I found myself frequently referencing the handout I had been given by our cardiopulmonary instructor, and running to adjust my classmate partner who was playing my “patient”. My second year PT class was spread out across the tables we usually used in orthopedics, every single pillow, bolster and prop in use as we attempted to prop our faux patients.
We were well into our cardiopulmonary class, and spending time in a rare pulmonary lab instruction. Our professor had instructed us in the positions to place patients to facilitate the expansion (or contraction) of various lobes* of the lungs. By placing the patient on their right side in a comfortable way and propping a small towel roll under the right ribcage, we not only opened the thoracic facets and costovertebral joints of the left (as we had learned in orthopedics), we also facilitated the expansion of the lobes of the left lung.
By changing the towel roll placement, moving the head of the bed or the patient’s arm position, we could selectively help a patient inflate the superior or inferior lobe.
It was during this class that I had two “a ha” moments:
1) All of the systems of the body are interrelated
This was painfully clear from day one in Gross Anatomy when a slight heaviness in my hand with my scalpel could clear away not just the ubiquitous fascia I were hoping to cut, but also annihilate the subtle and important nerve structures I sought to expose.
Anyone who has had the opportunity and honor to perform dissection knows how subtly tissues layer together, adhere onto one another, and transform based on surrounding structures. In cardiopulmonary lab, positions we had used to facilitate mobilization of the musculoskeletal system, were also similar to the positions required to mobilize the lung tissue underlying the muscles and bones of the rib cage.
Given this information, it stands to reason that changes in the musculoskeletal positioning (such as with slumped posture I assume with computer use) would change the underlying function of my visceral organs (in this case, the lungs).
Interestingly, changing our breath is also connected with changing our emotions and perceived ease in our bodies. When we breathe in a way that is slow, where our exhalation is slightly longer or matching our inhalation, we calm our bodies and reduce anxiety.
2) Our breath is under volitional as well as autonomic (or automatic) control.
Skeletal muscle within our body (that which creates movement across our joints and the broader movement required for walking, running, doing the dishes) is under our volitional control. We create plans about movement (high up in the cortex of our brain), nerves transmit these plans, and with practice, our body can carry out these plans.
Our breath is controlled both autonomically (fortunately, we don’t have to think about breathing, our bodies keep doing it automatically), but it can also be controlled volitionally.
James Nestor recently published a fantastic book called Breath. In it, he recounts the story of a young woman who was born with quite severe scoliosis who transformed the curvature of her spine through stretches and learning to control her breath in unique ways that encouraged inflation in particular lobes of the lungs. In this manner, she decreased the abnormal curvature in her spine. She also helped other women with scoliosis improve their spinal function through a similar process. Mr. Nestor recounts several stories such as this throughout his book, an incredible reminder that how we choose to move changes our function and health outcomes.
We learned during our aforementioned lab, with the use of tactile cues from our classmates, and positioning to inflate different parts of our lungs using the skeletal muscles that influence breath. Breath can be made conscious (and certainly this is the focus of many forms of meditation).
Try these simple techniques to engage with awareness around your breath:
Sit comfortably in a chair, without letting your back rest against the chair back. Let your feet rest solidly on the floor. Feel a stacking of the pelvis (many of us need to move the pelvis slightly forward so we shift our weight away from our tailbones. Allow your spine to rise up out of the pelvis, balancing your ears over your shoulders. Let your chin relax slightly toward your throat and let your eyes be soft.
From this position:
1) Noticing: when you inhale, say to yourself “breathing in”, when you exhale, say to yourself “breathing out”. Perform for 10-20 breaths
2) Belly breath: when you breathe in, allow your belly to expand in three dimensions. When you breathe out, feel the abdomen gently contracting. Allow your exhalation to be slightly longer than your inhalation. Perform 10-20 breaths
3) 5x5 breath: inhale for a slow count of 5- letting your belly stay soft and letting your breath move your belly with your inhalation. Breathe out for a slow count of five, allowing the elastic properties of the abs, the diaphragm, the intercostals (muscles between the ribs) to naturally let the belly and rib cage to return to the start position by the end of your exhale. Perform 10-20 breaths
If you are looking for a good read and would like more information on breathing, please check out James Nestor’s non-fiction, Breath.
Until next time, happy moving (and breathing!)
While our right lung has three lobes (superior/middle/inferior) our left lung has only two (superior/inferior) due to the real estate taken up by our hearts.