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A Dual MD/PT Perspective of the Physics and Physiology Behind Immune Health

COVID-19 research is revealing lung and vascular disease characterized by excessive lung and vascular inflammation with thrombotic clotting. This 17 minute discussion between Dr. Anca Sisu, a certified Functional Medicine Physician, and Dr. Heather Carr, a Physical Therapist from One 2 One Physical Therapy specializing in breathing and  Postural Restoration, provide a joint perspective on how to address both the physiology and physics of immune health. How you posture and breathe has a direct influence on your ability to clear out and move inflammatory debris.

Please refer here to learn what One 2 One Physical Therapy considers to be the most important breathing and postural exercise you could be doing now to support your health amidst COVID-19. 

We are currently offering a special of $85 for a customized 55 min Posture and Breathing Restoration virtual session. Contact us at or 571-257-0056 for more details.

Are you Getting Enough Oxygen when you Breathe?

Check out this 8 minute video to find out!

This article is going to discuss the physiological aspects of breathing, specifically related to our primary blood gases, oxygen (O2) and carbon dioxide (CO2). “The Oxygen Advantage” by Patrick Mckweon and “Advanced Buteyko Breathing Exercises” by Artour Rakhimov serve as the primary resources for this article and where you may obtain more information on this topic.

The primary purpose of breathing is to take in oxygen, one of our most vital nutrients. About 90% of our energy production requires O2 and thus impacts virtually every cellular, tissue, and systemic process in our body. A by-product of these cellular energy reactions is CO2 and thus is generally considered a waste product.

Typically, we assume that we need to take big breaths to maximize O2 and minimize CO2 levels in our body. In reality, we don’t need to take bigger breaths or breathe more frequently to increase our O2 blood saturation as it takes very little breath volume and rate to do so. The key element is getting O2 to disassociate from our red blood cells (hemoglobin) and get into our tissues.

The trigger to facilitate O2 to leave hemoglobin and get into our cells is actually CO2!

Yes, we need adequate levels of CO2 in our blood to serve as a stimulus for O2 to transfer into our cells, tissues, and organs. CO2 is not just a “waste product” for us to excrete via exhalation but a potent driver of our ability to fully oxygenate our body!

What determines our level of CO2 in our blood? How much we breathe! If one is over-breathing they are likely getting rid of too much CO2 for adequate oxygenation. Over-breathing can be characterized by taking too big of a breath and/or breathing too rapidly. For example, fast breathing is very commonly seen in asthmatics. In fact, Buteyko breathing techniques (as will be described here) have been heavily used in asthmatics with amazing success. However, the problem of over-breathing is not limited to asthmatics but has become a modernized society health issue as most of us are not breathing correctly. This even includes elite level athletes!

We generally aim for our patients to achieve about 8-10 breaths/minute but we typically find that many of our patients are averaging significantly more than this. On the flipside, some individuals will have a slower breath rate but are taking too big of a breath coupled with excessive belly breathing. Please refer to this video to learn more about belly breathing:

Regardless of whether you are breathing too rapidly or with too much volume per breath, either scenario is considered chronic hyperventilation and is taking away too much CO2 out of the lungs and blood.

One breathing pattern that lends itself to chronic hyperventilation is habitual mouth breathing which results in a higher volume breathing averaging 12-15 L/min compared to nasal breathing which is ~ 6 L/min. Therefore, if you mouth breathe you are nearly doubling your air volume with excessive CO2 loss!

Once these blood gas “habits” are established the nervous system adjusts and establishes a baseline point where it aims keep the same CO2 level. The nervous system perceives this to be a “safe” level and is constantly modifying your breath rate and volume to stay within this range. Therefore, if one starts to increase one’s CO2 levels by either reducing their breathing rate and/or volume they may feel like they aren’t getting enough air. We refer to this as “air hunger” as it makes one feel a bit panicky. This is the nervous system’s way of trying to protect you and thus what keeps one ultimately in an over-breathing pattern.

