There are many important things that we do on a daily basis. The one that is at the top of the list is breathing. We could live if we couldn’t hear, see, masticate, but we cannot live with out the wonderful life of the breath (for more information on the hierarchy of our bodies systems read Paul Chek’ s article series on www.ptonthenet.com titled Scientific Balance Training 1-6).

Within the world today, there are a lot of environmental, chemical, nutritional, mental, emotional and physical stressors that can cause breathing difficulties. Over prolonged periods of time, these stressors can induce Asthma. Getting a client with this dysfunction can bring about many challenges when designing a program. So, how do you go about training your asthmatic client when they have difficulty breathing? In this article I am going to cover a holistic approach to working with a client that has asthma. I will cover physical, nutritional, and mental/emotional aspects of program design and training. Everything that is contained in this article is recommended from my clinical success experiences. Nothing in this article is intended to contradict or challenge any advice, recommendations or Rx medications that your physician has given you. Please consult your physician before following any of the recommendations below.

Let’s first define asthma so we all understand what it is. Asthma is a chronic lung condition that is characterized by difficulty breathing. Individuals with this condition tend to have hyper-responsive airways (react by narrowing when irritated), which makes the flow of air in and out difficult. These individuals tend to have one or a combination of the following symptoms:
• Wheezing
• Coughing
• Shortness of breath
• Chest tightness

If you follow the conventional approach to treating this disorder, you will put on inhalants, sometimes steroids and you will be told that you are basically allergic to everything, even life! Being aware of what can trigger your asthma and exacerbate the symptoms is definitely an aspect that should not be overlooked. Although, if you go around living your life in fear, this can as well exacerbate your asthmatic symptoms. We will talk more about fear later on in the article and how fear can alter physiology and your breathing pattern.

When we breathe incorrectly, it can cause a myriad of health problems. “Incorrect breathing actually has the potential to cause or contribute to a number of health problems including but not limited to cardiovascular problems, increased stress, visceral disorders, and musculoskeletal dysfunction among other things. These issues are some of the biggest problems in people today. It has been said that poor breathing plays a role in about 75% of the ills that cause a person to see their doctor (1).

Just imagine if you did anything pathologically 20,000 times per day. Assume, for example, that you have a fixed thoracic kyphosis and you do 20,000 medicine ball back tosses per day. You would surely develop a world class shoulder impingement syndrome! Not that breathing is as dynamic as a medicine ball back toss, but the point is that if you do anything incorrectly repeatedly day in and day out, pathology is sure to come. That is why if you teach your clients how to breathe properly you can impact their health far greater than if you simply stick to traditional gym exercises (CHEK 2).” (To read more about the mechanics of breathing; read Breathing for Optimal Health by JP Sears).

PHYSICAL NEEDS:
On a physical level, one way to increase your lung capacity and decrease the symptoms above is to:
1. Get educated about what good posture and movement is
2. Get assessed by PT or CHEK Practitioner
3. Find an NMT Therapist to work on all the adhesions from incorrect breathing
3. Perform a corrective exercise and flexibility program

Just to give you an example of what incorrect breathing can do:
“First off, let’s define posture: the position from which movement begins and ends. So, no matter if you golf, play an instrument or you are just your average Joe, if you begin with poor posture, the end result will be poor. How does that correlate to having asthma?

You need to first find out if you are breathing correctly (diaphragmatically) or inverted (using your accessory muscles: chest and neck muscles). Sit up straight in a chair and put one hand on your belly and the other on your upper chest. Take a deep breath in and then exhale. What did your hands do? The one on your belly should have moved out (belly protrusion) on the inhalation and came back in on the exhalation. If your belly or hand did not move at all and the one on your chest went in/out, then you are breathing inverted. This is done by using the second string or accessory muscles as the starting pitchers. This can lead to a number of dysfunction not only with the respiratory system, but can lead to chronic neck pain, headaches, decreased lung capacity, shallower breaths, more per minute, decreased peristalsis (constipation), poor lymphatic movement, and varicose veins and on and on and on!

