From SVB2017
By Marlène Turcot
Gymnastic breathing instructor
Québec City (Québec)
Breathing is life
There is no life without breathing
In all the great functions that sustain life, breathing is, with circulation, the most important. It is an evidence that the respiratory function plays an important role in our life. Especially when we have a respiratory deficiency, we understand how a difficulty in breathing handicaps our health. Mrs. Metge-Sandra spent all her life to developing her method. I was offered the chance to meet her in Paris and to be trained to teach her method.
Born in the South of France in 1909, she passed away in Paris in 2002. Grad Prix winner at the Paris Music Conservatory in singing and piano, singing teacher, she observed the impact of the respiratory function on different persons to help her students develop control of their body as an instrument. She also created breathing gymnastics enabling a deep physiological breathing mechanism rather than partial thoracic breathing.
She realized very quickly that her work went well beyond singing. Her method is based on deep physiological breathing, that which we have at birth. In this respiratory reeducation, all the importance is given to spontaneous exhaling. This respiratory work ensures the development of deep muscles: dorsal, abdominal, transversal and oblique muscles, enabling the diaphragm to be the engine of the breathing motion.
This method has preventive and curative therapeutic properties, providing physiological breathing and voice permanently to each human being.
Mrs. Metge-Sandra is one of the rare persons, in the respiratory field, to signify the importance of respiratory reeducation insisting on the ”spontaneous exhaling” in the oral position of the smile.
Here is what Mrs. Metge-Sandra observed:
The majority of human beings do not know how to breathe and practice a respiratory mode sufficient to sustain life, but insufficient to ensure profound exchanges that guarantee a physiological and psychological balance that the modern man is far from knowing.
Less muscled due to a sedentary lifestyle, in a polluted atmosphere, with a relentless rhythm of life that uses its nervous system, the 21st century man does not know how to breathe, cannot breathe fully and practices a lazy and partial breathing, the thoracic breathing.
The truth is, any subjects practicing this incomplete breathing will become tired, whatever their activities, a famous fatigue, so common in the modern man, a general fatigue resulting in daily life in insufficient exchanges and a lack of oxygen in the body, a nervous fatigue that worries the medical world without, nonetheless, finding an efficient remedy.
It is with the practice of deep breathing, physiological breathing, that any subject can access, by ”remuscling”, to deep exchanges in the respiratory system in daily life, to calm and to the possibility of physical activity without fatigue.
Contemporary literature considers breathing as being the work of lungs with the help of the nose and mouth. The lungs collect and exchange gas (using the blood globules as a vehicle), but in reality, each living cell in the body plays a role in breathing. All body cells need oxygen to live, develop and produce the required energy for body functions. The role of lungs is to extract oxygen in air, to transfer it to blood that will carry it to body cells.
Breathing has, among other functions, the regulation of water quantities in the blood system and a contribution to the body’s thermal balance.
It is also noted that the fundamental process of breathing is the chemical use of oxygen by the cell to oxidize energy substances and to liberate they energy they contain. This results in the liberation of H2O and CO2. This is produced in mitochondria[1]. This is therefore a function of primary importance for each of our cells.
By its respiratory system, our body communicates mostly with the exterior world. It is with a surface of 130 square meters that our tissues are intimate, the blood, in contact with ambient air through the pulmonary air cells.
It is considerable physiological evidence: this respiratory function mechanism, our will can direct it. In fact, our will can modify its frequency: the number of respirations, exhalations and inhalations that are numbered at 12 to 16 each minute, can be increased or decreased, by accelerating or slowing them. Our will can modify the breathing rhythm by amplifying or shortening exhalation and inhalation. Finally, our will can suspend during a few moments the respiratory function by blocking its mechanism with the dorsal, abdominal or diaphragm muscles.
While our will cannot influence our digestive system, whether it be the peristaltic movements of the intestines or the secretions of the liver, our will cannot intervene in our gland functions, that it remains powerless in changing our heart and arteries beats, our will can, however, have a precise action on our breathing.
A regrettable observation: this function being life itself. The only function over which our will can act is the function that is the least known and the most neglected.
But how can we neglect a function that, we have determined, has a primary role in life? The 21st century man does not know how to breathe fully, cannot breathe fully and practices a lazy and partial breathing: the thoracic breathing.
Respiratory illnesses keep increasing and the weakness in respiratory muscles increases this degeneration.
Deep muscles, if not developed with precise respiratory work, will not allow deep breathing, the physiological breathing that gives exhalation the most important role in the act of breathing.
By practicing this breathing mode, persons focus all their attention on emptying pulmonary air during exhaling without worrying about inhaling which occurs automatically and in a direct link with the scale of emptying provoked by exhaling.
PARTIAL THORACIC BREATHING
In thoracic breathing, the attention is on inhaling in the goal of storing the most air possible in the respiratory system. Inhalation is active and systematically provokes the displacement of the thorax upward and the lifting of the shoulders.
However, exhaling is always neglected and only partially empties, passively, with exchanges reduced to a maximum: there is therefore sub-oxygenation. This lack of oxygen is at the basis of physiological and psychological perturbations. Any person with this mechanism experiences shortness of breath.
