Stretch and Breathe

August 8, 2022

Breathing is a key component in Pilates and the correct breathing during exercise makes a big difference. However, as we know, breathing is more than just having enough oxygen to exercise. Our ventilatory efficiency has a direct impact on blood pressure, PH of the blood and heartbeat rhythm among other, which alters the metabolism and the physiological stability of the whole body. The same happens the other way around, psychological components such stress, anxiety, depression and even sedentary lifestyle may alter the way we breathe. Consequences and symptoms may appear and can escalate accordingly to the degree of the inefficient breathing patter that the individual may experience and the environment that the individual is exposed to (eg. Exercise).

 

As physical therapists we are trained to identify when a client/patient struggles with breathing, especially if this seems to interfere with the exercise, and help them to take control of their breathing, mind and bodies in order to perform the exercise safely and correct.

 

Since I started working here, I have performed the assessment on 2 different clients with a pathology known as Ankylosing Spondylitis. In this autoimmune condition the bones enter on a self-inflammatory cycle that cause a reduction of mobility, bone fragility and fusion, and pain flare ups. This inflammatory process can evolve and spread to other joints or bony structures such the thoracic cage. When this happens the thoracic cage bones can suffer the same condition of movement restriction and pain. Without movement and expansion at the thoracic cage, lunges can’t expand properly, decreasing the amount of air that can enter in the thoracic cavity, therefore, reduce the O2 exchange which will develop into more respiratory complications.

 

The best way to prevent the movement decay within a patient who has condition is exercise and movement. Pilates is a great approach to deal with mobility, movement control and improve fitness condition overall, however, due to the nature of the Pilates principle, the increase in ventilatory capacity and thoracic movement is not targeted accordingly. During the movement in Pilates, the activation of the core muscles for movement control, limits the actual expansion movement of the bottom ribs, limiting the pulmonary capacity. If we combine the limited movement with the common instruction of exhale/breath out during the movement (also to increase movement control) we find that the the pulmonary areas that can be ventilated during the movement, don’t receive that oxygen supply. Additionally, pilates requires the client to manage mobility, breathing, movement control and in many occasions, physical effort to perform the movement.

 

However, to promote that ventilatory capacity, the only main points of focus should be breathing and a specific kind of movement that promotes the expansion capabilities of the thoracic cage in a safe manner. This requires some modifications to our current class format, allowing our clients to relax and focus on the breathing and moving during the class rather than working out. Additionally, a slower pace will be required to allow clients' bodies to adapt to the physiological changes in O2 concentration within the blood.  

 

Although there are only two clients affected with this condition currently in the Harrogate clinic, they are not the only ones who could benefit from the addition of this class as the main purpose is to exercise the thoracic expansion and the increase of ventilation capability of the lungs, this could also be beneficial for other types of clients. Patients who have breathing difficulties, which does not have to be the same pathology (Asthma, COPD, pulmonary surgery, long covid…) or want to improve the ventilatory capacity (pregnant women, athletes, anxiety sufferers those with a sedentary lifestyle…).

We will be launching this new class later in August, keep an eye on the timetable!

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