The combined forces of the pelvic floor muscles form a supporting mechanism for the pelvic viscera from below – imagine interlocked fingers cradling a bowl. This hammock of muscles also interacts with the diaphragm when the abdominal pressure inside changes – as happens when we breathe. Breathing can be affected by a weak pelvic floor, possibly contributing to dysfunctional breathing patterns.

We frequently find ourselves explaining to clients why it’s important to have a strong pelvic floor for overall core stability and to help reduce back pain. We’ve spoken elsewhere about fascial connections, and with these muscles the connections are numerous.  They are connected with the anterior longitudinal ligament (this stabilises your vertebral joints and helps to prevent hyperextension of the vertebrae) which runs down the front of your spine, and at the front they connect with your deep abdominal muscles. Since the fascia of your rectus abdominus muscles connect with your ribs, the pelvic floor essentially extends up the front of the body as well as up the spine, creating a far wider reaching sling that is first apparent.

As soft tissue therapists it is quite difficult (and intrusive) to manipulate the pelvic floor muscles, but that doesn’t mean they aren’t important, or that we can’t education you about them. Given what we note in the above paragraph, soft tissue work we undertake in areas around your lumbar spine, abdominal and diaphragm regions will have some influence over the pelvic floor. For you, these muscles are important because keeping them toned and strong can help to prevent many problems and lead to a happier, healthier life. There’s a few links at the end which explain how to exercise your pelvic floor.

One issue that a strong pelvic floor can help to prevent is stress incontinence (leaking of urine when you cough or laugh) and it can also help to reduce the risk of a prolapsed uterus in women. So these muscles are particularly important for anyone who is planning to, or has been pregnant. The benefits of a strong pelvic floor during labour are that delivery and pushing can be more efficient, as well as assisting with healing the perineum in the postnatal period.

Regularly exercising and toning your pelvic floor can help with all of the above, with future pregnancies, to reduce the risk of urinary disorders and helping to your body return to a good pre-pregnancy state after the birth. For everyone else – men included – the benefits of a strong pelvic floor are improved bladder and bowel control, good pelvic organ support and improved breathing function.

Here’s a few links for you:

Netdoctor explaining about pelvic floor exercises and stress incontinence.

NCT advice on pelvic floor exercises before and after birth.

These muscles are also important for men who may experience incontinence or impotence.

Livestrong’s advice on the benefits of a strong pelvic floor.

With dysfunctional breathing, the muscles which attach onto the ribs will frequently become shortened, and incorrect upper chest breathing patterns result. The outcome of this can be chronic overbreathing and overbreathing pattern syndrome symptoms. Which, as Sandy Fritz states so well in the quote above, can lead to altered emotional and physical factors – or put another way, reduced or poor performance in activities.

Overbreathing can also affect decision-making and can have a negative impact on sleep and recovery. Fatigue can also occur because of dysfunctional breathing patterns.

All of these factors point towards sympathetic dominance which we have discussed in a related article on Overtraining.

Soft tissue therapy for dysfunctional breathing

During treatments we are able to assess for functional breathing patterns – or as the case may be, dysfunctional patterns. If we find that there are breathing issues, then as long as there isn’t an underlying condition (e.g. bronchitis), we can work on soft tissues to return breathing patterns to normality. Trying to rectify the breathing disorders without therapeutic intervention may not be effective – the mechanisms of breathing (muscle action) need to be normalised before the disorder can be fixed. During treatments we are also able to educate on the correct way to breath with the aim of preventing the issues arising in the future.

You may also be interested in reading another of our articles “And Breathe!” which also looks at breathing and soft tissue therapy and the benefits of breathing efficiently.

Both Tim and Lynne have attended a course run by the renowned Leon Chaitow, on Breathing Pattern Disorders.

Photograph credit: Dan Lane Photography

But why is massage therapy important if you use your voice to earn your living (or socially for that matter)? Just as a dancer or athlete seeks out regular maintenance massage, a vocal artist should also consider this as a tool to keep them in tip-top condition. In technical terms, a vocalist is no different to an athlete – you both use muscles to perform. You both rely on those muscles to enable you to ‘play’ well, to enjoy yourself or put on a good performance. The only real difference is that there are different key muscles involved. An athlete will have regular treatment with a view to avoiding injury and increasing their speed, strength and stamina. The same benefits can apply to vocalists.

