Spinal cord injuries can profoundly alter the body’s ability to breathe naturally, leading to various respiratory challenges. Diaphragmatic breathing, a specific technique, offers a pathway to address some of these difficulties. This article explores the connection between spinal cord injury and respiratory function, and how diaphragmatic breathing can support individuals in managing their breathing more effectively.
How Spinal Cord Injury Affects Breathing
A spinal cord injury (SCI) can disrupt the intricate communication between the brain and the muscles responsible for breathing, leading to varying degrees of respiratory dysfunction. The severity of breathing problems typically depends on the level and completeness of the injury. Injuries occurring at higher levels of the spinal cord, particularly in the cervical region (C1-C5), can significantly impair the function of the diaphragm, the primary muscle for inhalation. For instance, injuries at C1-C2 often result in complete diaphragm paralysis, necessitating mechanical ventilation.
Below the diaphragm, injuries can affect the intercostal muscles located between the ribs and the abdominal muscles, which are important for forceful exhalation and coughing. When these muscles are weakened or paralyzed, lung capacity can decrease. This can lead to a weakened cough, making it difficult to clear secretions from the airways, increasing the risk of respiratory complications such as atelectasis (lung collapse) and pneumonia.
Understanding Diaphragmatic Breathing
Diaphragmatic breathing, also known as belly breathing or abdominal breathing, is a technique that focuses on engaging the diaphragm, a dome-shaped muscle located at the base of the lungs, separating the chest cavity from the abdomen. This muscle is considered the most efficient muscle for breathing. In normal, relaxed breathing, the diaphragm contracts and flattens, moving downward, which creates more space in the chest cavity and pulls air into the lungs.
During exhalation, the diaphragm relaxes and moves upward, pushing air out of the lungs. Unlike shallow chest breathing, which primarily uses accessory muscles in the chest and shoulders, diaphragmatic breathing emphasizes the movement of the abdomen. When performing diaphragmatic breathing, the belly expands during inhalation as the diaphragm descends and contracts, and it falls inward during exhalation as the diaphragm relaxes. This controlled engagement helps to maximize air intake and expulsion.
Improving Respiratory Function with Diaphragmatic Breathing
Diaphragmatic breathing offers distinct advantages for individuals with spinal cord injuries by optimizing the function of remaining respiratory muscles. This technique helps strengthen the diaphragm, which can be weakened or partially paralyzed after an SCI. By consciously engaging the diaphragm, individuals can improve lung ventilation and increase the amount of oxygen taken into the bloodstream. This increased oxygenation can reduce the overall effort required for breathing.
Diaphragmatic breathing can also enhance cough effectiveness, a particularly important benefit for individuals with SCI who often struggle with clearing their airways due to weakened abdominal and intercostal muscles. A stronger diaphragm can contribute to a more forceful expulsion of air, assisting in mucus clearance and reducing the risk of respiratory infections like pneumonia. Regular practice can also lead to a slower breathing rate and improved gas exchange within the lungs, contributing to overall better respiratory health.
Techniques for Diaphragmatic Breathing
To perform diaphragmatic breathing, find a comfortable position, either lying on your back with knees bent and head supported, or sitting upright in a chair with shoulders, head, and neck relaxed. Place one hand on your upper chest and the other hand just below your rib cage on your abdomen. This allows you to feel your diaphragm move as you breathe.
Inhale slowly through your nose, allowing your stomach to rise against the hand on your abdomen. The hand on your chest should remain as still as possible, indicating you are primarily engaging your diaphragm. As you exhale, gently tighten your abdominal muscles, allowing your belly to fall inward, and exhale slowly through pursed lips. Consistent practice for 5-10 minutes, three to four times a day, can help make this breathing pattern more automatic and efficient.
Important Considerations for Practice
For individuals with spinal cord injuries, incorporating diaphragmatic breathing requires professional guidance. It is important to consult with healthcare professionals, such as physicians, physical therapists, or respiratory therapists, before starting any new breathing exercises. These specialists can provide personalized guidance based on the specific level and completeness of the spinal cord injury, and any co-existing respiratory conditions.
Starting slowly and gradually increasing the duration and intensity of practice is important to avoid fatigue or discomfort. Individuals should be mindful of their body’s responses and recognize any signs of overexertion, such as lightheadedness or increased shortness of breath. Adapting techniques, such as adjusting body position or breath duration, may be necessary to ensure safety and maximize effectiveness. Consistency and patience are important, as it takes time and repeated effort to retrain breathing patterns and strengthen weakened respiratory muscles.