In order to have good diaphragm mechanics on inhalation, you must first master exhalation and be able to acquire a “zone of apposition” (or ZOA). Dr. Sarah Petrich defines what a ZOA is, and the corresponding diaphragm biomechanics.
The adduction drop test and apical expansion tests were used with permission from the Postural Restoration Institute®.
About Sarah Petrich, PT, DPT, PRC, NCPT:
As a specialist in Postural Restoration, Pilates, & Dance Medicine, Dr. Sarah Petrich provides physical therapy and Pilates training focusing on re-balancing posture, alignment and breathing for patients and wellness clients. When not in the clinic or on zoom, she's often traveling around the nation teaching educational courses to healthcare professionals, Pilates instructors and other movement specialists. You can find her and her courses on her website www.sarahpetrich.com or on Instagram at @drsarahpetrich.
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The air . Hi, I'm Dr . Sarah Petrich , and we're back to talk about the zone of opposition breathing that I talked about in a couple other videos previously. Uh , and first of all, we gotta know what the zone of opposition is. Well , uh, it happens to be , uh, in reference to what your diaphragm does when you breathe and what position it's in. Now, when you exhale, the first thing that should happen is that your diaphragm should dome up , uh, kind of like a parachute. If you've ever, when you were a kid, played with the , that big parachute in gym class and , um, all the kids were around the edges of it and pulled it down as the diaphragm parachute it up. Yes, I said the diaphragm, the parachute, parachute it up. That's what your diaphragm should do on exhalation. So I have my , uh, trusty rib cage here and I've got a TheraBand that I'm gonna try to make into a diaphragm today. We'll see how it goes. So if your diaphragm here, okay , attaches and it bit better attached to the inside of your rim cage . But also it attaches to your spine, not this high up, but actually attaches down lower. I just don't have that much , uh, segments to show you, but it generally is here. When you exhale, it should, and I'm gonna put it on its stand when you exhale, it should dome up into your rim cage . And as you can see, as the diaphragm domes up, we don't have as much air in your lungs. Now you don't actually get all the air out of your lungs at any one time. So it'd be much more like this. I just can't demonstrate it perfectly. But , uh, when you exhale, just to reiterate, your diaphragm domes up into that cavity and the air expels out. Now this is actually when the muscle is at rest or it's relaxing. This is really important because any muscle is gonna be much more efficient and better at contracting if you start it in a more relaxed position. You wouldn't go to the gym and decide you're going to work out a bicep and you're like, I'm gonna start with my muscle contracted like this and then tense it up more. That would be kind of ridiculous. So we always start with the arm straight where the muscles at its longest, and then we contract it and you work the muscle through the whole range of motion and you're also gonna get a better muscle contraction. So that's why we're gonna talk first today about getting a good zone of opposition on exhalation because we gotta get this diaphragm to relax really good first in order to A, get the diaphragm to work a little bit more functionally for you, but b, also to attain a good breathing posture where your ribs are not flared out, creating a flat distended diaphragm, but instead we get your ribs to come down and in and back so that you get a nice curve to your diaphragm where it's domming up. So here's the tagline. You want curvy diaphragms and not flat diaphragms on your exhale. Now, how we do that is gonna be really important when you exhale as that diaphragm domes up, there's certain muscles that help move your ribs in order to get you in a good position. And those mu those muscles should be your abs. In fact, everybody thinks first abs are important for spine stability, core stability and strength. It is good for posture, it is good for posture, but first you want it your abs to work good for good breathing posture. And then you can work on your abs for strength and stability and all of the other fun things, but abs for breathing first. So how do we change your breathing and how do we get this zone of apposition where this, this diaphragm domes up and has more fibers up against the rim cage so that we get more air out and a more relaxed diaphragm to function for us when we eventually inhale and try to contract it. So let's do some things to change that pattern. The first thing that you can work on is to work on a breath , uh, pattern, which is more like triangle breathing, where you exhale completely and then hold your breath. And I usually like to tell people, especially if you're not comfortable holding your breath out for very long, try to exhale and hold your breath as calmly , uh, as possible knowing that you can breathe in at any time 'cause you have control over that, that calmness is really important so that you also allow your rib cage to move as you exhale and let those ribs swing back. Uh, in another video that we talked about , um, if you think of the rim cage as the shape of a bell, when you exhale, you want that bell to kind of swing backwards and that's gonna get these ribs tucked in a little bit more and these ribs in the back will elevate up. And actually, since the diaphragm happens to connect to the spine, the diaphragm will actually dome up and pull up on the spine and help you dec decompress your back. So, hey, you can even help the length and space between your vertebral bodies for good spine health just with good breathing. Now that's one thing you can do. So breathe with an exhale, then hold your breath out for as long as you comfortably without panicking can, and then you inhale. So that's number one. Number two, I mentioned that when we exhale these ribs go down in and back your abdominals, help do that. Now there are several people that work way too hard and they don't know how to use their abdominals effectively and efficiently, and they tend to grip and use them or misuse them in a dysfunctional way. So I'm, I'm very hesitant to cue abdominals and engaging abdominals for breathing. Instead, I like to use what I call abdominal buddies. These are muscles that are not abs, but they could be an arm muscle, like a shoulder muscle or a leg muscle to help engage the right muscles around your torso to actually promote more ab work so that you don't even have to think about it too much. You accidentally get abs to fire. And then there's one other thing that we can do and we're gonna do that as well in a minute, but you can also do some breathing proprioceptive tricks. And my favorite one is to blow up a balloon. So get ready. That's coming. Thanks everybody for watching and I wanna do an extra special thanks to Oxygen Plus I hope you learn something. And if you'd like to find me, you can find me@sarahpetrich.com. S-A-R-A-H-P-E-T-R-I-C h.com . Or if you wanna learn more about Oxygen Plus you can find them@oxygenplus.com.