Supporting the Muscles of Respiration

Breathing 101

Each and every day you draw a breath without thinking. Sleeping or awake, your body is unconsciously keeping your muscles of respiration working to bring oxygen in and release carbon dioxide as waste. This process is controlled by the most primitive part of our nervous system.

Despite the fact that the process is involuntary, many of us do not use our muscles of respiration to their full potential. Lack of exercise and poor posture all contribute to improper breathing techniques. The diaphragm becomes shortened and less efficient. The accessory muscles of breathing are used more and overworked. This stress on the body can lead to more than just shortness of breath. The digestive, lymphatic and nervous systems can also be effected by shallow breathing.

Deep abdominal breathing is the optimal breathing pattern for the body. In deep abdominal breathing, the breath brings the diaphragm down as the muscles of the abdominal wall expand. The rib cage is allowed to expand passively, rather than the result of the action of the accessory muscles of breathing. This action of the expansion of the abdominal wall and diaphragm helps to massage internal organs, pump the deeper vessels of the lymphatic system and provide ample space and mobility of vessels of the digestive, cardiovascular and nervous systems. It also means increased lung capacity and more oxygen to the cells in the body.

Muscles of Respiration

Diaphragm: The main muscle of passive (resting) respiration. This bells shaped muscle is used to raise and lower the ribs to activate the lungs.

Internal and External Intercostal Muscles: These tiny muscles between the rib cage help to raise and lower the ribs, increasing and decreasing pressure in the thoracic region.

Scalenes: These small muscles (usually a group of 4) help to lift the upper ribs and sternum.

Sternocleidomastoid: This muscle that connects the sternum and clavicle to the mastoid process works with the scalene muscles to raise the ribs and sternum.

Pectoralis Minor: Underneath Pectoralis Major on the front, top of the rib cage, this group of small muscles helps to raise the upper ribs.

Rhomboids: Located on the back between the shoulder blades, this muscle helps to pull back the shoulder blades to provide space for respiration in the upper regions.

 Abdominal Wall (Rectus Abdominus, Transverse Abdominus, and Internal and  External Obliques): These muscles of the abdomen help to expand and contract the belly during deep abdominal breathing.

Quadratus Lumborum: This muscle can impede deep abdominal breathing and the movement of the rib cage when it is shortened.

Practicing Deep Abdominal Breathing

If is simple to begin a practice of retraining the body to perform deep abdominal breathing. First lie on your back in a comfortable position. Next, place one hand on the belly at approximately the navel. Focus your breathing so that you are able to use it to raise and lower your hand. Feel the difference as you use your diaphragm muscle to take breathes, rather than shallow, shoulder breathing. You may find that this process relaxes you. You may need to spend about 15 minutes doing this each day for a week or more before this process becomes more second nature.

How Can Massage Help

Massage therapy can assist you in the process towards promoting deep abdominal breathing. Massage can help to open the body through the shoulder, chest and diaphragm. Your therapist may use myofascial release, trigger point therapy and/or Swedish massage techniques to facilitate this opening. It will take a series of weekly sessions in order to see real results, as the body has spent a long time with inefficient breath.



Muscles of Respiration: Johns Hopkins School of Medicine:

Accessory Muscles of Breathing I and II: Bahnda Yoga:






Inflammatory Foods and Chronic Pain

Nutrition as a means to combat chronic pain has become a topic of interest in medical communities today. As more and more patients are looking for relief from chronic ailments like fibromyalgia, migraines, diabetes and idiopathic pain, doctors, nutritionist and holistic health practitioners are looking closer to explore the cause and treat more than the symptoms. This kind of whole-body treatment often leads to looking at causes of chronic inflammation.

Within the body, inflammation can have a number of reasons. It may be physical trauma such as a sprain or break. Acute illness may be another cause. Allergens such as pollen enter into the body and can cause an inflammatory reaction. In most cases, these causes of inflammation are short lived and resolve as the illness, allergic response or physical trauma heals. In some cases the inflammation is long term and does not resolve. This leaves the body in a constant state of crisis. Some signs and symptoms of chronic inflammation are: gastrointestinal disorders, asthma/wheezing, nasal congestion, rashes and heart problems. If left untreated, chronic inflammation has been linked to cancer, diabetes, Alzheimer’s and heart disease.

Diet often plays a role in chronic inflammation. The modern diet consists of heavily processed and sugar-laden foods. Foods such as red meat, hydrogenated vegetable oils, sugary drinks, fried foods and refined carbohydrates (white bread, etc) are often considered inflammatory foods. They create a response in the body much the same as allergens. In contrast, foods such as nuts, olive oil, tomatoes and fatty fish can have an anti-inflammatory response in the body. There are several diets that have shown to improve symptoms in patients experiencing chronic pain and inflammation. As with any change to your healthcare routine, it is best to research each option to find the limits and benefits before starting on a new diet.