We can determine the extent of our CO2 tolerance/set-point with the following test, which we refer to as the “control pause” or the “BOLT” (Body Oxygen Level Test) based off of the Buteyko Breathing method. To perform the test:

  1. After a regular exhale, pinch your nose to hold your breath and start a stopwatch.
    1. Note-do not take a bigger breath in or out prior to starting the test.
  2. Hold your breath until you feel a moderate urge to breathe.
    1. Note-this is not testing how long you can maximally hold your breath, just until the first urge.
  3. At this point stop the clock. The time recorded is your score.
    1. A time of 40 sec or more is considered excellent, 30-40 good, 20-30 fair, and below 20 poor. It has been found that there is a correlation between these scores and overall health with decreasing health the lower the score, particularly below 10 sec.

Now for the most important part: How do we improve our breathing so we can get enough oxygen delivery to our body?

First, if you are habitually mouth breathing you need to switch to nasal breathing. In addition to facilitating an appropriate breathing volume, nasal breathing has a number of other important physiological effects on the body. Nasal breathing warms and humidifies air for improved gas exchange vs mouth breathing which can be very dehydrating. It is via airflow through the nasal cavity which promotes nitric oxide (NO) production. NO is a powerful anti-microbial agent and serves to sanitize the air we breathe. This can also impact the type of microbiome colonies in the oral cavity and gut which is extremely important for our health. NO is a vasodilator which has implications for improving gas exchange in the lungs as well as influencing circulation and blood pressure.

In addition to learning how to breathe through your nose during the day it is imperative that you only nasal breathe when you sleep. If you continue to mouth breathe during sleep you will essentially reverse all the good training you did during the day as well as reduce your body’s ability to oxygenate. This is crucial for the cellular repair that should be occurring during sleep. A simple, inexpensive solution to ensure consistent nasal breathing during sleep is to tape the lips. I recommend using the hypoallergenic tape, Hypafix, (can easily be bought on Amazon) that can be cut into strips to be placed over the lips as displayed below. Myself, husband, father, and many of my patients are proud mouth tapers!


If you are unable to consistently breathe through your nose then that must be addressed first. There can be a myriad of reasons why this is a problem as well as solutions which is not within the scope of this article. However, if you are limited with nasal airflow one thing you may try is a nasal clearing technique described by Patrick McKweon here:

“Reduced Breathing Training,” which is a version of Butekyo breathing has been shown to significantly improve one’s CO2 tolerance. It must be done for a minimum of 5 min, 2x day to have a significant carry-over effect but we have many patients practice up to 30-60 min a day broken up into segments no less than 4-5 minutes at a time. The first step is to take notice of your habitual breathing pattern. How many breaths do you take a minute?  Is there is any pause between the exhale and inhale? Do you take big or small breaths?

To begin the training, using a soft and gentle breath size (which is what your habitual breath quality should be) pause an extra 1-3 seconds after each EXHALE. You are essentially trying to slow down and soften your breathing rate and overall air volume which will gently increase the levels of CO2 in your lungs and blood. This will create a level of “air hunger” and discomfort. It is very important that you keep the intensity of this “air hunger” to no more than minimal. You will likely need to adjust the amount of time you are pausing after each exhale to maintain this mild intensity of air hunger while training. If you push beyond the minimal limit your nervous system will perceive you are in a stressful state and try to protect you by not allowing it to learn a new set point. This amount of time will vary from person to person as well as for a person depending on the time of day, recent food/beverage consumption, room temperature, activity level, etc. After you have practiced this for 5 min go back to your normal breathing pattern for 60 sec and then retest your control pause. It should have increased. If it didn’t or went down then you most likely pushed yourself too hard during the training and need to adjust.

Progress will vary from person to person but generally one should aim for their control pause to improve a few seconds each week. To get a more accurate and consistent control pause, it is recommended to take it every morning when one first awakes. When one’s control pause gets into the 20s there are also walking and exercise breathing techniques that can be incorporated to further progress. Overall, when one is performing exercise the goal is to only breathe through the nose. A great way to work up to this is to aim to maintain nasal breathing during walking and regular day to day activity in addition to at rest.

It is important to point out that certain individuals may need to proceed very cautiously or seek training from an experienced practitioner. Examples are individuals with heart or lung disease, migraines, post-concussion syndrome, any acute trauma, chronic infections, dysautonomia conditions such as POTs, or if you feel worse after trying the technique. If you are not making progress despite keeping yourself within the mild training parameters, there may be other factors that need to be addressed such as environmental problems. Examples are living or working in an environment with toxins such as dust, mold, poor ventilation, too high of a temperature (particularly during sleep), and/or consuming too may processed foods.

