MINDFUL BREATHING

Our breathing habits are deeply linked to our muscle activation, posture, movement patterns, state of mind, blood pressure, stress response and so on. Let's create and reinforce breathing habits that will help us improve function, focus and regain peace of mind.

Respiratory muscles have an important postural function. Thus, adressing breathing disorders is paramount to improving posture, stability, balance and movement.

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1) BABY STEPS INTO DIAPHRAGMATIC BREATHING

Diaphragmatic Breathing, a layered cake.

 

Let's start by imagining that diaphragmatic breathing is a layered cake. As we explore and practice those layers, keep in mind that you may only add one more layer if the previous one is solid and thus, is ready to support the next one ;)

Note: You may practice standing, seated or laying on your back. If you choose to sit or stand, please activate The Thread. If you decide to practice laying on your back,

  • start with knees bent (90˚ angle) and feet flat on the ground or if you prefer, you can support your calves on a pile of thick heavy blankets (hip 90˚ + knees 90˚ angle).

  • Try to soften any excessive curvature on your spine. If possible, avoid using a pillow under your head. If you feel it's really necessary, place a folded towel under your head. As you improve the configuration of your spine you will feel comfortable without having to use any support under your head.

Diaphragmatic Breathing

- step by step -

 

Before you start, place your tongue against your palate (ceiling of your mouth) and create negative pressure (create suction) as if you wanted to slightly "drop" the ceiling of your mouth. 

  1. Breathe through your nose (in this exercise, your mouth should remain close all the time). Breathe a few times.

  2. Exhale. Make your exhalation long, calm and silent. Ideally, you want your exhalation to last at least, 8 seconds. When you exhale make sure you squeeze the sides of your lower thoracic cage (lower ribs). View from the front (use a mirror), you should see the sides of your lower rib cage "contracting" towards the mid-line of your body. As if your lower chest and upper waist became "slender". Practice step 1 and 2 a few times, until the "squeezing" of your lateral lower rib cage becomes a little easier.

  3. Now let's focus on the inhalation phase. Your inhalation should last no longer than 4 seconds.

    • What happens to your upper thoracic cage (upper  chest) during the inhalation phase? Does your upper chest elevates, expands or lifts up? This is very common in shallow breathers. This breathing pattern activates the Sympathetic Nervous System ("the tiger in the room", "fight or flight") causing a cascade of physiological responses that feed our stress response. Exhale-inhale a few times and do a self-screen. From now on, try to keep your upper thoracic cage low and quiet. When you are calm, your inhalation should fill the lower part of your rib cage, not the upper chest. Look at the mirror to make sure that the sides of your lower rib cage are "contracting and expanding" with your inhale and exhale, while keeping one hand on your upper chest to make sure that your upper chest stays quiet.

    • Does your belly raise excessively during your inhale or does it drop down? For a long time, abdominal distension was thought to be a good indicator of diaphragmatic functionality, however after scientific research on the subject, no correlation between them was found. Lateral "contraction-expansion" of the rib cage is the only reliable indicator of diaphragmatic breathing. Therefore, we suggest you do not try to "expand" or distend your abdomen when you inhale, this common practice will get in the way of your diaphragmatic breathing and will affect in a detrimental way, the stability and activation of core and pelvic floor. 

  4. At the end of the exhale, enjoy the emptiness. Allow yourself to take a break and hold the emptiness for as long as you can. At the beginning, you may only be able to hold for half a second, but gradually, you will realize that it will become easier to hold for longer (also, your exhalations will become longer and more relaxed). Practice step 1, 2 and 3, until you become familiar with them and long exhalations w/squeezing lateral rib cage become more natural.

  5. Practice all 4 steps. Gradually, exhalations with "holding the emptiness" will become longer, waaaay longer, while still keeping the inhales 4 seconds long. Breathing in this way activates the Parasympathetic Nervous System, which is responsible for a calmer state of mind, digest-absorption, healing and restoring. The goal is to practice until this breathing pattern becomes natural and you do it without even thinking about it.

Note

At the beginning, diaphragmatic breathing can feel odd or unnatural. Practice this routine on a daily basis. Soon, you will be able to exhibit a diaphragmatic breathing while sitting, standing, walking, practicing Tai Chi... and that without even thinking about it! Be patient with yourself and enjoy the journey.