To start off, you need to work on breathing correctly or what is called diaphragmatically. Sit up straight once again and put your hand on your belly and one on your chest. The chest will and should move, but only at the last 1/3 of the breath. Take a deep breath in the nose and concentrate on allowing your belly to fill with air like a balloon and protrude out. On the exhalation through the mouth with pursed lips, focus on allowing your belly to empty the air out so your hand goes back in. That is the proper way to breath and most of society does breathe wrong. The respiratory system is one of the most important systems. If you can’t breath right, everything else in your body will not work correctly. Check out Paul Chek’s articles and read up on his hierarchy (totem pole) of the bodies systems, muscles, and joints. If for some reason this is hard for you sitting up, lie down and do it. Place your hands on your belly the same way or you can use something cold (light weight, glass, etc.) to give you some sensory stimulation.” (Breath Control and Wind Instruments Q & A, 2005 www.ptonthenet.com)

Now that you know how to breathe properly, which will alleviate some of the stress on your body, now it is time to learn how to correct it with simple exercise techniques. Most of the asthmatic clients that I have worked with tend to have forward head posture, increased thoracic kyphosis, rounded shoulders, decreased 1st rib angle, depressed sternum which crowds the respiratory and GI systems together. This can have a profound effect even on a client that does not have asthma. (For more information read Breathing for Optimal Health Part 1-2 by JP Sears on www.ptonthenet.com)

First off, get assessed and don’t guess! Inthis case, I am going to go with the most common type of posture that I have seen coupled with asthma, upper cross syndrome. What you want to do next is to correlate your assessment findings and stretch the short muscles and strengthen the elongated muscles.
Typical Shortened Muscles:
1. SCM
2. Scalenes (anterior and posterior)
3. Levator Scapulae/Upper Trapezius
4. Suboccipitals
5. Subclavius
6. Pec minor
7. QL
8. Serratus Anterior
9. Serratus Posterior Minor
10. Iliocostalis Lumborum

As well from being over worked, these muscles will hold a lot of tension in them, can develop trigger points, have decreased blood flow/oxygen to them and will have increased toxins within them. Getting these muscles worked on by an NMT Therapist is an important piece to your clients healing process.

Typical Elongated Muscles:
1. Longus coli and capitis
2. Long cervical extensors
3. Rhomboids
4. Mid/Lower Trapezius
5. External/Internal intercostals
6. TVA
7. Internal/External oblique (could as well be short)
8. Rectus Abdominus (could as well be short
9. Diaphragm

Designing a program for an asthmatic client should focus on the above groups of muscles, as well as to short or long ones found during your other assessments. A simple and effective way to target these muscles is to perform the diaphragmatic exercise above. Good posture is not only important for respiration, but also for the health of joints, visceral functions, muscle balance, energy efficiency, and aesthetics (Breathing for Optimal Health Part 2 by JP Sears on www.ptonthenet.com).

NUTRITIONAL NEEDS:
In my clinical opinion, this is one of the most important aspects when working with a client with asthma. Within our industry, many clients and trainers have a misconception of what health is. As Paul Chek says, “health is taking responsibility for one self (4)!” This does not mean that because you exercise, have abs, eat chicken and protein powder during the day that you are healthy. Health means taking responsibility in all aspects of life. That’s what the holistic approach encompasses compared to the convention approach. We seek to heal the person with the disease, not the disease that has the person (5). If you focus on the asthma (wheezing, coughing, shortness of breath), then you will be going around in circles forever. Those symptoms are the byproduct of the real problem. There is an underlining problem, whether it is structural, nutritional, mental or emotional, that is the cause of all the symptoms.

Anytime you are eating the American C.R.A.P (Caffeine, Refined/Processed foods, Alcohol/Aspartame, and Pasteurized milk) diet or not for your Metabolic Type (Read Metabolic Typing Diet by Bill Wolcott), you are causing stress to your bodies energy systems (5). What does stress cause…increased energy, fire or what we call inflammation! Inflammation causes an –itis of some sort and then chronic result of an –itis is an –osis of some sort (not enough or drained energy). When there is inflammation in one area, there will be inflammation in other areas of the body. When you eat an unhealthy diet or lead a poor lifestyle, these can influence the health of other organs as well. The liver, along with the stomach, intestines, appendix, pancreas, and kidney are all capable of reflexing into the diaphragm (5). When the above organs are inflamed, they can cause inhibition to the diaphragm. The diaphragm is the one of the main muscle for respiration and is innervated by the phrenic nerve (C3, 4, and 5)(9). When viscero-sensorimotor loop is interrupted by either poor posture or nutrition in this case, the diaphragm is inhibited. The accessory muscles have to work harder and the end result is chest breathing. Cleaning up your client’s diet, whether or not they have asthma, will always increase the energy flow and vitality of the entire person.

One of life’s biggest secrets when it comes to asthma is water. Now some of you might be saying how can lack of water cause asthma or water assist in relieving the asthmatic client’s symptoms? I want to discuss the role of histamine in the body, as well as salt and hopefully by that point you will have a better grasp on the importance of water.