Finally, this article describes the physiology related to breathing. However, as mentioned in a prior post (, it is also just as important to breathe properly from a biomechanical and postural perspective. In fact, these two aspects are inter-connected with one another. It will be very difficult to maintain appropriate breathing physiology if you are not properly breathing with your diaphragm and vice versa.

By Heather Carr, DPT

Founder of One 2 One Physical Therapy



The Truth About Belly Breathing

Take 6 minutes to learn about how to properly belly breathe and how the respiratory diaphragm, abdominals, and pelvic diaphragm work together!

Is your breathing impacting your health?

By Noelle Ekonomou, PT, DPT

The diaphragm is often one of the most underestimated muscles in the body. It has a systemic impact on our health, including our pain perception, autonomic nervous system, lymphatic drainage, digestion, mood, and sleep. I often argue that it is the most important muscle in the body- it is the core of the core. Breathing is a coordinated movement of muscle and visceral contractions. It is a synchronous activity between the upper chest and rib cage, lower rib cage, and abdominal musculature. Our diaphragm not only attaches to the thorax, but it is strongly anchored to our spine and has connections to our deep hip flexor muscles (psoas), obliques, and transversus abdominus. Countless number of research studies have confirmed the relationship between faulty breathing mechanics and poor posture, abnormal scapular movements, low back pain, neck pain, temporomandibular joint pain, and pelvic floor disorders.

Faulty breathing patterns are correlated with hyperventilation. When our normal respiratory rate goes above 12-16 breaths per minute, we are actually “over-breathing” (or rather “over-inhaling”).  This mechanism of over-inhalation can eventually alter our posture, leading to a hyperinflated postural pattern. This means we are holding too much air in our lungs, called “air trapping”.  A cascade of hemodynamic and neurologic changes can then occur. The CO2 levels in our blood lower, which in turn increases the sympathetic or “fight and flight” response system. Your body is then constantly on high alert and in a stressful state. This is a very common breathing pattern for adults with sleep apnea, asthma, COPD, and anxiety- but we also often find this posture in many of our patients. This is because stress is often a large culprit of this breathing pattern.

This hyperinflated breathing pattern is also associated with over dominance of the “accessory” or secondary muscles of respiration in our neck and chest.  These muscles include the sternocleidomastoid, upper trapezius, scalenes, and pectoralis. When these muscles are over-worked to help us breathe, it alters abdominal pressure gradients, and can lead to painful trigger points which cause neck discomfort and headaches. Additionally, several studies including one published in the Journal of Biomechanics have discovered a relationship between the diaphragm and low back pain. Professor Paul Hodges of the University of Queensland (a chief researcher of the diaphragm), found that poor coordination of the diaphragm can result in compromised stability of the lumbar spine, altered motor control, and dysfunctional movement patterns (Hodges et al. 2005).

At One to One Physical Therapy, we use manual techniques and therapeutic exercises to restore breathing patterns, functional movement, and eliminate pain. Because our breathing dysfunction often involves holding our breath and hyperventilating, we place more focus on exhaling in our breathing exercises.  Exhalation promotes relaxation- imagine taking a sigh of relief. We couple exhalation with core activation and postural exercises, which aim to restore rib cage positioning, reduce accessory muscle use, and improve diaphragm coordination.  One way we do this is a specific breathing training technique utilizing a balloon.

We also believe in pairing breathing with mindfulness practices and “visualization” exercises for many of our patients. One major breathing technique we use is called Buteyko breathing. Buteyko breathing teaches you to slow down your breathing which promotes relaxation.

Please see the below videos for examples of our breathing exercises. These techniques are designed to restore your breathing pattern to relax tense muscles, improve your posture, and most of all, promote harmony and health throughout your body.

Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidisciplinary Healthcare. 2013; 6: 281-291. Doi:  10.2147/JMDH.S45443

Hodges PW, Eriksson AE, Shirley D, et al. Intra‐abdominal pressure increases stiffness of the lumbar spine. J Biomech. 2005; 38(9): 1873–1880[PubMed]

Rediscovering our Rhythmical Connection to Nature

By Heather Carr, DPT, NTP, PRC, OCS, MTC
The following article was heavily inspired by the book Blue Mind:The Surprising Science That Shows How Being Near, In, On, or Under Water Can Make You Happier, Healthier, More Connected, and Better at What You Do by Wallace J. Nichols as well as the teachings of the Postural Restoration Institute. There are also echoes from a number of other books (The Open Focus Brainby Les Fehmi, Sight and Sensibility by Laura Sewall, Primal Body, Primal Mind by Nora Gedgaudas and articles I have read (see here). Any study that is mentioned below can be referenced in Blue Mind.

Nature deficit disorder.  This is the situation for many of us living in a digital based society. In a typical day we send and receive more than 100 emails, check our phone 34 times, facebook 5 times, and spend ½ hour liking and messaging friends. For every hour we spend talking on the phone we spend 5 hours surfing the web, emailing, texting, tweeting, and social networking. This totals 90 eight-hour days per year. We spend at least 1 hour per day dealing with distractions which accounts for 5 full weeks per year.  We eat up an entire month each year allocating precious bodily resources to interruptions! When dealing with frequent breaks the brain spends so much energy managing the multi-tasking that there are less resources available to deeply process, analyze, and create.

In addition to the overwhelming amount of digital stimulation, we are also spending the majority of our existence indoors sitting in artificial environments. When we do get the chance to walk it is on hard flat surfaces with a barrier between our skin and the ground. If we actually find the time to exercise for many it takes place inside a gym behaving as hamsters on some sort of electronic equipment. Indoors we are breathing and smelling stale air coupled with any toxic by-products emitted from our surrounding synthetic creations. We are seeing walls and visually accommodating to not only small spaces but small brightly lit screens tempting us to develop myopia as we interface with our personal iclouds.  We are seeing and hearing TVs bombarding us with more artificial products to consume, constant repetitive chatter about which team or politician can win, how we should look, and what we should like. Finally, we are consuming and feeding our cells a plethora of artificial and highly processed ingredients tainted with pathological chemicals.

I don’t mean to sound so negative but am simply trying to be honest about what humans are really doing on a day to day basis. This brings us to the question of, “So what? Does it really matter if we are living this way? Am I being a bit dramatic?  Why do I care?” The answer is “From my perspective; Yes! It absolutely matters that we are living the majority of our existence in human-made environments.” I care because I care about my life, my fellow human beings’ life, and the life of our planet. I care so much that I am writing this article to hopefully inspire others to also care. However, I ultimately realize that I cannot reach or shift everyone who may read this. Yet, in order to be true to myself, I shall try.

Our bodies were designed to exist in natural environments. Life (with humans evolving 100-200,000 years ago) has spent 3 million years outside. Our DNA codes for us to solve problems outdoors moving in an unstable environment in order to survive. This is how we became so smart with our amazingly evolved brains. We are particularly connected to water and its blue, soft, rhythmic characteristics. From an evolutionary perspective, as we crawled out of the sea to try out life on land our senses depended on being able to find our liquid homes again. We spend the first 9 months of our existence in a fluid filled womb listening to the rhythmical sounds of our mother’s heart beat and breathing. Our bodies are 60-78% water with the brain 80% water by volume. If we don’t appropriately nourish ourselves with it, our cognition, physical performance, and general physiological functioning can decline to the point of death. The sounds, sights, smells, sensations, and sustenance of water and nature mean life. Our bodies and brains deep down know this and are desperately trying to tell us so via modern disease.

Research is proving the physiological connections between ourselves and nature. Different parts of the brain become more active when one is viewing nature scenes. These include increased functioning in the anterior cingulate and insula (associated with empathy); basal ganglia (involved with autonomic and rhythmical movements); prefrontal cortex (where our high level cognitive functioning occurs), and nucleus accumbens (reward and pleasure center). Our natural “feel good” biochemicals of endorphins, oxytocin, and dopamine are associated with being in a natural environment. One study tracked participants via GPS and showed that people experienced the highest levels of happiness outdoors. In another experiment, students whose rooms overlooked trees and a lake performed better on cognitive tests in addition to experiencing improved attentional functioning. Water images in particular have the ability to evoke positive emotions and sustain attention. On the flipside, urbanized environments are associated with increased stress and its physiological consequences such as an oversensitized amygdala (propagates fear and anxiety) and decreased functioning of the pre-frontal cortex and hippocampus (important for learning and memory).