Massage therapists use the manipulation of soft tissues in the body to reduce or remove pain, discomfort and muscle tension. Vocal massage is where the therapist focusses the treatment on muscles responsible for the production of the voice and breathing muscles. There are numerous muscles associated with breathing – we wrote about these in our post titled And Breathe!

By keeping the targeted muscles healthy, any imbalances, tension or tightness can be reduced and even eliminated. Relaxed muscles around the vocal cords should aid voice production and projection. Aside from the specific benefits of vocal massage a treatment will help you to reduce stress and improve alertness.

As with all of our treatments, they are individually tailored to match your needs. In vocal massage we focus on treating the muscles in the neck, shoulders, throat (including the larynx and around the hyoid bone), jaw, face, ribs, intercostals and diaphragm. The diaphragm and intercostal muscles are especially receptive to soft tissue therapy – helping you to increase lung capacity and breath more effectively.

We also look at the global picture, massaging the arms and back as areas of tightness there can translate to tension in the neck, producing headaches, pain in the jaw or ears. Fascial massage works on the jaw, lips and nose and work around the neck enables the larynx to be positioned more effectively, easing the vocal cords and giving you a greater vocal range.

Working around the throat, jaw and neck needs a sensitive touch and can be uncomfortable which is why we always work slowly and within your tolerance levels. Good communication between you and the therapist is vital and something we take very seriously. It can take a few treatments for you to get used to having these areas manipulated, but the benefits gained are worth it.

Asthma is a condition which affects many people, including myself. I have very mild asthma, and am very lucky to have only suffered two fully blown attacks. They are very scary, and the panic they cause because of the feeling you can’t breathe is not something I wish to repeat.

My first attack took place before I knew I was asthmatic, while mountaineering at altitude in the Swiss Alps. It wasn’t until a second attack a few years later (hoovering a very dusty carpet) that I was diagnosed. The symptoms were the same – shortness of breath and the inability to expel enough air. Very frightening when you don’t know a few puffs on a preventative inhaler would ease the symptoms. The hoovering episode was even more scary and with hindsight I should have called an ambulance. I eventually got my breathing under control and found a friend to finish the hoovering! I now take a regular preventative inhaler and the condition barely affects me. It’s only when I’m running in cold or windy conditions that I feel my chest tightening and struggling for breath.

I’m lucky – I don’t need more intense treatment because I have mild symptoms. However, I do frequently find myself breathing less fully – taking shallower breathes and once I get conscious of it I can often get anxious with it. That in turn prevents me from relaxing my breathing. I know that muscles involved in breathing get tense, and then they don’t work efficiently. The vicious circle ensues, because then my breathing isn’t great due to unbalanced or compromised muscles!

It is because of my personal experience that I have an interest in Breathing Pattern Disorders (BPDs) and how Sports Massage can benefit sufferers. This was also the reason that I attended a course with Leon Chaitow on BPDs.

What is Asthma and why does it happen?

This is a chronic disorder which affects the airways to the lungs. When a trigger irritates the bronchial tubes it can lead to compromised breathing and an asthma attack. Triggers can be internal factors (emotional stress) and/or external factors (stimulants such as pollen/dust).

On a physiological level, the bronchial tubes become chronically inflamed because of the irritant trigger, go into spasm and swell. This restricts the amount of air which can reach the lungs, leading to shortness of breath, tightness in the chest, wheezing and coughing.

On the level of the nervous system the sympathetic reaction to a trigger is for the bronchioles to dilate, after which a parasympathetic reaction occurs where the body sends the bronchioles into spasm. The tubes swell up and breathing becomes difficult, especially exhalation.

How is it treated?

This depends on the severity of your asthma, and the only person qualified to advise you is your doctor or specialist asthma nurse. Some people require the use of inhalers and preventative drugs and some need steroids and hospital treatment in extreme cases. In some cases it can be controlled by avoiding certain trigger factors.

Can Sports Massage help?

