Thursday Thoughts: Breathing Patterns are Normal, Until They Aren't

This post is based on a live case from the first The Eclectic Approach to Temporomandibular Management certificate course. I was demonstrating breathing pattern assessment using the Capnotrainer.

Check out these posts for a background on breathing/the Capnotrainer

Now that you're refreshed, let's talk about the case from the course. The case was a late 20s female, PT in fellowship training. She is very fit, works out regularly and has some history of HA and tension in her neck. She was not currently symptomatic at time of assessment.

Upon putting her on the Capnotrainer, in supine and sitting, she had great levels of ETCO2, averaging 37 mmHg (WNL is 35 mmHg and above). As an experiment, and to see what it would do to her ETCO2 levels, I had her breathe using a sternal breathing pattern.

Shortly after implementing this pattern, she said she felt "odd." Her ETCO2 levels dropped rapidly

it only takes a minute or so to change ETCO2 levels by changing breathing patterns
this is significant because it changes pH balance in all major body fluids - lymph, interstitial fluid, and blood

After sternal breathing for only 3-4 minutes, I cued her to return to her previous optimal breathing pattern. She was NOT ABLE to regain her normal breathing pattern. She needed to be cued to try different levels of inhalation, exhalation and different rates of breathing to finally get her ETCO2 levels back to WNL.

The significance of this is that breathing is a learned habit, only respiration is automatic. Once you develop an abnormal breathing pattern, due to pain, or a stressful life event, you may not regain your optimal pattern. I thought the above case was very interesting because as a relatively asymptomatic and healthy young individual, with good body awareness, she was unable to attain her normal breathing pattern after sternal breathing for only a few minutes. If she had an inefficient breathing pattern for months or years, this is not something you can cue and teach over 1-2 sessions. Like any habitual change, it takes times and practice.

This video for this case will eventually be posted on Modern Manual Therapy, thanks to those of you who subscribe!

Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!

Keeping it Eclectic...