Fatigue in Breathing Muscles Associated with Low Back Pain
Thursday, May 27, 2010 at 9:31PMA Word of Support for Breathing Exercises
I frequently talk to patients about the importance of breathing exercises in relationship to general wellness and also to back pain. It is a hard sell and people often seem to put much stock in utility of a focus on breathworks.
Several recent studies have bolstered the case for breathing exercises as a tool for management of back pain. One study published in the Australian Journal of Physiotherapy reported that “disorders of breathing are related strongly to recurrent low back pain.[i] Other studies suggest that respiration can impose a significant disturbing effect on balance in people with low back pain.[ii]
These studies establish groundwork for things that teachers or Yoga or Tai Chi have known for a long time. "Regulate the breathing, and thereby control the mind" (B.K.S. Iyengar).[iii] We might substitute, regulate the breathing, and thereby control the back.
A study published in the May 2010 edition of Spine looked at the relationship of inspiratory muscle fatigue to postural control in people with low back pain. The authors found that after fatigue of inspiratory muscles subjects used “a rigid proprioceptive postural control strategy, rather than the normal “multisegmental” control.”[iv] Sounds complicated.
The long and the short of it is that fatigue in our breathing muscles has a “negative effect on postural stability.” [v] This was true in healthy subjects (people without low back pain) and true to an even larger degree with low back pain symptoms.
So, if we use a less efficient, less effective method of stabilizing the lumbar spine when our breathing muscles are tired, how do we keep them from getting tired – exercise.
That exercise takes the form of breathworks – exercises that develop control and endurance in breathing muscles. I have referenced some basic breathing exercises in a related post (http://digg.com/d31SLIs).
A few of my favorite breathing exercises include:
Relaxing Breath Technique: [vi]
This breathing exercise can be done twice a day or more frequently when the mind focuses on experiencing pain.
- Place one hand on the chest and the other on the abdomen
- Inhale through the nose. Imagine that as a deep breath is taken in the hand on the abdomen should rise higher than the one on the chest. The goal is to have the diaphragm pull air into the bases of the lungs.
- Exhaling through the mouth. The hand on the abdomen should sink as the breath is moved out.
- Idealized rhythm for abdominal breathing:
- Breath in to a count of 7
- Hold the deep breath for a count of
- Slowly exhale through the mouth for a count of 8
- As all the air is released with relaxation, gently contract the abdominal muscles to completely evacuate the remaining air from the lungs.
- Repeat the cycle four more times for a total of 5 deep breaths. If possible, try to breathe at a rate of one breath every 10 seconds (or 6 breaths per minute).
Stimulating Breath (or bellows breath): [vii]
This breathing technique can be used to improve energy throughout the day. For example, it could be used during times of fatigue that may result from driving over distances or when you need to be revitalized at work. With this technique short, fast rhythmic breaths are used to increase energy, which are similar to the "chest" breathing we do when under stress.
- Sit in a comfortable up-right position with the spine straight.
- With the mouth gently closed, breathe in and out of the nose as fast as possible.
The analogy for this breath is a bellows. The upstroke of the bellows action can be compared to inspiration. The downstroke is exhalation and both are equal in length.
It is recommended that the rate of breathing can be as rapid as 2-3 cycles of inspiration/expiration per second.
While doing the exercise, you should feel effort at the base of the neck, chest and abdomen. The muscles in these areas will increase in strength the more this technique is practiced. This is truly an exercise.
- It is recommended that this exercise be done for no longer than 15 seconds when first starting
- With practice, the length of the exercise can be increase by 5 seconds each session
- The breathing exercise should not exceed one full minute.
These exercises while they sound subtle can be very powerful tools. As with all things, any new exercise should be undertaken under the guidance of a physician. Try these simple exercises and you will notice dramatic results if they are done consistently.
[i] Aust J Physiother 2006; 52: 11-16
[ii] Clin Biomech 2002; 17:548-550
[iii] http://www.egreenway.com/taichichuan/chi.htm
[iv] Spine 2010; 25(10): 1088-1094
[v] Spine 2010; 25(10): 1088-1094
Reader Comments (1)
This is a very informative post as it stated the different informations that we need about the breathing exercise.
This could really a lot of people specially to those who have some health problems in heart or other pulmonary issues. I too thank you for this post, since I am an asthmatic one these tips of yours really help.
A many thanks once again.