Monday, 1 July 2019

Muscles of Breathing

Muscles of Breathing

Any muscle that attaches to the thorax can potentially assist with breathing. Many of these muscles are involved in the movement of the upper and lower extremities as well as stabilization of the spine and thorax. These muscles only come into play during increased exertion or forced breathing. If you take a deep breath as you are reading this text, you are using some of these accessory muscles.

Primary and Accessory Muscles of Breathing

Muscles involved in quiet breathing are the diaphragm, scalenes, and intercostals. The diaphragm is the most important muscle of the group. It provides 60 to 80 percent of the breathing power through its ability to increase the volume of the rib cage in three dimensions. The diaphragm is the first muscle to be activated during inspiration. Initially, the contraction of the diaphragm causes its dome to descend and flatten. This descent is possible only because the inferior ribs are being held downward toward the pelvis by the quadratus lumborum muscle. If this were not the case, contraction of the diaphragm would pull the inferior ribs upward and the dome of the diaphragm would not descend.

At a certain point during inspiration intra-abdominal pressure, the resistance of the abdominal muscles, and elasticity of the thoracic contents stop the descent of the diaphragm. The continued contraction of the diaphragm now serves to lift the six lower ribs. Intra-abdominal pressure also pushes the lower ribs and rib cartilages outward, providing circumferential expansion of the basal rib cage.

Abdominal Muscles and Breathing

The body wall extends from the first rib down to the pelvic floor. The rib cage provides strong reinforcement and stability in the thoracic area, while the pelvis provides a stable ring at the inferior end of the spine. The body wall in between these two areas is made of the abdominal muscles and associated fascia (figure 1).

Muscles of Breathing

This lack of bony restrictions in the lumbar area enables breathing with a diaphragm, which requires a flexible abdominal wall. It also helps to lengthen your stride, because the pelvis is freed up to swing and rotate, assisting your legs in swinging forward. Breathing and gait are intimately connected through these mechanisms.

The four abdominal muscles are the rectus abdominis (RA), the external and internal obliques (EO; IO), and the transversus abdominis (TA). They need to fulfill many simultaneous functions, such as breathing, stability, force absorption, load transfer, and movement. No matter what type of exercise or training you are doing, these activities need to be controlled in a balanced and efficient manner. The EO and I both serve to depress the ribs in forced exhalation. They are rotators of the spine and contract eccentrically during inhalation. The TA is the mediumst muscle in the body, performing many simultaneous tasks. It originates in the back by the posterior and anterior layer of the thoracolumbar fascia (TLF). The upper TA interdigitates with the diaphragm, indicating its intimate function in breathing. The TA functions as a contractile tube surrounding the abdominal viscera. It works antagonistically with the diaphragm to help the organs move inward and upward during exhalation in all but the supine position. The TA is a stabilizer of the lumbar spine through its connections to the TLF. Its fascia splits into the sheaths that surround the erector spinae. Anteriorly it forms the posterior wall of the rectus sheath. The TA effectively can reinforce the posterior and anterior body wall while it participates in breathing (figure 2).

Muscles of Breathing

The Core and Breathing

balanced core. The diaphragm is not just a breathing muscle; it helps to stabilize the rib cage when you elevate your arms and modulate intraabdominal pressure. Gripping the abdominal muscles in an effort to stabilize your spine activates many muscles that are not essential for core stability or breathing and may actually impede proper core control. The instruction Pull your belly button in towards your spine keeps the diaphragm from moving in its full range. Over time the result may be a thickened diaphragm caused by a constant shortening of its fibers. Breathing efficiently will help reach the goal of a slim waistline by teaching the diaphragm and abdominals to lengthen and shorten more fully. In yoga, dance, Pilates, or another exercise system it is important to practice the integration of breathing and stability with movement (figure 3).

Muscles of Breathing

The stability function should not be given primacy to the detriment of efficient breathing. In truth, efficient breathing is a sign of biomechanically sound core control. The following are 11 exercises and imagery explorations for the breathing muscles.

