This is a chapter 4 summary of “Multidisciplinary Approaches to Breathing Pattern Disorders” by Leon Chaitow. The second edition will be coming out this December, and you can preorder it by clicking on the link or the photo below.

Loose-Tight

Chaitow likes to use the loose-tight concept as a way of visualizing the body’s three-dimensionality while assessing.  He likes to look at comparing structures as tight or loose relative to one another. Those areas which are loose are often prone to injury and more likely to be nociceptive.

If we try to see which muscles have a tendency towards tightness or looseness, stabilizers tend towards laxity and mobilizers to increased tone.  Obviously, all muscles function in both capacities, and some even stay more towards the middle (scalenes). But the tendency depends on which function is more dominant.

Posture and Respiration (Not PRI, Peepz)

Taking the previous concepts, Janda’s crossed syndromes can have a role in ones breathing function. With an upper crossed posture, the slumped upper body position negatively influences breathing function. Lower crossed syndrome will put the diaphragm in an anterior facing position, thus affecting diaphragm length-tension and breathing function.

Facilitation

Facilitation is an osteopathic term for a process involved in neural sensitivity.  There are at least two forms of facilitation: spinal (segmental) and local (trigger points).

Once facilitation occurs, any additional stress the individual undergoes can increase neural activity in the segment.

There are several ways to observe facilitated segments. You can observe these via palpation:

• Goose flesh in the facilitated area when the skin is exposed to cool air.
• Cutaneous hyperesthesia in the related dermatome.
• “Orange peel” appearance in the subcutaneous tissue.
• Localized muscle spasm in the facilitated area.

You can also see trigger point formation in these areas. There are several primary factors that contribute to trigger point activation:

• Persistent muscular contraction
• Trauma
• Adverse environmental conditions
• Prolonged immobility
• Febrile illness
• Systemic biochemical imbalance
• Factors such as age and general health status

Secondary factors may include:

• Compensating synergist and antagonist muscles to those housing primary triggers.
• Satellite triggers evolve in referral zone.

Stressors ranging from nutritional deficiency, hormonal imbalance, infections, allergies and intolerances, and low tissue oxygenation may all contribute to trigger points being maintained and enhanced.

Trigger points can either be active or latent.  Active trigger points refer a pattern recognizable to the patient, whereas latent trigger points are locally painful and only refer on pressure.  The latent ones can also refer patterns that are unrecognizable to the patient.

There are several ways to deactivate trigger points to include acupuncture, manual therapy, stress removal, and improved breathing function.