Proper breathing is a very important role in patient treatment. Breathing rehab has just begun to be noticed in the rehabilitation community and in Chiropractic. Patients that have altered breathing habits, or a breathing pattern disorder (BPD) can often have symptoms of:
*chronic back pain
*poor movement patterns (they don’t move well)
*resistant to exercise
*have food sensitivities and/or digestive disorders
*fail to respond to nutritional programs,
*depression and anxiety
As part of the rehab community, we are starting to see the connections between poor breathing in patients and their chronic health conditions. Thus more attention needs to be given to assessing breathing. Leon Chaitow ND, DO addressed the correlation of BPD and declining health in his book Recognizing and Treating Breathing Disorders.
The Graduate School of Behavioral Health Sciences has taken note and is training health care practitioners in the evaluation and correction of BPD. (see link on this page)
In the ground breaking book, Movement, by Gray Cook, MS,PT, written for the rehab community, he references the need for evaluating breathing. In the addendum of Movement, Dr. McLaughlin makes reference to the use of Capnography, the measurement of CO2 in exhaled air to evaluate breathing. The point of my preceding comments: Breathing is just now being recognized in the Rehabilitation community as being relevant in treating patients with musculoskeletal complaints. We need to understand how breathing can change the chemistry of the body and has far reaching effects in health and performance. It’s kind of a big deal, a really big deal!
So what does Dr. McLaughlin’s comments about capnography and CO2 at the end of some book have to do with breathing— she comments that it turns out that CO2 has everything to do with breathing. So when we are discussing breathing are we talking in terms of asthma or other lung diseases?
The answer is yes and no. Breathing, physiologically speaking plays a much larger role in our health than just thinking in terms of medical conditions such as asthma or lung disease which are only a small subset of breathing picture.
Everyone breaths, it is automatic, but does everyone breathe well? I have come to a conclusion that has stemmed over many years as a clinician, that there are two types of breathing pattern disorders commonly seen among patients; some may even have one or both. 1. Mechanical: Muscle/ Motor control problems 2. Behavioral: incorrect learned breathing behaviors
My friend and mentor, Peter Litchfeild PhD, points out, that those mechanical and behavioral BPDs are essentially just behavioral because they are learned and behavior is physiology in action. I totally agree, but for better understanding lets separate the two.
1. For example, a Mechanical BPD might look like this: The patient over uses their diaphragm to create movement in the body i.e. walking. What does this look like? The patient will either hold their breath or tighten parts of the diaphragm prior to engaging their core muscles. This is extra work for the body and will result in an altered breathing pattern. Altered breathing patterns can be fixed. In our office we use an exam, Neurokinetic Therapy (NKT), to determine the cause and provide the patient with proper home exercises to correct the problem.
2. Let’s address BPD due to incorrect learned behaviors. Here is an example of learned behavioral breathing: a patient in her 20s reported that when she was 7 years old she had a history of asthma attacks. As part of the testing to determine the cause, she was put in a plastic box called a Plethysmograph and told that she would have the air shut off and her mom could not be with her. So in that traumatic instance she learned to breathe incorrectly. However her body saw it as the “correct” way to breathe, and from then on set up a pattern to breathe using her chest, thoracic intercostal muscles and diaphragm all the time. While using all 3 of those muscle sets is of course necessary as you recover from a sprinting in a race so you can exchange air (oxygen and CO2). Using all 3 sets of muscles while one is sitting still will result in over breathing CO2 which will disrupt the chemical balance of the body. Over the years, her improper breathing has resulted in digestive disorders, brain fog, and pain. One can develop a BPD from a less traumatic event.
Taking a deep breath to relax is a learned behavior that ultimately results in over breathing and a less than optimal physiological response. Breathing patterns can be easily evaluated with Capnography, which measures expired CO2 levels. Capnography paired with O2 Saturation readings can then teach the patient what proper breathing looks like and feels like. Using capnography as a form of biofeedback (observing what your own body is doing) the patient learns to correct the breathing pattern themselves. Some one might say,” well CO2 is bad right? So not having as much CO2 in you blood is good right?” The answer is “Wrong!”
We need CO2 to balance the acid base equation in our blood stream; if it is not balanced then this will set off a cascade of chemical changes that can result in some of the symptoms listed above. I don’t want to bore you with the chemistry right now but the chemistry is quite interesting and can be found in any medical physiology book on respiration. If you have an interest just follow the chemistry of what happens when there is low CO2 in the blood stream.
Well how common is dysfunctional breathing? Dr. Robert Fried a Biopsychologist, makes this comment (by the way he is not referring to asthma attacks), “There are varying reports of its (dysfunctional breathing) frequency in the population at large, ranging between 10-25 percent. It has been estimated to account for roughly 60 percent of emergency ambulance calls in major US city hospitals.” (Fried, Robert, Breathe Well, Be Well. 1999, p 45)
In closing, if you think you might have a breathing pattern disorder or may be over breathing, call our office to schedule an appointment. Our office will have you fill out a questionnaire, which can be sent to you, and from that point, you can schedule a brief consultation with one of our Doctors to review your treatment options with you. In closing I leave you with this thought by Peter Litchfield, PhD,
“Differing melodies of breathing mechanics must ultimately play the music of balanced chemistry.”
Here is to better health,
Dr. Stephen Gradwoh
P.S. For those who want more information, see the video below for an example ...if you have even more interest in learning about breathing, see the banners below for special deals on signing up for classes for a certificate or Master Degree.