[Last updated 12/19/24]
This is “part 2 of the article, “Postpartum Rib Flaring & Stacking.” We recommend that you read that first!
“Core Breathing” essentially means using your breathing to keep your core in use throughout the day.
Fit For Birth’s Core Breathing Belly Pump® is defined as: “the rhythmic inhaling and exhaling that coordinates activations of the Diaphragm, Transverse Abdominis and Pelvic Floor to dynamically maintain intra-abdominal pressure so that the core may assist in stabilizing, accelerating, and decelerating any movement or exercise.”[1] Its main intention is to solve two problems with one cue:
- Shifting clients from compensatory chest breathing to a more balanced abdomen breathing
- Helping clients jump start core activation
If there is only one thing that you take from this article, let it be this:
It is inherent that the CBBP be performed with proper rib stacking & zone of apposition (ZOA) mechanics. In other words, you should alter CBBP in a client with rib flare, just as you would alter CBBP for a client with diastasis recti!
Connections between Belly Breathing and Core Activation
Using breathing as a method to activate the core is not only a concept important for clients with rib flare, but also for really any client. One physical therapy article that explains how breathing needs to be felt “all the way down into the pelvis” is titled, “How Breathing Better Can Take Your Core to the Next Level…”[2]
Proper breathing includes belly expansion. Literature from the Postural Restoration Institute (PRI) – from where the vast majority of the ZOA discussions are originating – explains, “…simultaneous ‘belly’ expansion and chest wall expansion is desirable upon inhalation via the nose without using accessory muscles of the neck…” [3]
So, just to be clear, scientific consensus is that the belly is clearly recognized as important when inhaling.
Furthermore, a 2017 study in the scientific journal, Breathe: The Respiratory Professional’s Source For Continuing Medical Education, gave this overview of proper breathing, explaining additionally where the breath should and should not be: “Studies of diaphragm movement and function claim that optimal respiration requires active control of the diaphragm, such that during inspiration, the lower ribs stay low and only expand laterally, while the abdomen expands instead of the chest.” [4]
Once again, the abdomen is identified as an important part of optimal breathing, but this time alongside the importance of rib alignment too!
Key points from this 2017 Breathe scientific study:
- Inhales that keep the lower ribs staying low (in optimal alignment)
- Lateral rib expansion that expands the abdomen instead of the chest
However, belly movement does not in and of itself mean that proper diaphragmatic breathing is happening. This is relatively self-evident since, at any moment, each of us can literally stop breathing but continue to use other core contractions to make our abdomens move in and out. Still, this reveals a deeper concept that isn’t often talked about: “just because an individual is abdominal breathing, it does not necessarily mean one is utilizing the diaphragm well to inhale. If you see a rib flare and lack of rib movement laterally and posteriorly during inhale and poor rib internal rotation and depression during exhale, they still might be inefficiently utilizing the diaphragm and utilize the accessory muscles to breathe.”[5]
Ultimately, movement of the abdomen and diaphragmatic breathing can be two different unconnected things. Having a moving belly, but poor diaphragmatic breathing is totally possible. These are not absolutely and permanently connected.
In my own experience, I have certainly witnessed clients over-using the belly movement, without being really connected to the breath. In those instances, I naturally coach toward less abdominal distention. Ultimately, once a more natural flow is restored, I focus toward more lateral and rear rib breathing.
In the case of rib flare, a “decreased ZOA is accompanied by decreased expansion of the rib cage, postural alterations, and a compensatory increase in abdominal expansion.”[6] In fact, the following PRI quote reflects the need for eventually minimizing the outward protrusion of the abdomen: “Abdominal muscle resting tension opposes the inspiratory action of the diaphragm by facilitating an increase in pressure in the abdominal compartment rather than outward protrusion of the abdomen during diaphragmatic contraction.”[7]
As most of us already know, it is possible to have compensatory chest-breathing. But take note that it is also possible to have compensatory belly breathing.
