Inhale and Exhale

by Rachel Miller, PT, DPT
​   Breathing.  We all know it's important.  We all do it- in fact, an average adult takes over 17,000 breaths every day.   Even though it is something that we don't often think about, HOW we breathe is very important.  Increased stress and anxiety can activate the sympathetic nervous system, where the body is operating in “fight or flight” mode.  Diaphragmatic breathing exercises are a way to stimulate the parasympathetic nervous system, which can help rest and restore.   You can start now by inhaling for a count of three, holding it for 1 second, and then slowly exhaling for a count of four.  Repeat a few times and then continue reading.
    As a Physical Therapist, I often see breathing patterns that can contribute to someone's pain or issues.  For example, someone who breathes into their upper chest and overuses their accessory breathing muscles in their neck, will often have more neck tightness and pain.  Excessive "belly breathing" can contribute to "pressure related issues" such as hernias, diastasis recti (abdominal separation), pelvic organ prolapse, and a non-functional core.  Now you are likely thinking, well, how should I breathe?  In my opinion, I prefer 3 dimensional breathing- the lungs should expand forward- but also sideways and backwards.  3D breathing will help to mobilize the thoracic spine (upper back) and the ribs.
    A very important muscle for breathing is your diaphragm.  Your diaphragm forms the top of your inner core, your pelvic floor is on the bottom, your deep back muscles in the back, and your transverse abdominis in front.  These muscles must all work together to create a functional core- a core that is reflexive and kicks in automatically when you need it.  
    Did you know that holding your breath is one of the most common ways to "cheat" when you are exercising?  This is way to compensate for lack of core stability, and will limit your ability to engage your deep core system in that moment.  As a Pilates instructor, I emphasize the importance of breathing, and often assign a breath pattern to an exercise.   Pilates focuses on core strengthening, but also breathing, posture, and control.   It is a great way to strengthen your inner core, as these muscles are so different that many people have difficulty finding and strengthening it.   I often cue to exhale on exertion- whether that is during the hardest part of an exercise or even with lifting kids or laundry baskets around the house.  This helps to activate the deep core muscles.  Give it a try.  And give some extra attention to your breath pattern - you may be surprised with what you find.