  • Low Inflammation Diet: Also knows as The Mediterranean Diet, this diet mimics the eating patterns of the coutries surrounding the Mediterranean Sea. It is heavy on fish, fresh fruits and vegetables and nuts. This diet has been shown to lower weight and heart disease. This diet may be the easiest to switch to from a more traditional modern diet.
  • Histamine Intolerance Diet: This diet would require additional testing with an allergist. But introducing low-histamine producing foods can help with people who experience chronic inflammation caused by increased histamine levels in the blood and cells.
  • Elimination Diet: Working with a nutritionist or allergist can help you to pinpoint foods that are causing sensitivities through IgE and IgG blood tests. You can then eliminate the foods from your diet for a period of 2-3 weeks. Once the foods have left your system, you can also “test” the reaction by introducing them slowly and singularly to your diet.  Here is a helpful handout to help you with the process.
  • GAPS Diet: Developed by a doctor in 1998 to help her own children with chronic issues, this diet explores the role between gut health and inflammation throughtout the body. This diet is perhaps the most challenging on the list, but it is not meant to be maintained long term. It is a series of steps towards healing.
  • Paleo Diet: The Paleo Diet is a system of eating that mimics our hunter-gatherer ancestors. This diet eschews processed foods, many starches and sources of carbohydrates. In this article, you can read about five clinical trials that have investigated the benefits of the Paleo Diet. While the sample sizes are small and short trial times, it does show some promise for the benefits of using the diet, at least short-term.

As with any treatment, the key to finding a nutritional source of healing is balance and sustainability. If you introduce too much as once, you are less likely to get a benefit from a half-hearted attempt. Working with a nutritionist can help you create a plan that is individualized to your needs and lifestyle. But looking into changes in diet can help you along the path to being free of chronic inflammation and pain.



  1. Harvard Health Publications
  2. Loren Cordain, PhD
  3. University of Wisconsin, Medical School file:///home/chronos/u-fe21f2f2ef386fc01a51e9b4efce43df04caa729/Downloads/handout_elimination_diet_patient.pdf
  4. Dr Natasha Campbell-McBride
  5. Histamine Tolerance Awareness



Unraveling Low Back Pain

This month we are spotlighting low back pain. Just about everyone has it at some point. You can blame it on poor posture, weak core muscles, sedentary lifestyle..whatever you want, but it doesn’t have to dominate your life. Today we will discuss how massage therapy and other modalities can help restore and support your low back for a pain-free life.

Anatomy and Muscles of the Low Back

The lower back is a complex and important part of the body. Forming the top of the pelvic girdle it supports and strengthens the upper torso, hips and legs. It is balanced by the core muscles in the front and often becomes tight and inflexible as a result of these core muscles being weak. Spanning from the last of the false ribs to the iliac crests, the low back is made up of several muscles:

  • Multifidus-small muscles along spine that strengthen and support vertebrae in order to reduce friction and joint degeneration
  • Erector Spinae Group– made up of iliocostalis, longissimus and spinalis, these muscles primarily work to extend the spine, but also have some rotational and  lateral flexion actions
  • Core Musclestransverse abdominus, internal and external abdominal obliques circle the low back and abdomen and these muscles are responsible for flexion and rotation of the spine and abdomen
  • Psoas-this muscle attaches the low back to the lower pelvis and is responsible for hip flexion
  • Quadratus Lumborum-this large muscle of the lower back is responsible for lateral flexion, extension of the spine and plays a role in respiration

Techniques for Addressing Low Back Pain

Your therapist may use one or more techniques along with traditional Swedish Massage to help you with low back pain. Often a series of session using these techniques will be needed to restore your low back to optimal functioning.

  • Myofascial Release: modality that uses sustained pressure to correct fascial imbalances within the body
  • Muscle Energy Technique: Muscle Energy Technique is a massage modality that uses the body’s own force to restore muscle length and fuction
  • Neuromuscular Therapy: Neuromuscular Therapy is a system of assessing and correcting imbalances in the body through lifestyle changes and myofascial trigger point work
  • Friction: by working on the origin and insertion of the muscles, your therapist can help to release and lengthen the muscles in the tight low back

Essential Oils for Low Back Pain

Essential oils applied to the skin with a carrier oil or added to an Epsom salt bath can be very effective for relieving low back pain. Below is a list of several oils that can help with back pain relief:

  • Lavender: general relaxation oil for muscles
  • Peppermint: anti-inflammatory and cooling relief for low back pain
  • Basil: stimulates blood flow and soothes spasms
  • Wintergreen: helps with muscle cramps and arthritis

Additional Resources for Low Back Pain

In addition to massage therapy, you may find relief in other complimentary medicine modalities.

