In my last post I talked about the role of the vagus nerve in reducing systemic inflammation and introduced the idea that abdominal massage might be a powerful tool for the many people suffering from autoimmune disorders. In this post, I will continue to expand on the science and theory behind this groundbreaking idea, as well as to introduce some at-home exercises and techniques which you can do yourself to help control inflammation.
Many of you are probably familiar with the work of Dr. Datis Kharrazian, whose books on thyroid and brain health are very popular among those of us interested in holistic health and functional medicine as it relates to autoimmune conditions. In Dr. K.’s book, “Why Isn’t My Brain Working?” he establishes the connection between gut and brain health and the vagus nerve’s important role in that connection. In fact, he asserts that digestive issues, such as slow motility, are often a sign of neurodegenerative issues. He recommends various techniques people can use to stimulate the vagus nerve, such as gargling, inducing the gag reflex, and singing loudly to improve the brain-gut axis. 
I raise this issue not to confuse my point about quelling inflammation, but to highlight the link between leaky gut, autoimmune issues, and vagal tone, and to mention the benefits of abdominal massage on the digestive system. Rolling really helps get things moving along in the digestive tract. This is due in part to the manual aspect of massage, but also highlights again the role of the vagus nerve on the autonomic nervous system. The sympathetic response increases cardiac activity and decreases digestion (when you need to run away from a tiger, your body won’t waste energy on digesting your lunch, it gets your heart pumping and sends blood to your extremities so you can run fast!); the parasympathetic system decreases heart rate (but increases heart rate variability) and increases digestion.
So, rolling right along, let’s circle back to the idea of abdominal self massage as a potential treatment for reducing the inflammation seen in autoimmune conditions. While there are no studies that I have found that either support or refute this claim, since it is a non-invasive technique that could potentially have a very positive impact on your health, it stands to reason that it is worth a try if you are attempting to heal or manage an autoimmune condition. It is very inexpensive and convenient, since it can be done in the privacy of your own home.
So how does it work?
It works on different levels. First, as already mentioned, the vagus nerve runs from your brainstem to your abdomen, so it is possible that it may work on one level by directly massaging the vagus nerve in the abdomen.
It also works by untacking the diaphragm, that parachute-shaped, deep muscle of respiration that separates the lungs from the abdominal cavity. By the way, the vagus nerve runs through the diaphragm. The more the diaphragm moves, the more stimulation it provides to the vagus nerve, which is why deep breathing in itself is an effective way to improve vagal tone.
Most people breathe very shallowly and higher in their chests than in their abdomens. Abdominal breathing helps to stimulate the vagus nerve. Lying prone with the Coregeous® ball under your abdomen increases this effect. The diaphragm, in addition to its dome of muscle, also has little “tails” that come down and attach onto the lumbar spine (think of the pull cords of the parachute). Abdominal massage with the Coregeous® ball, helps to relieve tension in these “tails” and in the rest of the diaphragm, allowing it to move more freely during respiration. This effect is especially noticeable to those who have suffered from respiratory problems, such as asthma, who might have even more constriction in these areas. (An additional benefit can be reduced low back pain, due to those attachments on the lumbar spine and their close relationship to the psoas and quadratus lumborum muscles, often culprits in low back issues.)
Conducting abdominal massage with the Coregeous® ball also mobilizes fascia (the connective tissue of the body) and breaks up adhesions. The fascia is rich with Ruffini endings, which also help to turn on our parasympathetic nervous system, inducing the relaxation response, and decreasing inflammation. Double whammy! The grippy texture of the Coregeous® ball helps in this process, as it has the ability to grab the skin and underlying fascia, helping to mobilize it. Having the ball directly against your skin makes it more effective.
Anyone who has had abdominal or bowel surgery will have additional benefits from rolling, as it can help to soften scar tissue in the region.
Finally, another benefit to abdominal massage can be a confusing one for those of us with autoimmune illnesses. The gut is home to a large number of lymph nodes. Massage can help to move the lymph and rid the body of toxins, stimulating the immune system. The question exists of whether stimulating the immune system in this way can increase an autoimmune response. I personally haven’t found that to be the case, probably because of the immune modulating effects of the vagus nerve stimulation, and I feel it is important to keep the lymphatic system running well for good health. However, I recommend that you start any new treatment (including self-massage with the Coregeous® ball) slowly, allowing time for you to evaluate how your system is reacting. (Remember, we are all different and might have different results.)
