Tag: postural restoration

Posted on

How Do I Keep My Lungs Healthy? Two Simple Techniques

If you have ever come to see me as a patient, you have heard me talk about the importance of breathing. Not just for lung health, but for the health of your whole body.

That’s why I’m so glad that Ron Hruska, founder of the Postural Restoration Institute, was kind enough to put together two exercises that will preserve your lung health, and that almost anyone can do!

He created a video explaining the importance of compliance in our bodies especially in relation to our lungs, which I will summarize in this post. You can view the full video here.

So what the heck is compliance?

In terms of our bodies, it is essentially how mobile or flexible an area of your body is or isn’t. If an area is more stiff, it has less compliance, and if an area is more stretchy, it has more compliance.

In our bodies, there are areas that are anatomically stiffer and others that are stretchier. That’s just the way we’re made.

For example, your back has lots of layers of thick muscle and fascia, which makes that area more stiff. Conversely, the front of our body, including our abdomen, has much thinner, fewer layers of tissue, so this area is more stretchy (and also why you should not belly breathe! It makes the stretchy parts stretchier, and the stiff parts stiffer! More on that here).

Similarly, our left lung and surrounding tissues tend to be stiffer because the heart takes up a lot of space on the left side. The right side tends to be stretchier (unless we end up compensating, but I won’t get into all that here).

So, in general, the LEFT BACK area around the lungs tends to be more stiff, and the abdominal region a little too stretchy. This stiffness works its way down the chain to the left back pelvis because your pelvis motion is intimately correlated with your ribcage motion.

Why should we care about stiffness and stretchiness?

In the video, Ron shares an article about how a transplanted liver can last hours longer in transit if it is placed on a balloon-like structure instead of a block.

In this scenario, the balloon is your diaphragm.

The liver, just like all your other organs, needs to be massaged and moved around to be healthy. Your diaphragm, when working correctly, is constantly massaging your organs via your breath.

Furthermore, your lungs have many different nooks and crannys that need to be cleaned out by the right to left, front to back, and top to bottom pumping action we get through breathing and moving.

So the best thing you can do to stay healthy is to breathe well and stay moving! Climb stairs, get up and down from your chair, go for walks, etc.

But we need to give our lungs special attention, because of the anatomical differences we discussed earlier.

How does this relate to COVID-19?

Ron also cites an article from CNN, which discusses how healthcare providers are making it a point to place more severe patients on their stomach, and rotate them at certain time intervals throughout the day. This helps patients who are ventilated recover from COVID-19 infection.

The reason that positioning helps these patients is that lying on their stomach creates more stiffness in their abdominal region (from the pressure of the surface), and more stretchiness in the back. It also drains the back lung area of any infection, fluids, and stale air so that it can fill again with fresh clean air. Similarly, when the patients lie on their right side, the left side drains so that it can refill, and so on.

What is so amazing to me is that Ron and the Postural Restoration Institute created simple techniques that place your body in a position that drains all the right parts of your lungs, but in a functional, physically active way. Patients in the hospital on ventilators can’t do this because they are too weak, but you can!

Why would you want to do these exercises?

It’s so important right now to keep your lungs healthy. And if your lungs are draining and refilling well BEFORE you get sick, the severity and duration of your illness will be much less. So, hopefully you DON’T get sick, but if you do it will be good to have your body as prepared as possible to combat the virus.

Having good stretchiness/stiffness ratios in your body and lungs helps with so many other issues!

Allergies, airway issues, pain syndromes, there are so many benefits to these techniques.

I hope you try them, you will benefit from doing one or both of these every day. And at the very least, get up and move, whenever you can!

A simple technique to keep lungs healthy!
Another exercise to keep lungs healthy!
Posted on

The Illusion of Symmetry

From the outside we look symmetrical. Left to right, it seems that if you drew a line down our center we would get two equal parts. Most anatomical drawings present the human body in this way.

When we dig a little deeper, it turns out that right to left we are quite different, and these differences can have a profound effect on our physical functioning.

Often I have patients ask questions like, “why is it that only my right knee hurts with running?”

Good question! Some may say that this is due to handedness, with most of us being right handed. But have we ever stopped to ask why it is that most of us end up being naturally right handed? I don’t intend to get into a debate about handedness, but it certainly hints that there is something else at play, some asymmetry inherently present in all of us. These asymmetries are normal and natural. However, these asymmetries can become problematic when they become unbalanced.

asymmetrical pelvis and ribcage

This can occur due to external or internal circumstances. For example, your life requires that you do repetitive tasks to one side only, like reaching for the phone on the right, or getting in and out of the driver’s side of your car. It may also be something intrinsic to you, such as an injury. If you had an injury to your left leg, you felt more stable on your right leg as you were healing. That is helpful while you heal, but that patterning of preferring the right leg to stand on can remain long after the tissues have healed.