This thoracic breathing mechanism solicits only a small part of the muscles, neglecting the diaphragm, abdominal muscles and dorsal muscles.
This respiratory mechanism is practiced in different activities is the mechanism we consider ”normal”. The deep muscles are less solicited due to a bad use of the respiratory function and an intense cerebration.
While we insist on air intake before each exhalation, it is difficult, even impossible, for the subjects with fewer muscles, to find and maintain tone in all their dorsal and abdominal muscular system. All the respiratory exercises should have the objective of toning, of setting muscles in their real anatomical place.
We can consider thoracic breathing as a sort of organic deficiency, of respiratory handicap. Disciplined respiratory reeducation can correct and bring a person to practice the only total breathing, the one we had at birth, the deep physiological breathing.
DEEP PHYSIOLOGICAL BREATHING
Deep physiological breathing gives exhaling a more important role in breathing. The subjects that practice this breathing focus all their attention on emptying the pulmonary air during exhaling without worrying about inhaling which occurs automatically and in a direct link with the scale of emptying provoked by exhaling.
The exhalation is active to empty at the maximum pulmonary air during the effort; the inhaling is done with no mobility in the auxiliary respiratory muscles and with the diaphragm being sort of passive: the exchanges are increased to the maximum.
Deep respiration muscles are a real brace for the bowels. During physiological breathing, the body’s most important muscles participate in the action of breathing.
This breathing mechanism is not inaccessible. In some daily moments, the body finds this respiration: laughs, cries, screams, coughs. Nature sets muscles to their real anatomical place. Some sports, some occupations keep this mechanism by the precision and tone that requires deep breathing.
Exhalation is the vital phase for the resistance of the respiratory function: « he who breathes will live long, intensely and peacefully ”[2].
”The majority of human beings only half breathe: we inhale because that part of the action of breathing is the condition for living. But we do not take care of exhaling because of muscle laziness notwithstanding that we better repair our strengths by exhaling with measure than by filling our lungs. […] With training, we are fortunately capable of making our breathing as good as it was unconsciously bad before.”[3]
The voice and breath are extremely linked physiologically. Voice is the sound reflect of an exhalation. Without breath, voice does not exist. The human voice remains the most precious way of communicating between people. Human voice and breath have been, throughout the centuries, an important revelation of human condition. Man is shaped by his environment. In the Aesop story, Xanthos orders Aesop to buy what is best at the market. Aesop buys tongues saying there is nothing better than tongues, link of civil life, key to science, organ of truth, reason and prayer.
How can we improve the respiratory function of persons with cystic fibrosis?
We saw that, when the respiratory work is foremost inhalation while neglecting exhalation, the diaphragm and all other auxiliary, dorsal, transverse, oblique abdominal muscles cannot deeply accomplish their work. The tone and exchanges in pulmonary air cells remains weakened. All the importance given to sound exhalation with the oral position of laughter with the help of different movements, leads to a respiratory gymnastic where the entire body breathes and reinforces itself. This exhalation is not only a simple breath, but is an expiratory noise where deep muscles are more solicited and moreover trained for better tone. All persons with cystic fibrosis, with noisy exhalation, benefit from large ventilation, freeing up mucositis. It is a real auto-clapping: expectorations are without violence and with relief. We give an important role to nasal passages to enable better respiratory health.
Some important advice:
- All respiratory work must begin with exhalation: do not force your breath. Keep your mouth open in the laughter position and breathe before doing an activity. When you are out of breath, exhale quietly. Your rhythm will bo back to normal.
- Take care of keeping good dorsal and abdominal tone. Deep breathing progressively adjusts muscles avec interventions to regain endurance and strength. It is good to exercise, but to avoid fatigue during training. We often do respiratory exercises on the ground. It is important to fell the spine on the ground, which enables reinforcing the pulmonary system.
- It is paramount to train your breath. The control of the respiratory function based on the deep physiological breathing mechanism with spontaneous exhalation guarantees a good control of respiration.
- Respiratory reeducation is a great necessity for pulmonary transplant recipients. After the surgery, when they have to breathe without a machine, there is often a panic. All the importance given to controlling exhalation, without rushing the respiratory muscles, allows them to avoid panic and make contact with their respiratory function at the same time. Calm and relaxation are an extreme necessity for them.
All persons, one day or another, are confronted to challenges. Illness, unfortunately, is part of that. A good muscle tone constitutes a safety engine for deep physiological breathing. Reeducating your breath, no matter what your physical condition, is a step towards regaining better health. In this respiratory reeducation is an important aspect, ethics. The Jules-Vernes de Nantes clinic team, made up of Alan Boone, teaching the Metge-Sandra method, and Drs. Philippe David and Gérard Dabouis, have brought together different specializations, a work of great importance for the health of patients and caregivers.
[1]Element in cell cytoplasm with the essential role of ensuring oxidation, cell respiration, the start of energy stocking by the cell and of other substances (Le Larousse)
[2](TaisenDeshimaru, La pratique du zen).
[3] (William Knowles, The Knowles Method of Breath Training)