Now let’s get to the details of how to conduct abdominal massage on yourself.
I recommend the Coregeous® ball as it is inexpensive and may be more effective than other types of balls. It has been specifically designed for this use, whereas other balls might not be appropriate and could possibly cause harm. Proceed with caution if you choose not to follow this advice.
Inflate the ball to about 85%, although you can begin with less air if you experience too much pressure in your abdomen. This is particularly important to note if you have had surgery or any type of physical or emotional trauma that has impacted your gut.
You will want to do this practice on an empty stomach, a few hours after eating. If your stomach is full, the food could back up into your esophagus, which won’t be pleasant! I actually enjoy rolling my abdomen before breakfast as part of my morning ritual. Rolling at bedtime is another wonderful option, due to its relaxing effect on the body and mind.
Lie down on the floor on your belly with the ball underneath your abdomen (under your belly button). Begin by breathing in through your nose, sending the breath into your belly. Feel your belly press into the ball on the inhale, and feel the ball expanding into your abdomen as your exhale through your nose. Continue here for several breaths to several minutes, as you get used to the feeling. If the pressure is too intense, follow my suggestion for modifying below.
You want to be able to take full abdominal breaths throughout this practice. If you can’t due to pain, then you need to modify, or your efforts will be counterproductive. If the body senses pain, it reverts to survival mode; in other words, you are turning on the sympathetic – or fight or flight – nervous system, not the parasympathetic or relaxation response that you want.
However, you may find abdominal massage to be uncomfortable at first. Learn to listen to your body to determine the difference between discomfort and pain. Usually your breath will be a good indicator. If you can’t take a full breath, modify or back off. If you can still breathe fully, despite some discomfort, continue.
The next technique you can try is called Contract Relax Breathing. See this video for a more complete explanation. Basically, you will continue with the ball under your belly button, inhale and inflate your belly, pressing it into the ball, then retain your breath for a couple seconds (breath retention is not advisable if you have uncontrolled high blood pressure or glaucoma), contracting the muscles of your core and spine, before exhaling fully through your nose, relaxing your muscles and allowing the ball to excavate deeply into your abdomen. Again, continue this for a several breaths.
You can then return to regular abdominal breathing while slowly rolling around on the ball, allowing the ball to explore all the areas of your abdomen, as if on a search and rescue mission for hidden tensions. If you find a spot where there is greater tension, you might want to linger there while breathing deeply into the area.
How to modify if the pressure is too intense:
The first thing you can try is to decrease amount of air in the ball. Experiment to find the right amount of air for you. You can add more air later when you are ready. Another way to modify your practice is that instead of lying on the ball, you can stand and lean against a wall, pinning the ball under your belly. If even that is too much (which might be the case if you have significant scarring or trauma), lie on your back, and just use your hands to roll the ball on your abdomen. Build up to deeper work slowly.
My recommendation is to start slowly, with just a couple minutes for the entire practice, as you see how your body responds. If there are no negative reactions, continue to gradually build the time you spend rolling on the Coregeous® ball. There is no hard and fast rule for how long you should do it. Use your body as a guide, rolling for as long as feels good to you. Practicing daily will yield the greatest results.
Decreased stress, improved digestion, better detoxification, reduced inflammation and decreased pain are the rewards that await you. Best of all, it is a practice that you control yourself.
Self-care is truly healthcare at its best!
-  http://www.elderandsage.com/1/post/2014/11/train-your-brain-for-gut-health.html A review of Dr. Kharrazian’s brain book and the link between the brain and the gut.
- “Soothing Stress with Yoga Tune Up® Therapy Balls.” http://www.yogatuneup.com/blog/2014/10/03/the-immune-response-and-deep-breathing/ with link to Youtube video featuring Jill Miller demonstrating “Gut Smash” with the Coregeous® ball. An article that explains why deep pressure massage with Yoga Tune Up® Therapy Balls helps to relieve pain.