Experiencing the Abdominal Muscles and Breathing

In this exercise, you will practice synchronizing breathing, stability, and movement functions of the abdominal muscles.

1. Start in a standing position. Place your fingertips below the ribs and above the pelvic crest at the side of the body. Gently push inward. Cough, laugh, or make a loud ha sound, and notice the strong contraction of the abdominal muscles. These muscles are helping to pull down the ribs and narrow the waistline to assist the ascent of the organs.

2. Keep your fingers in the same place, and inhale deeply. Notice that your fingers are being pushed outward. As you slowly exhale, feel how your fingers are moving inward. You are experiencing the lengthening and shortening of the abdominal wall muscle (figure 4). 

Muscles of Breathing

Breathing is the 24-hour conditioning of these muscles.

3. Practice gripping your abdominal muscles. As your finger test will demonstrate, the abdominal wall moves outward to a greater degree than when you fully exhale. Too much tension will not permit the abdominal muscles to slim your waistline while exhaling will.4. With your fingers in the same area, rotate your spine to the right and left. Laterally flex your spine to the right and left. You will feel the same muscle contracting, in this case to power movement. 

5. Now, prepare to integrate movement and breathing functions. Allow the abdominal wall to move outward and inward with your breath, but at the same time perform spinal rotations and spinal lateral flexions. Notice your breathing by feeling the fingers move out and in. Allow the abdominal muscles to change simultaneously in response to breathing and your movement.

Integrating Stability, Movement, and Breathing

The following exercise can be quite challenging, especially if you have been holding your breath whenever your balance or coordination has been challenged. Practicing the following steps helps you to gain awareness of more efficient breathing concurrent with stability and movement activity.

1. Start in a standing position. Place your fingertips below the ribs and above the pelvic crest at the sides of the body. Notice how your fingers are being pushed outward during inhalation and moving inward again during exhalation.

2. Lift your right foot off the floor; you are now balancing on one leg. Did the lifting of the foot cause you to grip your breathing? Are the abdominal muscles still moving in response to breathing? Remember, the TA especially can help with stability while allowing movement for breathing.

3. To increase the challenge, you can shake the leg that is off the floor. The shaking movement will challenge the stability muscles. The TA will increase its tone as it aids the stabilizing of the lumbar spine and pelvis. However, it still needs to move in response to breathing. 

4. Repeat this exercise with the other leg.

5. Perform Pilates, yoga, or dance movement or your favorite exercise
with the aim of allowing unhindered breathing.

The Intercostals in Breathing and Movement

The intercostals comprise three layers of muscles that span the area between two ribs. Even though the function of the intercostals is not fully understood, most likely the external intercostals, as well as the anterior (sternal) fibers of the internal intercostals, are muscles of inspiration. The internal intercostals are muscles of forced expiration. 

1. To begin, stand or sit upright. Place the tips of your thumbs between two ribs at the right and left the side of your thorax. Inhale and exhale, and feel how the ribs above and below your touch lift upward and move laterally.

2. Exhale forcefully, feeling the contraction of the internal intercostals between the ribs.

3. With your thumbs remaining between two ribs on the right side, laterally flex your spine to the left. Notice how the ribs on the right are moving apart (figure 5). 

The intercostals are being stretched on the right side; on the left side, the ribs are moving together. The movement of the ribs is a result of the lateral flexion of the spine, which spreads the ribs on the contralateral side and brings them closer together on the ipsilateral side.

4. Laterally flex the spine to the right, and notice how the ribs on the left are spreading apart and the ribs on the right are moving together. The intercostals are being stretched on the left.

5. Now practice combining the movement function of the ribs with their breathing function. Perform lateral flexion with the goal of sensing the movement of the ribs in response to breathing as well as the movement you are performing.

How the Scalenes Support Breathing

The scalene muscles are located between the cervical spine and the upper two ribs (figure 6).