Diaphragmatic Breathing

  

  1. Inhale and exhale through your nose. (01:02) 

  2. Exhale slowly (at least 8-10 seconds) and inhale (no longer than 4 seconds). (01:35) 

  3. Expansion-contraction of lateral lower thoracic cage. (02:36) 

  4. Enjoy the emptiness after the exhalation. (05:33) 

  5. "Lower thoracic cage and Parasympathetic Stimulation" vs "Shallow breathing (upper thoracic pattern) and Sympathetic stimulation"  (09:26)

  6. Summary of steps 1,2, 3 and 4. (12:10) 

  7. Practice all the time, while cooking, walking, watching TV, at the computer or when practicing your Home Routines (E.g. "The Thread", " The J", Mindful walk...). (13:46)

2) THE BREATHING WAVE

  • Lay on your front on a firm surface. Position a mirror so that you are able to see your trunk.

  • Place a couple of objects, one on your lumbar spine, the other between your shoulder blades. Ankle weights work perfect, they are comfortable, do not slide or roll over and are heavy enough so that you can "feel" them and develop lumbar and thoracic spine awareness.

  • Relax and observe both objects, their combined movements can easily reveal an existing breathing dysfunction.


Note: The Breathing Wave is a very good indicator of breathing functionality. However, this exercise requires you lay on your front. If you have troubles laying on your front or if you wish to lay on your back, seat or stand practice other mindful breathing exercises that have been adapted to those positions.


GOALS: 

  1. Exhalation should take twice as long as inhalation.

  2. Allow for a short pause between inhale-exhale and a longer pause (3 seconds minimum) between exhale-inhale.

  3. Allow the object on your lumbar spine to move up and down with your inhalation and exhalation. We do not see it on the video, but the lower ribs should expand to the sides (laterally) during inhalation, your waste should then be "widening" in all 360 degrees during your inhalation. Allow it to go back to neutral during your exhalation.

  4. Ideally, the object placed between your scapulae (shoulder blades) should barely move. The reason is that during a relaxed state there should not be a recruitment of an upper thoracic breathing pattern.

Breathing Wave

If you find it hard to perform this exercise, don't worry, we can help you regain breathing awareness and functionality. Our Breathing Assessments & Treatment Plans and our Mindful Breathing exercises were designed to help you adopt more appropriate and healthier breathing patterns. If you want to know more about it, do not hesitate to contact us.

NOTE: If your rib cage feels restricted, try the "Gentle Rib Release".

3) BREATHING AND SWALLOWING

The act of swallowing is deeply linked to posture and breathing functionality. In this 23-minute video, Dr. Roxann Diez-Gross, PhD, SLP-CCC, explains the breathing-swallowing connection and shows practical techniques for improving the coordination between breathing and swallowing. Breathing and swallowing are vital functions affected by conditions such as Parkinson Disease or COPD. However, children and young adults can also exhibit an impaired breathing-swallowing coordination.

This exercise has been designed to improve breathing-swallowing coordination, as well as shallow breathing, upper thoracic breathing and other breathing dysfunctions.

 

How is your breathing-swallowing coordination? 

  1. Sitting or laying on your back. Practice your diaphragmatic breathing routine.

  2. Be aware of the moment your body is  swallowing (saliva). Is it at the beginning, middle or end of your exhalation? Or is it at the beginning, middle or end of your inhalation? An impaired breathing and swallow coordination is usually associated to a swallowing that happens during the inhalation phase and/or at low tidal volume (when there is less air in your lungs, for example, at the end of the exhalation phase). Read.

 

Any room for improvement? To help improve swallowing functionality, practice your Body Awareness and Mindful Breathing routines. Focus on regaining a healthier posture and breathing functionality. The act of swallowing is highly dependant on posture and breathing functionality, thus improving these two aspects will have a beneficial effect on your swallowing functionality. Also, practice the next steps.

  1. You are still sitting or laying on your back, practicing your diaphragmatic breathing routine. Get ready for swallowing (collect the saliva at the back of your mouth).

  2. Once you are ready to swallow, inhale. Do not swallow yet. Finish your inhalation. At this moment your lungs should be full of air :) You can swallow now. If you need to swallow a couple of more times you can do so, as long as you are still somewhere in between the first half of the exhalation phase (in other words, as long as there is still lots of air in your lungs).

  3. Now you finished swallowing. If you followed the instructions, there should be lots of air in your lungs. Finish the exhalation.

  4. Relax. Continue your diaphragmatic breathing while "collecting" more saliva at the back of your mouth. Repeat.

 

Note: ​Do your best to AVOID swallowing at the end of your exhalation, when there is almost no air in your lungs. Also, try no to swallow during the inhalation phase, wait for the beginning of the exhalation phase.

"PD patients should assure that they have adequate air in their lungs before swallowing (same as with speech). If the lungs have sufficient air, exhalation will likely follow. I teach patients to hold a small amount of pudding or liquid in their mouths, inhale through the nose and swallow before letting any of the air out. I also teach them to be aware of the nice long exhalation that should follow. " Read

- Roxann Diez Gross, PhD