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Jared Woolever

PRI In-Service (Part 2)

frau blst einen roten luftballon auf

If you missed Part 1, be sure to check it out here: http://smartgrouptraining.com/an-introduction-into-the-postural-restoration-institute/

In Part 1, Nancy, a PRI physical therapist in our network, covers what PRI is and how she uses it to help reposition her patients.  Repositioning is an essential part of a well-rounded program.  In all of our programs, we’re trying to get our clients as close to neutral as possible before we train them.  Watch Part 1 first, and then move on to Part 2 next.

In Part 2, Nancy shows us a couple exercises that do a good job at repositioning.  If you haven’t tried these out, I highly recommend giving these exercises a shot.  Watch the hands-on portion of our most recent in-service done for our trainers below.

 

Breathing Like A Baby.

Have you ever watched a baby breathe?

 

They are “Buddha belly breathers”. You will see their bellies go up and down, up and down, as they use their diaphragm to fill their little lungs all the way up. And while we may think of the lungs as doing all the work, it is actually the diaphragm that is your primary breathing muscle.

 

Diaphragm

 

The diaphragm is a thin wide sheet of muscle that separates the rib cage from the abdomen. It is dome shaped at rest, but when it contracts it flattens out significantly. When this happens the organs below it have to go somewhere, so they push down and out, which is why good diaphragmatic breathing causes your belly, sides, and back to expand. In conjunction with the pelvic floor (which is why your guts can only go down so far) a stable “core” is created. When the diaphragm and pelvic floor are lined up on top of each other, with the viscera pushing out in all directions, your core is working as it should, and the more power, strength and injury resilience you will possess.

 

But have you ever seen a baby scream? We probably focus on all the noise they are making, but take a look at how they are breathing, just don’t wait too long, or they really get wound up!

 

Do you see what’s happening? No more Buddha belly. Now the muscles of the chest, neck and shoulders are doing all the work. These muscles are activated during times of stress, when we get kicked into “fight or flight” mode. We breathe shallower, faster, with our shoulders up in our ears instead of relaxed. This is not a good place to be. Change that diaper already!

 

Well as you are no doubt aware, babies aren’t the only ones who stress out. So many of the clients who walk through our doors live in a chronic stress state. Work, home, pour nutrition, lack of sleep – they all contribute. Because of this they have forgotten how to breathe correctly, with the diaphragm. Instead they are constantly in “stress breathing” mode, and they are suffering for it. Forward head posture, poor thoracic mobility, and neck and shoulder pain. Many times when you talk to such clients they will tell you that their neck is always “tight”, they know they have a bad habit of carrying their shoulders up high, they go for frequent massage; we hear those stories more and more. Think about it. If you are breathing and/or carrying yourself that way all the time, that means those muscles are in some level of contraction all the time – no wonder they are tired and sore!

beautiful young sportswoman has a pain in her shoulder

More often than not, those same clients will score a “1” on their shoulder mobility screen. When that happens, it’s time to dig in and do your breakouts  to find out why. While there can be a number of reasons, AC impingement among them, often times we find it can be a matter of teaching them to restore good breathing patterns that makes all the difference.

 

Now I suspect some of you may be thinking – “Teach people to breathe, are you crazy? They will never go for it.” And I won’t lie (although I am crazy), there is much education and persistence that will be needed here. It amazes me that we still struggle to get grown men and women to be still and quiet long enough to focus on “low level” things like this. We don’t lay around and do breathing for 10 minute stretches, but a couple minutes of focused work in this area can make all the difference.

 

My favorite way to start retraining “Buddha belly breathing” is with crocodile breathing. In crocodile breathing you lie face down on the floor with your forehead resting on the back of your hands. Inhale through the nose, and focus breathing into your belly. By laying face down you are creating feedback; we say “the floor is the front of the core”, and by giving the belly something to push against, it makes it easier to breathe into IMG_0241the back and sides. Get hands on with your clients here; by putting your hands on their low back and then sides, you can ask them to “breathe into my hands”, which gives a targeted focus. Some will get it right away, those who don’t are usually still not breathing down low. Make sure their shoulders are relaxed and down; even lying down many people are not aware they are in the “stress position”.

 

From crocodile breathing you can work on the same thing in the supine position, and then move to more challenging breathing work, such as 3-month breathing progressions, cat/cow with breathing, and kneeling holds with breathing.

 

Don’t be shy about rescreening Shoulder Mobility. It’s high on the FMS hierarchy for a reason. Oftentimes clearing up SM, particularly if breathing retraining helped, will result in a whole host of other dysfunction being cleared up as well. That’s because posture will improve, the ability to create intra-abdominal pressure and therefore stability can improve as well. All this makes for a better moving, stronger and ultimately happier client. That is what we all want.

 

And it’s all because you breathe like a baby.

 

How cool is that?

 

Dean Carlson