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IADMS 2001- Training Breathing Mechanics for Better Trunk and Spinal MobilityTraining Breathing Mechanics for Better Trunk and Spinal Mobility
Juan Carlos Fernández , PT; Jordi Pérez, PT; Carlos Puértolas, MD; Institut del Teatre de Barcelona, CEPA Oriol Martorell INTRODUCTION: This presentation exposes one of the works our students carry out in classes of physical conditioning and postural work, or in individual sessions of rehabilitation or corrective alignment. It seeks, with it, to analyse how we use the breathing musculature keeping in mind that, almost all of it, combines this function with another motor action on the different skeletal structures on which it settles. Its agonistic, synergistic or antagonistic function, in the thoracic expansion, it will depend, in many cases, on the position the trunk is and on the fixation points for the muscular work. Of all this we deduce the influence that posture, alignment and body mobility exercise on breathing effectiveness, and vice versa. WORKING FIELD: This work is carried out in the two official dance schools of Barcelona (Spain): Ø the center of primary and artistic studies “ CEPA Oriol Martorell”, where the elementary studies of dance are imparted, and... Ø the professional Conservatory of Dance of the Institut del Teatre of Barcelona, in which are carried out the three specialties of classic dance, contemporary dance and Spanish dance. Its application is carried out through two ways: § Inside a discipline denominated “physical work and postural education'', § In individualised sessions for those students attend with specific necessities. WORKING TEAM: Our team, present in both schools, it is formed for a MD specialist, and three physiotherapists (the three former professional dancers). We have, essentially, two functions: - A pedagogic action of which are part the disciplines “Anatomy applied to dance” and “Physical work and postural education.” - The therapeutic and medical cares, in which are included the sessions of “Specific and personalised work.” FINDINGS ABOUT BREATHING AND CLASSWORK IN DANCE STUDENTS: The discipline “Physical work and postural education” it supposes for our students a physical conditioning and a kinesiological learning that they develop in a progressive and structured way, constantly revised and modernised. As for the work of the breathing, initially our focus contemplated it as a means to improve the effectiveness and yield of air ventilation and a better co-ordination between breathing and movement. The observation allowed noting some aspects that drove us to a new perspective of the use of breathing mechanics, now also, in function of a better and bigger degree of spinal and thoracic mobility. The facts that were verified are: • The aspects and concepts of the breathing system that the students possess are not very clear • Lack of perception and of three-dimensional conscientiousness of the structures that intervene in the breathing. • Not very effective breathing, presenting restrictions of thoracic and diaphragmatic mobility, apnoeas excess, inhaling and exhaling phases mostly too short, etc. • The practice of certain dance techniques, for their own dynamics or for their misunderstood execution, it can predispose to the lost of flexibility in certain areas of the spines and the thoracic cage. • Great part of the muscular action, in breathing, relapses on the secondary or synergistic musculature, physiologically and functionally not adapted for this task. • In breathing, the student uses the most instinctive and comfortable thoracic expansion, adopting breathing patterns that has tendency to mobilise, exclusively, the most flexible areas in the thoracic cage consolidating, through the time, the restriction areas and hypersoliciting the proximal muscle-skeletal structures. • Certain forms of breathing and/or the restricted use of breathing mechanics, it frequently coincides with alterations of body balance and alignment, overload and injuries. • Absence of stretching and flexibility exercises for the thoracic cage • Ignorance or scarce use of the different possibilities of thoracic expansion: à Difficult breathings in postural situations or in movements that behave the closing of some intercostal spaces à Insufficient implication of the thoracic expansion in the qualitative development of the danced movements. Starting from these points the work was guided to improve and/or to solve these lacks ASPECTS ON THOSE IS BASED THE USE OF BREATHING MECHANICS TO IMPROVE THE TORSO AND SPINE MOBILITY We found basic two necessities: - To maintain a good thoracic and spinal flexibility. - To endow the student of the capacity of using, in a voluntary way, the resources that the thoracic expandability provides him. With such purpose we centered ourselves in three aspects: 1. Influences of the posture and the body movement about the expandability of the thoracic cage and the effectiveness of the breathing muscles. 2. Repercussion of the breathing types and the thoracic mobility on the spinal and body alignment and mobility. 3. Function and level of responsibility of the different muscles that intervene, direct or indirectly, in breathing. Examples that allow illustrating the analysis or focusing from which take place the three mentioned aspects: A) In the relationships alignment–movement regarding the breathing, we can find an excessive use of the supraumbilical fibres of the abdominal muscles. In such a circumstance, the descending pressure, caused by the diaphragm during its contraction, impacts too directly on the abdominal and pelvic organs, for what there is a tendency to inhibit the infraumbilical fibres of the abdominal muscles in a way to allow a pelvic tilt forwards and a distension of the abdominal wall that it will reduce the pressure coming from above. To mention, also that this same excessive contraction can bring the torso backwards, with the rising increase of the dorsal kyphosis. B) This leads us to a second reading, the relationship that settles down between the thoracic expansion regarding the spinal mobility and other corporal structures mobility. A thorax with restriction of mobility of the upper anterior intercostal spaces causes a