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Understanding the order of importance for our survival that our bodies place on our various body systems can provide a road map for successful resolution of health problems.

Paul Chek has a priority system that he uses and teaches to his students (such as myself) to help us help the people that come to see us seeking treatment for their various aches and pains and health problems.

No matter what the symptom, from low-back pain to digestive troubles to fatigue, the idea is to start examining the patient/client by looking at the system at the top of the hierarchy – breathing, and progressing down until a dysfunction is found, and addressing that dysfunction first.

Breathing is at the top of our body’s priority list for obvious reasons – we can’t survive more than a few minutes if we can’t breathe. So in our body’s innate wisdom, it will sacrifice all other body parts and systems in order to make sure that we can still breathe.

Not being able to breathe through the nose is relatively common, either due to the nasal passage being too small or due to allergies or sickness. The body makes a fair number of compensations in order to accommodate mouth breathing, the most obvious one being to bring the head forward to allow for easier air-flow when mouth breathing.

Forward-head posture greatly increases the forces on the back. For every inch the head is forward, the weight of the head is added to the workload the upper back muscles must carry. Heads weigh between 8 and 12 pounds, so if the head is 2 inches forward, that is 16 to 24 pounds of work those poor back muscles are forced to do, which can lead to upper back strain, shoulder problems, and low back problems.

Because the body will always sacrifice a back in order to breathe, one can’t fix a back by only treating a back, if the person is not breathing correctly.

Hyperventilation will increase the pH of the blood which has chemical consequences in the body, such as making it more difficult for the hemoglobin to release the oxygen to the cells (not good), and it also causes more calcium to enter the the muscles and nerve tissue, making them more excitable than they should be.

Blood that is too alkaline causes the arteries of the brain, heart and body to constrict, increasing blood pressure and reducing blood flow to these tissues. Reduced blood flow results in a huge variety of symptoms, from headaches, to digestive issues, to fatigue, to cold hands and feet, and on and on.

The above are only two examples. There are many ways people breathe incorrectly and many various problems that can manifest in the body because of it. So no matter what the issue, it makes sense to check and correct breathing first. Changing how one breathes is not an easy process, but well worth the time it takes.

If you have breathing issues like hyperventilation, chest breathing, shallow breathing etc., seek a physical therapist or a CHEK Practitioner for help, or try yoga. Structural Integration (a form of massage therapy) can help open up the nasal passages if your nose tends to be blocked.

Paul Chek puts bite and chewing (temporomandibular joint and teeth) second on his totem, because if you can’t eat, you won’t survive long either. He is obviously correct, but I think the body prioritizes circulation higher than eating so I would put circulation 2nd on the priority list. After all, a severed artery or a heart attack are both emergencies that need to be addressed immediately to avoid death. I think of the CPR mantra – ABCs – Airway, Breathing, Circulation.

The circulatory system delivers blood carrying oxygen, nutrition, communications via hormones and peptides to the cells, and returns cellular waste to the liver for recycling or disposal.

Any tissue that for whatever reason is not receiving the blood flow it needs will be unable to function optimally.  The body will alter its posture in order to protect a tethered or partially plugged blood vessel.

Blood vessels should be somewhat mobile – they should slide with the tissue as one reaches an arm up overhead, or as the legs move as we run or walk.  Moving our bodies through full range of motion daily should help keep the mobility in the vessels.

However, if a blood vessel becomes stuck and is no longer able to slide (due to a fall, MVA, not enough exercise etc.) suddenly the body has a problem.  For example, if there is a blood vessel tether in the "leg pit" or groin area, the front of the hip is stretched as we walk.

From the tether on downstream the adhered blood vessel is also being stretched, which would narrow the diameter restricting blood flow.  Suddenly the body will discourage a long stride in order to prevent a serious injury to the vessel.

The body will try to adjust by tightening certain muscles and relaxing others to change the position of the pelvis, leg or foot in order to accommodate the compromised  blood vessel and improve blood flow.

The common adaptation is too much anterior rotation (pelvis-bucket pouring water out the front) to keep adequate slack in the blood vessels going into the leg. 

No matter how much that poor pelvis position might wear out a hip joint or cause facet-joint irritation in the low back, that is the sacrifice the body will make to protect its circulation.

Furthermore, no amount of hip-flexor, quad, and low back stretching will create a permanent change if there is a tethered or compromised blood vessel in the groin area. Muscles, bones and joints are the slaves of the blood.

Maybe hip and knee surgeries could be prevented if blood flow were restored before too much cartilage damage occurred.

If you have spent a lot of time stretching and you are getting no more flexible, perhaps this is the reason.

