DNS: Breathing and Core Activation
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- เผยแพร่เมื่อ 27 ต.ค. 2020
- Renowned Czech manual therapist Karel Lewit once said: "If breathing is not normalized, no other movement pattern can be." The manner in which we breathe dictates how efficiently we stabilize and how well we move. This video provides instructions for learning how to use the diaphragm to develop a physiologically NORMAL breathing pattern and for generating ideal intra-abdominal pressue. Don't "just breathe", but learn to breathe correctly.
Clinic website: cloverdalechiro.com - แนวปฏิบัติและการใช้ชีวิต
Best explanation on breathing I’ve heard in the past ten years! Thank you for including the action of the pelvic muscles, it clarifies a lot. 🙏🏻
Thank you for your kind words of appreciation.😁
Hands down the best explanation of proper breathing on the internet!
Thank you Neil
These classes are so informative and instructions are amazingly absorbed by me!Thanks from Australia!
Thank you Moya, I am glad you find our channel helpful,
I am worried for so many days and I see soo many bell breathy vidio but this vidio make me healthy I never seen before woow keep it up
Wow excellent boy
Thank you Master Tule. Breathing correctly is the essence of health and wellness. Breathing incorrectly will bring a lifetime of ailments.
Hello Morris, thank you for a rather sublime series of videos. Do you perhaps have a quick tip on how to facilitate expansion of the diaphragm around the lower back whilst standing upright? I can do a full 360° expansion while being in the first position shown in the video but as I stand up I only manage to expand in the front.
Hi Miro, that is an excellent question. First, it is essential that your chest and abdominal wall are relaxed. Holding tension, while is a common pathological strategy for stabilizing, will prevent you from being able to create an ideal 360-degree expansion of the abdominal wall. The diaphragm must be able to descend straight down towards the pelvic floor for this to occur. Holding the chest high or the upper abdominals tight (drawing in) will interfere with this process. Next, place your hands around the circumference of your waist. Thumbs in the back portion of the abdominal wall, the web of your hand into your sides, and a couple fingers in the front of the abdominal wall just above the inguinal ligament. Practice breathing into your hands- feel the abdominal wall expand into your thumbs, web portion and into your fingers with each breath in. You can also wrap a Theraband around your abdomen. Cut two tennis balls in half and put one of the halves in each quarter of the abdominal wall: left-back, left-front, right-back, and right-front. Be sure the band is not too snug. The band and balls will provide cueing where to breathe.
@@TeamGasparin Thank you for an exhaustively detailed reply, I'll keep on practicing and the results will hopefully follow. Take care and thank you once again.
Thank you so much . During child pose breathing my lower back rounds and hard to keep the spine neutral . Also my shin bones of my leg have so much space between the floor and it is not completely touching the floor.
Hi Barkha. It is a prerequisite for stability training to establish solid points of support. Your support points and fixed points serve as anchors for your muscles to pull towards. This is why my videos spend so much time explaining how to create and maintain ideal support points. As best as possible, you must try to keep your shins in contact with the surface. If your ankles are too stiff try placing a rolled up towel under your ankles. Press your shins into the towels. Eventually you should be able create proper support without the towels. Whenever someone's lower back rounds during breathing we know they are probably either over activating their rectus abdominis, hollowing their abdominal wall or using spinal flexion in place of intra-abdominal pressure. Relax your chest, back and abdominals. You might need to have some fascial/muscle work done in those areas to allow the ideal breathing/pressurization to develop.
Hi Morris,
Thank you for all the DNS video series.
I am just a bit confused. May I ask you If the lower ribs should be anchor down and stretch down by the obliques during exhalation. How can the lower ribs can move upward like bucket handles when it is anchor down?
Hi Christophe. That is an excellent question. The ribs need to move like a bucket handle during respiration and cantilever during trunk rotation. So, it is imperative to maintain mobility of the entire ribcage. Another imperative is that the ribcage and shoulders do not move towards the head during inhalation, they need to set in the vertical plane to permit the diaphragm to function properly. If the ribcage is resting too high or moves pathologically during respiration then stability is most certainly compromised.
There are two basic strategies that can be used to bring the rib cage into a neutral position. The first strategy would be to use brace and literally lock the entire rib cage down into position. This would be effective for powerlifting but not very economical and would significantly limit trunk mobility. The other strategy would be to use exhalation. A long exhale will necessarily activate the oblique abdominals and this will draw the rib cage into position. The next step will be to relax the chest, back and abdominal muscles enough to keep the ribcage in its correct position while still permitting a normal breathing pattern.