Histamine is a natural occurring neurotransmitter in the body that regulates water metabolism and distribution in the body(8). You might have heard of the word histamine used in anti-histamine medications to get rid of a runny nose of a cold. Well, I am going to educate you on a holistic way to decrease histamine levels in the body without taking over the counter toxic medications. They do more harm to your insides than good. As you learned above that inflammation can cause inhibition, well taking over the counter medications is a great way to cause inflammation in the stomach and liver, causing inhibition of the diaphragm.

“It has been recognized that asthmatics have an increase in histamine content of their lung tissue and that is the histamine that regulates bronchial muscle contractions (Batmangheligdji, 115). Dehydration is one of the many major stressors that we can inflict upon our body. I would have to say that 100% of the clients that walk through my door are dehydrated. As well, when they start drinking the recommended amount of half your body weight in ounces of water a day (8), most of their aches and pains are alleviated. When we are dehydrated, the body releases more histamine to regulate who and what gets water and where it goes. When you are short of breath, the histamine is causing vasoconstriction in the lungs preserving water for the lungs. When we breathe, water is evaporated in the lungs. But when there is an increase in histamine, there is constriction and less water evaporation, which is a natural conservation of the body’s water. So if you have asthma, have a client with asthma, or know anyone with this disorder, one of my first recommendations is to drink water!

The next thing I want to talk about in relation to water is potassium. Many Americans, young and old, drink OJ in the morning secondary to the belief that it contains lots of vitamins???? The OJ of today is just enriched, full of sugar, and full of harmful pesticides, herbicides and fungicides from the GMO Oranges that are used. My recommendation is to stay away from it either way. As well, OJ contains high levels of potassium. According to Dr. Batmangheligdji in Your Bodies Many Cries for Water he states that “high loads of potassium in the body can promote more than usual histamine production (Batmangheligdji, 119). As you know, histamine causes vasoconstriction, which will exacerbate your client’s symptoms. The only thing are body was designed to drink was water. Drinking water in the morning will not only aid in the healing process of asthma, but also aid with digestion and much much more.

For more information on the benefits of water and its hidden secrets, read:
1. How to Eat, Move and Be Healthy by Paul Chek
2. Your Bodies Many Cries For Water by Dr. Batmangheligdji
3. Hidden Messages in Water and The True Powers of Water by Masura Emoto

The last topic in relation to water is salt. I am not talking about our toxic and bleached table salt (NaCl). I am talking about Celtic Sea Salt which is taken from the ocean, dried naturally and then sold without being chemically altered. When you are dehydrated, you body begins to conserve salt (8). The problem is that with the C.R.A.P diet of America today, people are either eating too much NaCl or they are on a salt free diet of some sort. So when it comes to dehydration and the conservation of salt, this can be a problem. How does salt relate to water in the body, as well as asthma? Well, when we breathe in and out, the body needs water to keep the lungs and airways passages moist. When we are dehydrated, the bodies produce mucous to protect the lungs and the airways. Over a period of time and dehydration, there is more mucous build up and air has trouble going in and coming out. The end result is chronic asthma and a life of constant phlegm. Well, this is the point that salt comes in. First off, salt is a natural antihistamine, as well as a mucous breaker. In order for the body to be reassured, there must be water and salt present before there is relaxation and secretion of the mucous. “A pinch of salt on the tongue after drinking water fools the brain into thinking a lot of salt has arrived in the body. It is then that the brain begins to relax the bronchioles (Dr. Batmangheligdji, 120). Instead of placing salt directly on the tongue, what I recommend my clients to do is to put a pinch of the salt in every water bottle they drink. For the asthmatic client, I recommend two pinches.

For more information on this great product, go to www.celticseasalt.com to learn more.

Up to this point you have learned that incorrect breathing can cause poor posture, poor posture can inhibit breathing, as well as how nutrition and water have profound effect on the respiratory system. By getting on a corrective exercise program, eliminating the American C.R.A.P diet, and drinking more water you can easily alleviate your client’s asthmatic symptoms.

MENTAL/EMOTIONAL NEEDS:
Our breathing can tell us a lot about how we feel (11). Just like water in a river can express its calm nature by being still or by flowing at a fast rushing pace. Anytime we are under stress of any kind, anxious, nervous or anything of the sort, are breaths becomes faster and shorter. This mimics asthma and in some cases can cause it over prolonged periods of time. As well, chronic overuse of the muscles involved can cause many musculoskeletal and physiological dysfunctions.
This kind of stress on the body can have a profound effect on how we think, feel and look. Lets first talk about stress and what happens to the body when we are “stressed.” First off, when we are stressed you are activating the part of your Autonomic Nervous System called the Sympathetic Nervous System (SNS) or you might know it as your “flight or flight” nervous system.

