This is Part 1 of a series about the mechanics of breathing, and how breathing relates to pain, physical therapy, and performance
Breathing
On any given day, we take anywhere from 17,000-30,000 breaths. Like blinking and swallowing, breathing is not something we have to actively think about. If you are healthy, you likely view breathing as a natural and involuntary activity. But have you ever given thought to the quality of your breathing? Conscious attention to breathing can provide insight into both your physical and emotional states.
The role of respiration in overall health should be of particular interest to physical therapists. As clinicians who pride ourselves on a whole-body approach, it is our responsibility to consider the role of breathing in physical therapy. After all, breathing is the basis for everything we do.
Why should physical therapists worry about breathing?
In our stressful and fast-paced society, many people are susceptible to developing breathing dysfunctions. These dysfunctions can feed into the functional impairments we see in the PT clinic. Breathing pattern disorders may contribute to musculoskeletal conditions by impairing motor control and compromising trunk stability.
Many athletes and patients display dysfunctional breathing patterns, limiting performance and increasing vulnerability to injury, therefore as movement experts physical therapists are the ideal experts in assessing and treating dysfunctional breathing
Mechanics of respiration
Let's briefly review the mechanics of respiration:
Inhalation, also known as inspiration, is an active process during which air enters the lungs. The diaphragm contracts and flattens and the ribs move upwards and outwards. As the dome of the diaphragm lowers, the overall size of the thoracic cavity increases. The volume of the pleural cavity increases as well. This expansion of the lungs is associated with a fall in intrapleural pressure.
Exhalation, also known as expiration, is typically a passive process, during which no muscular contractions are needed. At the end of inspiration, the respiratory muscles will relax and the chest wall and lungs elastically recoil. The dome of the diaphragm moves superiorly and the ribs depress. This results in a decrease in the volume of the thoracic cavity and a decrease in lung volume. This change in volume is associated with an increase in intrapleural pressure.
While expiration is primarily a passive process, it does become active during forceful breathing. For example, expiration is active when playing a wind instrument or during exercise. During forced expiration, the anterior abdominal muscles and internal intercostals contract, increasing the pressure in the abdominal wall and thorax.
End of Part 1..