Look for an osteopath or someone that has done training to release nerves, as the blood vessels usually travel in the same channels as the nerves if you think this might be affecting you.

If you want to search for other posts by title or by topic, go to www.wellnesstips.ca.

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“When the emotional brain is out of order, the heart suffers and wears out … The proper functioning of the heart turns out influence the brain as well.”

Dr. David Servan-Schreiber, MD, PhD goes on to say that “Some cardiologists and neurologists go so far as to refer to a “heart-brain system” that cannot be dissociated.” The brain and the heart are connected via the autonomic peripheral nervous system, which is not under conscious control and regulates organ function.

As I’ve discussed in many other tips, the sympathetic branch (fight or flight), raises heart rate, blood pressure etc. whereas the parasympathetic branch slows heart rate, lowers blood pressure etc. The goal for optimal health is to have the two branches balance each other, rather than have one branch (usually the sympathetic one) racing out of control.

It is now known that the heart  produces some of its own hormones, and actually has its own perceptions, which can influence the function of the whole body including the brain. It sends messages back to the brain via direct nerve connections also, creating an interconnected loop. So, learning how to control the heart can make a huge difference in our ability to come to peace with the emotional brain.

One of the ways to see the connection between the brain and the heart is by looking at the variability in heart rate in response to the constant demands of the sympathetic (accelerator) and parasympathetic system (brake).

It is not normal to have an extremely steady heart rate, where the space between each beat is identical for long periods of time – there should always be minute variations and adjustments, which is a reflection of the give and take in the nervous system.

When the emotional brain is not happy – when we are depressed, anxious, worried, overly stressed or angry, our heart rate variability lessens, and the beat becomes more chaotic, showing up on a biofeedback graph as jagged, disorderly beats.

When feeling joy, happiness, love, gratefulness, compassion or other positive feelings, our heart responds by "smoothing out" the rhythm, making the wave on a biofeedback graph appear harmonious and coherent.

On a biofeedback graph, the space between the peaks won't be even, reflecting good heart-rate variability, but the graph itself will be less "jagged" if that makes any kind of sense at all. Look at the graphs here to see the difference between a non-coherent and a coherent heart rhythm.

When the heart is beating in coherence, the brain works more quickly and more accurately, the autonomic nervous system stabilizes, our respiratory rhythms and our blood pressure variations synchronize, and our emotional state can dramatically change.

When we are suffering emotional distress, our heart will beat in a chaotic fashion. This can happen for a few minutes or for much longer periods of time over the course of a day, depending on how we are coping. No wonder so many of us are tired all the time, and some of us suffer from heart palpitations and anxiety attacks.

In the same day, our hearts may be beating in coherence for periods of time too. The more time spent in coherence, the healthier and happier we are. And thankfully, we can train heart coherence, and it is a very effective way to deal with negative emotions via the body, as I was explaining last week.

And when we get good at achieving heart coherence, we can use it when we are under emotional stress to keep our physiology working well, so we no longer live in a state of chronic stress, which has such negative consequences for the body.

Although there are many software biofeedback programs on the market now that measure heart coherence and can be very helpful to learn how to bring oneself into coherence at will, they are not necessary.

One can achieve coherence by taking a few minutes to set aside one's troubles, sit or lie down, and focus on the action of taking a few deep breaths. Be an observer, and watch the air pass your nostrils, fill your lungs, and feel the ribcage expand.

Then without forcing, watch the air come out, being mindful of the feeling as it passes through your throat and out your nose. Breath easily, long, deep and slow for a few breaths.

Then focus in on your heart, and feel as if you are breathing through your heart or the centre of the chest, washing the heart in fresh oxygen with each inhale, and removing the waste with each exhale.

Pay attention to any warming feelings or feelings of your chest emotionally expanding. Think of someone you love, or perhaps your favourite place in the world. Think of something you are extremely grateful for, or a time where you did something that made you feel wonderful. When you feel that inner glow, you have achieved heart coherence.

With practice, one can achieve coherence quickly, even in stressful situations. Coherence provides a good opportunity to access both the cognitive and the emotional brain, as the system is in balance. It can also provide a direct line of communication into the emotional brain.

Once in coherence, one can ask the heart a difficult question, and look for the reaction – greater warmth and comfort, or a feeling of withdrawal – and know how the emotional body is viewing the situation.

It is said that we are happiest when we follow our heart, so learning to hear what our heart is telling us can be very valuable indeed.

The ideas in this tip come from a book I really enjoyed – The Instinct to Heal – Curing Depression, Anxiety, and Stress without Drugs and without Talk Therapy, by David Servan-Schreiber, M.D., PhD. Do read the book for more details.