The simple answer is yes it can. Unless you’re in the middle of an attack then massage is beneficial. It can reduce stress and relax out chronically short or tight muscles that are involved in breathing.

We recently wrote a post titled And Breathe! which details the active breathing muscles found around your rib cage, shoulders and neck. It is often the case with asthmatics that the inspiration muscles become chronically tight so treatment aims are to reduce any restrictions or tightness in those muscles. In addition, global treatment (i.e. full body massage) would be given to soothe and relax out the nervous system and switch off the sympathetic dominance which contributes to anxiety and stress levels.  There’s more about that issue in our post on Overtraining. We would encourage anyone with asthma, regardless of severity, to have a treatment.

Speaking from personal experience I know that having work done to my diaphragm,  intercostals (muscles in between the ribs) and neck can greatly improve my breathing – that is surely a good thing. Even if I don’t suffer severe symptoms I can potentially prevent it reaching that point with regular treatment.

During relaxed breathing there are very few muscles which are active. On inhalation the diaphragm and some intercostals (muscles in between your ribs) are working. When you exhale the process more or less simply involves elastic recoil of the lungs and therefore the diaphragm – essentially relaxing and returning to the non-contracted position.

There is however a vast difference between relaxed and forced breathing. When you exercise or require more oxygen (such as when you are stressed) breathing rate increases. Accessory muscles are recruited to help with the demand. During inhalation these muscles are working: diaphragm, external intercostals, pectoralis minor, scalenes, sternocleidomastoid, serratus posterior superior, serratus anterior, pectoralis major, upper trapezius and subclavius. That’s some list.  For exhalation you need to have the internal intercostals, serratus posterior inferior, transversus abdominus, rectus abdominus, quadratus lumborum, external and internal intercostals working.

So what does breathing have to do with Soft Tissue Therapy?

With many breathing disorders and pathologies which affect the lungs (e.g. asthma) the muscles recruited during breathing can become chronically tight, inhibited or dysfunctional. A catch-22 situation develops where breathing is affected by muscle dysfunction and dysfunction further adds to muscle tension.

With soft tissue therapy, tense muscles can be relaxed, chronically tight and short ones can be lengthened, trigger points can be eradicated, and, importantly for you, the pain will be eased. If your muscles are working more efficiently, and if you are in less pain or discomfort then you will breathe better. Better breathing means your respiratory and circulatory systems will function to higher levels; exercise will feel easier, and you may be able to work harder than you could before. I’m sure we’d all agree that better breathing is a good thing, regardless of how much physical demand we place on our bodies.

Benefits of breathing efficiently:

• Reduced stress
• Efficient delivery of oxygen throughout the body
• Better removal of carbon dioxide
• Total body relaxation
• Reestablishing normal sleeping patterns
• Improved quality of sleep

During increased oxygen demand, and also inefficient breathing there are many muscles working as you have seen above. As soft tissue therapists we can help to relax, lengthen or return those muscles to normal function. We’ve both attended a CPD course on Breathing Pattern Disorders and have used techniques learnt there to the benefit of our clients. Whether you have a diagnosed pathology or not, is, (to some degree), irrelevant, because we all breathe, and we would all benefit from doing so more efficiently.

As alluded to by one of the comments I have been in touch with a couple of people and suggested some stretches, which seems to have stopped the symptoms. I basically sat down and worked out some things which would stretch out the tissues mentioned.

The general key when stretching out psoas/iliacus/abdominals is that you don’t just sit there and stretch out one portion of the fibres. Move around within the stretch and get into the different fibres of the muscles. They don’t just work in one plane, and have a multitude of minor variation of angles which it is beneficial to stretch into.

Here are a couple of pics of the stretch cycle that I tend to do before a run/race to warm up the torso ready for the miles that lie ahead. These are a series that stretch one hip flexor, you then have to do it all in a mirror image to get to the other.

Make sure the back knee doesn’t touch the ground, and look UP to the hand. Move back and forth, into and around the stretch. Apologies for the non-level shot, but Lynne didnt think she’d get me in the frame.

Now look at the other hand, again, the back knee doesn’t touch the ground. Move around in the stretch, feel the different fibres of muscles and breathe into them. Don’t count the seconds. Do it so that it feels right.

