Breathing with the diaphragm is utilizing your strongest and most efficient breathing muscle. The diaphragm is a dome shaped muscle that goes from the front of the rib cage to the back. When it contracts, the diaphragm flattens down to pull air in; when it relaxes, it domes up to push air out. Your diaphragm works a lot like a window shade going up and down. Chest breathing is accessory breathing and should be "add on breathing" to the diaphragm. However, many people use their chest a lot when they breathe. If you sit in slumped posture, it is easy to slip into this habit. If you watch babies, they breathe correctly; you can see their little diaphragms move up and down when they are asleep and you can see how they use both the diaphragm and chest when they cry. It is easiest to learn diaphragmatic breathing lying down, then standing, and finally the most difficult position is sitting. Begin by lying or standing, then put the thumb of one hand on your notch at the top of your breast bone and let the palm rest across your chest; put your other hand below your ribs and above your navel. If you are doing diaphragmatic breathing, you should feel movement only with the lower hand. You could try putting both hands at your sides and place a book on your belly and you should feel or see the book move up and down.
Concentrating on breathing with your diaphragm is the quickest way to begin self quieting.
Here is how it works. You have a motor nervous system that controls your muscles and an autonomic nervous system that controls your internal organs. The autonomic system has two major subdivisions called the sympathetic system (stress; flight or fright) and parasympathetic system (relaxation). Some muscles, such as your diaphragm are supplied by motor nerves and autonomic nerves which means that you can breathe without thinking about it or you can "override" the autonomic system with your motor system and have slow diaphragmatic breaths whenever you want. Chest breathing should not be your primary breathing muscles in a relaxed mode. Chest breathing is a way we tend to increase sympathetic tone resulting in increased muscle tension.
You can test to see if you can "override" the sympathetic tone with your motor system on your very next breath. The next time you watch a "tear-jerky" movie and are sniffing away, concentrate on stopping chest breathing and breathing entirely with your diaphragm. It works! This is an extremely powerful technique to use when you have to speak in front of a group, make a sales pitch, talk with your teenager, etc. Many people feel diaphragmatic breathing is the single most helpful technique they learn. Things that increase sympathetic tone that can set you up for a stress response include:
* caffeine (chocolate, tea, coffee, and soda) * nicotine * sugar, especially on an empty stomach * chest breathing
that you have the idea of breathing with your diaphragm, concentrate on completely
exhaling. People with an irregular breathing pattern do not exhale completely Even if you
breathe with your diaphragm and exhale 70%, you quickly progress to chest breathing. You
can practice completely exhaling by imagining you are blowing at a lit candle, just enough
to make it flicker, not blow it out. Or you could imagine blowing lightly across a baby's
Why do we care about breathing patter and increased sympathetic tone? We care because increased sympathetic tone results in increased muscle tension and pain.
Each individual responds to events in daily life through biochemical changes within the body and brain. The alarm in the morning is perceived by the ear, transferred to the brain center for hearing by biochemical events within the nerve, then interpreted by the brain centers which send messages to the rest of the body through additional chemicals saying, "open your eyes, jump out of bed, get dressed." Chemicals are different depending on how the event is perceived by the brain. If the event is perceived as an emergency, fight or flight event, chemicals such as adrenaline and testosterone are released in increased amounts; if the event is perceived as a normal, easy life event the brain and body chemicals are different and give activating but calmer directions to all organs and tissues.
FMS individuals' brain centers and nervous systems tend to respond to life events with fight or flight chemicals rather than quieting chemicals. The autonomic nervous system that controls heart rate, breathing, stomach and intestine activity, bladder function, and circulation tends to send out more fight or flight chemicals than quieting chemicals.
We say it has a high idle at rest, always ready to jump. The on/off switch for full activation is hypersensitive. This means even normal daily events may activate biochemicals that are meant only for use during short periods of high stress.
This constant activation of stress chemicals is destructive to the body over the long term. Circulation to muscles is decreased so muscles ache from lack of oxygen and accumulation of waste products. Breathing rate increases and breathing is shallow and irregular so the FMS individual complains of shortness of breath and low endurance during aerobic activity. Heart rate increases and is often irregular, chest pain and pressure are experienced. Stomach and intestinal activity increases, excessive abnormal smooth muscle contractions can cause stomach and abdominal pain, diarrhea, and indigestion. Hyperalertness occurs and light irregular sleep patterns prevent repair and replacement of all body cells.
It is important to use management techniques that quiet the high idle or high resting level of the nervous system. It is important to use management techniques that assist the autonomic nervous system in responding to daily events with "calm" chemical activation of organ systems instead of "fight or flight" emergency activation.
These techniques are termed PHYSIOLOGICAL QUIETING. They are management techniques targeted to the autonomic nervous system.
The three major techniques are:
2. HAND W ARMING
3. BODY /MIND QUIETING
BREATHING - Approximately ten to fifteen percent of FMS individuals have a sense of dyspnea (air hunger) even in a resting state. During exercise an FMS individual's breathing pattern is irregular when normal individuals would have extremely regular breathing. The diaphragm, the major breathing muscle, becomes dysfunctional much as other muscles do in FMS. Accessory breathing muscles in the neck and chest take over for the diaphragm. Since breathing affects tissue oxygen levels, body metabolism, heart rate and the body's acid base balance, when breathing is erratic and the muscle action producing breathing patterns is changed, these physiological processes are severely altered. Heart rate is increased, nerve/ muscle resting level is elevated, and blood pressure changes.
