Breathing. The first and vital step in post-partum recovery.
Breathing. It’s something we’ve all had a lot of practice at. You would think that doing it correctly would just come naturally and automatically. Sadly, like breastfeeding and GHD curls, it’s just not as easy as it looks. And even sadder still, if done wrong, can create so much dysfunction throughout our body. The saddest part is that poor old mothers draw the short straw AGAIN when it comes to bodily sacrifices made for the sake of our offspring - I’ll explain this further in a moment. This blog however is not meant to be one of miserable revelations but an easy solution to positively impact the health and function of your entire body. But first, like most well-meaning blogs, you have some learning to do….
Get to know your Diaphragm.
I doubt many people give much thought to their diaphragm. You know it’s there under your ribcage and you have a vague idea that is has something to do with breathing. Well I’m hoping by the end of this little blog, you’ll appreciate this muscle for all it’s worth.
The diaphragm is a muscle that connects to your spine, your rib cage and the base of your breastbone. And like your heart muscle, it is vital for the health of your body and should work hard for you all day, every day. When it contracts, it flattens out and pulls down on the lungs creating negative pressure for air to fill. But that is not where the role of this amazing muscle ends.
The diaphragm works together with your core and pelvic floor to provide stability for your spine and pelvis and regulates the pressure within your abdominal cavity – this directly influences conditions such as diastasis recti (abdominal separation), prolapse and low back pain. When the diaphragm contracts, it create pressure downward into the abdomen, this lengthens and strengthens the pelvic floor which is important for optimal pelvic floor function.
The diaphragm also plays an integral role in our blood circulation and lymphatic function assisting with drainage of inflammation and filtering pathogens from our blood.
However, the most amazing (and modest) function of the diaphragm is the way it interacts with our Vagus nerve.
The Vagus nerve
The Vagus nerve is the longest nerve in our body and it is responsible for the body systems that keep us calm and relaxed without our conscious control. It is our “feed and breed” or “rest and digest” command centre. This means it is directly related to our digestive, sleep, hormonal and sexual health. When we breath properly, the diaphragm massages the Vagus nerve and stimulates it.
There is no one on the planet that needs more cooperation from their Vagus nerve than the post-partum woman. A well-functioning Vagus nerve will mean she can:
Actually sleep restfully when she has 5 minutes to do so;
Digest and absorb maximal nutrients from the scraps of food she finds left on (or under) the high chair;
Have energy and zest for life when interacting with her children;
Feel desire to be intimate and reconnect with her partner when she is good and ready (and no sooner);
Relax enough to allow her hormones to produce breastmilk and a reliable let-down;
Feel grounded and calm when the baby poos through his/her best clothes on the way to a café to meet her friends for the first time; and
Heal her body after giving birth.
What does pregnancy do to our breathing and diaphragm?
It is one thing to breathe deeply into our diaphragm to massage our Vagus nerve, lengthen our pelvic floor and stimulate our core muscles to stabilize our spine and pelvis. But try doing this when there is a giant/tiny human pushing your diaphragm back up towards your throat. A baby in the latter stages of pregnancy will push up on your diaphragm, down on your pelvic floor and outward on your core muscles. This stuffs up the entire breathing process!
Not only are we losing all the benefits of proper diaphragm function and motion, but to get any oxygen, we have to start using what are called “accessory” breathing muscles. These are muscles of the neck/ upper shoulders and jaw and this way of breathing is known as a SHALLOW breathing. Other causes for shallow breathing are conditions such as asthma and anxiety. These muscles are usually involved with neck movements but when we are shallow breathing, we use them all day every day. This makes the muscles tired, sore, and tense leading to neck pain, headaches, jaw pain and shoulder tension.
This muscle tension can also lead to pressure on the nerves and blood vessels that run down your arms. This might be why you might wake up with pins and needles or numbness in your hands!
Unfortunately, once the baby comes out, your diaphragm doesn’t just kindly go back to it’s pre-pregnant, contracted and proactive self. It remains wide, high and downright lazy, leaving your accessory muscles to continue to be overworked. These muscles not only create pain and discomfort but they also activate what is known as our “fight or flight” response. This releases stress hormones in our body creating feelings of anxiety and an alertness that interferes with sleep and healing.
*Yes! We can impact our stress levels just by how we breath!
There is such a thing as a pelvic floor that is TOO TIGHT!
When you “shallow breath” you miss out on a lovely massage and lengthening to your pelvic floor. This can make the pelvic floor too tight! A pelvic floor that is too tight can cause:
Tension in the birth canal (the baby literally has to come through your pelvic floor);
A forward tilting pelvis leading to pressure on your low back and pubic joint pain (pubic symphysis dysfunction)
Inhibition of your core muscles (delayed healing of a diastasis recti);
Tightness and pain around your coccyx (tailbone); and
Pain or discomfort during intercourse.
How can correct Diaphragm expansion ease low back pain?
Many aspects of our modern lifestyles lead to tightness and shortening of the muscles at the front of our hips known as our hip flexors. The include:
Sitting for long periods at a desk>car>couch;
Doing certain exercises wrong at the gym or home;
Poor posture; and you guessed it...
Pregnancy causes your hip flexors to tighten like never before. The weight of your growing baby changes your posture dramatically. Your pelvis tilts forwards and your expanding abdomen stretches and weakens your core and turns off your glutes. So the muscles of your lower back grab on for dear life. They tighten and spasm to stop you from falling flat on your face.
Breathing properly with good diaphragm movement helps to lengthen and relax the hip flexors. This reverses that forward pelvis posture and takes the pressure off the muscles of the low back allowing them to relax, providing a lot of relief!
