I can’t tell you how many times a past client has returned to my office with the complaint, “I was doing so well. I couldn’t believe my neck (back, head, etc…) didn’t hurt much at all anymore, and then, for no apparent reason, the pain is back. WHY?”

Typically, the return of the neck pain (or back pain, headaches–you get the idea) did not involve any change in activity level, stress level, or anything else that would seem to matter. At first it was a mystery: Why had the pain returned?

Digging a little deeper, it became clear, and holds true for most every person that comes back with this complaint: The problem wasn’t that their activity/work/stress level has changed. The problem was that they felt so good that they allowed themselves to fall back into old habits. Habits that they had been aware of for a while and changed, then felt better and slid back into “unawareness,” and the pain returned.

Remember those little, round snow saucers we had as kids? If you kept going down the hill in the same path, pretty soon that path was entrenched, icy and fast. Much faster than a new path would be. You could, in fact, be slightly outside of the path, tip your saucer toward it and land in it, then fly down the hill. It was the “default” path.

Same with pain habits. With awareness they can be changed. Without awareness you go right back to your default mode. Old habits return, pain returns. The good news? When awareness returns, the pain goes away.

It’s possible to make a new, fast path with the snow saucer. Just takes a little time and lots of repetition. Same with your body habits. You can change, but it does take some education, a little time, and lots of repetition.

We’d love to show you how!

Warning: Some of these may surprise you!

1.  DON’T try to “stand up straight” and have “good posture.” Many times with back pain our bodies adopt a crooked or bent over posture. This happens for a reason: To keep pressure off of the nerves. If you try to straighten up, your body will tell you immediately that this is the wrong thing to do by increasing the pain you’re feeling.

2.  DON’T try abdominal strengthening or core stabilization. There’s been plenty of research done on this and none of it has shown that strengthening our core decreases back pain. Not that it’s bad to have strong core muscles. It just doesn’t help with back pain, especially in the acute stage. It can, in fact (and I’ve seen it many times), make people hurt more and retard the healing process.

3.  DON’T believe “no pain, no gain.” If it hurts, don’t do it. Don’t try to push through the pain. Again, especially in the acute stage. This doesn’t mean just lie in bed or sit on the couch. No activity is bad AND forced activity is bad, as well. Move in ways that feel comfortable, or at least safe. Stay under the radar of threat so your muscles don’t tighten up more, increasing your back pain, and so your fight/flight response isn’t turned up further, again, increasing your back pain.

So what SHOULD you do if have back pain. Listen to your body. Move in a way that feels ok and that decreases the tightness/guarding. Find positions of comfort and change them when they start to feel uncomfortable. And, if you need to, seek guidance from a professional who believes in your body’s incredible capacity for self-correction and healing.

Shallow, upper chest breathing is associated with headaches/migraines and most chronic pain, including neck pain and low back pain. Here are a few easy tips to get started with healthier, diaphragmatic breathing.

1.  When you breathe in, your stomach should move out. There should be minimal movement of your shoulders (up) and upper chest (out).

2. The easiest position to learn to breathe with your diaphragm is lying on your back. Put one hand on your upper chest and one on your upper stomach. The stomach hand should move up as you breathe in and down as you breathe out. It’s much easier to learn in the gravity-eliminated position of lying down than sitting or standing.

3.  Try to slow down your breathing. Aim for a count of four on inhalation and a count of  six on exhalation.

4.  Inhalation activates the sympathetic (fight or flight) part of our nervous system and exhalation activates the parasympathetic (rest and repair) part of our nervous system. That’s why it’s healthy to slow down your breathing in general, but especially to slow down the exhalation.

5.  Visual cues work well. The website www.bfe.org has a breathing pacer that’s free for the first month. Click on “EZ Air Plus.” (Unfortunately, doesn’t work on Macs).

Most importantly, remember, you don’t have to breathe perfectly all the time. Small improvements can reap huge benefits. And the first step, as always, is awareness.

Breathing is something most of us don’t usually think about. If we’re still alive and breathing, we must be doing it right, right? Wrong.

Let’s start with the disadvantages of rapid, upper chest breathing. Things I see in my physical therapy practice every day. Like neck pain, low back pain, anxiety, poor sleep, cold hands and feet. And headaches. Especially headaches. In all my years of practice, I have never, not once, met someone suffering from headaches who breathed well. (Most of my clients with headaches have a similar story: headaches for years, poor sleep, cold hands and feet, tight neck muscles–all related to upper chest breathing).

Let’s get to the good news…

What are the advantages of breathing well, that is, slow, diaphragmatic breathing? There are SO many advantages that I can’t even begin to  list– much less describe– them all here. Let’s start with three important ways breathing well is related to feeling well, as in, less pain.

