Having a strong, properly functioning diaphragm is more important than ever right now. Underlying respiratory issues such as sleep apnea, COPD, Asthma, and even chronic sinus problems can significantly put you at a higher risk if you contract COVID-19. I just recently watched a very informative video from a Bariatric Surgeon that explains how COVID-19 actually kills you. If you haven’t seen it, here’s the link: https://www.youtube.com/watch?v=4J0d59dd-qM
It appears that the virus itself doesn’t kill you, but the significance of your inflammatory response. Your inflammatory response is stimulated by a fight or flight response, also known as a sympathetic nervous response. Well, from my study of research and coursework through the Postural Restoration Institute (PRI), there are many people that have an increased sympathetic system and don’t know it!
Your ribcage position tells the story. The angle at the base of the sternum is called the infrasternal angle, or ISA for short. Ideally, we like to see the angle between 85 and 95 degrees, depending on the person’s body type. Very petite women or slim men may have more narrow angles, whereas a linebacker may have a bit wider one.
If your angle is abnormally very wide or very narrow, there is a great possibility that you could be using a breathing strategy that is more sympathetic in nature. This is because your ribcage is putting your diaphragm in a poor position, which causes you to automatically utilize your accessory muscles such as intercostals, traps, back extensors, and hip flexors. This increases stress on the body slowly over time and can lead to a multitude of problems including joint pain, difficulty recovering from colds, breathing problems, and anxiety.
If you have underlying musculoskeletal conditions such as back issues, shoulder pain, neck stiffness, or knee pain, you also most likely use an altered breathing strategy. Your body moves in kinetic chains, that go from your skull all the way down to how you weight bear through your feet. These chains influence the ribcage and also, in turn, are influenced by the ribcage.
Your respiratory system and how you manage pressure also play a huge role in whether you tow the line at being more sympathetic. Inhalation triggers the sympathetic system and exhalation triggers the parasympathetic system (rest or digest). This is observed when someone hyperventilates; they inhale much more than they exhale which creates more anxiety and panic and they have difficulty relaxing. When you have them breathe into a paper bag, it improves their gas exchange, promoting exhalation, which then relaxes them and relieves the panic.
Focusing on exhalation exercises will improve ribcage position, reduce sympathetic drive, and improve diaphragm activation. Exhalation exercises will reduce overuse of accessory muscles and improve overall gas exchange and lung function. Here are a few of my favorite activities.
- Test your diaphragm here!
- Buteyko breathing: Take a normal inhale through your nose and a long exhale through your mouth. Pause for as long as you can comfortably. Inhale through your nose and try to take a normal inhale through your nose. Repeat sequence 5 breaths, 5 times. Work up to being able to hold an exhalation pause for 15-20 seconds comfortably. It’s super challenging!
- Balloon Breathing: Breathing sequence is the same as above except you are breathing through a balloon. If you cannot blow up a balloon, you can start with a straw. The balloon is like a weight for your diaphragm, it will help with strengthening.
- Fog the window breathing: Inhale through your nose and exhale by sighing, as if you are fogging a mirror. Pause for as long as you can comfortably. Inhale normally through your nose and repeat 4 more breaths in a row. Repeat 5 times.
Challenge the positions that you are breathing in; the harder the position, the stronger your diaphragm will get. Here’s the easiest to more challenging line up:
- Laying on your back
- Sitting on a stool with your knees pulled up to your chest
- On hands and knees
- Prayer stretch pose
- Downward dog
- Full squat, heels down
If you suspect you are breathing incorrectly, and would like an assessment, I am offering a 30 minute telehealth assessment for $35. I will personally assess you and give you breathing exercises that are specific to your needs to help you improve your strength and endurance.