One of the most common breathing patterns we see is the hyperinflated pattern. Essentially, the athlete is in a state of excessive inhalation – breathing on top of breathing – with inadequate exhalation. They just can’t get air out efficiently. This hyperinflated pattern of breathing can be asymmetric (typically see the left rib-cage flared more than the right) or symmetric (both rib cages flared) as described by the Postural Restoration Institute. While these differences are important, particularly to the physio, hyperinflation has consequences regardless of symmetry.
Taking it a step further: inhalation is to excitation and tension (sympathetic-dominance) as exhalation is to relaxation and inhibition (parasympathetic dominance). Inhalation yields excitation – why heart rate increases with inhalation and decreases with exhalation. The dominance of this fight-or-flight response is essential in short bouts of performance, but is pretty much awful if maintained for long periods of time as it prevents recovery and relaxation – both of which are important for system neutrality. As my dad always said, everything in moderation. With this hyperinflated state inhibition of muscles, particularly the extensors, is difficult and the athlete cannot get into and sustain a variety of movements because the nervous system is under constant threat. The increased pH of the blood due to decreased CO2 levels also contributes to a sensitive peripheral nervous system. No wonder people with persistent/chronic pain display this hyperinflated, stressed-out state – a threatened nervous system is often a painful one!
Clearly, exhalation needs to be emphasized for a balanced, efficient system. By emphasizing flexion-biased breathing patterns, the system can approach a balance. pH levels can be normalized and beneficial training effects can be realized without adding rigidity to the system. By facilitating ribcage over pelvis mechanics, the diaphragm and pelvic floor can return to their normal resting length and function allowing the diaphragm to act like the diaphragm. I think many of our barbell-based strength training systems lend us towards this hyperinflated state so some reset movements likely need to be thrown into programming.
So what to do about this? That’s coming in a near future post but – spoiler alert – it involves forced exhalation, flexion and developmental patterns, and some recovery strategies. In the meantime here’s my earlier post on diaphragmatic breathing for recovery.