April 1, 2020

Pratiloma: How to Strengthen your Respiratory System.

Many of us are asking these days: What can I do to strengthen my respiratory system?

Bonus: I will describe ancient practices you can do naturally and easily without leaving the house!

With the world fighting a respiratory pandemic that dramatically challenges the lungs and the ability to breathe, strengthening muscles of breathing may be a powerful preventative tool not to be overlooked. If 50 percent of elite athletes have diaphragmatic fatigue, then it is likely that all of us do. But that can change, quickly, no matter how old you are.

The science behind the breathing technique has numerous benefits that far exceed how it will help us all breathe through the coronavirus pandemic.

Pranayama for Respiratory Strength

Pratiloma is a yogic breathing technique (pranayama) involving partially closing the nostrils while inhaling in order to create inspiratory resistance.

What is the benefit of inspiratory resistance? When airway resistance is created during inhalation, it exercises the diaphragm and the muscles of inspiration in ways normal breathing does not. Shallow breathing, due to a sedentary lifestyle, sitting for hours a day, and chronically mouth breathing renders many muscles of breathing underactive, weak, and easily fatigued.

Numerous studies have been done on the benefits of pratiloma, but under a different name. In Western medicine, this technique is called inspiratory muscle training (IMT) and has been found to be an effective treatment for numerous health concerns, including breathing afflictions, heart health concerns, and digestive issues (such as GERD and reflux), along with significantly enhancing athletic performance.

In yoga, a pranayama technique where resistance is created during exhalation rather than inhalation with partially closed nostrils is called anuloma.

Experience the Benefit Right Now

Use your fingers to partially close both your nostrils (from the outside) to create a significant amount of comfortable resistance while you inhale. Take a deep breath in through the nose (mouth closed) against the resistance you are creating by partially closing your nostrils. After the full inhalation, release the pressure hold on the nostrils and breathe out freely. Take five full inhalations and exhalations as described.

Notice what new muscles engage as you breathe in against resistance. Most likely, you will feel your diaphragm contracting and ribcage expanding for the first time in recent memory. When you create inspiratory resistance, the primary muscle of breathing, the diaphragm, is forced to fully contract. You will feel this dramatically as you reach maximum inhalation underneath the ribcage on both sides of your body.

For comparison, breathe normally. Release the nostril pressure and take a breath in and out through the nose without any resistance. Most likely, you will feel a free effortless breath without any awareness of your diaphragm contracting or intercostal muscles expanding. The reason you do not feel your diaphragm contracting is because when we breathe “normally,” the diaphragm only minimally contracts. Diaphragmatic fitness (IMT) or regular full contraction of the diaphragm is key to seeing the related health benefits.

We breathe 26,000 times a day. In order for the inspiratory muscles of breathing to fully contract and relax 26,000 times a day, an optimal level of diaphragmatic fitness must be maintained. Muscles not regularly taken through their range of motion and exercised can atrophy; become tight, stiff, and rigid, and prematurely fatigue. The diaphragm is the primary muscle of breathing, making diaphragmatic fatigue a more serious concern.

Inspiratory Muscle Training for Athletic Performance

For elite athletes who sprint, there is a reflex called the metaboreflex: when you’re in a sprint, the diaphragm can fatigue, first compromising breathing efficiency (oxygen in, and CO2 out). The metaboreflex diverts all blood oxygen to the heart and lungs, leaving the arms and legs without oxygen. The sprinter finds themselves with legs that just will not fire. This is when you see the sprinter run out of gas just before the finish line.

Inspiratory muscle training or pratiloma is used by sprinters to strengthen the diaphragm enough to push back the metaboreflex so they can finish the race in full sprint. As a result of a modern, mostly sedentary lifestyle, most people suffer from diaphragmatic muscle fatigue and do not realize the long-term detriment is may cause.

When I wrote my first book, Body, Mind, and Sport, I interviewed comparative anatomists and pulmonologists about the mechanics of breathing. I was told again and again that while we have five lung lobes, we really only need two—the upper two. I was told that most people rarely breathe into the lower lobes. I kept searching for answers because it didn’t make sense that we would have five lobes and in reality only need two.

Now, many studies link strengthening the muscles of inspiration and accessing all five lobes with each breath to numerous health benefits. The number one driver of weak muscles of inspiration is diaphragmatic fatigue, which has been shown to chronically affect and compromise performance of both male and female athletes.

One study reported to me by Patrick McKeown, author of The Oxygen Advantage, found that 50 percent of elite athletes have diaphragmatic fatigue and need inspiratory muscle training or regular pratiloma pranayama. If elite athletes have this fatigue, most likely all of us regular folk do!

Lung and Breathing Support

IMT has been effectively used in physical therapy to support healthy breathing for patients with compromised breathing. The resistance created with pratiloma or IMT strengthens the diaphragm, which is chronically weak in many patients with compromised breathing. In my practice, after Body, Mind, and Sport was released, I received letter after letter thanking me for the help readers received from learning how to nose breathe—the main premise of the book.

The nose is 50 percent harder to breathe through than the mouth, which creates the natural resistance needed to keep the diaphragm strong enough to breathe fully 26,000 times a day.

How Does This Effect Digestion?

The diaphragm is one of the largest and most important muscles of the body. It separates the chamber that holds the heart and lungs from the upper digestive organs: stomach, liver, gallbladder, and pancreas. The esophagus penetrates the diaphragm and becomes the stomach just below the lower esophageal sphincter (LES) at the level of the diaphragm.

GERD (gastroesophageal reflux), heartburn, hiatal hernia, and indigestion are common symptoms when the stomach exerts undue upward pressure on the diaphragm and LES. If this upward pressure (called udvartana in Ayurveda) persists, stomach acid can linger in the stomach and leak through the LES, causing a variety of digestive concerns.

Pratiloma, in the form of inspiratory muscle training (IMT), has been studied repeatedly. It has been demonstrated that strengthening the diaphragm in this way restores healthy function of the LES and is an effective therapy for GERD and other upper digestive health concerns.

How to Perform Pratiloma

Note: Always check with your medical doctor before starting any breathing practice.

>> Sit comfortably with back straight. Stop immediately if you ever feel uncomfortable.
>> Take 10 deep inhalations through partially closed nostrils, creating enough resistance to feel the diaphragm contract as you inhale.
>> Follow with a full exhalation without any nostril resistance.
>> Perform five rounds of this practice twice a day before breakfast and in the evening.

How to Perform Pratiloma with Kumbhaka (Breath Retention)

Adding a breath hold to this practice is the traditional way it is practiced. When you begin to see breath hold improvements or longer effortless periods of breath retention (kumbhaka), you’re beginning to glean the benefits of what is called intermittent hypoxia.

These benefits include: boosting stem cells, nitric oxide, EPO (erythropoietin), vascular endothelial growth factors, and transcription factors that protect the genome while powerfully lowering blood sugar.

>> Sit comfortably with back straight. Stop immediately if you ever feel uncomfortable.
>> Take 10 deep inhalations through partially closed nostrils, creating enough resistance to feel the diaphragm contract as you inhale.
>> Follow with a full exhalation without any nostril resistance.
>> After the full exhalation, perform an exhalation breath hold for as long as comfortable (no strain).
>> Perform five rounds of this practice twice a day before breakfast and in the evening.

Have you tried pratiloma? What did you find?




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