How to Use CBBP with Rib Flare
Fit For Birth’s CBBP can be thought of as a tool for those who have rib flare and rib thrust, as well as for those who do not have rib flare and rib thrust. In either population, the assumption is that we are guiding the CBBP within the structure of optimal ribs over pelvis “stacked” alignment. This is the same assumption as for Fit For Birth’s “Corset Bracing” exercises. They are tools; exercises that you can use with varying results for varying clients and postural demands.
For these two exercises, and millions more, each fitness professional gets to practice experimenting with whichever works. Inevitably, some will work better than others. Specifically when managing rib flare, focusing sooner on the “rib-down” Corset Bracing exercises may be more prudent.
Here’s how.
Fit For Birth’s Pre & Postnatal Corrective Exercise Specialist (PPCES) course focuses initially on the Core Breathing Belly Pump® mastery because it tends to quickly elicit “active control of the diaphragm” as well as core muscles. So, we encourage the cue “inhale to fill belly & ribs” as in abdomen & ribs, (again with the assumption that ribs remain in proper “low” alignment position). The CBBP is part of a progression, and if you’ve completed the PPCES, then you’ve practiced live with our head coaches, watching form and function instantly change in the vast majority of cases. The reason this tends to work so well is because so many of us are so disconnected in connecting the diaphragm with core, and this cue can excitedly activate the entire inner unit and outer unit to elicit amazing immediate results.
For most clients, once CBBP is learned, and chest breathing is a thing of the past, we begin to coach clients toward even more rib-focused abdomen breathing, both laterally and into the back. This is in direct acknowledgement that “sticking the tummy out” is not the long term result we are looking for. This kind of refinement of breathing is critically important – for rib flaring individuals but also for literally everyone.
Use CBBP as a step in your progression. Once chest breathing is no longer an issue, it’s often so much easier to achieve solid true diaphragmatic lateral and back “rib breathing.”
The CBBP can be thought of as a step toward Corset Bracing exercises and optimal breathing.
How to Use Corset Bracing with Rib Flare
The ability to brace one’s corset is important for any client, but it is also naturally more conducive to reinforcing the “rib down” posture that is so important for clients who are showing signs of rib thrust and rib flare. Fit For Birth graduates will recognize this concept in the Pre & Postnatal Diastasis and Core Consultant (PPDCC) course, which teaches “corseting” both in general and as a way to close diastasis recti. In the course, Corseting is defined as “exaggerating the usual exhale components of the natural breath cycle in a manner that promotes the development, strength and endurance of the TVA and PFM.” Although this definition identifies aspects of the core’s inner unit, it is inherent that the ribs, pelvis, obliques, and abdominals in general, are in positions of good function.
If rib flaring is evident in your client, these kinds of corsets are one of many wonderful exercises for your tool box. Hold first for just a few seconds, but then practice for several minutes or more.
The CBBP was discovered to fill a gap. It teaches clients how to quickly move from chest breathing to abdomen-centered breathing, just like the scientific evidence for optimal respiration suggests.[8] Even better, clients, especially pregnant ones, who do not have access over their inner unit gain incredible function often immediately. Ideally, CBBP is performed with ribs low, but it’s simply not the teaching focus of this particular exercise.
Corset Bracing exercises, on the other hand, have their place because they naturally emphasize keeping ribs low, even during the inhale! But remember this critically important point: Ideally, Corset Bracing would be performed with true diaphragmatic lateral & rear rib expansion “abdomen” breathing rather than chest breathing.
As with any of your exercise selections as a fitness professional, it’s an art and skill to be aware if you are emphasizing one aspect while potentially worsening another. That’s why assessing your client’s specific needs is so important. Does the client in front of you – right now at this moment – need to be coached on abdomen breathing that decreases her chest breathing pattern, or does she need more corset strengthening, to emphasize the lateral and rear rib expansion?
| Emphasis | Risks | |
| Belly Breathing |
|
|
| Corset Bracing |
|
|
CBBP & Corset SAMPLE PROGRESSION within the Fit For Birth continuum:
- Core Breathing Belly Pump – emphasis on expanding abdomen and reducing compensatory chest breathing
- Core Breathing Belly Pump – emphasis on expanding ribs laterally and to the rear
- Corset Brace Holds – emphasis on expanding ribs laterally and to the rear
- By natural definition of this exercise, your client will be holding longer and getting stronger at rib stacking and abdominal tensioned diaphragmatic breathing
- Consider any additional emphasis depending whether or not your client does have a particular kind of rib flare.
