Intra-abdominal pressure
The one movement we all perform, and must perform no matter what ails us, is breathing. Breathing occurs in a continuous cycle from birth to death, and any other kind of movement pales in comparison to how much it affects our health.
When we breathe in, our lungs and the whole upper body expand. Beneath lungs, the diaphragm has activated and contracted. In the process it presses downward into the abdominal cavity pushing organs downward. All of this creates higher pressure inside the lower body with every breath cycle. Above and around diaphragm ribs turn like bucket handles: out & up –increasing the space where lungs live.
When lungs have filled with fresh air, the diaphragm relaxes, ribs lower back and internal organs within the abdominal cavity bounce / glide upward. Pressure inside the abdominal cavity lessens again.
The structures of human pelvic region react to these changes of pressure with every cycle. When we lift heavy weights, play wind instruments, or do strenuous exercise, the pressure will be intensified even more. In fact, we can use intra-abdominal pressure to create extra support for lower back. In the below video compilation, you can observe weight lifters hold their breath at a certain point of their performance. Filled up to brim the torso becomes more taut, a bit like a balloon being blown. Many of us do this instinctively whenever situation requires it.
Seems simple enough:
the body fills up and pressure rises; the body (partly) empties out, and the inside pressure comes down. But unlike a balloon, our bodies are not equal on all sides(1). The spine is more in the backside of us creating a comparatively hard support, so is most of the length of ribs. Ideally they move slightly when breathing.
Our bellies are designed to be soft. It is like an accordion when we move from standing to sitting to standing. Humans give birth to live offspring, so there has to be room for a womb to grow. Maybe another reason is the very short span of time, which our ancestors have spent on two legs. A soft belly makes sense for quadrupeds whose bellies are more sheltered beneath their trunk.
In humans strong connective tissue, muscles and probably in some degree belly fat cover and protect internal organs of the abdominal cavity.
When intra-abdominal pressure rises the front is able to give more than the bone-supported areas of back and upper abdomen.
I have been pondering the possible effects of my own fairly stiff upper back to my pelvic health. During manual or movement sessions with my (mostly female) clients I make sure to asses whether this is a salient point of departure for them. Recently a conversation about male pelvic health offered me new points of view. I was lucky to be able to ask Ciaran Regan about the relation of breathing and pelvic health in men. He pointed me to a gentle exercise he recommended to increase the capacity of one’s back to expand. I was subsequently launched to foray into relevant literature. In order to share practical tools with you I wrote this article.
Myofascia (muscles and connective tissues in concert) functions in harmony, especially when we are lucky to be trauma-free, or to have healed any such. When there are unhealed scars on physical or emotional level, the nervous system may create alternative patterns of activation. Consequently, our posture can change. (2)
It speaks of the ingenuity of living bodies –us– that they create new pathways for movement when old pathways are inhibited because of accident or over-use. That is why we can still walk even after a calf muscle has been permanently damaged by an injury. Indeed, movement professionals are often able to continue their careers nevertheless. Reactions to emotional trauma come from the most ancient part of our brain, and are designed to make sure we can survive even in a hostile environment.
The pelvic area can react strongly when
changes occur elsewhere in the body.
A soft underbelly can be powerful. A powerful abdomen can be soft. In fact, suppleness and ability to relax are hallmarks of healthy muscle. A problem in relation to intra-abdominal pressure occurs if the thin sheets of muscle in our lower torsos (the lower abdomen, the pelvic floor) give out when weak. In women the pelvic floor can weaken ceasing to properly support the uterus, the bladder or the rectum. In men hernias are surprisingly common. (3) There is a link between prostate health and pelvic floor. (4)
In order to know which corrective exercises to do, every individual should be assessed by a specialized manual therapist. Only then will you know what to strengthen and what to release. Meanwhile, the one movement we all perform, and must perform no matter what ails us, is breathing. We can work with it. Breathing occurs in a continuous cycle from birth to death, so that any other kind of movement pales in comparison to how much it affects our health.
If there is tightness in any area of the abdomen and thoracic, that area will not expand or release tension during the breathing cycle. Sometimes there are muscles that are in fact spasming. These tissues are in continuous shortened state and may have forgotten how to let go and return to their proportional rest length. Because pressure inside those areas will rise, some other area will compensate and expand beyond its capacity. Muscles in those areas can become stretched and weakened because they are asked to keep lengthening 4-20 times every minute.(5) They will never have the opportunity to, –and may then loose their neurological ability to– shorten into a proportional rest length.
Interestingly, massage clients often sense the overstretched tissue as painful, and ask for those areas to be massaged. The spasming or tightened areas may be neurologically ”asleep” so that we are not conscious of them. This is related to how human nervous system works. It is up to a bodywork professional or physical therapist to asses the client and work as needed –if the goal is to alleviate posture-generated pain.
If you have read all the way here, you probably see why there can’t be one general breathing routine that will help everybody’s posture. However, I’m going to gingerly post a couple of exercise here.
Go gentle, keep breathing. You assume responsibility for your own body and health when using these instructions. Please, if you have any medical issues do consult your physician, or if you’ve been referred to physical therapy, ask your trusted professional.
