Exhale, Exhale, Exhale…..Why is it so important? Jen’s latest blogs answers this question…
Posted 12/07/2011
I typically get my blog ideas for clinical experiences, and over the past week, I had a couple patients who were having trouble with their home exercise program that I had given them. Both patients were experiencing upper back/neck tension with the exercise shown below. This exercise should relieve tension (not cause it) when performed correctly. Therefore, I further analyzed the patient’s performing this activity. In both cases, the problem was that they were not exhaling correctly. One individual was exhaling with “pursed” lips, while the other was exhaling very quick and forcefully.
Those who have been to our clinic know that breathing is important with every exercise you do! Respiration is the foundation of the science of the Postural Respiration Institute™. Exhalation is the focus of today’s topic. There are several reasons why we emphasize patient’s breathing correctly with our activities, but most importantly to appropriately using the diaphragm as a respiratory muscle rather than a postural stabilizer, to help us get into a “neutral” or flexed position, and to minimize use of accessory (neck) muscles to help breathe on the next inhalation.
I had to teach both these patients to exhale correctly, and when doing so they had no tension in their upper back or neck performing the exercise. The exhalation phase of breathing should be about three times longer than the inhalation. If one does not fully exhale all the air, then “dead air” remains in the chest wall, your ribcage remains elevated and externally rotated, and muscle tension develops in your neck and shoulders. We sometimes use a spirometer to measure the amount of air you can exhale, which is often decreased. If you never get all the air out of your body, you cannot fully inhale because space in the lungs in being occupied by the “dead air”. Not only is this important for decreasing muscle tension, but air exchange controls oxygenation of our body. When we inhale, we supply our body with oxygen, and with exhalation we eliminate carbon dioxide. If you have “dead (non-oxygenated) air” in your chest wall, you cannot fully re-oxygenate on inhalation, and you may be fatigued easily, get out of breath with simple activities such as going up a flight of stairs, get headaches, not sleep well or wake up tired after a full night of sleep.
To help these two patients over the past week, I really encouraged a full exhalation. I am often saying “Blow all the air out, every last bit drop of air that you have in your lungs.” I often utilize tools such as a straw, party favor or balloon to help the patient realize they are getting the air out, as well as provide a small amount of resistance which engages the abdominals and assists with pulling their ribcage down into a depressed and internally rotated position assisting them to get all the air out. So, please consider, have you (and/or your patients) been exhaling correctly (and fully) with PRI activities?
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Posted December 7, 2011 at 10:49am by Jennifer Gloystein.
Tagged With: Balloon, Breathing, Diaphragm, Exhalation, Headache, PRI Concepts, Respiration • 2 Comments