thorax, in the long run, in upper-anterior closing. This causes traction of the neck flexors, with the rising cervical extension. In the moment it will be needed an increase of the ventilatory capacity or intensity, the superior costal opening won't take place with easiness, what will cause an excessive work of the neck flexors, and a thoracic expansion, essentially, at expense of a back-lumbar extension C) As for the muscular protagonisme, we contemplate the indisociability among the breathing action of the muscles implied in it, with its or their other motor responsibilities. As an example, we will mention how the latissimus dorsi being a muscle in fan, it could have a synergistic action in inhaling or exhaling, according to the position of the body, and according to if it participates together with the RAC (rectus anterior chain) or the RPC (rectus posterior chain). The same thing happens with the quadratus lumborum, the one which, in spite of being considered as a expiratory muscle, in certain circumstances, when stabilising the last rib it can become a synergistic of the inspiration. Lastly, to mention that on the contrary, muscles with a remarkable inhaling action, they can be relegated to their minimum participation due to the frequently noxious effects on the body alignment. As it is the case of the scalene muscles and of the sternocleidomastoid muscle, those which, however, we will use in specific exercises of upper-anterior expansions. OBJECTIVE As it has already been introduced along this presentation, the main objective of this work is to train the dancer to be able to use the resources that the different kinds of thoraco-diaphragmatic expansions offer, in order to allow a maximal flexibility of the thoracic cage, and to minimise thoracic and spinal restrictions. Thereby facilitating a better body alignment, and favouring a better control and quality of the dance movement DEVELOPMENT We begin to apply this work starting from the six years of age. This requires a program that it develops the knowledge and the aptitudes, as well as the habits, in a progressive way adapted to the level and age of the student; and offered in the most experienced, playful and amusing possible way. This program includes: 1. Becoming conscious, perceptively and conceptually, of the anatomic structures that are involved in breathing and in thoraco-diaphragmatic mobility, special emphasis in the three-dimensional perception. - By means of games of localization of the body parts or the structures implied in breathing... - Through the learning and localization of the muscle-skeletal structures with a degree of complexity in relationship to the student's age, etc. 2. Kinaesthetic perception of breathing and of the different ways of doing it - Practice of inspirations, expirations, apnoeas, nasal and buccal ventilation, ventilatory intensity, soft inspirations, explosive expirations, etc. - Experimentation of the different possibilities of thoraco-diaphragmatic expansion. For example: the abdomino-diaphragmatic, the upper-anterior, the lateral or costo-lateral, the postero-lateral and inferior one, etc 3. Learning and practise of the different kinds of breathing mechanics, to be able to use them in a voluntary way. - Frontal and upper expasión , postero-medial costal expansion, Prone essential diaphragmatic breathing, with the consequent lumbar lordosis diminution, bilateral costo-lateral expansion, postero-monolateral rib cage expansion, etc. 4. Consciousness and kinaesthetic perception of the different kinds of breathing and thoracic expansion and its repercussion on the spine, alignment and movement. - Experimentation and identification of how an excess of protagonisme of the supraumbilical fibres of the abdominal muscles, has tendency to close the anterior rib cage spaces, and how much can that increase the dorsal kyphosis... - Experimentation and identification of how can a correct upper torso expansion help... and in what can its inadequate use harm... - etc... 5. Practise of different kinds of tonic control exercises which, in a direct or indirect way, contribute to improve breathing - Through relaxation exercises... - By means of exercises of control on intensity and amount of air in and out flow... - etc... 6. General stretching and specific thoracic cage flexibilization, especially in the areas with reduction or restriction of mobility. 7. Study and use of the thoraco-diaphragmatic and spinal mobility to improve thoracic expansion - Opening of the anterior intercostal spaces - Opening of the low and posterior intercostal spaces - Opening of the lateral intercostal spaces - Flexibilisation of the RAC myofascial structures by means of paradoxical breathing exercises Etc… 8. Study and use of the thoraco-diaphragmatic and spinal mobility to improve thoracic expansion - Flexibilisation of the rachis in flexion by means of posterior rib cage expansion - Flexibilisation of the rachis in lateral flexion by means of monolateral rib cage expansion - Flexibilisation of the rachis in rotation by means of monolateral back expansion - Costal expansions directed to the correction of concavities in the scoliosis. - Etc 9. Use of different kinds of thoracic expansion to improve or to influence the quality and dynamics of dance movements - Experimentación, identificación y control de movimientos similares, pero dinámicamente distintos según se realicen en espiración o inspiración RESULTS The present work is being developed for five years. After this period, we have been able to evidence the following results: · An improved consciousness about the importance of breathing mechanics to the physical condition, body alignment and movement · Improvement of breathing efficiency, with diminution of apnoeas · Reduction of the thoracic restrictions resulting in a larger spinal freedom CONCLUSION To end this presentation, we would like to state our deepest conviction that the study and use of this work should represent, for students and professionals dancers, a step forward towards a better knowledge of their body as an instrument for their physical conditioning and technical work, and in particular a very important resource to preserve and to favour their health |
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