So this particle is an add-on to the rest of my ‘Postural Training Series’ (see parts 1, 2 and 3 ) and was inspired by a series of events that ‘the universe’ led me to encounter since writing my last article…

Event 1- began with a comment Michael left after part 3 of my postural training series. In it 3D diaphragmatic breathing was mentioned, and at first I didn’t know how to respond as in my training and career up until now I hadn’t really come across this in any sort of way that made me take notice – I viewed diaphragmatic breathing as “just lying down and ‘consciously activating the TVA (transverse abdominal)’”, and this view of consciously activating a muscle goes against a lot of what I believe (I will be writing an article on subconscious activation soon – promise!).

Event 2 – Literally a couple of days later I was on a IASTM (‘Instrument Assisted Soft Tissue Mobilization’) course and got chatting with a top chiropractor. He explained the purpose of diaphragmatic breathing and how it’s applicable to the rehab process in a way that made sense to me – what particularly caught my attention was that he also talked about the subconscious nature of this technique!

Event 3 – I had a client come to me with some serious lower back pain and very poor posture (in the sense that his back wouldn’t adapt to his movement and was really stuck in a kyphotic position). Manipulations and massage hadn’t helped and when I asked him to bend forward it just wasn’t happening – he simply couldn’t bend forward without pain, and even the smallest movement caused pain. So, the workout I demonstrated in the video of part 3 of my postural series became pretty redundant as the client could barely move! With all this in mind I decided to add my most recent discovery in lower back pain rehab…diaphragmatic breathing.

Now I am not saying that my recommendations in part 3 were wrong (and even if they were I would never admit it – haha!) but what I am saying is this: everything I said works and helps if you’re already in a decent state of repair. But what if you are not and the exercises I described are too aggressive? Again, I come back to rehabilitation being a journey and you must start where the client is now. This so important to remember (and very easy to forget).

What is Diaphragmatic Breathing?

The technique is very simple:

1. Lie on your back and close your eyes.

2. Does the chest rise or does the abdominal region? Diaphragmatic breathing causes the diaphragm to move down and in doing so pushes everything else out of the way in all 3 planes – to the front, to the back and to the side. So you should only see the abdomen rise, the rising of the chest should only come into play when you need extra air during exercise, it should be diaphragm first then the other respiratory muscles, and in that order.

3. If this doesn’t happen just raise your legs and feel the difference – the need to stabilise your legs up with your knees in a 90 deg position activates the abdominals and this in turn kicks on diaphragmatic breathing.

4. Now raise your arms straight above your head and slowly move them from side to side. Feel the obliques start to fire with each breath. Now we are really starting to get the “core” firing by our breathing pattern.

5. Now step back and think about the position you are in! Looks a lot like a baby in a cot playing with a mobile! This is how we first developed our core and it would make sense that this is the key to getting it firing again especially since a lifetime of sitting all day has turned it off!

Diaphragmatic Breathing: A Case Study

So, going back to the reason I am posting this…My client with severe lower back pain came in and was struggling with all step and reach patterns so I knew I needed to regress the program even further:

- I got him to lie on his back with legs and arms in the air and got him breathing. He immediately felt his abdominals start to fire – brilliant!

- I then got him swaying his arms, and still just focus only on breathing. He then felt his obliques start to kick in – even better!

- I repeated this with the legs and arms in different positions until, when I laid my client out flat with his eyes closed, diaphragmatic breathing came naturally.

- Then came the moment of truth…I put my client on his feet. And, to my delight, he started some stepping and reaching with no pain! I then started to move in and add more aggressive motions with different heights, angles and ranges. My client reported that he felt a massive, instant decrease in pain when moving and standing.

I’m still going to be a student of this for a while but so far this technique has a 100% effectiveness rating from me (admittedly this is based on a sample of N=1 – not statistically significant but it has given me a new starting point for some of my less able clients). To conclude (for now), I believe that:

1. The body works using subconscious movement and muscle activation.

2. There are always ways to regress a movement back to the ‘true’ basics.

3. So much can be learned from watching the real masters of movement – babies.

4. Finally, I can’t emphasis enough the importance of regress to progress (see part 3 of this article series) and every exercise program should be a journey from where your are now to where you want to be. There is no single route, although some routes are better/faster than others.

One final word of caution before I finish off: I seriously advise that if you’re a trainer and your client has serious back pain then refer on to someone who knows how to deal with this because if you get it wrong things could be made a lot worse!

If anybody has some good info on this topic please get in touch as I am still learning (and always have been) and am always keen to know more.

Scott