  • Acupuncture: working with an acupuncturist  is a safe and effective way to relieve low back pain caused by muscle or nerve involvement
  • Chiropractic Care: through the process of adjustments, your chiropractor can help to realign the boney and ligamentous structures of the body to promote better posture
  • Osteopathic Medicine: Osteopaths use gentle manipulations to restore soft tissue and boney imbalances (be sure to ask if they do manipulations when making your appointment)
  • Nutrition: Weight and diet (inflammation) can play a role in low back pain
  • Yoga: poses such as Downward Facing Dog, Cat-Cow and Forward Bend are simple asanas to get your body moving and restore flexibility and function to your lower back



Detox 101

The process of detoxification does not have to be daunting or time consuming. In this post we will learn how to safely detoxify the body to improve your overall health and well being.

What is detoxification?

To begin, detoxification is the process of cleansing the body. You will work to cleanse the blood, lymph and skin systems within the body. This process should be gentle, as too much detoxification can release stored toxins too quickly and do more harm then good. It should also be a simple process that works to restore the body systems holistically. Quick fix diets and aggressive cleanses can deplete you and leave more building to do after the initial cleanse than is necessary.

When to Detox:

Many people find Spring as a good time to start a detox/cleanse. You may already be in cleaning mode preparing to shed Winter clutter and prepare for Summer. Why not extend that to your body, as well?

Detoxes can help to remedy:

  • Sluggishness
  • Poor circulation
  • Fatigue
  • Joint Pain
  • Allergic Responses
  • Bloating

Methods of Detoxification:


  • Gentle Juice Cleanses- stick to 3 day juice cleanses that are made from organic, raw juices
  • Sugar Detox- removing simple carbohydrates (such as sugary treats, soda and other processed foods) and replacing them with complex carbohydrates, good fats and proteins can help the body process your food in more effective ways
  • Removing Additives and Artificial Ingredients- while many things in our food supply these days are “general regarded as safe” this is no way means they are the optimal option for one to consume
  • Whole Food Diet- less processed foods will be gentler on the digestive and elimination systems and keep you fuller longer
  • Drink More Water- this is an easy thing to add in. Rather than drinking large cups, try for 1/2 a cup every half hour. This will keep your body hydrated throughout the day.

Bath/Skin care:

  • Dry Brushing- used daily, dry brushing can help improve skin quality and circulation
  • Mineral Baths- adding mineral salts like himalayan and epsom salts to a bath can help pull toxins from the body and improve muscle function
  • Clay- kaolin and bentonite clays can be added to baths or used as masks to draw impurities out of the skin 
  • Switching to More Natural Products- many of the products you may be using each day contain harmful chemicals that are absorbed into the skin. Too find products that are healthier alternative please check out the Environmental Working Group’s database

Alternative Medicine:

  • Massage- manual therapies like Manual Lymph Drainage and stretching can help to flush toxins out of the body and encourage proper circulation
  • Acupuncture- your acupuncturist can help support detoxification through the use of needles and/or herbs
  • Yoga- the stretching and breathing techniques utilized in yoga can help to promote proper circulation and support and nourish the organs

It is helpful to start slow and keep in mind that the body may react less than favorable to a detox plan at first. This is completely normal as it gets accustom to a lessening of the toxic load. Give your plan at least a week (except for the juice cleanses, which should be limited to 3 days) before expecting results.

Natural Allergy Relief

There are natural ways you can find relief this allergy season. Read more to find more about managing your symptoms naturally!

Dietary Changes

The foods you eat during allergy season can have an impact on your allergic response. Depending on the severity of your allergies, you may need to avoid them only during certain seasons or all together.

Foods to Avoid

Dairy, while helpful for some, can cause increased mucus and swelling in the body. If you suspect you are bothered by dairy, you can try eliminating all dairy for 2 weeks from your diet to check for relief from the symptoms. Otherwise you may want to cut down on dairy consumption while experiencing allergy symptoms. Fresh fruits and vegetables can also trigger something called Oral Allergy Syndrome. This syndrome is the result of cross-reaction from certain types of pollen. For example, if you are allergic to ragweed, cantaloupe may trigger numbness and swelling in the mouth. You can find a handy chart here to help you track which foods to avoid.  

Foods that Help

Berries and onions contain a compound called quercetin. This compound can help to lower the histamine response and has anti-inflammatory properties. Pineapple contains a compound called bromelain. Bromelain is an enzyme that is responsible for providing anti-inflammatory benefits. Fish and certain types of seeds are high in Omega 3 oils. These oils are also anti-inflammatory and protect the delicate nasal passages. Local, raw honey contains pollen and propolis which can help to build immunity in the body to local allergen sources. You can also find quercetin, bromelain and Omega 3 oil supplements at your local health food store.