Morris Gasparin, DC thank you Morris for explaining with such great details. I will definitely try it :)
It is difficult to alternate inhaling with relaxed trunk and exhaling with tightening while trunk circumference is decreasing. Once I tighten while exhaling I can't exhale as much, then I have hard time relaxing for inhale and my breaths get very shallow. What can I do to improve? Somehow I seem to do better when I do Ujjay breath like I do in Yoga. Is this ok? I can do Ujjay to start, then work up to normal exhale while tightening?
Breathing should always be relaxed, especially while resting or during light activities. The corrections necessary to develop a pattern of respiration that is truly physiological depends upon a person's presentation. Some people tend to have a very tight or hollowed upper/mid abdomen. This person also tends to have very low muscle tone in their lower abdominal region. They must learn to relax the region that is tight and drawn in allowing it to expand during inhalation. Also during inhalation, they must be able to activate the lower abdominal muscles. The other challenge for someone with this presentation is to keep the upper abdominal region from hollowing during exhalation. Here, we should definitely see the abdominal canister become smaller during exhalation, but the abdominal wall should never become drawn in or hollowed. The key is to maintain the same amount of intra-abdominal pressure during both inhalation and exhalation. The only thing that changes is the circumference of the cylinder.
The other common presentation is what we call a "Frog Bell". This would be someone with lots of pressure but very little activity of the abdominal wall. The pressure they create causes the abdomen to balloon out to look like a frog's belly. They must learn to activate their abdominal wall without pushing their belly out more. Using very long exhalation will naturally help to activate the abdominal wall into a cylinder and it will also help to pull the ribcage down into position.
So, do have an abdomen that is too tight and hollowed or is it too relaxed and not able to contain the pressure? Also, how tight/stiff is your ribcage?
My abdomen is narrow and I have a tendency to hollow it. My rib cage does increase in circumference at inhale when I pay attention to the cylinder shape, so it probably is not tight.
I have a tendency to arch my lower back to stick my buttocks up, which I am correcting when I notice. I am slender but have a fat pooch in lower belly (had c-section twice also) and I have a difficulty activating the lower abdominal muscles (I do not even know how).
Before learning the correct way in your video, I used to breathe into front belly and then deflate (hollowed mid abdomen and curving the spine) at exhale.
I am going to keep practicing and hope that I will find the way to keep lower abdominal activation and the internal abdominal pressure while exhaling.
Thank you for your guidance and I appreciate any additional help for someone like me.
@@chiem5687 What you are describing is an abdominal "hourglass" presentation. There is hyperactivity in the upper abdominals and rectus abdominis. This is creating a narrowed or hollowed appearance. Consequently, there is minimal reflexive activation in the lower abdominal region. This will cause the "fat pooch". Also, scar tissue like that from a C-section will inhibit the abdominal wall. The scar must be massaged and mobilized before you will be able to activate the entire abdominal canister. It is my experience that using long consonant vocalization during a very protracted exhalation can facilitate the activation of the abdominal wall. Place a couple fingers on each side of the abdominal wall just above the inguinal ligament. During exhalation try saying "OOOOOOOOOOOOO" with a fairly loud volume for the entire duration of your exhale (5-6 seconds). You should be able to feel the lower abdominals activate towards the end of the exhale. Once you feel the activation, try to inhale down into the same area (feel for it with your fingers). Next, try to maintain that same activation during your exhalation (can be without vocalization). Tactile stimulation will also help your brain to become aware of where you are trying to pressurize/activate.
@@TeamGasparin I have found out that I do suck in and tighten my mid and upper abdominal muscles very often, not only at exhale, often when I shift my body positions, as in bracing. I was surprised to find this, since it is my own body doing it without me knowing. So I am catching myself, then relaxing the front mid abs, and do the 360 degrees breathing.
I have started massaging the scar tissue from the C-section. I did find the lower abdominal activation by saying "OOOOOOOOO". However I cannot tell if I am maintaining the activation during exhalation (probably not). I feel tense and not relaxed, trying to maintain the abdominal activation at exhale, which puzzles me a bit because you say breathing should be relaxed, but I guess once this becomes habitual I will be able to remain relaxed and activate at the same time?
I now am hopeful that I will be able to breathe correctly to support my spine and the whole body. Thank you very much for your help.