Last one, stretch out over the top, this is stretching the same area as the last 2 stretches, but puts the enphasis on other parts of the tissue and fascia. Again, breathe into it. To stretch the other Hip flexor do it all again but starting with the other leg forward to begin with.

You can follow these if you like, or make up your own, I find they work. If they don’t work for you, find something that does.

Another point that is worth making is that if the psoas or iliacus has become chronically shortened through overuse/abuse/misuse, it may be that just stretching might not be enough to loosen the structures out enough to be able to run painfree (hopefully it will be, but maybe not). In that case, all is not lost. It is a treatable condition, and there are a number of things that we might be able to help out with – involving assisted stretching, muscle facilitation and Soft Tissue Release, (much like the well vaunted and much publicised Active Release Therapy- its the same thing, just under a different – and I believe patented- name).

Obviously every situation is different, and each client is individual, but if you do have an issue with this and want to get it looked at to see if we can help you out, please do drop us a line, Lynne or I would be glad to help. (I’ve had it and self-treated it, and Lynne has treated me and knows what its all about – psoas, iliacus and diaphragmatic release are underused by a lot of soft tissue therapists, but having come to realise just how important they are, we try to implement it in our treatments as much as possible).

So I went about trying to workout what it was that was hurting.
The area that was most in pain was just under the xiphoid process (the bottom of the central part of the rib cage), to the right of centre. Somewhat contrary to common sense I tend to start poking around things that hurt to see if I can make it hurt more, generate a response and see if I can find trigger points – even when I’m running.

After this happened a couple of times in races, and running around with my hand jammed into my solar plexus, racing while trying to work out what hurts is a little detrimental to your final placing – but is a good way of working out what it is that actually is causing the pain.
I worked out that it was the diaphragm that was hurting… it has an attachment to the inner surface of the lower 6 ribs and to the xiphoid process. As I poked around, I could feel that the pain continued around the inside of the ribs, left and right, but it was mostly painful right under the xiphoid process.

I also noticed that as I was running, I felt more free when my body turned in one direction (twisting at the waist), than in the other. Hmmm. Rotation around the spine was easy in one direction, but restricted in another.
Interestingly, the diaphragm attaches posteriorly (at the back) on the upper 2 or 3 Lumbar vertabrae.

Following along a logical trail, there must be something else that is causing this pain – to hammer home a point, I was pretty sure that this pain in the diaphragm was the smoke, the symptom of something not being quite right, and the fire – the cause was somewhere else.

Working Anterior to Posterior, what muscles could possibly be causing this pain?
Directly attaching to the cartiledge of the lower 6 ribs is the Transverse Abdominus, favourite of Pilates instructors, and a muscle that compresses the abdominal contents,
Internal Obliques also attach to the bottom 3 ribs AND the abdominal aponeurosis (fascia)
Rectus Abdominus attaches to the xiphoid process and 5-7 ribs
External Obliques attach to the lower 8 ribs.

A very rough idea of whats going on. Black is External obliques, Green is internal obliques, Blue is Rectus Abdominus, and red is obviously the pain. (this is not an exact representation of origins and insertions, more to give an idea of where the tissues are and which direction the fibres go in).

Wow. All the flexing and rotating muscles of the front of your body, all attaching to pretty much the same place. Fascially they are all very much connected. If any one of them is slightly off, or is crossbridged to another by collagen, or is damaged, then its going to upset the whole lot. Once that happens, because they fascially connect together and are fascially connected to the diaphragm, guess what happens.
Yes, they will affect the breathing.

slightly difficult to draw on a person

After a bit of abdominal self massage I worked out that although they were a little tender, they were not spasming, and they didn’t seem to be eliciting the pain that I was feeling in the diaphragm. So the obvious has been ruled out. What other structures are associated with the same attachment points as the diaphragm?
Well, posteriorly, psoas attaches to the bodies and transverse processes of L1-L5, lower down it shares an attachment with iliacus. Both are major hip flexors, and have a lot to do with running. Both are often neglected when it comes to massage, and psoas is a muscle that is fascially connected to the diaphragm.
Hmmm. Thats a possibility.
The way to test this is to stretch out before a race and see what happens.

