diaphragmatic breathing, exercise for breathing
I know what you may be thinking...
I know what you may be thinking..."Not another article on core conditioning!"
"What more is there to learn about core conditioning?"
I am glad you are asking these questions because far too many trainers and therapists feel they have a strong grasp of core training fundamentals. However, there are far too many clients and patients who leave training sessions and/or therapy sessions with a poor ability to breathe and stabilize their body.
How do I know this?
Because I am regularly asked to consult with individuals with chronic musculoskeletal pain and guess what they say when I asked them how they got injured?
Those three infamous words: "I don't know."
Following is an example of the type of client who is referred to me for training.
Case example:
A 57 year old woman recently consulted with me for chronic hip and back pain. She stated that she would like to exercise but every time she tries she experiences hip pain and low back pain radiating out into her leg and foot. An MRI of her hip revealed moderate-severe degeneration in her right hip. An MRI of her left knee revealed a significant meniscus tear, and a lumbar spine MRI revealed moderate disc degeneration and spinal stenosis (narrowing of the spinal canal). In addition, she said the only trauma she could recall was a skiing accident that injured her knee 20+ years ago; but she had recovered and has had no problems until the last few years. Currently she is experiencing trouble walking, sitting for long periods of time which she has to do for her job, and sleeping on her back or stomach. She reported she routinely works 12-16 hours per day and sleeps 4-6 hours per night.
During my evaluation of her as she stood, she reported some discomfort in her low back and I noted that her lumbar erectors were significantly hypertonic (they actually felt rock-hard as if she was actively contracting them upon palpation). The erectors were only slightly less active in a supine position. What clue does her hypertonicity give you? What information can you take from the MRI studies? Although you may not be a doctor or therapist, the first thought that should come to mind is that this individual is under a lot of compression. Osteoarthritis (aka, degenerated joints) is not a genetic condition. No matter what you may have heard from your doctors, parents or friends, it is not hereditary. Degenerated joints occur because the compressive forces around the joint are too significant for the muscles to control and therefore the joint takes the stress. Over a prolonged period of time (usually years) the joint begins to deteriorate (loss of articular cartilage, the bones of the joint increase in density causing bone spurs to form), and there is a subsequent loss of joint space. Pain occurs when there is a significant amount of degenerative change.
Although you may not train, condition or rehabilitate clients who have this many problems, recall that the client in question did not have problems either until a few years ago. She had many years of pain-free living and performed her activities of daily living with no problem.
COMMENTS: The important take-home message here is that the patterns seen in the case study were set up many years earlier and they require a highly specific approach in order to help the client achieve some relief. What patterns are your clients demonstrating that are leading them down a bad road? Our commitment to the health of our clients has to be for the long term whether they remain our clients for 8 weeks, 8 months or 8 years.
Therefore, our primary goal must be one of improving a client's movement patterns while not surrendering to the trap of the short term goal of weight loss or a faster running time.
This begins by understanding the fundamental function of the core region of the body (lumbar spine, thorax, pelvis and hips).
What is the fundamental function of the core area of the body?
BREATHING!!!
And did you know that proper diaphragmatic breathing is directly related to core stability?
Karl Lewit, a noted physical medicine doctor, has stated: "If breathing is not normalized, no other movement pattern can be."
So my approach to all clients begins with an evaluation of their current breathing mechanics and instruction on how to breathe correctly with the support of the diaphragm. We then progress to breathing with core activation and limb dissociation. While there are many approaches to teaching diaphragmatic breathing, the following is an easy method to use with most of your clients. To ensure proper diaphragmatic movement, check especially for three-dimensional movement in the thorax with minimal to no activity in the upper chest and neck throughout the movement.
1. The client lies quietly on her back, with knees bent and supported
2. While taking a deep breath in through her nose.
3. Watch the ribcage. It should be expanding front to back and side to side.
4. The breath is held for 5 seconds at the top of the inhalation.
5. The client then exhales through her mouth (relaxed lips) until all the air is out her lungs and her ribcage relaxes.
6. This position is held for 5 seconds before inhaling again.
7. Repeat for 5-10 cycles.
This should be performed a minimum of 2-3 x/day while lying supine and also while in an upright posture to ensure proper motor programming. This is a powerful way to perform physiological quieting, restore diaphragmatic breathing, and set the client up for core activation.
Conclusion: As trainers we must be invested in the longevity of our clients' health - not merely in achieving a temporary 5-10 pound weight loss they may experience because we are kicking their butts in the gym. Recall from the last newsletter: chronic pain, fatigue, injuries and illnesses are just a few of the signs that our clients are not performing at their functional capacity. Teaching and educating for proper breathing and proper core function are necessary in expanding your clients' functional capacity and helping them achieve their goals.
For more strategies on improving a client's ability to breathe and stabilize his or her core, visit our website at www.fitnesseducationseminars.com and check out Complete Core Conditioning available on two DVDs and Form and Function 2nd Edition. Both are available at Fitness Education Seminars.
diaphragmatic breathing, exercise for breathing
By: Evan Osar