A summary of what CORRECT breathing does in your body:
Massages the vagus nerve for optimal “Breed and feed/rest and digest” function;
Regulates the pressure within the abdomen to decrease risk of hernia/prolapse and low back pain;
Keeps you calm and able to have good quality sleep;
Activates your spinal and pelvic stabilizers protecting you from injury and low back pain;
Helps to heal diastasis recti;
Influences pelvic floor movement and function;
Relaxes the muscles of your neck and shoulders, reducing neck pain and headaches;
Promotes healing and repair by increasing oxygen; and
Provides optimal biochemistry of your body.
If all these factors don’t convince you to get your breathing right then I have one final plug. Fixing your breathing with proper diaphragm and ribcage activation with help to bring your ribcage back in and down which narrows your back and allows you to fit back into your old tops and bras!
Symptoms you may experience with a POOR BREATHING pattern:
Low back pain, hip pain or sciatica;
Poor sleep/ inability to fall asleep;
Digestive problems such as bloating, reflux etc.;
Anxiety or a constant feeling of stress/agitation;
A diastasis that won’t heal despite your best efforts;
A pressure feeling in your pelvis or vagina;
Pelvic floor dysfunction;
Poor wound healing;
Pain with intercourse;
Shortness of breath;
Pins and needles in your hands and/or fingers;
Neck, jaw or shoulder pain or tension; and
**If you experience any of these symptoms, we recommend clearing them with your doctor first as there are many causes of these symptoms. Hopefully the cause is only the way you breathe and you can fix it in a jiffy!
Where to begin your breathing rehab.
1. CHECK WHAT HAPPENS WHEN YOU INHALE
What you want to see/feel is:
Your abdomen rising; and
Your lower back expanding.
Your lower ribs widening; (This is called 360 breathing.)
What you DON'T want to see/feel is:
Your chest rising towards your neck;
Your abdomen drawing in; and
The muscles in your neck and shoulders tightening.
2. CHECK WHAT HAPPENS WHEN YOU EXHALE
What you want to see/feel is:
Your abdomen gently fall;
Your ribs coming closer together; and
Your back rise from the floor.
What you DON'T want to see/feel is:
Your abdomen pushing out;
Pressure on your pelvic floor; and
Your back pressing into the floor.
3. CHECK YOUR “INFRASTERNAL ANGLE”
Your infrasternal angle is the angle that is made between your lower ribs. Take a look at the picture below to see what I mean.
This angle should be about 90 degrees. An angle wider or narrower than this indicates dysfunction in your diaphragm and breathing technique.
Pregnancy widens the infrasternal angle as a result of the baby pushing up and out on your ribcage. This prevents the diaphragm from lengthening and contracting the way it is supposed to. And as I mentioned above, it rarely springs back after pregnancy without a little assistance.
If your angle is too wide, you should focus on full exhalations pulling your ribs in and down. If it is too narrow, you should focus on deep 360 inhalations and expansion.
Rib counter-pressure with full exhale for a WIDE infrasternal angle.
Lying on your back, place your hands on either side of your lower ribs. Fingers to the front pointing to each other and thumbs at the back. As you inhale, feel your hands move further apart. Breathe into your hands. Then as your exhale, squeeze your hands towards each other, imagining you are squeezing all the air out of a balloon. At the same time as you exhale, draw your belly button in and push any remaining air out of your lungs by whispering “haaaaaaaaa”. You should feel the muscles around your rib cage tighten. Repeat this for 4 breaths. They do not have to be consecutive.
Back expansion for someone with SHALLOW BREATHING or who predominately ”belly breathes”
Getting breath into your low back for full 360 breathing is often the hardest part of breathing rehab. Your breath will always follow the path of least resistance so creating pressure against the front of your body will make it easier to direct your breath to the back. You can do this in a full squat with your knees against your chest or lying over an exercise ball or foam roller. Then as you inhale, visualize the breath moving into your low back and feel your back expanding then relaxing softly with your exhale. Sometimes the movement is very subtle so it can be helpful to have a partner place their hand on your low back and provide feedback as to whether they can feel your back moving at all.
PHYSICAL THERAPY FOR BREATHING AND DIAPHRAGM FUNCTION.
Achieving a healthy breathing technique is a vital part of your post-natal rehab. It is very rare that I meet a woman who has had a baby, has come to see me for some discomfort and her breathing and diaphragm is optimal. Self-awareness of your breathing and tailored exercises are fundamental to getting the best long term results. However often there is so much tension in the body as a result of incorrect breathing and diaphragm tightness, that it is essential to get these areas treated so that you can do your exercises properly. For example, sometimes I go through certain exercises with a women to correct her breathing but she is completely unable to get her ribs to expand when inhaling or stop her abdomen from protruding when exhaling. Once I treat her and release those tension points, she finds it much easier to expand her body to allow her to breathe properly.
Areas that often need a little T.L.C. include:
Diaphragm spasm. This is a muscle and can get tight spots too!
Stiffness in the muscles between the ribs;
Tightness in the muscles of the lower back and hip;
Tightness in the muscles of the outer abdomen;
Tightness in the muscles at the front of the chest;
Tightness in the muscles that sit on top of your sciatic nerve,
Tightness in the external pelvic floor; and
Pain and tension in the neck and shoulders.
Having these areas treated not only allows you to breath better but it also makes you feel so good!
impacts not only your musculoskeletal system but also your nervous system, immune, circulatory, hormonal, sexual and emotional health. It is an integral part of a woman’s post-natal rehab and should be the first thing that is addressed. It’s easy to fix and can create so much change in a very short time. If you would like to learn more or have yourself assessed, make an appointment with Nadine or Jess. We would be happy to help you on your road to better health and function.