THE MAJOR CAUSE OF BAD POSTURE—AND EVEN WORSE THINGS THAN THAT!

Good posture occurs when the muscles of the body support the skeleton in an alignment that is stable as well as efficient, both in stillness and in movement.

Bad posture is the result of a number of things including bad habits developed over time as the body seeks ways to accommodate muscle spasm, weakness, tension or imbalance between muscle groups. Causes of bad posture include but are not limited to injury and muscle guarding, muscle tension and muscle weakness, and the incorrect use of technology. Genetics and hereditary can also play a role. However, there is one cause of bad posture that, in my experience, tops the list—shallow breathing.

Most people have heard of the diaphragm. Sadly, most people hardly use their diaphragm when breathing. They are shallow breathers. They utilise only a small part of their lung capacity. So, what exactly is the diaphragm? Well, it is a great, strong dome of flattish muscle located in the lower rib cage, that is, at the base of the lungs or, more exactly, at the bottom of the chest between the lungs and the stomach. The diaphragm, which is shaped like a parachute, separates the chest cavity and the abdominal cavities. The floor of the chest cavity which contains the lungs and the heart is made up of the diaphragm. The abdominal cavities contain the digestive, reproductive and excretory organs.

The diaphragm works like a pump. It has the capacity to move upwards and downwards—and inwards and outwards—thereby changing the volume of both the chest cavity and its passive occupants (specifically, the lungs). When we breathe with our diaphragm, air is drawn into the lower lung spaces. The diaphragm and the intercostal muscles—the muscles between the ribs—should be used to take the in-breath to the middle and lower parts of the lungs. During inhalation, the diaphragm contracts and flattens. That causes our upper abdominal muscles to relax and extend slightly. Our abdomen thus moves forward, and the lower 'floating' ribs flare or expand slightly outward to the side. In addition, the diaphragm is the principal muscle used for exhaling. When we exhale, the diaphragm—in an upward movement—relaxes and returns to its ‘normal’ dome-shaped position. What happens here is the upper abdominal muscles contract, and air (in the form of carbon dioxide) is expelled - in fact, forced out - from the lungs.

How the diaphragm works.

Now, what happens when we fail to use, or hardly use, our diaphragm when breathing? Terrible things! Most people are 'chest breathers'. Chest breathers are shallow breathers. They use only the top portion of their lungs. They don't fill up the bottom part. Chest breathing is a very 'shallow' and ordinarily haphazard and non-rhythmic form of breathing, with almost all the outward movement being confined to the upper chest. One of the results of chest breathing is that the lungs are never filled completely, so the body rarely, if ever, receives sufficient oxygen. That is not good. There is a lung condition known as atelectasis, which is the collapse or closure of a lung resulting in reduced or absent gas exchange. It may affect part or all of a lung. There are several causes of atelectasis, but one of them is—you guessed it—shallow chest breathing. What we don’t use, we lose. If we don’t use all of our lungs, we end up with part of our lung collapsing or closing. Not nice at all. When we breathe correctly—that is, breathing deeply using our diaphragm—we use the bottom of our lungs as well as the top.

Atelectasis of the right lower lobe seen on chest X-ray.

(Source: Hellerhoff. Wikipedia.)

Mouth breathers are invariably chest breathers, but chest breathers aren't confined to mouth breathers. When we breathe with our chest, the neck, shoulders and upper rib muscles are all 'engaged' as our chest 'elevates' toward our chin when breathing inwards. The result? Chronic neck and shoulder tension which, of course, lead to pain. Worse, over time there can be noticeable postural changes in the body such as a forward shift in the head and a rounding of the shoulders. When the head is pulled forward, the additional pressure on the neck, shoulders and back rises dramatically. The result? Well, there are several, but one of the nastiest is tissue damage ... and more pain. Every 2.5 cm (inch) that the head is thrust forward from its natural position adds another 4.5 kg (10 lbs) of stress and pressure on the neck, shoulders, back and spine. More bad stuff. 

The answer to all this is not to throw back your shoulders. Silly but well-intentioned advice, that. No, the answer is to learn to breathe correctly—that is, deeply, using the diaphragm, drawing air into the lower lung spaces, and exhaling fully. When we do that properly, rhythmically and habitually, our posture will improve dramatically. The shoulders will go back where they should be, there will be less rounding of the shoulders, and the forward tilt of the head will be corrected as well. The result? Not only good posture but a much better state of fitness and overall health.

So, when we breath, we should fill our entire lungs with air. It helps immeasurably if you can breathe through the nose. (Sorry, mouth breathers.) Practise ensuring that your out-breath is longer than your in-breath. That will also assist with posture. It also relaxes both the body and the mind. In addition, the regular up-and-down movement of the diaphragm massages the abdominal organs.

One of the best things you can do for yourself is to learn to breathe correctly. It is never too late to start.

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MINDFULNESS MAY EASE TINNITUS SYMPTOMS

Dr Laurence McKenna

New research led by Dr Laurence McKenna, pictured, from University College London Hospitals NHS Foundation Trust (UCLH) and Dr Liz Marks from the Department of Psychology at the University of Bath has found that a mindfulness-based approach to tinnitus can make the symptoms of the condition less severe, less intrusive and less troublesome.

Tinnitus is a physical condition experienced as noises or ringing in the ears or head when no such external physical noise is present. The condition, which can result from a wide range of underlying causes, is usually caused by a fault in the hearing system itself, and is a symptom, not a disease in itself. At present there is no actual 'cure' for tinnitus. However, many of the causes of tinnitus are treatable.

It is an extremely distressing, even disabling, condition in and of itself. Worse, the condition is associated with many other problems such as emotional stress, insomnia, auditory perceptual problems and concentration problems. Tinnitus afflicts a significant percentage of the population—about ten to twenty per cent of the population. Some people are more at risk for the condition—musicians, military personnel, people who otherwise work in loud environments, and seniors.

Regrettably, there is at present no treatment to stop the noise of tinnitus. That’s where mindfulness comes in. The essence of mindfulness is—acceptance and non-reaction. It’s like the old-fashioned tape recorder or the modern-day video surveillance camera; the equipment records but does not react to what it hears or sees. So it is with mindfulness.

The research team found that mindfulness-based cognitive therapy (MBCT) helps to significantly reduce the severity of tinnitus compared to relaxation-based treatments, an approach recommended by many tinnitus clinics.

For the study, which has been published in the journal Ear and Hearing, seventy-five patients took part in a trial at UCLH’s Royal National Throat, Nose and Ear Hospital, receiving either MBCT or relaxation therapy. The research team found that both treatments led to a reduction in tinnitus severity, psychological distress, anxiety and depression, but the MBCT treatment led to significantly greater reductions in tinnitus severity than the relaxation treatment, and this improvement lasted for longer.

‘MBCT turns traditional tinnitus treatment on its head — so rather than trying to avoid or mask the noise, it teaches people to stop the battle with tinnitus,’ Dr Marks said. 

In other words, people learn how to 'allow' and 'accept' tinnitus rather than fighting it or trying to push it away. This is the practice of non-resistance: what you resist, persists. How true that is!

Study: McKenna L, Marks E, & Vogt F. (2018) ‘Mindfulness based cognitive therapy for chronic tinnitus: evaluation of benefits in a large sample of patients attending a tinnitus clinic.’ Ear and Hearing, 39(2), 359 - 366. DOI: 10.1097/AUD.0000000000000491

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