Breathing and trunk stability

It is estimated that as many as 80% of Americans will suffer from some form of low back pain during their lifetime (Clark & Lucett, 2011).  Low back pain can be caused by many different factors, including postural changes over time due to prolonged time spent in one position (such as sitting), acute trauma, and lack of trunk stability.  There are many muscles that contribute to trunk stability, but one of the most frequently overlooked muscles is the diaphragm.  According to John Hopkins School of Medicine, the diaphragm is the primary muscle for inspiration (http://oac.med.jhmi.edu/res_phys/Encyclopedia/Diaphragm/Diaphragm.HTML).  It functions as a balloon and inserts into the lower ribs.  When you inhale, the diaphragm presses down and spreads out, increasing abdominal pressure, which increases trunk stability.  Boyle, Olinick, and Lewis (2010) point out suboptimal breathing patterns and postural impairment often lead to complaints of low back pain.  They suggest implementing a therapeutic exercise program that promotes proper positioning of the diaphragm and lumbar spine and enhances neuromuscular of the deep abdominals, diaphragm, and pelvic floor.

Improving diaphragmatic breathing can be done a number of ways.  An easy way to focus on breathing is to lie down on a bed or on the floor in a supine (face up) position.  Start with your knees bent and your feet on the floor.  Place your hands at the crease of your belly and hip, slightly in fro the hip bones.  Inhale, filling the belly all of the way down into your finger tips.  Exhale normally.  Perform 10 rounds of this.  Then, move your hands out so they are just above the hip bones.  Inhale, filling the lowest part of the belly and allow your belly to expand outwards, so the skin presses against your fingers.  Exhale passively, without force.  Perform 10 rounds here.  Now, elevate your feet so they are resting on a ball or chair (your knees should be at a ninety degree angle with your hips).  Perform the same breathing patterns as described above, first focusing on breathing into the hands in a more forward position, then breathing into the hands to expand the belly outwards.  Eventually, you should be able to elevate your legs without resting them on anything and perform your breathing with the trunk stabilizing the legs.

Working on breathing for 3-5 minutes a day will begin to re-establish proper breathing mechanics and begin to restore trunk stability.  Focusing on diaphragmatic breathing also stiulates the parasympathetic nervous system, resulting in a calming effect.  Breathe for a healthier back and a calmer mind.

Yours in health and wellness,
Jenn
www.bewellpt.com

P.S.- Please feel free to contact me with questions regarding exercise or topics you would like to see covered.  I can be reached at pilottij@gmail.com


Clark, M.A., & Lucett, S.C., (2011).  NASM's Essentials of Corrective Exercise Training.  Lippincott Williams and Wilkins: Philadelphia.
Boyle, K.L., Olinick, J., & Lewis, C., (2010).  The value of blowing up a balloon.  North American Journal of Sports and Physical Therapy, 5(3), pp. 179-188.