They can lift the upper two ribs, increasing the inner thoracic volume. With-out the upward pull of the scalenes, the descent of the diaphragm during inhalation would reduce the potential space for ventilating the lungs. They are therefore active whenever the diaphragm contracts. The scalene muscles also have the ability to laterally flex the neck.

1. Gently place your fingertips on the sides of your neck. Flex and extend your head and cervical spine. The sternocleidomastoid will be active by this movement and become prominently palpable on the side of the neck. If you feel it just in front of your fingertips, you are in the general location of the scalene muscles.

2. As you inhale, slide your fingers gently upward along the side of the neck to assist these muscles in lifting the top ribs (figure 7).

3. As you exhale, slide your fingers downward again.

4. Repeat the upward slide during inhalation and downward slide during exhalation three times. Notice whether you can breathe more fully when assisting the scalenes with your imagery and touch.

5. To fully appreciate the correct anatomical function, it is sometimes helpful to perform the incorrect function. During inhalation slide your fingers down along the scalenes, and notice what happens to your breathing.

6. Finish the exercise by sliding your fingers upward on inhalation while also laterally flexing your neck to the right and left. The scalenes are now involved in both breath and movement.

7. Remove your touch, and notice changes. Most likely your posture is more erect and your breathing has deepened.

The Quadratus Lumborum in Breathing

The quadratus lumborum (QL) muscle attaches to the iliac crest, the first to fourth transverse processes of the lumbar spine, and the lowest rib. It can elevate the pelvis and laterally flex the spine. In breathing it serves to anchor the lowest rib to the pelvis, assisting the descent of the diaphragm.

1. Place your hands on the posterior lower rib cage. Visualize the 12th rib below your hands (figure 8).

2. As you inhale, slide your hands down the back toward the pelvis to support the function of the QL for breathing. Imagine the 12th rib being pulled down toward the pelvis.3. As you exhale, slide your hands back up again. 

4. Repeat the sliding and imagery three times. Notice whether the touch and imagery deepen your inhalation and lengthens your exhalation.

First and 12th Rib Movement

Creating awareness of the first and 12th ribs helps to increase the space available in your thorax for breathing. As you inhale, the first rib circle is being pulled upward by the scalenes; at the same time, the 12th rib is being anchored in the opposite direction by the QL. This pull in opposite directions maximizes space in your thorax.

1. Place one hand close to your first rib circle. Place your fingers just below the clavicles where they attach to the sternum.

2. Put your other hand on the lower back in the general area of the 12th rib (figure 9).

3. As you inhale, imagine the first rib circle floating upward, while the 12th rib is dropping down toward the pelvis.

4. When you exhale, simply relax your mind and your touch.

5. Repeat the touch and the imagery three or four more times. Rest, noticing changes in your breathing such as a more relaxed and lengthened exhalation.

Ribs Coordinating With Diaphragm

The descent of the diaphragm is like a piston moving downward in its shaft. When the piston stops moving down due to the resistance of the abdominal muscles and the organs, the diaphragm assists in elevating the ribs. Both the descent of the diaphragm and the lifting of the ribs are concentric (shortening) muscle contractions of the diaphragm (figure 10). 

When you exhale the lowering of the ribs and the ascent of the diaphragm are eccentric (lengthening) actions of the diaphragm.

1. Create a model for the diaphragm and rib movement using your arms and hands. Your hands and lower arms are the domes of the diaphragm; your upper arms are the ribs.

2. Place your hands on top of each other and in front of the lower part of the sternum. Hold the elbows to the sides.

3. As you inhale, move your hands down to model the descent of the diaphragm. Mid-breath the elbows and upper arms lift to model the movement of the ribs.

4. As you exhale, perform the reverse. First, the elbows and upper arms move down (the ribs), then the hands move up (the diaphragm).