Interestingly, if you go ahead and really stretch out the psoas and the iliacus, there is no way you can stretch them out with out also stretching the main abdominal group which I have also been talking about. By working through one muscle group, the other is automatically worked as well.

I have been working specifically on hip flexor flexibility for the past couple of weeks now, including stretching before races, and I haven’t had any of the pain which bugged me in past races. I’m not going to come out and say that it was specifically psoas, or it was specifically iliacus, restraining psoas and making the diaphragm spasm, or it was specifically the abdominals and I’m going to refrain from making a statement like that for good reason.

All these muscles are fascially connected, the only reason they have different names is because someone went around arbitrarily dissecting and naming things, actively disgarding the fascia as they did so. I suspect it is something to do with an imbalance in the muscles and fascia somewhere, perhaps some collagen binding between psoas and iliacus, and aggravated by weak abdominal muscles. However, the answer seems to have been to stretch out the muscles and fascia associated with the motion of flexing of the hip – and so far, that answer has been vindicated.

As a minor note to this, from my visit to an Osteopath recently, it seems that my sacrum was wonky – which may well have contributed to the feeling of freedom on one side of my body, and stiffness on the other. Muscle, bone, and fascia are all linked and connected and the more I learn, the less physical distinctions I seem to be making.

Yes, I know they are only drawn on, but still…. grrrr.

So what does poor posture mean for our bodies? Well, muscles can become weak and elongated, short and overly tense, switch off completely because others have taken over their role or just generally dysfunctional. You might experience muscular pain, joint stiffness, headaches, a sense of not being quite right, or suffer from RSI (repetitive strain injury). Whatever the cause, poor posture isn’t good for muscles, tendons, ligaments and joints, and the effect is felt all over your body.

Here’s how it goes….you come to work, just like you do every day. Switch on the computer, check your in-tray, in-box, action list, make a coffee and settle in to the day’s work. I know. I’ve been there. You do the same things over and over again, day in day out. Your chair stays in the same position. Your phone is probably a little out of reach because otherwise it gets in the way of the keyboard (go on, check how far away it is). Papers are piled up on either side of you. The filing piles up. If you’re lucky (or perhaps unlucky) to have a paperless job then you just come in, sit down and keep your arms in the same position for what, 2-3 hours at a go? Longer? Basically, apart from the coffee breaks, a quick wander around the office and lunch (that is if you take lunch away from your desk), you’re sat at your desk with your body fixed pretty much in one position.

Is that good for you? No. We’ve posted elsewhere (Fascia. Fascianating) about how fascia is kind of like plastic, needs to be able to glide freely and how it becomes stuck and bound together with inaction.

Now consider your desk set up and seating position. In the position you’re in, with limited movements, think about what your shoulders are doing. Really take a few moments to notice how they are positioned. Now your neck. What’s happening there? And what about your pelvis?

Lets look at each of those in turn.

Shoulders: most likely they’ll be rounded forwards, hunched over. In general, this means the muscles on the front of your chest are short and tight (predominantly the pecs but also muscles in your neck and obviously shoulders) and those at the back will be weak and long (upper trapezius, rhomboids – in between your shoulder blades). Because your shoulders are forwards there could be a tendency for your mid back curve to be increased, putting pressure on your spine.

Neck/head: the ideal position for your head is with your ears directly above your shoulders. I’m betting your head is forwards meaning the chin is forwards and muscles at the back of your neck are long and weak, or maybe not firing effectively.

The average head weighs about 10lbs. For every inch your head is forwards your muscles have to cope with an additional 10lbs of weight – so for a 2 inch head forward position your head is effectively weighing the equivalent of 30lb – 3 times the weight that it should be!! Now imagine the strain that your muscles are trying to cope with, there’s no wonder after years of sitting at a desk that a stooped forwards position leads to muscular pain, headaches and dysfunction. When your head is positioned correctly gravity distributes the weight downwards and your muscles don’t have to work anywhere near as hard. This is because gravity is working in a good way, rather than pulling your head forwards and downwards.