My aim in posting these exercises is that the delicate actions of breathing will create activation and lengthening in your deep musculature, both very subtle. With time and patience this will hopefully start to balance your body. I have been breathing like for at least 12 years, and have found it beneficial. In any case you can be sure the time spent breathing like this will not be wasted effort: it is now generally accepted that concentrating on, and calming down, breathing will have a healthy effect on your heart and nervous system. Concentrating on breathing is more helpful than traditional meditation for people who struggle with anxiety. (6) On conscious level it gives the mind a task while relaxing, very useful for anxious, traumatized and ADHD populations.
Which of the poses should I choose?
Is your back curved? Does it curve backward, or does it curve forward? You can always do both version 1. and version 2. in as gentle a version as possible. Use minimal props to avoid over-stretching. The pose in version 3. I recommend to all and everyone. Don’t force yourself into any pose, start from as relaxed a position as you can.
Props you may use:
a yoga bolster
dense cushions that offer enough support
rolled up towels or blankets
an exercise mat or a thick carpet
In any of these poses try and let your breath do its thing –without actively sucking in air or pushing it out. Become conscious whether you are doing this or if you are ”letting breathe”. Your autonomous nervous system will keep you breathing even in sleep or deep relaxation. Instead, direct breath towards tight areas designated in descriptions below.
1. Exercise for people who have a forward curving belly and / or tight back. ”The Military Personnel” and ”The Dad-bod”:
Lie on your stomach on exercise mat or soft rug. For people with ample breast tissue, place a bolster, a cushion, or a rolled up towel below your breasts. This creates more space so that you can curve over the support comfortably. Rest your forehead on your hands and make sure your mouth and nose remain free. Remove glasses! Your neck should remain fairly straight. You can place a rolled towel under your ankles in case they are stiff. It should make you more comfortable even in case your back is very stiff..
Focus on your breathing. Let your breath do its thing without actively sucking in air or pushing it out. Try and direct the movement towards your sides and your back. Having your front against the floor or the bolster will support this intention. Stay in this position from two minutes to ten minutes, as often as you can.
Here is one version of this breathing exercise by Ciaran Regan. He shows next steps where you advance into doing the exercise in a more challenging, vertical position. I recommend practicing the horizontal position for a time until it becomes comfortable, before trying out the advanced versions.
2. Exercise for people who se chest is tilting downward. Often the upper back is rounded and / or shoulders are turning towards the front (”The Professor”):
Place a bolster or a firm cushion under your ribcage while laying on your back. When you sit in front of the bolster, make sure there are two hand-widths between your buttocks and the edge of the bolster. You can absolutely use rolled up towels or blankets instead of a yoga bolster. If this position feels uncomfortable, definitely do that, so you can reduce height of the support behind your back.
The second video shows Candace Cabrera go into this pose. To follow instructions start video at one minute thirty seconds (1’30”).
While in this pose, direct your breath towards sides and front of ribcage. Relax the length of your stomach. Try and let breathing happen by itself. You don’t need to actively push air out or suck in air.
Repeat this exercise often, and stay in it from two minutes to ten minutes.
3. Exercise for when you have tightness here and there,
or when you are not sure which one to do:
Do both versions after each other, or on consecutive days. You can start without bolster or any other extra support –unless you need support below breast tissue, injured knees, stiff ankle joints or any other personal need for adjustment.
4. There may be a version that almost everyone could benefit from:
Most of us will benefit from regularly rotating the spine into a gentle spiral. It is the only way to relax some of the deepest muscles of the human spine. So, in case you look to ”lengthen” your spine, this is the exercise you should do. It will help you relax and when done correctly, increase lung capacity by allowing a teeny tiny bit more movement in the thoracic. Gentle twisting aids digestion.
Ideally your body moves through rotation with each step we walk or jog. Consequently practicing this pose may help those activities feel easier. To round up the program make sure you go for walks, so the small intrinsic muscles involved will get a chance to activate, as well.
Obviously it is important to do the twisting position both
1. knees towards left and 2. knees towards right. Possibly you’ll sense that one side is harder for you. Keep practicing both sides anyway, as there may be other tight spots laying low ”beneath” the initial experience.
On the third video Carolyn Chaiko instructs how to set up a gentle, supported twist.
Notes and sources:
(1) ”Sides” is an imperfect term here, because humans consist of 100% biomorphic shapes. There are no straight angles in our bodies.
(2)These are unconscious processes which you cannot change by weight lifting, protein intake, shots of testosterone, high intensity training, diet changes, will power, yoga, meditation, talk therapy, or manifesting. The presence of re-routed myofascial activation patterns tells us nothing about your character or motor-skills.
(3) Large number of men’s hernias are Indirect Inguinal Hernias in the pelvic area, caused by a feature of male anatomy, which is not the topic of this text.
(4)
(5)The amount of breathing cycles per minute varies according to at least age, overall health and situational demands on body. Breathing four cycles within one minute is a rate achieved by some meditators while intentionally calming down their breathing. 20 cycles per minute is pretty fast, and would point to stress, which could be exercise (healthy stress), illness or anguish.
(6)https://hbr.org/2020/09/research-why-breathing-is-so-effective-at-reducing-stress
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