Ep. 93 - Breath Work to Unlock Your Potential - with MPT Melanie Connell
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Melanie Connell is a licensed Physical Therapist of 20 years with certifications in Manual Therapy and Nutritional Health Coaching. She started her own clinic called "Remedy Physical Therapy" in Orange County with a very clear mission: to provide a remedy for athletes sidelined by persistent pain and injuries.
Melanie works with athletes who have underlying issues that have continued to persist in their lives and limit their ability to reach their goals and potential.
In college, Melanie played volleyball and knew that she wanted to be in the sports world and help athletes, but she didn’t want to be a personal trainer or athletic trainer. She majored in exercise science.
The most common injuries in female high school athletes are recurring, overuse injuries. In females, patella and femoral pain is pretty common. Hip pain, heel pain, knee pain is common in runners.
Because I have such a niche practice, I am not necessarily treating people post surgery, but people who come in with general pain with a certain movement or motion. However, I do treat athletes who have had surgery and have not been able to get back to their previous level of play before their injury.
Only about 1 of 2 athletes with an ACL injury return to their normal level of play after surgery. Research is suggesting that you should go through a full 9 months of rehab, some even say 12 months, before you return to sport. If athletes have not progressed far enough or came back too early, there is a high likelihood they could retear again (in the next 6 months).
My husband is an example of that. He had his first ACL tear in his 20’s, playing basketball. Went through a whole reconstruction of his knee, ACL, PCL, and Meniscus. 6 months later, he retore his ACL again and then a year and half from that previous surgery, had a third one, all in the same knee. Now he is 47 and just had a knee replacement.
Stories like this and recurring injuries are very common even when people believe they are the only ones walking through it.
If you wait to return to play and go through your full rehab (9 months), you are 50% less likely to have a recurring injury. Waiting to return improves your ability to adequately return to your sport.
For select athletes with ACL injuries, there is an opportunity to slowly rehab and skip surgery. This can only be done if there is enough stability in the knee even after the ACL tear.
Breathing
There are four main categories of breathing:
Pain
Posture
Pressure
Performance
A pressure example is people who have leakage issues or incontinence. This is common in women we are pregnant (pre or post pregnancy). You should be able to regulate pressure through breathing which affects your pelvic floor.
Posture at a basic level is when you breathe in and your rib cage opens, so you can have more postural mobility and stability.
In pain, breathing is used a lot for down regulating to calm the body. Pain can be triggered by a lot of things, it doesn't necessarily mean there has to be an issue in the tissue. So breathing can tap into the nervous system to help the body not have to feel such a heightened anxious type of pain. For example, I would teach someone to slow their breathing down.
In adults we generally breathe about 12-20 breaths per minute, but we should really be breathing 6-10 breaths per minute. It’s a much longer inhale and exhale. It doesn’t have to be super big, but just lengthens out the time. What this does is help to bring your nervous system back into a rest and digest state and gets rid of that sympathetic fight or flight mode.
You can look at where anxiety is driven from, there could be psychological problems, stress & trauma, digestive issues, there could be a lot of different components. Breathing in and of itself can help reduce a lot of stress. It helps you wind down and not feel a lot of body tension.
Breathing is something that is so natural, but when you think about it you can become anxious about it.
We inhale oxygen and we exhale carbon dioxide, but there is a certain level of carbon dioxide that we actually need to retain. So that balances the O2 and CO2 in our blood to get the oxygen back to the muscles. The muscles can use oxygen better when there is a certain level of carbon dioxide in there.
What I am finding is when people have anxiety and panic issues is that they are really sensitive to carbon dioxide. By learning to control your breath rate, do breathe holds, or even breathing through your nose, that can improve that tolerance to carbon dioxide. That can help with panic but also leads back to help with performance.
When someone has a hard time recovering with exercise or has a hard time regulating their heart rate and breathing when they are exercising, like they are huffing and puffing a lot, there are things they can do to improve that ability during performance and with recovery.
You can test the length of time that you can exhale through your nose and see what number you are. It is a slow and continuous breath out through the nose.
