Breathwork in Physio?

  • Posted December 16, 2021

Breathwork might not be the first thing you think of when you see a physiotherapist, but breathing can be a key player when managing pain and functional movement. Why is that?

The Respiratory System

First, a quick the lesson on the role of respiratory system.

Other than providing oxygen to our cells, breathing helps regulate many other systems in our body as well. Our breathing gets heavy when we are working harder— exhaling more CO2 to balance our body’s pH. Taking long, slow breaths can help calm our nervous system and decrease any tension and stress in our body. We also time our breathing with bracing when doing challenging tasks or exercises to protect the muscles of our core/trunk.

The muscle that helps this all happen, is our diaphragm.

Respiratory System

The diaphragm sits at the bottom of the rib cage and rests in a “curve” shape, creating a domed ceiling atop of the abdominal organs. Breathing in, the diaphragm contracts and actually flattens, pushing the abdomen out. This type of breathing is called “diaphragmatic breathing” or “belly breathing.” It’s common to find that some individuals will breath solely through their “chest,” meaning they don’t allow their diaphragm to fully contract and relax. Integrating diaphragmatic breathing can be a powerful way to change the way we feel in our body, and even our movement patterns!

Pain Regulation

There are many reasons why your physiotherapist might integrate breathing into your rehabilitation. There is good evidence to suggest that through neurological and chemical pathways in the body, deep slow breathing can have an effect on the perception of pain (1). By focusing on breathing patterns which have a physiological effect on pain perception, a physiotherapist might have a way in to “down-train,” or calm the nervous system, and teach about safe and therapeutic movements to aid in rehabilitation.

The Pelvic Floor

It’s common even in the world of pelvic floor to see a physiotherapist focus on breathing as a way to work with the muscles of the pelvic floor.

Here’s an analogy to help why:
You can imagine the trunk of the body like a pressurized cannister. The muscles of the abdomen and back are the sides of the cannister, the diaphragm the top, and the pelvic floor the bottom. When the diaphragm moves during breathing, it contracts and relaxes in tandem with the pelvic floor; the diaphragm contracts during inhalation and moves down, and so does the pelvic floor. During an exhale, the diaphragm rises up, and the pelvic floor moves with it as well.

The pairing between the diaphragm and pelvic floor has important implications. In states where their might be tension, tightness or even pain in the muscles of the pelvic floor, the breath can be a powerful way to release and relax those muscles (2).

The Core

Let’s continue on with the cannister analogy above.

It can be a common misunderstanding that the “core” is considered only the muscles of the abdominal wall, when in reality, it’s the entire “cannister.” Stability of the core tends to be the crux of many key movements (3), and when core stability is lacking, it can affect anyone from the folks lifting weights at the gym, to the elderly getting out of bed in the morning.

Diaphragmatic breathing has been found to be a key factor within the strength and conditioning world to enhance core stability (4). Timing one’s breaths during challenging activities (where the demand of the core is higher), can help synergize the muscles of the “cannister;” allowing them to work together to accomplish a task.

There’s a saying in our world- proximal stability helps distal mobility. The use of the breath can help stabilize the proximal aspect of the body—the trunk, to allow for the ability to the distal parts of the body safely and effectively—the arms and legs.

Pretty neat, huh?


Physiotherapist Can Help Train Your Breath

It might seem like a ridiculous thing to need to work on one’s breath, I mean we’ve all been breathing from the start, how hard can it be!? But life happens, and it’s too easy to get stressed or get distracted.

The good news is, there are always tools to help us get back on track.

If you’re interested in learning more about how your breath can help heal your body, book in with our physiotherapist Isha. Ask how we can incorporate your breath into your treatment plan and use its benefits for getting you back to doing the things you love!

1. Busch V, Magerl W, Kern U, Haas J, Hajak G, Eichhammer P. The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing–an experimental study. Pain Med. 2012 Feb;13(2):215-28. doi: 10.1111/j.1526-4637.2011.01243.x. Epub 2011 Sep 21. PMID: 21939499.
2. Park, H., & Han, D. (2015). The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing. Journal of physical therapy science, 27(7), 2113–2115. https://doi.org/10.1589/jpts.27.2113
3. Panjabi, Manohar M. The Stabilizing System of the Spine. Part I. Function, Dysfunction, Adaptation, and Enhancement, Journal of Spinal Disorders: December 1992 – Volume 5 – Issue 4 – p 383-389
4. Nelson, Nicole MS, LMT Diaphragmatic Breathing, Strength and Conditioning Journal: October 2012 – Volume 34 – Issue 5 – p 34-40 doi: 10.1519/SSC.0b013e31826ddc07

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