@@TeamGasparinwhen you say you should be able to feel the lower abdominals activate towards the end of the exhale, are you speaking of the TVA at the bottom activating? Thanks in advance. Your channel and information are amazing and very well presented.
edit: I think my biggest issue is I have some rib flair, especially on the left side, and I have a hard time breathing down low because of this. It’s wrecking me because I have lost all access to internal hip rotation, and not have si joint, lumbar, and outer hip pain due to what I believe is all my accessory muscles kicking in to protect and stab alive me instead of my big movers, and shakers.
what if my pelvic floor hurts while breathing out .I am not able to tighten it, its either contracting hollowing the abs or pushing out more weakening the plevic floor. Do you suggest any cues. Your contents are great.
The pelvic floor muscles eccentrically contract (lengthen) and hold (isometric) during inhalation and concentrically contract (shorten) during exhalation. If you are experiencing pain during the exhalation (concentric activation of the pelvic floor) phase of respiration probably indicates that you have trigger points in these muscles. The trigger points may also cause inhibition of these muscles too. This is a common side effect of abdominal hollowing. Chronic concentric activation of the abdominal wall will cause a reflexive gripping of the pelvic floor. Over time, the muscles become strained and can develop trigger points and scar tissue. Here are a couple tips that may help. First, try massaging your pelvic floor. If you are able to deep squat comfortably, you can self-massage the area while breathing into your pelvic floor. Child's pose is another good position for this. Second, only after you can breathe in and out without pain try a gentle kegel during the exhalation. This voluntary contraction of the pelvic floor must be against intra-abdominal pressure. Always be careful how much intra-abdominal pressure you create. You never want to overwhelm the ability of the pelvic floor to contain that pressure- "only as much as necessary and as little as possible".
What video do I start with? Is there a progression?
Hi Cody. The foundation of trunk stability is intra-abdominal pressure. Without pressure there cannot be an ideal pattern of stabilization. Without proper diaphragmatic function there cannot be ideal intra-abdominal pressure. The pattern in which we respire indicates how the diaphragm is functioning. For the diaphragm to begin functioning correctly it requires a stable anchor to pull towards. In a physiologically respiratory pattern the diaphragm must descend in the thorax during inhalation. This requires the ribcage and the thoracolumbar spine to be a stable anchor. When the ribcage is elevated or elevates towards the head (vertical movement vs expansion) during inhalation indicates the direction of diaphragmatic movement is reversed. Rather than the diaphragm descending the ribcage is elevating. We always begin by assessing the resting posture of the chest and pelvis and correct them as necessary. The next step would be learning how to breathe correctly so that during inhalation the abdominal wall expands throughout its entire circumference and pressure is felt into the pelvic floor. The next step would be to maintain this pressure during exhalation. Once someone can breathe and maintain pressure correctly we can to train stabilization. We always begin people in a position that addresses there most pressing deficits - shoulder stability, hip stability, foot support ... . We must be careful to choose exercise positions that are not too difficult or challenging at first or else the patient will simply train their compensations and make their problems worse. The basic Dead Bug (dying bug) in the supine 3 month position or even the prone 3 month/modified child's pose are excellent positions to start.
Do you have any cues for when patients don't understand how to do this or can't facilitate the movement? Any 'external cues'? I've heard people say to 'breathe into your pockets'. What works for you?
Hi Carrie. I have found that one of the strongest barriers to ideal breathing is the inability to relax the chest and the abdominal wall. Years of tension and gripping (holding the chest high or abdominal hollowing) restrict both the chest wall and the abdominal wall from expanding during inhalation. As a result of this the chest has to lift rather than expand during respiration. Try giving yourself time to relax before attempting to change your breathing pattern. You may also need some manual therapy to mobilize your rib cage and release your abdominals if they are restricted.
Sir, what does one do if they cannot get any pressure down into pelvic floor? And when it’s possible, are we supposed to push outwards and hold pressure while exhaling, like in the abdominals? Thank you for helping people, you are a great human 😊. Please help!
There are two more common reasons why people cannot pressurize down into their pelvic floor- either the postural position of their back and chest or the tension in their upper abdominal wall. The scenario is what we call the "Open Scissors" posture. In this presentation, the chest is held too high and the pelvis is tilted forward. Looking at the body from side you can see that the diaphragm and pelvic floor are no longer parallel or stacked one over the other. The diaphragm does not descend vertically. Instead, it drops more forward and down causing pressure to build only in the front part of the abdominal wall. The second presentation is the "Hour Glass". People with an "hour glass" posture have a narrow, drawn in abdomen. Their upper abdominal muscles are held very tightly as they suck in their belly. Consequently, intra-abdominal pressure is poorly distributed throughout the abdominal canister. The lower abdominals, pelvic floor and the posterior abdominal wall cannot activate. The solution depends on your specific presentation- either allowing your chest to drop down and back into a more neutral position, or allow the upper abdominal muscles to relax.