Diaphragmatic breathing promotes the relaxation response. One of the the ways it does this is by activating the vagus nerve (which lies close to the diaphragm, so when we breathe deeply and the diaphragm moves up and down, the vagus nerve is stimulated). 75% of the parasympathetic (rest and repair) nervous systems’s fibers come from the vagus nerve, so the vagus nerve is a VERY big player in the relaxation response. So much so, that slow, deep breathing is one of the most efficient, non-medication ways we have of going from the state of “fight or flight” (where most of us tend to hang out) to the much more healthy “rest and repair.” When our bodies are in a relaxed state our brains are considerably less likely to perceive input as threatening, and so pain signals are significantly turned down. Research has shown that decreasing anxiety can decrease a pain level of 7/10 to 3/10. Definitely significant.

Diaphragmatic breathing also improves oxygenation. Of course it does. Seems obvious. But did you know that the lower parts of our lungs are about 7 times more productive in oxygen transport than the lower parts? So when we breathe using our diaphragms (and thus the lower lobes), we get much more oxygen to all of our cells, including the cells in our hands and feet (they’re warmer–a nice fringe benefit), and our nerve cells (less pain). And all healthy cells need oxygen. Only pathogens (unhealthy cells) don’t.

Lastly, diaphragmatic breathing stimulates lymphatic drainage. Our lymphatic system has been compared to a sewage system (yuck!). It removes toxins, wastes and abnormal cells. The lymphatic system doesn’t have any pumps, so it relies on muscle contraction and deep breathing to keep it moving. Using our diaphragms to breathe stimulates the cleansing of lymph nodes, increasing lymphatic drainage. This increases the rate of toxin elimination (including the byproducts of inflammation, which cause pain) by as much as 15 times!

Gil and I instruct every single person we treat in diaphragmatic breathing, including often using biofeedback training (a picture is worth a thousand words…). If you’d like to learn more about the link between breathing and pain relief, or to schedule an appointment, give us a call (920.615.6055 or 920.835.1551) or send us an email (currentpt@gmail.com). We’d love to hear from you!

Things have to be pretty bad for a sixteen-year-old varsity volleyball player to quit the team, but that’s exactly what happened to one of our patients.

Kate (not her real name) came to see us at her parents’ request because of upper back and neck pain and increasingly frequent and intense headaches. It all started when she was on a four-wheeler on bumpy roads for an afternoon, a story that makes a lot of sense for the symptoms she had. Certainly, the physical symtoms she was experiencing could be accounted for by hanging onto the handlebars for dear life. The point to be made here is, she should have gotten better on her own. We usually do. So what happened to keep her from recovering?  And, the story could just as easily have been, “It all started after exams,” or, “It all started after a fight with my boyfriend.” The cause and effect does not always correspond so understandably. Again, the point is, something pushed her over the edge of her tolerance and her body wasn’t able to get her back on track.

In fact, Kate’s pain and headaches kept getting worse. Kate is a good student, responsible, and a great athlete, varsity in two sports. She went to traditional physical therapy and was treated with strengthening and stretching exercises. She kept getting worse. Soon, not only did she have to quit the volleyball team, but she was missing a troubling amount of school. Her physical therapist realized his approach wasn’t working and sent her over to us.

After we evaluated Kate, a few things were clear: She could move her neck and shoulders fairly well, but the nerve testing showed her nerves were likely not sliding along their pathways the way they should. Even though Kate could move well when asked to turn her neck, etc, when we watched her move it was as if her neck was much tighter than it actually was. And, her hands and feet were cold, even more than usual, except when she had a bad headache, when she would get uncomfortably warm.

Kate’s treatment consisted of gently facilitating the movement that her body already wanted to do, but she was not allowing to happen. (I will describe why this happens in another post.) Once she moved freely and let go of the guarding activity, of which she was not even aware, the blood flow increased (as demonstrated by warming of her skin, which is the opposite of what happens with the stress response), the nerves moved along their pathways with less resistance, and her pain lessened considerably. We taught Kate breathing exercises (she demonstrated quite shallow, rapid, upper chest breathing. Check your breathing… This is really common) which also increased the blood flow to the nerves/skin and helped her nervous system shift into a less anxious, more calming, mode. Kate was able to continue with these activities with some simple home exercises.

The headaches decreased in severity and frequency almost immediately. The neck and upper back pain took a little more time, but within a few weeks Kate was no longer missing school. She also was able to play varsity basketball without problems. Does this mean she’ll never suffer from headaches and neck pain again? No, most likely she’ll fall back into her old patterns at times, but she now knows there’s nothing terribly wrong, and she has tools to deal with the symptoms when they do recur.

In the next post we’ll talk in more detail about the importance of slow, deep breathing. In the meantime, practice slowly inhaling and even more slowly exhaling…