Asthma is a chronic obstructive lung disease affecting twenty five million children and adults in America*. Saying that differently, one in twelve people have asthma*. That’s a lot of people! Individuals with asthma are essentially under attack by the environment around them. Allergens, exercise, colds, flus, and stress can trigger an asthma attack on a moment’s notice. Most asthmatics know what their triggers are and hopefully know how to handle their flare ups, but lets talk about what happens during an asthma attack.
An asthma attack occurs when the smooth muscle surrounding the bronchioles (tubes in your lungs) constricts unnecessarily, narrowing the airway and inhibiting the flow of air into and out of the lungs. Think of a water hose with a kink in it; the water doesn’t flow as easily and can even stop entirely due to the blockage. This constriction leads to labored breathing and wheezing as the afflicted individual attempts to maintain appropriate oxygen and carbon dioxide levels. While asthma attacks themselves occur in episodes, those with asthma have chronic smooth muscle constriction in their lungs. This chronic constriction leads to labored breathing throughout the day aggravating the secondary breathing muscles and leading to inappropriate breathing techniques.
During normal breathing, the inspiratory phase (inhale) utilizes the constriction of the external intercostals to expand the rib cage, which pulls the lungs out, while the constriction of the diaphragm causes pulls the lungs down. These two actions combined open the lungs and increase their volume, lowering the pressure in the lungs causing air to flow in. This action is typically done involuntarily throughout your day, meaning that for the most part you don’t have to think about every breath you take, your body will automatically do the work for you. Upon exhale, these primary breathing muscles will relax causing the volume of the lungs to decrease and the pressure to increase, which forces the air back out. Lucky for us this is another action that occurs automatically allowing us the ability to think about things other than our breath. A healthy breath cycle utilizes the primary breathing muscles, the diaphragm and external intercostals, to allow air to flow in and out, creating an abdominal thoracic breath.
As breathing becomes labored and your airways become constricted, as it does with asthma and other strenuous activity, in order to get air in you have to call in some backup. The backup help comes from your secondary breathing muscles. These muscles act to open the clavicle and upper ribs creating a stronger vacuum. This is known as clavicular breathing. These secondary breathing muscles include, the upper trapezius, pectoralis minor, scalenes, sternocleidomastiod, levator scapulae, and serratus posterior superior (think upper back and neck). This list could just go on and on, as anyone with asthma knows, there is a point during an attack where you feel as though you are using your whole body just to take a breath.
Now you may be thinking, why in the world are there muscles surrounding my airways? At what point would I want to constrict my airflow? Let me assure you, there are times, such as when you are just hanging out watching TV, or sitting at your desk at work, where you don’t need as high of a level of oxygen flow. Think rest and digest here. The smooth muscles surrounding your airways can constrict a little allowing oxygen flow to decrease as the demand for oxygen is not high. Conversely, if you are out running a marathon or chasing your kids around the park, the increased muscular work demands more oxygen consumption, which leads to a dilation, or opening, of the airways. Think fight or flight. The smooth muscles surrounding the bronchioles relax a bit allowing for a larger flow of oxygen in and out.
Asthmatics, however, have an ever-present airway constriction causing the secondary breathing muscles to become chronically over worked. The placement of these muscles around the neck and upper back make them an easy, and much needed, target for a little YTU love. Tune in Friday for my favorite rolling techniques to soothe my aching breath!