If you want to search for other posts by title or by topic, go to www.wellnesstips.ca.

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Servan-Schreiber, David MD, PhD. The Instinct to Heal: Curing Depression, Anxiety and Stress Without Drugs and Without Talk Therapy Rodale Inc., US, 2004.

Marek Malik et al. Heart Rate Variability
Standards of Measurement, Physiological Interpretation, and Clinical Use Circulation 1996;93:1043-1065.

Tiller WA et al. Cardiac Coherence: A New, Non-invasive Measure of Autonomic Nervous System Order Alternative Therapies in Health and Medicine. 1996; 2(1): 52-65.

Ginsberg JP et al. Improving Cognition in Recently Returned Combat Veterans with Post traumatic Stress Disorder by Heart Rate Variability Coherence Biofeedback Shirley L. Buchanan Neuroscience Laboratory, Dorn VA Medical Center, Columbia, SC., 2008.

McCraty R et al. Impact of a workplace stress reduction program on blood pressure and emotional health in hypertensive employees. J Altern Complement Med. 2003 Jun;9(3):355-69.

Luskin F. et al. A Controlled Pilot Study of Stress Management Training of Elderly Patients With Congestive Heart Failure Preventive Cardiology 2002;5(4):168-172, 176.

McCraty R. et al. Heart Rhythm Coherence Feedback: A New Tool for Stress Reduction, Rehabilitation, and Performance Enhancement Biofeedback 2002;30(1):23-25.

Doc Childre et al. Psychophysiological Correlates of Spiritual Experience Biofeedback 2001;29(4):13-17.

McCraty R et al. Analysis of twenty-four hour heart rate
variability in patients with panic disorder Biological Psychology 56 (2001) 131–150

McCraty R et al. The impact of a new emotional self-management program on stress, emotions, heart rate variability, DHEA and cortisol Integr Physiol Behav Sci. 1998 Apr-Jun;33(2):151-70.

McCraty R et al. The Effects of Emotions on Short-Term Power Spectrum Analysis of Heart Rate Variability American Journal of Cardiology. 1995; 76(14): 1089-1093.

Rein G. The Physiological and Psychological Effects of Compassion and Anger Journal of Advancement in Medicine. 1995; 8(2): 87-105.

Copyright 2008 Vreni Gurd

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Obstructive sleep apnea, often a result of being overweight, is a condition that is linked to heart disease, liver disease and type 2 diabetes.

Dmitriy Kruglyak who hosts the www.trusted.md site, asked me in December to listen to a webinar put out by the drug company Cephalon on their sleep apnea / narcolepsy drug, Provigil, and to blog about it. As you can see, I’m a little behind in my commitments! Obstructive sleep apnea is a condition that affects 18 million Americans, and is linked to heart disease, congestive heart failure, stroke, diabetes, metabolic syndrome, depression, liver disease, not to mention various cognitive impairments, so beyond the obvious problems of fatigue and inability to function well due to lack of sleep, sleep apnea has far-reaching health consequences. Good sleep is one of the foundational health principles – one simply CANNOT be healthy without adequate sleep.

Obstructive sleep apnea is a condition that is caused by a blockage in the airway during sleep resulting in a stoppage of breathing for short periods of time, several times a night. The blockage is usually caused by the tongue or the tonsils falling back in the throat when the sleeper is on his/her back, resulting in snoring at best, and a complete airway blockage at worst. This leads to lowered levels of blood oxygen, resulting fluctuating heart rates and blood pressure in an effort to deliver the required oxygen to the body. The disruption in sleep in addition to the lowered blood oxygen, increases sympathetic load (chronic body stress) and all that that entails. Obesity is the biggest cause of the problem, with food sensitivity, especially to gluten and dairy being another potential cause. Diagnosis usually involves going to a sleep clinic for a sleep study. Obstructive sleep apnea (OSA) is chronically under-diagnosed – 1 in 5 adults have mild OSA, and 1 in 15 has moderate OSA, and often the bed partners of those with sleep apnea are also sleep deprived due to the noise of the snoring. So, it is quite probable that as many as 1 in 3 adults are not getting enough sleep. The health implications for the population are staggering!

