prone to hypertonicity.”

Your homework this week:
Spend time learning how to breathe with your diaphragm.
Use your core when you need it.
Relax your core when you don’t need it. 

Still have no clue how to do a diaphragmatic breath? Never fear, your anatomy loving PTs are here! We can assess your breathing and all the muscular, bony, and neural structures that can possibly affect that breathing. Then, most importantly show you exercises and movement patterns that can help your “core” function as a useful unit.

Happy Moving!

Crystal Hazelton, PT, MPT, OCS

This article is not medical advice. If you have pain or concerns, consult your physical therapist or physician.

Week 1: Let’s get acquainted, Core.
Week 2: Alignment - build the scaffolding to support your weak spots while they heal and repair
Week 3: Diaphragm and what Queen Elsa got right
Week 4: Pelvic floor muscles
Week 5: Transverse abdominis and multifidus muscles
Week 6: Shoulder girdle and hip
Week 7: Functional core exercises
Week 8: Round robin demonstration of CTS Physical Therapists’ favorite core exercises. 

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