There are two general different types of attention. The first is “directed attention” which requires a great deal of energy and is valuable when making decisions, interacting with others, and focusing on a task. The second is “involuntary” and requires little effort, allows the brain to rest, and is facilitated by natural environments. This “involuntary” state allows the mind to wander and serves as a desirable default mode for the brain. In this state, neuroplastic memory, learning, and creativity can optimally occur. This state could also be referred to as “flow” where one loses sense of time and self being completely in the present moment.

Our brains crave predictable patterns with a layer of novelty. This developed out of our long history of surviving in the wild. Natural landscapes provide a stable, often rhythmical, and familiar background as we scan for unpredictability. For our ancestors this was typically a predator, the opportunity to be a predator, or an opportunity to mate. The brain positively changes itself in reaction to these random perturbations against a trusted environment. In the book Blue Mind by Wallace J. Nichols, he discusses how water serves as a fitting natural agent to satisfy these needs within us. The rhythmic sights, sounds, smells, and sensations water creates for us are soothingly repetitive yet have just enough variability to keep us entranced. Furthermore, research has shown physiological benefits to being in and around water such as decreased cortisol and sympathetic nervous system activity (associated with the stress response) with increased parasympathetic activity (associated with a calm state propagating rest and regeneration).

Within this required juxtaposition of predictability and unpredictability, is our body’s dependency on receiving multi-sensory experiences.  In order for us to detect novelty, we need to be able to see, smell, taste, hear, and feel it. With properly dosaged sensory stimuli, our prefrontal cortex (high level cognition) is optimized and we can exist in state of relaxed awareness. Our senses are closely connected to our memory and cognition. Weakness in one is often related to weakness in another. As we age, we get more forgetful and distracted in a large part because our brain is not able to process what we hear, see, and feel as well as it once did. This also parallels a young urbanized society that is deprived of natural environments and stimuli.

From a proprioceptive perspective, not being able to feel the ground (as we are typically walking around in shoes on artificial flat surfaces) has significant repercussions for our bodies. It is a stressor for us to not perceive the ground. We need to wear shoes with arch supports to essentially bring the ground up to our foot because otherwise we are unable to sense it. Without this sensory input, our neuromuscular system reacts by increasing tension which can alter our breathing, postural patterns, and biomechanics setting us up for musculoskeletal injury and pain. Dysautonomic conditions such as POTs can be associated with individuals who have difficulty processing proprioceptive information from their feet. Furthermore, any stressor to the body can manifest in another system as per the “Integrated Systems Model of Stress and its Potential Clinical Patterns.”

From a visual perspective, the chronic near-work we endure in our digital and literate based society is associated with the development of nearsightedness, otherwise known as myopia. This visual impairment can be viewed as an adaption to the stress imposed on the visual system through the constant accommodative processing that is occurring through reading and interacting with a 2-dimensional digital landscape. Other visual adaptations such as astigmatism and issues with binocularity (ability of the eyes to work together) may occur in response to the functional stresses we impose on ourselves coupled with the postural ones. As stated previously, any stressor to one system in the body can also impact another per the “Integrated Systems Model of Stress and its Potential Clinical Patterns.”

From a hearing and sound perspective, the constant bombardment of noise, particularly if loud, creates stress in our bodies. Studies show that people who live in places with continuously high levels of traffic sounds have a greater risk of high blood pressure, heart attack, and suppressed immune systems. We evolved listening to a silent landscape layered with the rhythmical sounds of nature. Most types of music can actually emulate this and have shown to demonstrate similar activation patterns in the brain compared to natural sounds. The noises of traffic, TV, and certain genres of loud music that we are bombarded with in modern culture do not reflect what our auditory systems evolved under.