The "symptom relief" treatment for obstructive sleep apnea that works well is Continuous Positive Airway Pressure (CPAP). The sleeper wears a mask which delivers oxygen at a pressure that keeps the tongue and tonsils from sliding back and blocking the airway, effectively preventing the stoppages in breathing and allowing for a better sleep. But as soon as the treatment is stopped, sleep apnea returns, so CPAP can only be considered a "sleep apnea management system." It does not deal with the cause. In my opinion, to address the cause of sleep apnea, one can reduce bodyweight by staying away from all processed and fast food, sugar, flour products (baked goods, pasta, crackers etc.) and polyunsaturate vegetable oils, find out what ratios of carbohydrates, proteins and fats are right for one's biochemistry (metabolic typing) and eat accordingly, and exercise regularly. It may be worth going to one's physician to be tested for food sensitivities, and remove those foods from one's diet as well.

I thought it took a lot of guts for a pharmaceutical company to invite bloggers and other media to a webinar about a drug. By doing this, they are not able to control the message that is put out to the public, but by the same token, it is a realization that social media is here to stay, and controlling a message may no longer be possible in today's world, so why not embrace the new technology, and be as transparent as possible. I thought the information the company gave was very balanced – they came right out and said that their drug, Provigil does not address the cause of sleep apnea at all, but rather, provides a way to cope with daytime sleepiness.

As one who deals with a major sleep problem many nights of the week (although not from sleep apnea), I know what it feels like to struggle through a day with that dizzy feeling near the front of the forehead, the lethargy, and the inability at times to think straight. It is not an enjoyable feeling. Would I take a drug like Provigil? I don't think so. The researchers did not seem able to explain very well how the drug works, and so I would be concerned as to the chain reaction that it caused in the body. What does it do to cortisol, for example?? Drugs usually affect one part of our physiology which provides symptom relief, but then the part that is altered by the drug affects other parts and so on and so on. Which is why we get side-effects, and possible disease processes from the alterations in the normal physiology. Even though the journey may be longer, I feel it is safer to resolve the underlying cause of the problem through diet and lifestyle modification, and if deemed necessary through functional medical testing, appropriate supplementation.

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I just love learning. If I could figure out a way to make money taking courses all the time, I think I would be in heaven. I’ve taken this course before so the info was not new, but you know, somehow I needed to be bonked over the head with a sledgehammer again on how we will pretty much sacrifice any other body-part to be able to breathe.

We can only survive minutes without oxygen, so if holding that spine in that twisted way is going to help you breathe, even if the result is a sore back, so be it. So no matter where the pain or discomfort, it is worth making sure one is breathing properly. If not, one must figure out what is driving the improper breathing pattern.

There are a variety of reasons why breathing may be compromised, and sorting out the cause is the only way to fully resolve the breathing pattern. Mouth breathing will cause the head to move forward in order to open the airway, and a forward head posture will pull the lower jaw (mandible) pull back in relation to the top teeth (maxilla). This pulls the tongue down from its resting position up on the hard palate and the top gum line reducing neck stability.

For proper diaphragmatic breathing, the top face of the tongue must be up against the roof of the mouth. Frequently along with a forward head posture is an overly rounded upper back and depressed chest, which can prevent the diaphragm from descending properly. In this way, a poor breathing may cause a cervical disk issue, osteoporosis).

Allergies, whether airborne or from food can cause problems with respiration. Head, jaw, facial or cervical injuries may be at the root of a breathing problem. Craniofacial growth disorders caused by poor nutrition of one’s parents or poor nutrition in childhood may result in a structurally narrow face, crowding of teeth, small sinuses and a small airway. Mouth breathers sometimes fall into this category if the nasal passages simply are not large enough.

Parasites, drugs and too much sugar can also affect breathing rates. Anxiety, stress, grief or other emotional issues that increase sympathetic load will put pressure on the respiratory system and increase breathing rates. Avoidance issues may stiffen the ribs reducing the bucket-handle motion that is supposed to happen with diaphragmatic breathing.

Poor breathing patterns are frequently responsible for neck pain, because if the diaphragm is not adequately used, the thin muscles of the neck are working hard to pull up the ribcage with every breath. Ouch! And if transversus abdominis, one of the local stabilizers of the spine, is helping to force the air out with each breath in order to be able to take another breath in again quickly, it is too busy to do its main job of stabilizing the low back and pelvis.

So poor breathing can result in a sore back and pelvic pain. And if the trunk is unstable, it is pretty tough to stabilize the limbs! We were given an example in class of someone who was sent to an Ear, Nose and Throat specialist to fix a nose problem that was impeding breathing in order to successfully resolve a chronic achilles tendonitis.

Faster breathing rates (more than say, 16 breaths per minute) may cause a blowing off of CO2, the result being a higher blood pH, which has all kinds of consequences to the body from a chemical perspective. Reducing whatever chronic stress may be resulting in the faster breathing rate, whether emotional, nutritional, toxicological or physical would be helpful, in addition to actively learning to breathe correctly and at a slower pace.

