Module 4: Step 1 = “Breathe”
Welcome to Step 1 of the ‘7 Steps to Fixing Abdominal Separation’ online instructor program.
Breathing is a step NOT to be missed in the rehabilitation process of fixing diastasis recti and this is why it’s number 1 in the 7-Step ‘Breathe’ Principle™.
Webinar 1 – Breathe Principle – Step 1 – Breathe
PASSWORD TO VIEW THIS VIDEO = breathe
The average person takes between 17,280 – 23,040 breaths per day.
That’s approximately 16 breaths per minute at rest.
Breathing is the simple act of receiving oxygen into the body.
The diaphragm is a flat, dome-shaped muscle that separates the thoracic from the abdominal cavity.
In order to get oxygen to come into your body, you have to drop the pressure that is within your thoracic cavity, by increasing the capacity of the thoracic cavity.
There are 3 ways you can breathe.
- Elevate the shoulders (chest breathing)
- Let the abdomen release out in front of you on the inhalation (belly breathing)
- Widening the rib cage using the intercostals muscles (rib cage breathing)
HOW DO THESE BREATHING TYPES AFFECT THE BODY?
- Chest breathing = where someone elevates the shoulders to enable the inhalation to occur. This is not ideal, because you end up holding a lot of tension in the neck and jaw, and this can result in cervical vertebrae disc damage.
- Belly breathing = where the diaphragm drops DOWN into the abdominal cavity. This increases the space in the thoracic cavity, making the space larger to enable breathe to come in. Sounds good, but it isn’t.
If effect, you’re increasing the space in the thoracic cavity but decreasing the space in the abdominal cavity because the diaphragm is dropping DOWN into the abdominal cavity. You can deal with the pressure via belly breathing in a few ways:
- You can let the abdomen release OUT in front of you, commonly known as belly breathing, or
- You can take the continuum of increased pressure in the abdomen and push it DOWN onto the pelvic floor.
So, when you breathe only with your diaphragm, you have a high level of intra-abdominal pressure and an increase in pelvic pressure. This repeated way of breathing is like a plunger on the organs of your pelvis.
Belly breathing can also leave your spine vulnerable because it causes a relaxation of the transverse abdominus muscles – the very muscles that are supposed to be supporting your spine.
- Ribcage breathing is a widening of the ribs on inhalation. There are muscles in between each rib called the intercostal muscles that enable the ribs to move out to the side. Breathing this way enables the volume of air in the thoracic cavity to become greater (increasing its circumference), without any downward plunging, or upwards neck tension.
EXERCISE OF DISCOVERY
Take a few moments out of your day right now to see which breathing category you fall into.
The more you understand the mechanics of this yourself whereby highlighting the changes required in your own body, the easier it is for you to relay this information on to others.
Experiment with rib lifting (see first chapter) and then try breathing by:
- Elevating the shoulders,
- Letting the abdomen push out in front of you,
- Using the diaphragm to push downwards, and
- Allowing the intercostals to widen the ribs
LINK BETWEEN BELLY-BREATHING AND DIASTASIS RECTI
Think back to the section on rib lifting and all you’ve read so far about increases in pressure gradients here in the breathing section.
There is a significant link between how a pregnant woman’s body is in alignment and how effective her breathing patterns are.
Diastasis recti doesn’t just suddenly happen – it’s a gradual process of misalignment, malfunctioned breathing and too much pressure building up in the wrong areas.
Thrusting the ribs forwards compresses the posterior (back) part of your ribcage, leading to a decreased amount of space in the thoracic cavity to enable you to breathe properly.
With belly breathing, in effect, you’re allowing the diaphragm to drop DOWN into the abdominal cavity, decreasing the space in the abdominal cavity.
When a pregnant woman habitually starts rib cage lifting and adopt a belly breathing pattern, pressure will build up and up in the wrong areas, until there’s nowhere else for it to go.
IS BELLY BREATHING EVER APPROPRIATE?
Belly breathing is oftentimes used in association with relaxation, because it helps the diaphragm relax
When babies breathe themselves, they do so using a belly breath, but this is when they’re lying down on their back.
When dealing with the postnatal client, whose breathing mechanics are already non-optimal attributing to their diastasis and built-up intra-abdominal pressure, belly breathing is not recommended, unless supine when the spine does not need support from the transversalis muscles at the front.
LINK BETWEEN DIASTASIS RECTI AND PELVIC FLOOR DYSFUNCTION
Studies* show that 66% of women who have diastasis recti also report some form of pelvic floor dysfunction.
If you come across a client who has both of these conditions, take it as a red flag, because her pressure gradient system and alignment is way off.
Spend time getting her to breathe correctly, fix her faulty alignment mechanics and decrease the pressure off of the pelvic floor and you’re on to a winner.
*There is little research on this condition; Boissonnault & Blaschak (1988) found that 27% of women have a DRA in the second trimester and 66% in the third trimester of pregnancy. 53% of these women continued to have a DRA immediately postpartum and 36% remained abnormally wide at 5-7 weeks postpartum. Coldron et al (2008) measured the inter-recti distance from 1 day to 1 year postpartum and note that the distance decreased markedly from day 1 to 8 weeks, and that without any intervention (e.g. exercise training or other physiotherapy) there was no further closure at the end of the first year. In the urogynecological population, 52% of patients were found to have a DRA (Spitznagle et al 2007). 66% of these women had at least one support-related pelvic floor dysfunction (stress urinary incontinence (SUI), fecal incontinence and/or pelvic organ prolapse). (Spitznagle et al 2007)
HOW DO I TEACH THORACIC BREATHING?
There are several ways you can teach your postnatal clients to breathe into their thoracic cavity.
VIDEO – Me demonstrating 7 techniques you can use to teach your clients to breathe into their thoracic cavity
Remember: there’s more than one way to peel an orange, so you may have to cycle through a few of these techniques with each client you rehabilitate, before finding the one that works best for them.
EXERCISE OF DISCOVERY
After reading through the above information, how do you think you breathe? Are you a chronic chest or belly breather?
There are ways of opening up the intercostals making it easier for you to breathe into the thoracic cavity.
Try out this stretch here:
Start by shuffling your hips over to the right.
Then, move your legs to the left and cross the right foot over the left.
Raise your arms and move them over to the left to make a C-shape with your body. Keep the ribs down and feel the tension release in your obliques.
NOTE: if you have particularly tight shoulders, perform the same stretch in standing if that feels more attainable.