Dr. Tyler Ideus
June 11, 2020

In the previous two articles, we have discussed how our breathing affects our ability to relax as well as our ability to stabilize joints. This helps create both mobility and stability in our joints. In this last article, I want to discuss the thresholds of breathing function.

There comes a point where our need to stabilize becomes so great, that breathing must be avoided. On the other hand, our body’s demand to get air into the lungs leads the brain to forget about balanced stabilization and just does everything it can to  bring air in, so we get enough oxygen to the brain.

An example of the first scenario is when a person is lifting heavy objects. Whether that be in the weight room or moving heavy furniture, eventually the demand on our joints becomes so great, the brain has to say, “Okay, we are going to forget about everything else and just use all our muscles to stabilize our joints, so we don’t injure them.”

There then becomes a point where the load is so heavy the body will substitute good stabilization and rely more on passive tissues (intervertebral discs) for stabilization. This means our body will just use the muscle to move the load.

On the other hand, it is easy to see that at the end of a long race or marathon, peoples’ form completely breaks down because the brain is saying, “Okay, I just need oxygen to my brain, so I don’t pass out.” This is also when the brain says, “To heck with joint stability.”

While these adaptations to movement and load are important, and often the best thing at the time, the question is how many reps does one perform under the poor stabilization strategies? Certainly, a few reps in a bad position, or a few miles with poor form, won’t be a problem. But, when those become a patterned movement with many reps or many miles are performed, it’s no longer a matter of if you’ll be injured, but when!

Unfortunately, our egos can lead to bad patterns. For example, I can lift more weight with a bad pattern, so I think, “Oh, I lifted more using that form.” Then the next time we are in the gym we use the same movement we “felt” before and after a while, every rep is performed that way. All of a sudden we have grooved a bad habit and pattern.

This is why, so often, passive modalities can be unsuccessful. Sure, they can help in the short term with pain, but until the bad patterns or positions are addressed, the tissues that are treated with the modalities become painful again.

I like to use the analogy of hitting your thumb with a hammer. Say you are a construction worker, and you hit your thumb with a hammer ten times per day. Then you go to the doctor and say my thumb hurts. The doctor says, “Oh yes that looks sore, let’s put a band-aid on it, do a little ice, and that should help.” So the construction worker does that, gets some relief and is back to work the next day.

His day goes just like the one before. He hits his thumb ten times during the day and ends up in pain again! He goes back to the doctor and says the band-aid and ice didn’t work. So then he gets meds and again feels better. He then goes back to work the next day, hits his thumb again ten times, and goes back to the doctor and says, “Well the meds didn’t work.” I think you can see where we are going with this. Until we take the hammer away, pain will still be present.

Therefore in these cases, it is my job to identify the pattern, or the “hammer” if you will, that is creating tissue overload and make the patient aware of what needs to be corrected. I help the patient learn what to avoid, how he or she should perform various movements, how the movements should feel, and in time, new patterns and habits form. This is like taking the hammer away.