Strong structures can only be built on solid foundations, so we make sure that everyone has the basics covered as far as movement is concerned. Some of the positions we check for pain or discomfort, asymmetry or inability, are the overhead squat, single-leg balance, single-leg squat, in addition to how you move lying down on your stomach or back.
The most basic, and thus the first thing we check and clear, is respiration, which we will also call diaphragmatic breathing. With balanced and strong respiratory function, you can use your deep spine stabilizing system (DSSS) to control power transfer from your legs to your arms or vice versa (i.e. walking, running, jumping, climbing, throwing, punching, kicking, etc.) Of course that power can transfer without diaphragmatic breathing, it’s just not quite as controlled or effective.
Consider the dancer; in order to move their limbs in an artistic and aesthetically pleasing way, they have to have an incredible amount of control over not only what one limb is doing, but also what the rest of the body is doing. This control is gained and maintained through countless hours of practice, but the possibility of control like this comes from “core” stability, or a stable canister.
For years it was thought that sit-ups and crunches were the exercises to do for core strengthening. Then they were found to be potentially harmful to the lumbar spine, which was the structure they were meant to protect.
So planks became very popular, as well as exercises on gym balls, and yoga, and Pilates, and all sorts of fat-blasting high-intensity routines. All of this in the name of core stability, that elusive eliminator of low back pain. The problem with sit-ups is not always that they’re harmful to the low back, but it’s definitely strengthening a less necessary structure, the rectus abdominus.
The DSSS is made up of the diaphragm on the top, the pelvic floor on the bottom, and the transverse abdominus around the front, as well as the short muscles between each vertebra. If there are visible six-pack abs, the transverse abdominus is likely to be much less active, which could potentially be a reason for spinal discomfort, particularly in the low or middle back. This is because the transverse abdominus forms a large band around the midsection, much like the labelled part of a can.
When you think about a soda can (or mineral water, because we’re healthy), it’s strongest when it’s sealed, with the top and the bottom parallel. This is how the DSSS works, when the diaphragm and the pelvic floor are parallel and directly above and below one another, and a nice, strong band of transverse abdominus to hold all that pressure where it needs to be.
So if we want to correct your breathing what are we looking for? We want to make sure that you are breathing into your belly, for starters. Have you ever watched a baby breathe? Their breath is taken into their belly. The diaphragm pulls down into the belly, filling the lungs with as much air as the baby needs.
Much of Dynamic Neuromuscular Stabilization (DNS, a rehabilitation technique used at Twin Cities Movement) is geared towards watching people move and comparing it to how a baby moves in the same pattern. So following the principles of DNS, we want to see people breathing into their belly deeply, and slowly exhaling.
If the chest moves too much, as it commonly does, it’s called paradoxical breathing. This often makes it difficult to take in a full breath, and can sometimes be related to tightness in the neck, upper back, and chest and shoulder muscles. This type of breathing can often result from respiratory disorders such as asthma, but it can also result in a desire to appear fit, with the gut sucked in and the six-pack flexed. It’s ironic that our cultural struggles to appear fit and healthy could actually be causing harm in some cases.
But I digress.
We want you to be able to breathe into your entire canister if you need to. Like a good canister, it is strongest when the pressure pushing in (your braced DSSS) equals your pressure pushing out (your diaphragm filling the cavity with air). At this point your extremities will be able to do whatever they’re capable of with the rest of you supporting and stabilizing them (like dancing, weightlifting, running, throwing).
The purpose of this article is not to scare anyone into believing that they have a problem with their breathing, but to introduce the importance of it in certain situations. Rehabilitation of an injury could be one of those situations, that’s why it’s the first thing we check after we find out what’s bothering you. The nice thing is, it can be pretty easy to check it yourself (at least for any obvious issues, and of course don’t hesitate to alert your healthcare provider if you notice anything that causes you concern).
Take a deep breath, as far down into your belly as you can. Your lower abdomen should stick out above your beltline. Take another deep breath with your hands on your sides, just below your ribs. You should feel that area filling under your hands. If you are someone who holds their gut in all the time (it’s totally ok, many of us do it, especially after pizza), you might notice some difficulty getting the lower abs to relax enough to let all of the belly out. If this is the case, lie down on your back and prepare for some relaxation.
When lying on your back, place one hand on your sternum and the other hand on your lower belly, and make sure your head isn’t tilted too far back. If it is, grab a small pillow, and make sure to tuck your chin a bit. Take a deep breath in, again aiming to fill that lower belly, let it all the way out, exhaling much longer than the inhalation. The hand on your belly should be moving up and down, but there should be little to no movement in the hand on your chest. If there is a lot of movement in your chest, start by practicing very intentional breathing into your belly. With every breath, make sure that your chest is not moving. Another way to cue this is to push a little with the hand on the belly, at that point it could be a little easier to push out against the hand.
It could take a little more attention, in which case we’re going to flip onto our stomach. In this position your forehead should be on the floor, with your chin tucked, so you’re not lying on your nose. Keep your arms at your sides. When you take a deep breath into this position, it will be difficult to move into the chest, so you can more easily take a lower belly breath. You will feel your lower back rise very slightly with each inhalation. This is called alligator breathing, and once you’ve done it long enough you should be able to flip over onto your back and breathe into your belly.
So of course proper breathing isn’t the secret key to every episode of back pain in the country, but learning how to breathe properly could be the first step to fostering the physical independence that makes a lifetime of movement possible and enjoyable, it could help take the edge off that low back soreness, it could help you relax and regulate stress (like meditation), and it could allow you to step up your game.