If you are a mouth breather and wake up with a wet pillow, or if you find one or both nostrils chronically clogged, you may find an Ear Nose and Throat specialist helpful, particularly if the problem is structural. Nose mucous may also be due to allergies or food intolerances, so learning what you may be allergic or sensitive to may also be helpful.

Sometimes Rolfers or other Structural Integrators can open nasal passages too. Then seek the help of a physiotherapist or Chek practitioner to help you correct your posture and breathing pattern, or in a pinch, read Breathe your way to a more mobile back.

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Breathe – Are you a chest gripper?
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Do you have back pain? Either up between the shoulder blades, in your mid back or even in your low back and pelvis? Do you have degenerative disk disease? Do you have neck pain? Do you have an inguinal hernia or did you have one repaired? Do you suffer from incontinence issues, or are you always aware of where the nearest bathroom is just in case? Are you thinking about bladder suspension surgery? Do you have a prolapsed uterus?

These diverse health issues may be due to or partially due to "chest gripping", a term coined by physiotherapists, Diane Lee and Linda-Joy Lee, referring to the common faulty stabilization strategy of tightening the upper abdominals (external oblique and rectus abdominis) by drawing the navel in towards the spine when stabilizing one’s trunk against the forces put through it while standing, walking, lifting and carrying, or sitting and lying down.

This poor stabilization strategy may develop as a result of a trauma, poor habitual posture, or even psychological factors, such as trying to hold in one’s gut in order to appear thinner, or constantly tightening the upper abdominals in order to show off that six-pack.

"Chest gripping" results in a restriction of diaphragmatic breathing. The abdominal muscles act like a belt squeezed tightly around the lower ribs, making it next to impossible for the diaphragm to descend properly to get a proper breath of air. Instead, the chest expands and the shoulders are pulled upward by the small neck muscles with each breath, which can lead to neck strain, and possibly a need for a faster breathing rate, which can cause a blowing off of C02.

Furthermore, constant chest gripping tends to stiffen and compress the spinal column resulting in compressive forces through the vertebral joints and intervertebral disks causing disks to degenerate, and a loss of the segmental mobility that is needed for fluid, pain-free motion.

And ribcage gripping frequently results in an overly-rounded upper back, and the long erector spinae muscles becoming longer and often weaker than they should be. Frequently it is long, weak muscles that become sore, rather than strong, tight ones.

And an overly-rounded upper back almost always results in the head being too far forward. For every inch that the cheekbone is forward of the top of the sternum (manubrium), the upper-back muscles must counteract the weight of the head.

So, if the cheekbone is two inches forward of the manubrium, assuming the head weighs between 10 and 15lbs depending on the person, there is between 20 and 30 lbs of force going through those poor upper back muscles.

Simply by letting go of the upper abdominals that are gripping the ribcage and bringing the head back over the body, there would be less stress on those upper back muscles.

Chest gripping also squeezes the internal organs forcing them down, requiring a functional pelvic floor with good tone to counteract the constant pressure. When the pelvic floor isn’t functioning well in women, incontinence may result. That "bearing-down" pressure can also lead to inguinal and umbilical hernias and prolapsed uteruses.

To notice whether or not you are a chest gripper, place one hand on your upper chest and the other on your lower ribs, and observe your breathing pattern. Your rib hand should move more than your chest hand. If you are lying on the floor, as the air comes out of your lungs, notice if your upper abdomen gets soft and gushy, or if it becomes more firm. Gushy is good. You should be able to dig your fingers under your ribcage, and keep them there as you breathe. If you are gripping your ribs you won’t be able to get your fingers in there.

When you are standing, do you notice that you have your upper abdominals constantly contracted? If you look in the mirror, do you see big divots just below your ribs on both sides of your abdomen? Try letting go of those muscles and soften the look of your abdomen. A healthy abdomen is not contracted all the time.

Breathing a normal amount of air into your lower ribcage can be a good way to let go of those ab muscles. The trick is to change your habit so that you stop ribcage gripping all together, so every time you walk through a doorway, tune into your body and let go of your ribs if you catch yourself gripping.

If you find your pain increases when you let go of your ribs, seek the help of a physiotherapist that can help you connect to your transversus abdominis, pelvic floor and multifidus, the deep local muscles that are meant to stabilize your spine and pelvis.

Related tips:
Breathe your way to a more mobile back
Reduce neck strain
Hyperventilation increases your body’s pH

www.wellnesstips.ca