Traps like Mt. Everest?
You know who I am talking about, the people who have their
shoulders so elevated they appear to be trying to clean their ears with their
Glenohumeral joints. (see above)The ones that when you palpate their traps, accessory
breathing muscles and especially their first rib, you feel like you need a
hammer and chisel to break up the spasm.
They are often high strung; a little stressed out, and may
have chronic pain, or even better RSD (chronic pain on steriods).
What is going on here?
Obviously, a lot of things but what these individuals will
share is that they are breathing with their accessory muscles, not their
diaphragm. Most simply put these people
are not breathing properly.
I calculated that person who takes the average 10 breaths
per minute, breathes 16.560 times per day.
The diaphragm can handle this task; it is uniquely designed
to do so, as it is both a smooth and skeletal muscle. Smooth muscles do not fatigue. The traps and
accessory muscles of the neck cannot, they are mere skeletal muscles, as a
result of this unwanted demand placed upon them they become hypertonic and
angry.
Aside from decreasing accessory muscle hypertonicity thus decrease neck and shoulder pain and pathology, other benefits of Diaphragmatic
breathing include:
- Increased oxygenation
- Stimulation of the parasympathetic nervous system to elicit relaxation
- Decreased emotional stress
- Improved circulation and improved peristalsis due to the up and down action of the diaphragm on the abdominal viscera.
- Decreased symptoms of chronic pain patient
- Decreased symptoms of RSD and other autonomic disorders.
- The patient has a lot of opportunity to practice (theoretically over 16,000 times per day)
The challenge is that it can be surprisingly difficult to teach.
Traditional techniques included visualization, placing your
hand or another item on your stomach and make it move. These work for some patients, but for the really tough ones I use the following;
3 easy ways to facilitate diaphragmatic breathing:
1.
Elevate your legs: This will put the weight of
the abdominal viscera, and facilitate diaphragmatic breathing.
2.
Bend over so that your hips are at a 90 degree
angle and make sure to rest your arms on a piece of furniture. Gravity is now
acting on the abdominal viscera and facilitating the diaphragm to contract. In the picture below, note that the arms can be bent and supported closer to the trunk.
3.
Make an “OK” sign with your fingers, if you are
old enough to remember Sasson jeans it is their logo. It is called the Gyan Mudra and it is used in
yoga and meditation practice to facilitate diaphragmatic breathing.
If you don't know where to start with your treatment of a chronic pain patient begin the same as a human does as it enters the world, with a diaphragmatic breath.