Symptoms described by FMS individuals that can be directly attributed to hyperventilation, the most drastic form of erratic breathing, include: dyspnea, palpitations, chest pain, choking or smothering sensation, dizziness, vertigo, paresthesia, hot and cold flashes, faintness, trembling, and fear or anxiety feelings. With this in mind, returning to diaphragmatic breathing becomes an important aspect of FMS management.
The diaphragm a large sheetlike rnuscle that rests in a dome shape upward into the chest to the nipple area from the bottom of the rib cage and the spine. As you inhale the dome flattens and pulls down to the bottom of the- rib cage. During exhale the diaphragm moves back to the dome shape.
When breathing correctly, the shoulder and chest areas remain quiet, the jaw is relaxed, and the teeth are separated. Inhale, let your abdomen rise, exhale, let it fall. There is equal time for inhale and exhale, inhaling through the nose, exhaling through the mouth or nose. Exhale is passive and quiet. Diaphragmatic breathing eases and reverses the biochemical effects of hyperventilation and makes it easier for air to flow into the lungs. Practice the diaphragmatic breathing initially in a reclined position, then in sitting and standing. Practice hourly during the day, 7-8 breaths.
HAND WARMING - Circulation to muscles, nerves, internal organs, and the brain is often significantly decreased in FMS individuals. FMS individuals describe being core cold, not being able to warm up. Their hands and feet are cold, their buttocks feel cold, even their internal organs feel cold. Often a cold feeling is a cardinal sign of worsening FMS symptoms of muscle aching and fatigue within the next 6-8 hours.
Decreased circulation means blood vessel constriction. Blood vessel walls have three layers, one of which is muscular. The muscular layer is controlled by the sympathetic (fight or flight) nervous system. An active sympathetic system causes' constriction of the blood vessel wall, a quieting sympathetic system causes dilation or relaxation of the blood vessel wall, so the blood vessels allow more blood flow. When more blood flows through the vessels there is increased heat from the increased blood volume which results in hands, feet and other body parts warming.
Hand warming is a technique to increase blood volume to body parts. Mental imaging and frequently repeated thoughts transfer to nerve activity that quiets the sympathetic (fight or flight) nervous system activity resulting in dilation of blood vessels. To accomplish this:
1. "Visualize the warmest place your hands can be, holding a warm cup of hot chocolate, holding your hands over a camp fire or radiator, or slipping your hands and feet in the hot sand of a beach on a summer day."
2. "Think of the warmest color and surround your hands and wrists with that color. Let that color flow into your hands, deep into the palms, fingers, wrists while they get warmer and warmer."
3. "Focus your attention to your hands and say to yourself, "My hands are warmer and warmer, warmth is flowing into my hands, warmer and warmer."
To accomplish a resetting of the autonomic nervous system, to slow the high idle, it is necessary to practice the techniques that quiet the sympathetic system frequently for short periods. The instructions are: "Practice hourly for 30- 60 seconds, wherever you are. No one will know you are doing it." Put colored dots up around your work and home or buy a watch that buzzes every hour to remind you. Then hourly do:
* 7-8 slow, low diaphragmatic breaths
* Release jaw, quiet shoulders, quiet chest .
* 7-8 repetitions of hand warming
BODY / MIND QUIETING - Body/mind quieting serves many important functions helping FMS individuals. Excessive muscle resting levels and internal organ activity can be decreased through physiological quieting of the body/mind.. Abnormal sleep patterns are improved with physiological quieting of the body/mind. Physiological quieting of the body/mind assists the immune system in optimal functioning.
To accomplish body/mind quieting: Find a quiet, warm room with a chair or bed that gives complete support from your head to your feet. Use pillows for support of your neck, low back, arms, and knees.
1. Focus on your breathing, feel the pattern of breathing, let your abdomen rise with inhale, fall with exhale.
2. Feel the warmth or coolness of your hands and feet, left side and right. Let your hands and feet feel warm, feel warmer and warmer.
3. Feel the support of the bed or chair and release into that support, let your feet, legs, hips, back, shoulders, arms, neck and head sink deeper and deeper into that support.
4. Focus on your face and neck. Notice where there is any tension or tightness, where there is quiet, calmness in each part of your face and neck muscles - your forehead, eyes, cheeks, tongue, throat, neck. Then say to yourself 3-4 times slowly, "My face and neck muscles are quiet and calm, my face and neck muscles are calmer and calmer."
5. Proceed from head to toe in the same manner, focusing on head and neck, back (upper, middle and lower), shoulders and arms, hips and legs, chest and abdomen.
6. Focus again on diaphragmatic breathing, and hand warming.
One to two 20 minute body/mind quieting sessions a day are recommended. Try doing it 20 minutes before you get out of bed in the morning and 20 minutes before going to sleep at night.
Integrating physiological quieting throughout the day is an essential aspect of self care in FMS management.
Designed, developed and owned by
The Fibromyalgia Community,
a CSSA Partner, (a 501(c)3 non-profit corporation)
maintained by Chip Davis and Jane Kohler
The Fibromyalgia Community website is a privately owned site.
Copyright (C) 1997-2002 The Fibromyalgia Community.
All Rights Reserved.
July 25, 2004
Health Information Disclaimer