Breathing through the COVID 19

We all know that the COVID 19 causes a persistent cough and shortness of breath.

One of the most important thing to help minimise the impact of the virus on the lungs is to ensure that you are breathing properly.

Many of us are not breathing with our primary muscles of respiration and so may find that we suffer from additional muscular aches and pains when we do get a bad cough.

The impact of a bad cough

When you have a bad cough you will use additional muscles – known as accessory muscles to help the main respiratory muscles and to force a deep breath an exhalation or cough. The problem is that these muscles tire easily, and are therefore prone to fatigue injuries when you are coughing persistently.

Once muscles tire other muscles kick in to help move your body to suit the demands placed on it. Repeated coughing can result in chronic muscle pain due to the strain on these muscles, which will causing pain on breathing.

As you start to compensate for those tired muscles, and recruit other muscles to help you breathe (and cough) the change in function can result in injuries to joints that join the ribs to the spine or to the sternum, or joints, or soft tissues of the neck, thorax and lower back.

How should we normally breathe?

In normal breathing (respiration) there are 2 phases –

• Inspiration – breathing in oxygen in to the lungs
  • As you breathe in your diaphragm flattens and moves downwards increasing the volume of the thoracic cavity. The air pressure inside the chest cavity decreases .
  • The primary muscles of inspiration are the diaphragm and external intercostal.
• Expiration – breathing out carbon dioxide from the lungs.
  • During expiration, the muscles of diaphragm relax and diaphragm moves upward. decreasing in the volume of the chest cavity. The air pressure inside the chest cavity increases. This pushes out carbon dioxide outside the body.
  • Due to the elastic recoil of the lungs and surface tension relaxed expirations should be a passive process.

When you breathe deeply other muscles are involved to lift the ribs and sternum (chest plate) in inspiration and to depress the ribs on exhalation. The muscles involved are unlikely to fatigue and are controlled by voluntary and involuntary mechanisms.

Additional muscles (are recruited when the system is being challenged either due to an increase in the respiration rate or when the system is dysfunctioning – such as when you have asthma or a respiratory disorder – such as pneumonia.

• Accessory inspiration muscles
  • Any muscle of the upper limb or the thorax can be involved in forced inspiration. However the main ones are
  • Sternocleidomastoid, scalenes, pectoralis major and minor, lower fibres of serratus anterior and latissmius dorsi, serratus posterior anterior
• Accessory expiration muscles
  • The abdominal muscles and the lower fibres of iliocostalis and longissimus, the serratus posterior inferior and quadratus lumborum.

How to breathe deeper?

• Breathe through your nose not your mouth
  • Ideally you should breathe in and out through your nose.
  • This filters out more of the nasty stuff you are breathing in (than through your mouth)
  • Keep practising especially if you are a habitual mouth breather. It will get easier.
• Ideally you should use your diaphragm to breathe.
  • by pushing the air right down to the bottom of your lungs you improve the exchange of oxygen and carbon dioxide
  • Your diaphragm will massage your abdominal organs – stomach, liver and bowels, improving their function.
  • This in turn helps your lymphatic system to get rid of the bodies waste through your bowels
  • Your heart will function more efficiently
  • Your body wont use your accessory muscles to breathe and your shoulders and neck muscles will relax
• A more efficient respiratory system is a more relaxed one, which in turn will help you to relax
• In my next blog I look at how to practice breathing through your nose and into your diaphragm.

How can an osteopath help ?

I can help determine exactly what has been injured, give you advice on how to manage the pain, and to ease it through exercises, (and normally I would treat it through hands on treatment such as massage, joint mobilisation and manipulation)

Feel free to give me a call as I will be working from home as well, and I am offering free 10 min telephone advice chats, as well as 30 min Telehealth consultations for a more in depth assessment and advice and more specific exercises to try and keep you all pain free. 07474 521 329