PILATES AND BREATHING

Bianca Thyer, Physiotherapist

1 March 2024

Pilates exercise was founded in the 1920s by Joseph Pilates, a German born fitness enthusiast who managed his own health issues including asthma, rickets and rhematic fever through his therapeutic exercise regime. The development of his spring-based resistance apparatus famously began when Joseph Pilates served as an orderly in the First World War where he attached bed springs to the hospital beds to help support injured patients. Pilates, as suggested by its original name “Contrology”, emphasises the control of body position and movement, and is traditionally based on six principles including:

·       Breath

·       Concentration

·       Centering

·       Control

·       Precision

·       Flow

If you’re new to pilates, the ones probably standing out to you are “Breath” and “Concentration” as you think back to when your pilates instructor said “don’t forget to breathe!” as you tried to concentrate on coordinating all your limbs into what felt like somewhat impossible but strangely comfortable positions whilst also activating your pelvic floor and glutes, and trying to keeping your back flat! It can be overwhelming right?

Joseph Pilates himself, once said “Above all, learn how to breathe correctly.”

So, let’s start there!

Breathing influences all our body systems and is essential for life, but undoubtedly the three main functions of breathing are to:

1.      Transfer Oxygen into the blood

2.      Remove carbon dioxide waste from the blood

3.      Help to maintain a constant acid-base or pH balance in the blood

Breathing is adaptable and can be changed consciously and subconsciously in response to a particular situation or medical condition. For example, your pilates instructor may cue you to breathe in a particular way which would be considered a conscious or voluntary change you make to your breathing. You may have also experienced a subconscious change in your breathing as part of the body’s reaction to stress or anxiety. For example, when you walk into the studio and your instructor says “we’ll be doing a planking series today”…

Your heart is racing, you’re suddenly out of breath, perhaps feeling a bit flustered and you catch yourself scoping out where the nearest exit is!

Breathing plays a key role not only physiologically, but also impacts on our mental state and can in some cases be a contributor to feelings of anxiety. Therefore, having awareness of how you are breathing and the ability to adapt it will serve you well not only for your pilates classes, but for your everyday life.

Let’s take a look at how breathing works:

Figure 1.

The mechanics of breathing can be quite complex with various pressures involved, but I’d like you to focus on the muscle labelled “diaphragm” in the diagram above. This is the main muscle of breathing and works 24/7, 365 days a year for as long as you live! The diaphragm, abdominal wall, deep spinal muscles and pelvic floor forms the group of muscles more commonly known at the “core”. This means that how you breathe affects your core too!

During quiet relaxed breathing, the diaphragm actively contracts or flattens as air starts to fill the lungs during inhalation pushing the abdominal contents downwards. The pelvic floor and abdominal muscles work with the diaphragm in a piston like motion relaxing to make room to moderate pressure in the abdominal cavity. During exhalation, the diaphragm passively relaxes back into its dome like shape as the lungs empty, the pelvic floor lifts and the abdominal contents return to its original position.

There are a wide variety of breathing techniques practiced in the health and wellbeing space that have great benefits for meditation, stress relief and relaxation. However, I would like to draw attention to two ways of breathing during exercise, that without realising can become habitual and lead to uncomfortable symptoms affecting your everyday life.

1.      Breath holding

Please listen to your Pilates instructor reminding you to breathe! Holding your breath during exercise will not only cause you to fatigue quicker, but also puts pressure on your pelvic floor which can contribute to urinary incontinence. Take special note in your day-to-day life particularly when using  electronic devices, you may find yourself holding your breath without even noticing! This can contribute to brain fog, headaches and dizziness.

2.      Forceful exhalation

When breathing at rest and during light activity, exhalation is designed to be a passive process. It is normal for exhalation to become more active as exercise intensity increases. However, forcing your exhalation when it is physically not required for example during a light exercise such as cirlces with your feet in the straps (everyone’s favourite!), can encourage a habit of actively engaging your abdominals in breathing and/or constantly “holding” your abdominals or “sucking in” your tummy. This makes it difficult for your diaphragm to expand for inhalation and causes tension in your pelvic floor muscles, and can contribute to pelvic pain or feelings of shortness of breath.

Here are two simple exercise to draw awareness to your breathing and encourage a healthy diaphragmatic breathing pattern. I like to do this exercise when I notice myself getting tense, breathing shallowly or when I’m struggling to fall asleep.

1.      Diaphragmatic Breathing

• Place one hand one your chest and one hand on your tummy

• Take a breath in through your nose

• As you breathe in, you should see and feel the hand on your tummy rise

• Relax and breathe out

• As you breathe out, you should feel the hand on your tummy fall

• The hand on your chest should be keeping relatively still during both inhalation and exhalation

2.      Relax your shoulders!

Put reminders around your house, workplace or car to regularly prompt you to relax your shoulders and breathe with your tummy!

Every breath you take is a gift and should nourish you in whatever you are doing. So, whether you are smashing out your reformer pilates class or enjoying a coffee at Padbury’s or Willing Coffee next door, take a moment draw awareness to how you are breathing and try out these simple exercises to encourage a healthy breathing pattern.

BIANCA THYER

Bianca is a Senior Physiotherapist and Pilates Instructor with experience in working with a variety of clients including those with acute and complex chronic pain, post-surgical rehabilitation, pregnancy-related musculoskeletal pain and sports injuries. Bianca has completed additional training in Clinical Pilates, Paediatric and Respiratory physiotherapy, and has a special interest in working with people with chronic lung disease and dysfunctional breathing/breathing pattern disorders. Her previous work in this area includes roles as a Pulmonary Rehabilitation Physiotherapist in Queensland, and more recently a Respiratory Health Educator and Physiotherapist at Asthma WA.  

Bianca is experienced in working with people who have developed unhelpful breathing patterns that cause uncomfortable symptoms such as:

• shortness of breath on exertion

• feeling of air “hunger” or that you can’t take a deep breath at rest or with exercise

• frequent sighing or yawning

• unexplained shortness of breath

• sore neck, shoulders and back

Those with conditions such as Asthma, COPD and Anxiety, are more at risk of breathing pattern disorders that can contribute to worsening symptoms. If you are experiencing trouble with your breathing it is important to exclude any undiagnosed medical conditions by booking in to see your GP. Once underlying conditions have been optimally managed by your GP or Specialist, book in with our physiotherapist, Bianca, for assessment and intervention to optimise your breathing pattern.

References:

• Figure 1: Diaphragmatic Breathing diagram (2020). Hohman Rehab. Accessed 26th February 2023 at https://hohmanrehab.com/diaphragmatic-breathing-easy-for-the-breath-and-mind/

• The History of Pilates. Pilates Foundation (2023). Accessed 19th February 2024 at https://www.pilatesfoundation.com/about-pilates

• Vieira KJV, Carvalho LC, Borges JBC, Reis CJD, Iunes DH. The respiratory effects of a Pilates method protocol: Randomized clinical trial. J Bodyw Mov Ther. 2022 Oct;32:149-155. doi: 10.1016/j.jbmt.2022.04.014. Epub 2022 Apr 25. PMID: 36180142.

• Wells C, Kolt GS, Bialocerkowski A. Defining Pilates exercise: a systematic review. Complement Ther Med. 2012 Aug;20(4):253-62. doi: 10.1016/j.ctim.2012.02.005. Epub 2012 Mar 13. PMID: 22579438.