The senses of taste and smell are intertwined with what we eat. Just as we need the natural elements of water, air, and sunlight to survive, food is also essential. For 97% of our human existence and depending on where we lived, we consumed wild animals, fish, seasonal plants, nuts, and berries. Grains were not introduced until 10,000 years ago and are inherently very difficult for humans to digest, particularly the way they are processed and prepared by modern methods. Furthermore, the modern processing of foods such as pasteurization, spray drying, freeze drying, and the addition of artificial ingredients and preservatives didn’t occur until the last 150 years. The use of aggressive and toxic organic and synthetic pesticides and fertilizers has exploded over the most recent century. Genetically modified foods began in the 1980s. In sum, we have radically changed our diets in a relatively short amount of time (.001-.0005% of human existence) to industrialized quality food.  Not only are we not consuming food as it was intended for us but our sources of fat and protein (mainly animals) are also not being fed what they were inherently designed to eat (grass grown by the natural elements of the environment) but instead are  grain fed. This is in addition to various cocktails of medications including antibiotics and hormones to increase their size and manage the illnesses they are very susceptible to existing under these conditions. The amount of nourishment we obtain through the meat and plants we eat is ultimately reflected on the quality of nourishment they obtained.  In sum, our connection to mother earth through our senses of taste and smell via dietary and nutritional sustenance has dramatically been altered.

A prominentely pervasive pattern in nature is rhythm. This occurs from the vibratory nature of subatomic particles that make up our bodies and universe all the way to the human and celestial bodies they create. The term “fractal” means a neverending pattern that is persistent in nature. Our world is fractal and rhythm is the pulse, breath, and dance of it. Unfortunately, we are losing our natural inherent tempos. Our heart rate, breathing patterns, and ability to properly shift side to side when walking are becoming somewhat extinct as the incidence of chronic disease, pain, and movement dysfunction in our digital society rises. It is imperative for us to regain our rhythm through rediscovering our cadence with our environment.

Our lack of sensory interface with our environment not only impacts our physiological functioning from a cognitive and physical perspective but also from an emotional one. Because we do not sense nature we do not empathize with it. We view it as unnecessary and disconnected from us. This feeds an egocentric state of being versus an anthropocentric (recognition of the relationship between self and nature) and biocentric (self is nature) perspective. When we view ourselves as separate, we create a compassionate blind spot towards other people and/or nature. However, immersion in nature, creates positive feelings and a sense of interconnectedness with our world. We feel as if we are a part of something larger than ourselves that eliminates a dualistic perspective. In order to conserve our environment, we must first conserve our experience with it. This means reconnecting to mother earth through all of our senses.

In conclusion, we need to sense and feel nature to feel good and function at our best. Nature nurtures us. At the same time, nature needs us to nurture her. The only way we will take care of her is to care about her. The only way to care for her is to sense and feel her. Such is the rhythm of life.

How can we reconcile a digital and natural world?

I admit that the story I just told could lead one to believe I am recommending that we completely abandon our lives and retreat to a pastoral lakeside forest after taking some wilderness survival courses. This is obviously not realistic or practical. Although it might be fun and beneficial to do periodically… Or perhaps a more reasonable “Top 10” solution would be:

  1. Get outside whenever you can and leave your digital entourage behind. If you can’t get out of the office then make use of those windows to visually expand and connect.
  2. A virtual substitute (art, tranquil natural music sounds or videos) can be an alternative (although still not as powerful) to the real thing.
  3. Be mindful of the sounds, sight, smells, and sensations you are feeling in nature. Aim for a multi-sensory experience.
  4. Water is particularly calming and rejuvenating for our bodies. “You don’t need to meditate to water because it meditates you.” (Blue Mind)
  5. Consider if what you are eating is truly natural and was grown the way nature intended.
  6. Mindful eating habits please. Make the experience be about connecting you, the food (thoroughly tasted and chewed), and any natural surroundings (including people) around you.
  7. Do you really need to be checking your phone, email, and social network as often as you are?
  8. Rediscover how to properly multi-dimensionally shift and rhythmically move your body. As a Physical Therapist, this is my area of expertise and I heavily rely on the PRI approach to accomplish this.
  9. Walk, or even better play, barefoot outside on soft uneven earth such as grass or sand if you can.
  10. Be grateful to be not only a part of, but have the ability to be consciously and sensorily aware of our amazing and ever evolving universe.

