“You want me to WHAT?????” Oh the faces I get when I tell a patient for the first time that I want them to blow into a balloon. Sometimes there are outright refusals. But I promise you, I have a very important reason behind it all. After several years of working with clients on breathing I’ve come to the conclusion that just about everyone these days has poor breathing patterns. Sure, I’ve treated several yogis and well trained vocalists and its always the same … poor diaphragmatic breathing. YES, I mean you, the opera singer that gets back pain every time she goes on stage! So as a physical therapist, why do I care about creating good breathing patterns in my patients & clients? Besides being linked to fatigue, lightheadedness, panic attacks, anxiety and even irritable bowl syndrome; poor breathing is integrated with poor posture and can lead to injury. When one doesn’t use their deep abdominals and diaphragm together to pull air in and push air out efficiently they compensate by using accessory muscles in the body that lead to excessive strain and torque. Most often this can be linked to neck and back pain, headaches, and shoulder pain. Most injuries are tied to poor “core”, and you can’t have an effective core without effective and efficient breathing. “But Sarah, I’ve been working so hard at my belly breathing!” “—Exactly.” If your belly is pushing out a lot, what do you think is happening to your abdominals? Are your abs expanding or contracting? When the belly expands forward, what do you think is expanding? Your lungs are not in your stomach. (HINT: your pushing your guts forward). Yes, the diaphragm contracts on inhalation with belly breathing and that is a good thing…but I want more! If the belly expands too much (a little is normal) one looses the synchronicity of the abdomen and pelvic floor maintaining proper core control. Instead, the lumbar paraspinal muscles and/or the neck muscles will overwork to help pull air in and can contribute to compression of the low back and tight, sore necks. “Above all, learn how to breathe correctly.” - Joseph Pilates So what is good diaphragmatic breathing? What does it look like? When inhaling, the belly may expand a little but the rib cage should also expand in 3 dimensions - the front, back and sides (where the lungs are). If a person doesn’t breath and expand the ribs in all these dimensions, the ribs get tight and loose elasticity. The hardest dimension for most people, and arguably the most important dimension, is the back of the ribs, and when that area gets tight, the low back goes with it.
So how do I train good breathing? Stay tuned to learn how YOU can use a balloon can change your life….
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“One of my legs is longer than the other!” As one of the most frequent comments I hear from clients (second only to “I have a very high tolerance to pain”), I’m here to reassure you. Most people “look” like they may have a leg length discrepancy, but VERY few actually do. The most frequent cause of one leg appearing to be longer than the other is pelvic asymmetry. When the pelvis is rotated it changes the orientation or angle of the hip socket. This little change in orientation affects everything below it (and a lot of things above it too). For instance, if the left half of your pelvis rotates and tips forward, the left hip socket faces more forward. The femur/ thigh bone has to rotate out in order to keep the foot facing forward. This rotation glides the femur in the socket forward and can make it appear shorter. However, sometimes it can actually appear longer due to overly stretch ligaments in the front of the hip socket. Left forwardly rotated pelvis: Neutral pelvis: Left leg appears shorter Leg length is equal There are a few cases that make me suspicious of a true leg length discrepancy that may need correcting for:
1) A total joint replacement or similar type of surgery 2) Genetic growth disorders/conditions To figure out for sure if you have a leg length discrepancy, one needs an x-ray so the actual bone can be measured and compared to the other side. Keep in mind that fewer than 0.08% of people have an actual leg length discrepancy. Many times this is corrected using a heel lift. However, I discourage the use of heel lifts because it does not lift the whole foot, only the heel. If you only lift the heel you are starting to change the mechanics of how that ankle moves. Its like wearing a slightly higher heel on one foot vs. the other, and who wants to do that? Instead I promote the whole foot being elevated. If it is a small degree of difference this can be accomplished with a shoe lift an insert for the inside of the shoe. If it is a greater degree of difference the shoe itself should be adjusted by the appropriate amount by your local shoe repairman. Talk to your therapist to figure out the right amount of adjustment. If that is not you, rest assured, all you need is some help with that pelvic rotation! I recently talked to two local running stores, Run N' Fun (Calhoun Village) & Marathon Sports, to see if they carry my favorite supportive shoes that are on my shoe list. To my excitement, they do! And that includes my favorite of them all, the ASICS Foundations. For my clients they are offering discounts. Just tell them your therapist, Sarah Petrich, recommended they come to their store to buy some shoes.
Run N' Fun: 20% discount Marathon Sports: variable discount depending on the shoe 10 - 20% Stay informed on new blog topics, changes in Pilates and Healthy Spine Classes and new offerings. Emails will be kept at a bare minimum and contact information will not be shared with any third parties.
Traditional custom orthotics are rigid, made of hard plastic and are designed to force the foot into one "ideal" position. But our feet are made to move and adapt to the ground. Rigid orthotics do not keep this in mind, nor do they respect the neurological system's response to a hard, often painful piece of plastic under the foot. When a rigid, unforgiving arch support is placed under the foot the foot often starts to pull away from it because it is painful. Overtime this response can result in the person weight bearing more on the outside of the foot rather than through the center of the foot. Developed by Dr. Coffin, D.P.M. and Ron Hruska, M.P.T., Postural Restoration® orthotics are designed to work with your foot mechanics and your neurological system to gain the perfect balance of foot stability and mobility. They are non-compressible, flexible orthotics that are uniquely matched to the patient's structure, gait and activities. They not only affect the feet but will help align the knees, hips and back to decrease tension, torque and compression. They are best utilized when combining with Postural Restoration® therapies.
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