I have seen people who have anxiety, stress, or pain, that they will be very far under 20 seconds. And really we want to be in between 30-60 seconds. That is really a test of where am I and how much can I let this breath out without feeling like you need to breathe in.We want to learn to control that.
As an exercise or practice for breathing, you can do breath holds. So that is doing boxed breathing. Inhale for 4 seconds, hold for 4 seconds, exhale for 4 seconds, hold for 4 seconds. It’s called boxed because they are all the same amount of time and the time on those can vary as well.
That is one way that I teach people for example if they are really stressed at work, to take a time out and step away to change your breathing pattern.
Where box breathing first originated was with Navy Seals. It was their way of being in a stressful, anxious situation and still being able to control their reaction.
That is what we want to do with any kind of performance and any kind of stress, positive or negative, we want to respond to it and not have to react to it.
For performance, there are a couple of things. I look at performance as a scale of training and recovery. You can’t just train and not recover because then the scales tip and you can’t perform well.
With performance breathing, part of it is learning how to breath through your nose (nasal breathing) instead of just gasping in and out through your mouth. That helps control your heart rate and that makes a difference when you’re on the field. Learning how to get more oxygen in that way because it helps your muscles and your brain.
Sometimes I tell people, after exercise, to do longer exhales than inhales. So if you are breathing in for 3 seconds, breathe out for 6 seconds and that winds you down a lot quicker and helps with your recovery.
Naturally when we breath through the nose, there is more friction and there is also a better filter through the nasal passage which allows for more controlled breathing. It shows the breath rate down because you can’t breath in and out as quickly.
We generally are stressed out, anxious, and breathing fast all the time, then that is something you want to pay attention to because that is your regular resting rate. Then you go try to perform and that is going to affect that. What you do on a daily basis is going to affect your performance, not just what you're doing on the field.
My passion for this started as an understanding of the diaphragm and just how important of a muscle it is. Knowing that it is linked to just about every single system in your body. I am curious by nature and I would hear things. So I would dive in and realize that breath can transform anything.
It is not the cure all but it links to just about anything, even digestion. The way your diaphragm sits, if you can breathe properly with your diaphragm, it can actually improve your digestive system because it moves down and creates more pressure in the organs to get your motility better.
The same thing, where your diaphragm sits is the top of your core and the bottom of your core is your pelvic floor. So when you inhale, the diaphragm moves down and the pelvic floor lengthens. When you exhale the pelvic floor comes back up to help with that pressure system and the diaphragm comes back up.
So what I see in athletes, that it is surprisingly common to not have kids yet and have leakage issues (peeing your pants from laughing so hard, peeing when you sneeze, etc.). That has to do with this heighted go go go sympathetic nervous system.
There is also a very little research that suggests that when someone has a lot of high stress because of low energy availability, that can link to pelvic floor dysfunction. It doesn't always have to be a weakness issue. Especially when there is no weakness like being pregnant or delivering a baby, it can be an issue of too much tone or too much tightness.
Scripture talks about the breath of life. In Genesis, it says that God breathed the breath of life into Adam’s nostrils to receive the holy spirit. So if you understand breath from the greek word and Hebrew word, it means wind or breath.
So in essence, it's God. It's God's breath. Breathing is from the foundation of Creation. That's when we really see it start to relate to ourselves spiritually and not just physically.
Richard Rohr, wrote a book called The Naked Now, so this is an excerpt from him. So the name Yahweh, Israelites were not supposed to speak it but it was supposed to be the sound “Yah” and “Weh” were supposed to be inhalation for “yah” and exhalation for “weh”. So it was a breathed word, not a spoken word.
“The one thing we do every moment is therefore speak the name of God” - Richard Rohr
Learn more about Melanie and her practice:
@RemedyOC
Rapid Fire Questions:
What are you loving right now?
Really loving Taylor Swift's new album
What are you listening to right now?
Podcasts, I like listening to podcasts while I am in the car. I like That Sounds Fun with Annie F Down
What motivates you?
Being curious about the things that I don't know
And of course my family in general, my kids and husband
What is the best advice you have been given?
As a mom, the days are long but the years are short