Grounding from an Electrical, Postural, Breathing, and Emotional Perspective

By Heather Carr, DPT, NTP, PRC, OCS, MTC

The concept of “being grounded” is becoming a common phrase that is being expressed these days. The connotations associated with “being grounded” are that it is a healthy and beneficial phenomenon. However, what exactly does it mean? The purpose of this article is to explore “grounding” from an electrical, postural, breathing, and emotional perspective.

The human body is constantly generating free radicals via oxidative reactions which if unchecked can contribute to immune and inflammatory stress. Anti-oxidants that serve to neutralize these reactive oxygen species do so by donating electrons. The earth’s surface has a net negative electrical charge characterized by an excess of electrons. Therefore, the earth is a natural repository of electrons to supply our bodies with anti-oxidants thus mitigating oxidative stress. However, this ultimately requires direct contact of our skin to the earth or the use of conductive sheets/pads/wrist bands (Earthing products) that are connected to the grounded component of an outlet.

Modern living subscribes to a plethora of toxins that we ingest and are exposed to through our foods and environment requiring significant anti-oxidant retaliation. Consider this relative to how the natural human electrical discharge mechanism between the ground and our bodies has become mostly obsolete. Until recently, throughout much of our human existence we walked barefoot and slept on the ground. Our shoes, particularly rubber soled, pose a barrier for this electrical conductance pathway. Furthermore, most of us are walking on artificial surfaces. There are many individuals who never or rarely experience barefoot contact on real earth. This is one of the reasons why walking barefoot on the beach is so enjoyable and relaxing for people. Not only are you experiencing wide open space (in contrast to the typical close-up, indoor, focal work we do on screens) and the natural multi-sensory rhythms of the ocean (as opposed to the artificial dissonance created by modern technological devices) but you are also absorbing electrons from the ground to neutralize free radicals in your body.

In the Journal of Environmental and Public Health, Chevalier et al (2012) describe in “Earthing: Health Implications of Reconnecting the Human Body to the Earth’s Surface Electrons” the numerous health benefits of this phenomena. Such effects of “earthing” that have been demonstrated include beneficial changes related to sleep, pain, cortisol level, autonomic nervous system activity, immune function, osteoporosis, heart rate variability, hypercoagulable blood, and glucose regulation. In addition to personally sleeping on an earthing sheet, as a Physical Therapist I commonly recommend them to my patients, particularly those who are experiencing pain, inflammation, and have difficulty sleeping. Thus far, in addition to myself, my family, friends, and patients have reported significant improvements in these areas since incorporating earthing practices.

From a postural perspective, “being grounded” means your body is authentically aware of where the ground is and its positional and gravitational relationship to it. This is the responsibility of our postural system which is primarily comprised of our visual, auditory, vestibular, and sensory-motor systems. Our postural system and essentially all of the systems in our body, work in the realm of patterns. Our brain-body is a dynamic habit centered organism. Furthermore, our neuromuscular system works in patterned “chains.” This means that groups of linked muscles fire together in synergized mechanisms to accomplish our functional needs to be upright against gravity and move. Our primal human essence of movement is walking which is comprised of two polar phases-being on the left leg and being on the right leg. This has an accompanying predictable neuromuscular firing pattern from the foot all the way up to the head including the visual and vestibular systems.  Each side is essentially a conjugate of the other with opposite patterns occurring simultaneously.  When the left leg is on the ground it is in the “grounded” phase when the right leg is in mid-air, and thus ungrounded. The opposite occurs for the right stance phase of gait.

Our postural system is intimately linked with our breathing (respiratory) system. Just like our alternating left/right walking, breathing also exhibits an oscillatory essence characterized by inhalation and exhalation. When we inhale the front of our rib cage elevates into external rotation as the diaphragm contracts and lowers. This is in contrast to exhalation where the front of the rib cage lowers. During exhalation the diaphragm relaxes as it returns to a upward domed position in apposition to the internal surface of the rib cage (referred to as the “zone of apposition”). Authentic and efficient breathing is characterized by being able to alternate between a full inhale when the diaphragm lowers and a full exhale where the diaphragm rises up into apposition with rib cage. This requires synchronized activity between the abdominal and pelvic floor musculature to control pressure and positional relationships throughout the trunk. These same muscular patterns are also involved in managing the process of walking. Therefore, how we breathe effects how we posture and move. Likewise, how we posture and move effects how we breathe.