The Postural Restoration Institute has a deep understanding of these asymmetries and how they affect us. This institute is unique in that it addresses these complexities of being a human when creating a treatment plan, which I have not seen in literally any other course or training for physical therapists, even when I was in my doctorate program this was glossed over at best.

Let’s Talk Asymmetries.

The primary source of these asymmetries is the center of our body, the trunk. It is the generator of motion in our limbs and it is our center of stability. At the center of our trunk (the “core of the core,” if you will) lies the diaphragm, which is dramatically impacted by the asymmetries of our organ and lung placement.

The diaphragm on the right tends to be more domed due to:

  • lower attachments of the diaphragm onto the right side of the spine compared to the left.
  • The central tendon (which makes the dome of the diaphragm) is thicker and stronger on the right than the left.
  • The right diaphragm has the support of the liver underneath.
  • The presence of three lung lobes on the right and only two on the left to make space for the heart.
Radiograph showing the right diaphragm (left side of picture) being higher than the left. This is normal human patterning.
Radiograph showing the right diaphragm (left side of picture) being higher than the left. This is normal human patterning.

All these things cause the right rib cage to be in an “exhale” position with the ribs dropping down and into the body, and the ribs on the left to be in an “inhale,” an elevated and expanded position. Think of the left lung as a big balloon pushing on the smaller balloon on the right. This causes an orientation of our ribcage to the left. The attachments of the diaphragm on the spine cause the spine to turn right.

The Postural Restoration Institute has recognized this natural asymmetry and incorporates this anatomical variance into their training of physical therapists and therefore the treatment of our patients. When I first heard that everyone is biased one way, it was news to me. When I was in my doctoral physical therapy program, we learned all the asymmetries of the vital organs, however the influence of this asymmetry was not applied to physical function. Furthermore, the asymmetrical structure and pull of the diaphragm was hardly mentioned, if at all. I find this surprising now as the diaphragm is a muscle that we use all day, every day, and it has profound impacts on how we move and interact with our world.

So what’s the big deal about the diaphragm?

The diaphragm is huge! It attaches to our lower back spine and interfaces with our abdominals, low back muscles, and hip flexors. After I took my first postural restoration course, I was pleasantly surprised at the emphasis on diaphragmatic function and it’s role as a driver of human movement. I was also surprised at how “belly breathing,” which I taught and practiced myself, was actually detrimental to harnessing the power of the diaphragm. The inherent asymmetries within our diaphragm drive the initiation of human movement, specifically walking. Essentially, the stability of the right diaphragm supports right stance phase of gait (standing on your right leg and left leg swinging).

walking still shot in Right stance phase with left swing phase

The problem occurs when we go to stand on our left leg, but we are still in right stance with our supporting muscles. The left diaphragm is not able to support our body in this position, and our right leg does not adequately recruit muscles to swing the right leg. This occurs not just in walking but also during day to day tasks. This can create all kinds of issues, knee pain on one side being just one of them. Fortunately, this asymmetry can be addressed with specific exercise that is asymmetrical, and therefore corrective. These exercises incorporate the breath to achieve diaphragm function.

Once again, I want to reiterate that this asymmetry is not a bad thing inherently. It is in fact a wonderful thing as it initiates the walking cycle and allows us to begin rotating through our trunk and pelvis. Asymmetry becomes a problem when we get stuck on one side, and are not able to get over to the other side. Relearning how to transition from right to left, and then back from left to right, is how we get balanced again.

Are you transitioning well from right to left stance?

You may have difficulty transitioning from side to side if you:

  • Tend to always have tightness in one hip more than the other
  • Always cross one leg over the other (usually the left one over the right)
  • One leg feels longer than the other
  • You notice different wear patterns on your shoes or bike saddle

Try this simple exercise to test your asymmetry:

Stand with toes pointed straight forward (feet not turned in or out). Keep this foot alignment as you transition to standing on one leg. You can touch a counter in front for support. Now, turn your pelvis so that the zipper of your pants comes over your right big toe. Try the same thing standing on the left leg, toes pointed forward, knee slightly bent. This time, try to turn the zipper over your left big toe. Notice if you can do this on one side, but not the other.

If you find one side to be challenging, but not the other, that indicates you may have trouble shifting to one side. Because of our natural human pattern, it is usually harder to do this standing on the left leg. That doesn’t mean you can’t stand on that leg at all, but it means that when you are standing you aren’t using the correct chains of muscles, which results in pain and dysfunction. To address this issue, come see me or a PRI trained therapist near you to get properly screened and the tools to find better ease and balance in your body.

Call Dr. Derya