5. Practice inspiration and expiration with the hand model to appreciate the coordination of diaphragm and ribs.

Using a Band to Train the Muscles of Breathing

Using a band, such as a Franklin Method medium-strength band, can be an effective means to stretch and strengthen the muscles of breathing.

1. Start the exercise in a standing position with a fairly wide stance. Place the band around the middle of your back near the thoracolumbar junction. Exhaling, flex your spine while pushing into the band as if it were a hammock (figure 11).

2. Inhaling, return your back into extension. Use the band to push the back forward and gain more stretch. 

3. Repeat this action four times, and return to the starting position.

4. Now exhaling, laterally flex your spine to the left by pushing the right side of your rib cage into the band. Your hands with the ends of the band move to the left.

5. Returning to the starting position, inhale.

6. Exhaling, laterally flex your spine to the right by pushing the left side of your rib cage into the band. Your hands now move to the right.

7. Repeat the action four times. Remove the band, and rest. Notice any changes in your breath and posture. Most likely your rib cage feels relaxed and your posture has improved.

8. To increase the stability challenge, also perform the exercise while standing on balls. This challenge will increase the tone of the core muscles. Maintain your breathing rhythms, even now.

Stretching Your Diaphragm and Intercostals With Balls

1. Balls are helpful to stretch the muscles of breathing. In this supine exercise, use a Franklin Method water-filled mini roller to this effect. You can also use a rolled towel or two softballs placed next to each other beneath your back.

2. Lie in the supine position and place the mini roller under your middle thoracic spine (figure 12).

3. Place your hands behind your head for more support.

4. Extend your spine, and lower your head to the floor.

5. Imagine and feel the stretch of the diaphragm. The sternal and rural parts of the diaphragm will be stretching especially. The anterior intercostals will be stretching as well.

6. Inhale and exhale fully to increase the stretch and toning of the diaphragm.

7. Wiggle and move your spine while breathing fully. This action stretches the fibers of the diaphragm in many directions.

8. Remove the ball and rest. Notice changes in your breathing. Your spine may feel lengthened and your shoulders more relaxed as well.

Jumping With Your Breath

Not all breathing exercises need to be of a quiet nature. In this exercise, you will practice the movement of the diaphragm and pelvic floor during jumping. This exercise is an example of applying your knowledge of breathing to a more challenging situation.

1. Focus on the movement of the diaphragm—down as you inhale, up when you exhale.

2. Jump up and down. Whenever you land, exhale and visualize the diaphragm rapidly moving upward (figure 13).

3. Inhale when you jump up.

4. Also, try the opposite: Inhale as you land, and exhale as you jump. Mostly it will feel less comfortable and more challenging. When you exhale on landing, the downward movement of the body is tempered by the upward movement of the diaphragm, allowing for a smoother and more stable landing.

Daily Practice

Having a daily routine to create more optimal breathing is one of the most important activities you can do to improve your movement skills and health. Following is a selection of exercises from this book for your daily practice. However, any exercise that you have found beneficial should be added to your daily routine. Also practice breath awareness during your daily life activities, exercises, and sports.

1. Visualizing the Diaphragm: Visualize the movement of your diaphragm. It moves downward during inhalation and upward during exhalation. Do this visualization with hand modeling. This exercise is effective whenever you feel you need to center yourself, calm down, or make sure you are breathing efficiently. You can also combine the awareness of the diaphragm with the movement of the abdominal wall.

2. Shaking the Diaphragm to Increase Circulation and Proprioception: This is a fabulous way to release tension in your diaphragm and your whole body. Do not go a day without doing this exercise. Athletic teams, gymnasts, and swimmers have added this exercise to their daily routine and use it to limber up before competition.

3. Stretching Your Diaphragm: This is the best stretch for the muscles of breathing. Over time it will improve your breathing capacity.

4. Tapping the Rib Cage: Tapping the origins of the diaphragm as well as the rib cage and back helps to release tension and free your breathing for greater efficiency. You can perform this exercise with loose fists or with Franklin Method or any other softballs.

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