Pelvis: are you slouching, in which case your pelvis will be tipped backwards (posterior tilt). Don’t just think about what you’re doing right now but about how you sit day in day out. Because you are now aware of it you probably sat upright a little more, this is perfectly normal, but what we’re after is for you to think about how you usually sit. Good posture need not be sitting bolt upright, just keeping your spine in a neutral position is good. Going back to slouching, which I think it’s fair to say from experience, after way too many years in an office myself, that the majority of people do slouch. What’s happening to your muscles? Well, for a start, just sitting for long periods leads to short hip flexors – the muscles that bring your leg up in front of you. When you think about it it is common sense – your legs are bent in a sitting position so the muscles which bend your legs will be held in a shortened position, even if they’re not contracting. Your glutes are inactive, they forget what their job is. Because your pelvis is tucked under your hamstrings (the muscles on the back of your thighs) also shorten. Even if you stand up and sit down a couple of times, its not your hamstrings or glutes that are really working, its the quads- which, as we mentioned, are already shortened.

One thing I haven’t mentioned so far is whether or not you sit with your legs crossed. I did, for quite some time, before working out (during training to be a massage therapist) that this wasn’t such a good idea. It’s led to me having one weak hip flexor (the psoas muscle) on the left and one which is too tense on the right – the leg that crossed. The good news is that with some strengthening work on the weak muscle I can rebalance this out fairly easily – oh, and I now keep both my feet flat on the floor when desk-bound!

It’s common with head forward posture for the gravity shift to cause your upper back to curve backwards and your the hips to tilt – one thing is compensating for the other (we’ve said elsewhere that everything is linked and connected), and you end up out of shape, quite literally, feeling a little wonky and perhaps not being 100% comfortable but not really knowing what is not quite right.

The risk to your health because of poor posture are not only muscular aches and pains, but headaches, compression of the spine, dysfunctional muscles and postural imbalances. These can lead to all sorts of other health issues which you won’t instantly connect with poor posture, such as breathing disorders.

How can you make things better? Find out if your employer will carry out a desk assessment, most places do these days because it’s a serious health and safety consideration for them. Get one booked in. Your screen needs to be positioned so that you look straight at it without your chin dipping (ideally your chin should be parallel to the ground) – this will help you keep your ears positioned over your shoulders and the gravitational forces from your head going straight down. Shoulders should be positioned directly over your hips and spine in a neutral position. Your chair needs to be the correct height and if needed use a foot rest. Your telephone should be within easy reach and if you’re on the phone a fair bit get your employer to invest in a headset – hands free calling significantly reduces neck and shoulder strain. Consider moving your mouse to the opposite hand for a few hours every few days – you’ll get used to it quicker than you think.

To start with this will all feel a little weird. It’s bound to because you’ve been sitting incorrectly for some time now. But please persist. Any imbalances which have worked there way into your body over months, maybe years, will take a decent amount of time to work their way out.

My final comment refers back to where this all began – restricted movements. You can change your job but for most it isn’t a practical solution. So we have to make do with what we have. What you can do is to get up and move. Do as cats do every time they move or get up – Stretch!

Most important is to move and keep your body fluid. I highly recommend a book called “Stretching” by Bob Anderson – he provides a simple easy to follow guide to stretches for various sports and daily activities, and I note the latest edition has a section on Computer Stretches!

Sometimes, as I was running, I would get a really really bad pain in the abdomen, on the right side, just below the ribs. I knew it wasn’t stitch- I’ve had that before, and it went pretty much as soon as I stopped running, only to return as soon as I started again. I then didn’t run for a few months, and when I went out for a run again, it didn’t hurt.
Wierd.
Didn’t think much of it until recently.

The most recent time I had that pain was in Mount Famine, when I was really pushing it, and the time before that was in a (fun) winter time trial over 5km with some of the guys down in Greenwich Tritons. I was fine for 4.75km, then I thought I’d up the pace- boom, within about 20metres I had that stabbing pain in the abdomen, and it didn’t go until I stopped. Mount Famine- it came, but by then, I figured out what it was.