Nettles has been used for centuries to combat the symptoms of seasonal allergies. This herb can help to reduce allergy responses such as sneezing and itchiness. Eyebright is an herb that can be used to help relieve itchy eyes. These herbs can be used in tincture, tea or compress forms.

Physical Changes

As simple as they sound, actions like vacuuming and dusting with more regularity, not wearing shoes in the house and washing your face/showering before bed can help keep the pollen out of your living spaces and greatly increase the air quality inside your home. You may also want to try daily saline rinses to clear nasal passages of debris and/or mucus.


You can use yoga to help find relief for your allergy symptoms. Inversions such as standing forward bends, bridge pose and downward-facing dog are simple poses to help drain the nasal passages. You want to avoid staying in these poses longer than a few minutes as to not cause swelling from pressure. Fish pose can help open the chest area for increased lung capacity and balance hormones. Nadi shodhana, or alternate nostril breathing, can help clear blocked nasal passages.

World Doula Week

March 22-28 celebrates World Doula Week. Let’s learn more about what a doula is and how they can help you during your labor and delivery.

What is a Doula?

A doula is a person who offers emotional and physical support during your labor, delivery and immediate postpartum period. Doulas work in a variety of birth settings: home, birth center or hospital. Often doulas meet with families before the labor for one or more prenatal meetings. This helps the doula get to know the family and help them to prepare for the impending labor. During labor, the doula will either meet the family at home or at your chosen birth location. Your doula will provide comfort measures, support and advocacy during the entire labor. Once the baby is born, your doula will help you transition to the postpartum setting and facilitate breastfeeding (if you chose to nurse).

Benefits of a Doula

Doulas have been shown to:

  • Reduce the use of medical interventions such as pitocin, vacuum or forceps and cesarean section
  • Provide comfort for the mother and reduce the need for pain medication
  • Facilitate shorter, more productive labors

During your labor, your doula will use comfort measures like massage, essential oils, warm compresses and positioning to help you through each contraction and keep your labor progressing. Your doula will also be a sounding board in the conversation about the benefits/risks of any interventions that arise throughout the labor. One thing your doula will not do is replace your clinician/care provider. They are there solely for your emotional and physical well-being. A doula can also help the partner focus fully on the mother during the labor. This support helps transition the family unit and promotes bonding during and after labor.

Where to find a doula in the North Virginia area?

Birth Options Alliance: Local organization that highlights birth services in the DC Metro area

DC Doula Match: A website about local doulas with fees, contact information and availability.

“Meet the Doula” Events: Many local groups host “Meet the Doula” events to offer a chance to meet local doulas in a low pressure environment.

Benefits of Prenatal Massage

It can be difficult to maintain balance during pregnancy. It seems like if it’s not your hormones, it’s your ligaments. Massage therapy is a safe and effective addition to your prenatal care that can help you to maintain posture as well as hormone and fluid levels in the body. It can also help to keep your organs functioning better as they react to the body changes through pregnancy. Research has also shown that massage therapy can provide the added benefit of shorter, more productive labors and speedier recovery time for the postpartum period. Massage therapy can be a wonderful compliment to a healthy pregnancy. If you have any questions about whether massage during pregnancy is appropriate for you, ask your birth care provider.

Massage Through Your Pregnancy

First Trimester

While there are massage therapists that prefer to not work during the 1st trimester, there is no evidence to support that it should be avoided. But even with that caveat many women may not want to have massage performed during this time. Frequent urination, morning sickness, breast tenderness and dizziness may make a full hour session uncomfortable. Your therapist can work with you to create a shorter session designed for stress and fatigue relief. Massage in the first trimester may also allow you a time to focus on yourself at the start of this new journey.

Second Trimester

Massage during the second trimester is like “preventative maintenance” for what is to come. Many women comment that the second trimester is the most comfortable time of the whole pregnancy.  Your morning sickness is probably over, but your body is just beginning to shift and grow. You may also experience a boost in energy levels. Massage during the second trimester can help to encourage deeper breathing and help alleviate back pain. This is also a time to encourage body awareness as your body grows and changes with your baby.

Third Trimester

During the third trimester, massage will help to prepare your body for labor. It will help alleviate the pain caused by joint separation or ligament pain. You may find that your stress levels rise during the third trimester as it finally sinks in that you will have the baby and soon. Massage can help you relax and, as in the first trimester, give you time to focus on just yourself.

During Labor

While you will not be feeling up for getting a full body massage during labor, massage is an excellent comfort measure to be used during early and active labor. In addition to traditional Swedish-style massage techniques, acupressure points located on the body can be used to provide pain relief and labor stimulation. If you have a doula, they will most likely perform some sort of labor massage to help with pain management and stress. If you do not have a doula taking a series of childbirth education classes and/or a workshop in labor massage for couples can be very beneficial for you and your partner to prepare for labor.