Let’s take this a “step” further. When we walk our pelvis and rib cage rotate in opposite directions. This means when the pelvis is rotating to the right the rib cage is rotating to the left and vice versa. When the rib cage is rotating to one side it exhibits a twist in which the left and right sides are in opposite phases. For example, when we are on the left leg our rib cage is concurrently rotating to the right. This means that the front right side of the ribs are in an open, elevated, inhaled state while the left front ribs are in a closed, lowered, exhaled state. The best way to understand this is to place your hands on the front of your ribs and feel this opposing motion when you turn your torso to one side or the other. Likewise, when we are on the right leg our thorax is concurrently rotating to the left in conjunction with the left ribs being in a state of inhalation while the right is in exhalation.  This comprises a pattern of whatever leg is “grounded” the corresponding side of the rib cage is in an exhalation state.  This means that exhalation correlates to the postural phase of being “grounded.”

The current trend of postural and breathing dysfunction amongst our modern living society is characterized by being in a chronic state of inhalation. Many of us are functioning in a stressed out mode characterized by excessive sympathetic nervous system activity and holding our breath. Consider what we do when we are startled or experiencing fear-we gasp! This is in contrast to “a sigh of relief” when we exhale into a calm and relaxed state of being. Unfortunately, this inhalation pattern has become a chronic breathing behavioral habit vs an acute transient one (such as if we were startled by a predator as was the case in our paleo times). This means the rib cage is excessively elevated and open in the front, closed in the back, with the diaphragm locked down in a perpetual contracted state, preventing a full exhalation and thus relaxation to occur. This means poor breathing excursion and airflow. It also translates into excessive tension in the psoas, hip flexors, back extensors, and neck musculature as the diaphragm is fascially and functionally connected to these muscle chains. Positionally, this pattern is typically accompanied by an excessive anterior pelvic tilt, lumbar lordosis, protracted scapula, and forward head posture. This is ultimately an “ungrounded” posture.

Now it’s time to connect our emotional system to breathing and posture. A study done out of Northwestern University lead by Dr. Christina Zelano demonstrated that during inhalation people are more likely to learn fear based memories compared to the exhalation phase of breathing. Inhalation was shown to facilitate the amygdala and hippocampus in the brain (involved with emotional processing and memory) to encode and retain stressful events significantly more than during exhalation. This relationship can also work in reverse where emotional patterns incorporating fear and anxiety can impact how we breathe, our posture, and thus our “grounding.” Individuals who experience anxiety related disorders tend to function in an inhaled state of breathing and its correlational postural pattern. Therefore, anxiety and stress states are typically “ungrounded.”

In order to potentiate one’s ability to be “grounded,” one must consider the behavioral, postural, breathing, and emotional dimensions that ultimately create it. Behaviorally, we can increase our electrical contact with the ground either naturally and/or through the use of Earthing products. We can also attempt to reduce our free radical production in that we have some degree of control over the amount of toxins we ingest and are exposed to.  By restoring appropriate postural and breathing patterns one can improve their ability to authentically “ground.” The method of the Postural Restoration Institute (PRI) is heavily focused on creating these grounded relationships. An important component to this is to establish a full exhalation to allow the diaphragm to achieve a relaxed domed position in contact with the internal rib cage. Furthermore, because the diaphragm is part of a continuous chain of synergistic muscles from the foot all the way up through the head, a portion of or all of these chains may need to be re-educated to ultimately create this grounded pattern. This typically requires practicing specific postural restoration techniques so that the brain-body can learn a “grounded” pattern. Finally, by addressing fear based emotional patterns one can also influence their breathing, posture, and thus ability to “ground.” Likewise, one can positively influence anxiety and stress via better postural and breathing function. It’s all connected!

Chevalier G, Sinatra ST, Oschman JL, Sokal K, Sokal P. Earthing: Health Implications of Reconnecting the Human Body to the Earth’s Surface Electrons. Journal of Environmental and Public Health. 2012;2012:291541. doi:10.1155/2012/291541.

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