Looking at the abdomen- the pain I was feeling was just under the ribs, on my right side. When I finished a hard run, it was slightly tender to touch- but the real issue was just to the left of the xiphoid process at the bottom of the sternum. That REALLY hurt, and, pressure there recreated the pain pattern that I was feeling during those all out aerobic efforts.
What could that be? What muscles attach there, and have bearing on breathing? The main one is the diaphragm- hence my suspicions of the spasming diaphragm. One might call this a Breathing Pattern Disorder- not one that is induced necessarily by bad posture, but perhaps one that is induced by breathing too hard(!)

So I sat (well, lay) down today to have a quick check around and see if I could sort it out. We studied abdominal massage during the course at NLSSM, and I have to say that I somewhat under-utilise it with my clients.
Using a soft touch, I worked my way around the area, noting that the area around the xiphoid process was tender and referring pain, especially under the ribs, my main abdominals felt tight, and the tissue between the ribs- the intercostals were really quite tender… all of this is probably because of a long period of exercise, and not getting enough massage to the muscles- hence the problems.
So I worked on the offending areas, working in the correct direction (so as not to disturb the peristaltic rhythms of the gut), feeling where there were adhesions between organs and muscular walls, and doing some Soft Tissue Release, especially on the diaphragm- that was pretty intense, and not without some discomfort.

However. I now feel much freer, more relaxed, and much more at ease with myself. It would seem that the phrase “a knotted stomach” is not just a metaphor, but also a physical condition which can cause anxiety and concern.
So, if you go to a massage therapist, don’t just expect a back rub- those soft tissues, organs and the like may well be in desperate need of some care. We are used to having our posterior musculature rubbed and soothed- so why not the anterior? It seems a little wierd, however, it is soothing, relaxing, and when done correctly, most rewarding.
I shall be using abdominal massage as a modality within a modality a lot more from now on.

There are a few misconceptions about oxygen, carbon dioxide and their relationship with the human body. When we breathe, we expel CO2, and breathe in O2. However, this does not necessarily mean that CO2 is poisonous to humans. No, we cannot live from breathing in CO2, but yes, we can have big issues from not having enough of it in our system.

When a person overbreathes – or, at the extreme of this, hyperventilates, the effect on the body is to reduce the amount of CO2 in the system, and the concentration of CO2 in the blood drops. This lowering of concentration of CO2 results in respiratory alkalosis- it causes the bloods pH levels to rise, from an average of about 7.4 up into potentially alkaline levels. (The body will attempt to respond to this by releasing bicarbonate from the kidneys, but this is only a short term buffering attempt).

Symptoms that are generally associated with increased alkalosis are fatigue, increased pain sensitivity, decreased cognitive function, anxiety and so on.

BPD can be seen in people who actually have no specific cause for an issue. There are myriad symptoms ranging from digestive to cardiovascular, emotional and musculoskeletal which can be a result of a disorder associated with breathing. The most common physical symptoms are abdominal pain, chest pain, headache and back pain- these combined are responsible for over half of primary care visits in the UK per year. Only 10-15% are caused by organic illness. Indeed, a patient with chest pain, on average sees at least 10 doctors prior to a diagnosis being made.

The causes of BPD can be wide ranging. Women have shown an historic prevalence for Hyperventilation – and studies have shown this may be due to progesterone in their bodies which is absent from men. As previously mentioned, it may have no obvious specific cause – but it brought on through accumulated stress. It may be biomechanical – the fascia in the body becomes used to sitting and relaxing in a certain manner, which may be comfortable for a person, but it sub-optimal when it comes to breathing.

No matter where you look, there are connections with pain, with dysfunction, with biomechanical issues, with physiology because people are not (for any number of reasons) breathing optimally.

I am not saying don’t go to a doctor if you have chest pains. By all means, go! Get it sorted. However, if there appears to be no good reason for an issue you are having – if there has been no discernable cause for pain, for a disorder that may be cropping up or general disaffection and brain fog, think about the way in which you are breathing. Think about your posture. Think about whether you are breathing more or less than you need to.
This may perhaps be the root of it.

(I must acknowledge Leon Chaitow in this post, without whose work, this entry would be significantly shorter, this is not an in depth look at BPD, I am merely scraping the surface with a fingernail, it’s a fascinating and deep subject matter – oh, and any mistakes are my own- don’t go shouting at Leon).

Tim