@@TeamGasparin I definitely have the open scissors scenario, but no matter how much I work on my glutes, low abs, and trying to let my chest/ ribs relax down I can’t seem to line everything up. I had this my whole life and trained as an mma fighter for 10 years and now my body can’t seem to loosen up enough to let things straighten out. I’m about ready to throw in the towel. Any thoughts on what I could try? I don’t know where you’re based out of, but if you’re ever in Oregon I’m literally dying for some help
@@Juggernaut365 I am located near Vancouver, Canada. There is a certified DNS practitioner in Portland that you could see. If you go the Prague School website at: www.rehabps.com/REHABILITATION/Home.html Click on the "DNS Certified Practitioners" tab and you will be able to find someone to help you. Good luck to you.
@@TeamGasparin thank you for the link! The closest I could find was way down in California, I will be reaching out to them, thank you VERY much ❤️
@@TeamGasparin I didn’t see anyone that is in Oregon, but i’ll keep digging. I would bet anything that I’m the worst case of this dysfunction that’s ever existed. Is there a trick to getting the abdominals reconnected to the brain to help bring the ribs down? Thank you for your time by the way, you’ve been more than generous by replying at all. I’m literally grasping at ANYTHING that may help me, I’m starting to stop breathing in my sleep now about 3-4 times a night. I’m scared sir!
wouldn't it be easier to form a cylinder in breathing if knees and pelvis would be at exactly 90-90 position, legs not resting like this
The amount of hip flexion should optimize the position of the pelvis. It will be much easier to create a canister when the pelvis is positioned correctly. The ideal position may not be with the hips at 90º. Sometimes a little more flexion works better.
@@TeamGasparin I thought that with feet and knees pointing outward hips are more externally rotated and therefore it's harder to inhale fully
@@2fastnfurious4u The initial position with pelvis in neutral, the knees inline with the shoulders and the feet inside the knees (heels are inline with the ischial tuberosities) creates an environment for the best possible muscle synergies. The position of the knees and feet, to the best of my knowledge, should not impact a person's ability to breathe or brace. However, when the knees are poorly positioned the ability to centrate the hip joints will definitely be compromised. Decentration of the hip joints will consequently have a negative affect on the entire kinematic chain. We must be able to effectively breathe and brace regardless of what position the knees and feet are in. Additionally, internal rotation of the hip joints while in flexion is not a normal physiological position and can also inhibit the obliques and transversus abdominals thus limiting the ability to create a canister for breathing and bracing.
So when you breathe in should you be still engaging the core musculature or should it relax?
Like any other muscle in your body the muscles that make up your core are always engaged to some degree. The amount of stiffness they create is meant to reflect the load applied to your body. During inhalation the muscles of the abdominal wall and the pelvic floor are supposed to engage eccentrically, lengthening under tension and then holding isometrically. During exhalation, these muscle switch to a concentric activation in order to tighten down so the amount of intra-abdominal pressure is maintained. So, the muscles are always on but are either lengthening or shortening depending on the phase of respiration.
@@TeamGasparin ok. Yes. That makes sense as I have seen emgs showing consistent signals that a muscle is firing. I guess it's just type 1 which are firing most of the time. What order does DNS say the muscles of core contract to a fuller state?
@@adamswinnerton6336 Activation of the abdominal wall is meant to be reflexive in response to IAP created when the diaphragm descends and displacing the abdominal viscera. However, there is much more to the core mechanism than simply breathing and creating pressure. One must take into account the shape of the abdominal canister as this provides clues to the quality and strategy of stabilization. If someone has a hollowed or drawn in abdominal canister they must first learn to relax their abdominal wall. Self massage and mindful relaxation are necessary. For someone with an abdominal canister that lacks tone and is distended will require activation prior to respiration. For them, the ribcage must be drawn down towards the pelvis and integrated into the canister. If not, they will never be able to control their pressure directing only out the front of the abdominal canister creating a balloon out the front resembling a frog's belly. Prolonged expiration is good way to activate the abdominal wall and bring the ribcage into position prior to pressurization. Inflating a balloon or prolonged phoenetics (SHHHHH or OOOOOOOO) are other techniques that can be used.
@@TeamGasparin ok. This is super interesting. Where online can I find research surrounding the testing and validation of DNS?
@@adamswinnerton6336 Just go to the Prague School website: www.rehabps.com/REHABILITATION/Home.html Click on the tab "DNS Literature and Research".