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Could The Way You Breathe Make Your Spondylolisthesis Pain Worse?

10/16/2012

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Most of you might be surprised to hear the answer is an astounding YES!

A very hot topic in the field of physical therapy and strength and conditioning is proper breathing. 
 
Doctors, therapist, strength coaches and others have been looking closer at breathing and the affects of improper breathing on the body. 
 
Some interesting findings associated with improper breathing are being discussed and some of these findings point to improper breathing leading
to an increase in overall stress and poor posture. In some cases this poor posture *could lead to back pain.

Without boring you with all of the science and anatomy, I want to stress a few
of the important points I have learned about proper breathing so you can understand why proper breathing could help to reduce some of your low back pain.

First, let's look at an abbreviated version of what really happens when you breathe........


WHEN YOU INHALE 
When a breath is taken (inhalation) the diaphragm tightens and moves downward.  This in combination with the expansion of your ribcage allows for more room in your chest cavity for your lungs to expand and bring in all that great fresh air. 
 
Small muscles called intercostals located in-between your ribs also work to help create more room for your lungs to expand in your chest cavity.
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WHEN YOU EXHALE

When you breathe out or exhale your diaphragm does just the opposite. It relaxes and moves upward. 

The intercostal muscles we mentioned also relax and the opposite effect takes place.

The relaxation causes a reduction in space in the chest cavity and the carbon dioxide is forced out of the lungs through your nose and mouth. 


SO WHAT'S THE PROBLEM?
Where most people run into problems is during the exhalation process. 

I recently read a great article by Mike Robertson title “The Breath-Stress Relationship”.  In this article Mike talked about the relationship of poor breathing and stress and the role they play in individuals who have imbalances and postural issues.  

One breathing related issue that Mike mentions that *could relate to many spondylolisthesis patients is the inability to exhale properly or completely.

I know from experience when I used to have my painful spondy episodes the pain would be so bad it literally took my breath away.  My breathing would be affected due to all of the muscles and tissue tightening up to combat the pain. 
 
I was almost always in a constant tightness.

Why was this a problem?

Think about the exhalation process. What is SUPPOSED to happen is the relaxation of the diaphragm and intercostals muscles which allows for the reduction of space in the chest cavity. 

But if you are not exhaling properly you do not allow for the FULL relaxation of the diaphragm and intercostals muscles.

It just so happens the intercostals muscles located between your ribs play a huge role in your posture. 

The intercostals are connected to your ribs which play a huge role in the mobility and health of your thoracic spine. We discussed the importance of the thoracic spine HERE.

Long story short, if this full relaxation process does not take place the constant expansion of the rib cage can force your chest to stick out.  If your chest stays expanded it *could lead to hyperextension of your low back and an increase of stress on your low back.  

Individuals who suffer from this breathing issue are basically walking around with a puffed out chest and extra pressure on the low back. 

For example stand up and expand or stick your chest out as far as you can.  As you do so pay attention to how you arch your low back to allow for this expansion of your chest.  Without proper exhalation this posture (although not as severe as the example) carries on all day. 


WHAT CAN BE DONE?
Start by working on your exhalation process as this may be one of the most common areas of improper breathing. 

Most importantly work on exhaling FULLY, especially if you are currently experiencing pain from your spondylolisthesis.

Exhaling fully will encourage the full relaxation of your diaphragm and intercostals muscles and will help to promote the proper cycle of breathing. 

This will also help to reduce stress and strain on the muscles and tissues that play an important role in back health.
 
The important thing to understand is that breathing improperly can lead to compensations from other areas (specifically the muscles of the hips and low back) to assist with each breath. These are areas that are often overworked in spondylolisthesis patients to begin with and are often contributors to pain. 

Forcing these muscles to do additional work *could lead to compensations and muscle imbalances throughout your body causing even more back pain.


TRY THIS FOR HELP
Here is a video by Mike Robertson on a drill he does to teach proper exhalation.

Try it out and see what you think. You will be amazed how good it feels to fully exhale and perform a proper breath.

I would highly recommend a visit to Mike Robertsons website and check out this post.  You can do so by clicking HERE. 
 
Leave a comment below and let us know your thoughts!

*Notice I use the word "could" a few times. The reason for this is that everyone's case and situation is different.  The human body is an amazing thing and we do not all suffer from the exact same issues. The best way to find out is to get screened and find a professional in your area who can tell you exactly what might be leading to your spondylolisthesis related pain.
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