Discover what your client needs for her particular imbalances. Then, just use what works.
What if my Client is Obviously Rib Flaring on our First Session?
If you identify that your client is obviously rib flaring on your initial assessment, starting her with “rib-down” corsets is certainly a reasonable thing to do. Just make sure that at some point you coach your client to not be a neck-straining chest breather. This may naturally happen from teaching her the Corset Bracing exercises, (ideally this would happen) but it might not. Often in fitness, clients are led to believe that they need to keep holding their tummy all day, which creates even more of a chest breathing problem, often with similar or worse implications than rib flaring. (This is why Fit For Birth suggests starting with CBBP for most of the population).
You are totally allowed to each Corsets first. You’re also allowed to teach none of this, and instead use other cues altogether. Fit For Birth education is meant to provide sign posts to help you organize your coaching. Our mission at Fit For Birth is to give you a basic structure, as well as outside the box ideas, that empowers you to think outside the rules, discover your own solutions, and know that there are many ways to help your clients toward improved function.
There are so many fitness rules, in part because there are so many positive solutions that can help people. Often, no one way is the right way. As long as you’re enjoying the process and helping your clients feel empowered and strong in their bodies, you’re well on your way!
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If you would like fun & research-based guidance as a fitness professional, or during your own pregnancy & postpartum, please check out these Fit For Birth offerings:
- Fitness & Wellness Professionals:
- 2 FREE CEU’s!
- CEC/CEU Courses, including our Pre & Postnatal Corrective Exercise Specialist (PPCES), the world’s first holistic perinatal CEC/CEU!
- Monthly Elite Membership – Community. Monthly education. Business mentorship & work opportunities. $27/month.
- Pregnancy, Pre-conception & Postpartum:
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James Goodlatte is a Father, Holistic Health Coach, Corrective Exercise Practitioner, Speaker, Author, Professional Educator, and the founder of Fit For Birth and Exercise For Longevity. Since 2008, when he found out he would be a father, his passion for holistic wellness shifted to children and families. Today, he is a driving force in providing Continuing Education Credits for the pre and postnatal world, with Fit For Birth professionals in 52 countries. James is a contributing member of the First 1000 Days Initiative at the Global Wellness Institute, and longevity researcher & educator.
References
[1] (n.d.) Belly Pumping, anyone? Fit For Birth. Retrieved 6/12/22 from https://getfitforbirth.com/belly-pumping-anyone/
[2] 2020. Kelly Kuhn, PT. How breathing better can take your core to the next level. Retrieved 6/11/22 from https://www.kellykuhnpt.com/post/how-breathing-better-can-take-your-core-to-the-next-level
[3] (n.d.) Zone of Apposition (ZOA). Postural Restoration Institute. Retrieved 6/14/22 from https://www.posturalrestoration.com/the-science/zone-of-apposition-zoa
[4] 2017. Russo, et al. The physiological effects of slow breathing in the healthy human. Breathe. Retrieved 6/12/22 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/
[5] 2015. Kamiyama, Kento, PT. Let’s talk about Ribs. Kamiyama Physical Therapy. Retrieved 6/14/22 from https://kamiyamapt.com/2015/11/23/lets-talk-about-ribs/
[6] 2010. Boyle, Olinick, and Lewis. The Value of Blowing Up a Balloon. North American Journal of Sports Physical Therapy. NIH. NCBI. Retrieved 6/14/22 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971640/
[7] (n.d.) Zone of Apposition (ZOA). Postural Restoration Institute. Retrieved 6/14/22 from https://www.posturalrestoration.com/the-science/zone-of-apposition-zoa
[8] 2017. Russo, et al. The physiological effects of slow breathing in the healthy human. Breathe. Retrieved 6/12/22 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/