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Breath as movement, breath as massage

[alternative title, kindly offered by a friend, "Have I been breathing wrong my whole life?!"]

A few days ago, I had the unfortunate incident of hearing myself sing whilst on the bike. It was towards the end of a session, a particularly fun chorus, and the music wasn't loud enough to cover the fact that I have never had singing training. I really have not given performers the full respect they deserve for being able to move around on a stage whilst singing in tune.

Saying that, it has always struck me how overlooked the breath is, given it's one of the few things our lives literally depend on; whilst most of us don't expect to add a weight to our squat before we can do an air squat, most of us expect to be able to do cardiovascular training (i.e. things that get your breathing rate up) without examining our breathing patterns at rest. And yet, it took me a long time to find clients who were interested in breathwork or even in following my breathing cues during exercise.

The thing is, breath is movement. If you are lying down, doing "nothing" - asleep, or watching TV, or mindlessly scrolling through Instagram - maybe feeling guilty about not getting enough movement - just focussing on breathing slightly more efficiently is an easy way to infuse your day with a bit more high-quality movement.

If breath is movement, then breath is also massage, because massage is simply the application of movement to our tissues - so if we value our regular (or irregular!) massage sessions, we really could give ourselves the gift of daily massage just by learning to breathe in the appropriate way.

So why isn't it enough to just... keep breathing, the way we always have done? Why am I still trying to make a point, when we sort of have no choice but to breathe?

Let's start by introducing the two types of breathing:

abdominal breathing (also called belly breathing, or diaphragmatic breathing), and

chest breathing.

Abdominal breathing is, simply, the way we were "meant" to breathe. On a recent course I attended, the instructor made the point that "we don't breathe, we allow breathing to happen", which is a very accurate way to put it. If our bodies are functioning without restrictions, diaphragmatic breathing is what happens. Conversely, if diaphragmatic breathing isn't happening for whatever reason, breathing becomes a more strenuous activity, which will result in muscle tightness, namely around the chest, neck, shoulders, and upper back.

The diaphragm is a thin, dome-shaped muscle (think half an inflated balloon) that sits roughly in between our ribcage and belly, separating what we refer to as the thoracic cavity and the abdominal cavity; i.e., the space your lungs take up and the space your guts take up. More specifically, it attaches to the inside of your six lower ribs, and your upper two or three lumbar vertebrae (i.e. the spine at the top of your lower back). So even without going any further, just considering the very basic anatomy of the diaphragm, and bearing in mind that movement is critical to tissue health, might spark some thoughts about how diaphragmatic breathing may be linked to back pain or digestive issues.

Moreover, there are openings in the diaphragm for veins and arteries (namely the vena cava and the aorta, through which blood circulates to and from the entire body), lymphatic vessels (essential components of our immune system), the esophagus (which our food passes through into the stomach) and the vagus nerve, which has many functions but gets most of its attention these days for its role in promoting the "rest and digest" nervous system response (as opposed to the "fight or flight" stress response). If these structures pass through the diaphragm, it is reasonable to expect that the function of the diaphragm will affect the function of these structures.

If that sounds like a lot of information... it is. Basically, diaphragmatic breathing - or the lack thereof - can have effects on our circulation, immune system, digestion, lower back pain, and stress levels.

It's also worth mentioning that the diaphragm acts as the "lid" of a container housing our organs and incorporating key parts of our musculoskeletal system. The rest of the container is formed by our back muscles, our abdominal muscles, and our pelvic floor. Like any container holding together fluids and soft substances, if one of those sides is compromised, the contents are no longer secure. Now obviously this doesn't mean that if you are a chest breather your guts will leak out of you... but it does mean that a dysfunctional diaphragm could lead to urinary stress incontinence, in the same way that dysfunctional abdominal muscles can lead to lower back tightness and pain. Extend that just a little, considering that your pelvic floor will help stabilise the pelvis, which will have a knock-on effect on your glutes, hamstrings, hip flexors... and it's not that much of a stretch to claim that "faulty breathing" could cause sports injuries like runner's knee, or impact your performance in any other way, in addition to the upper body issues I mentioned above.

Back to the self-massage-through-breath concept: everything is, as you no doubt are aware, quite snugly nestled into our abdominal cavity (which really isn't much of a cavity, since it is filled with organs), so every time we inhale - diaphragm relaxing, expanding the chest cavity and compressing the

abdominal cavity - we are giving all those organs a gentle squeeze. When we exhale, the change in pressure draws in fresh blood and fluids, "flushing out" our tissues, if you will. Like all tissues, our organs need movement but sometimes things get restricted - a blockage in the intestine, for example - in the same way that we might get massage for a "knot" in our shoulder or a "stiff" lower back, we can benefit from massage to our visceral organs. Whilst some practitioners (usually osteopaths, as far as I am aware) perform this manually and specifically, simply taking a few deep breaths can provide a much-needed bit of relief for tension in the abdomen.

There is so much more that could be written about the functions of the diaphragm and knock-on effects (I didn't even get onto shoulder mobility!), but what we all want to know is am I breathing correctly or not?

While it's impossible for me to know without seeing you, and even then I am nowhere near an expert in respiratory rehabilitation, here are some things to consider:

  • have you been pregnant, beyond the 2nd trimester? if so, there is a high likelihood you developed "faulty breathing" as a result of the baby pressing the diaphragm upwards (which you'll have no doubt been aware of at the time!), and there's a high likelihood that breathing pattern didn't just revert to diaphragmatic breathing after pregnancy

  • do you have a tight mid back?

  • do you suffer from headaches, jaw pain, neck or shoulder pain?

  • do you often find yourself sighing or needing to take a big deep breath?

  • do you feel chronically stressed, or do you suffer with anxiety or panic attacks?

  • do you suffer from IBS or other digestive issues?

  • do you struggle to follow breathing practices, for example pranayama in yoga?

Answering "yes" to any of one of these questions does not mean you are breathing inefficiently, nor does it mean that there is any direct causal link between your breath and your symptoms; however, it is worth investigating whether you can improve your breathing habits.

Here are a couple of simple exercises you can try, if you don't already have a breathwork practice:

  1. Lie on your back, with one hand on your chest and one hand on your belly. Breathe, however you wish. Observe which hand rises first, and which hand rises most. See if you can make the hand on the belly rise before the hand on the chest.

  2. Lie on your front, perhaps with a thin cushion or folded towel or blanket under your belly (definitely add that if you have lower back pain). Breathe deeply, focussing on feeling your lower back rise. You may feel your belly pressing into the floor or cushion/towel/blanket, but try not to actively tense the abdominal muscles and instead encourage the breath to inflate the back.

If you are already confident in your ability to breathe diaphragmatically, I highly recommend practicing kapalabhati ("skull-shining breath") which is a more vigorous form. It will be incorporated into appropriate yoga asana practices, but you can view a tutorial on Yoga Medicine Online (you will need a membership, but you can get a free 7-day trial - or you can view this video on YouTube).

There are of course, limitless creative and fun ways to incorporate breathwork into your existing movement practice or training, which will enhance your ability to move safely and efficiently. Please do share any links or suggestions in the comments below, or as always, feel free to reach out with any questions that this post may have sparked. Happy breathing!

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