The SNS is activated under any kind of stress, whether it is:
1. EMF (computer)
2. Chemical (work related)
3. Environmental (air, exhaust)
4. Nutritional (C.R.A.P diet)
5. Mental (Stinkin Thinkin!)
6. Emotional (Poor self worth)
7. Physical (Poor posture)
8. Spiritual and so on (humanize god)

When you SNS is activated, blood rushes to the extremities away from the organs and digestive system, cortisol (stress hormone released by adrenal glands) levels go up, and our heart rate and respiratory rate increases. Whether it is a big prominent stress like getting in a fight or something you don’t even know about, like the stress of a food you are eating, they all add up and have the same effect on the body.

The society we know of today is fast paced. People work more, move less and we are being outrun by technology. No one is taking the time to slow down and actually recognize what is going on around them or to them. A great example of this is how most people do not even think about health until they have a symptom or something major go wrong. Anytime you are in a stressful situation and your respiratory rate is affected, your breathing becomes almost doubled per minute. People tense up and tend you to use their chest to breath in order to keep up. As well, you have learned that people chest breath secondary to the diaphragm being inhibited. You can see how this all comes together and if one thing is wrong, it all is wrong. Our bodies are designed to handle stress, which is why we have our SNS. It is not designed to handle stress over and over again, each and every day without any use of its opposite, the Parasympathetic Nervous System.

We have evolved as humans at a slower rate than society/technology has. The stressors within our daily routine keep adding up. If you think of your body like a bank account, it easy to understand the flow of energy in and out. When you are stressed over and over again, that is comparison to withdrawing money out of your bank account. If the stress keeps up, before you know it you will be broke. The only way to keep up and replenish your body is to deposit energy back into the account. There are many ways to do this and you have two above, proper exercise and diet/lifestyle.

Below I am going to explain a third way to combat stress and asthma.

QI GONG FLOW:
Qi Gong is an ancient form of movement meditation that focuses on the flowing movement of internal energy call Qi, chi, prana, or lifeforce. “Qi” means air, breath of life, or vital energy of the body, and “gong” means the skill of working with, or cultivating, self-discipline and achievement. The word Qigong (pronounced chi kung) is a combination of meditation, relaxation, physical movement, mind-body integration, and breathing exercises (12)

The art of Qi Gong has been around for thousands of years. Millions of people have benefited from Qigong practices and believed that improving the movement of internal Qi maintains health and heals disease. In traditional Chinese medicine, good health is a result of a free flowing, well-balanced energy system. It is believed that regular practice of Qigong helps to cleanse the body of toxins, restore energy, reduce stress and anxiety, and help individuals maintain a healthy and active lifestyle.

It has been said that Qigong is one of the most powerful healing traditions ever developed in human history (12). In my clinical opinion, it is literally one of the many alternative health wonders of the world. Through working inside your body and mind, using the methodology of Qigong, you may achieve a perfect harmony in your body, mind, and spirit, so this may lead to a more energetic and healthier life. Therefore, Qi Gong is the Chinese way of cultivating the human body and is the ancient Chinese methodology for health, therapy, and longevity.

Chinese medicine is traditionally based on the theory of Yin and Yang. Chinese think everything consists of the yin and the yang. Such as for human being, female is the yin and male is the yang. The human body is also governed by the yin and the yang. The yin and the yang are in constant evolution and interaction between them. Disease and illness are the direct cause of the imbalance between the yin and the yang. Qigong is the natural method to control and adjust one's yin and yang to achieve the balance of them, so it optimizes the body's ability to use the most of latent energy within the human body and to guard against any invasion of disease or illness.

Now that you understand what Qi Gong is, let me explain why I am introducing it to you. As you know, a client with asthma has a problem with their lungs. According to the Chinese, our organs are the storehouse for our various thoughts and emotions. It is the brain that carries those thoughts or feelings into reality. When it comes to treating disease and illness, the Chinese focus on the internal Qi of the organs.
When it comes to the lungs, the Chinese believe that they are the main source of our olfactory and kinesthetic senses. Our lungs are associated with good impulses and righteousness. The lungs openings are associated with the nose and skin, which involve them in the senses of touch and feeling. This increases your ability to be more aware of what is going on around you, as well as increasing your ability to learn (Chai, 14).

The lungs are associated with the air element (To learn more about the 5 elements, read The Polarity Process by Franklin Sills). When the air element or lungs express in a negative manner, they express emptiness, sadness and depression. When our lungs become stressed and overworked from our poor nutrition, posture and/or other stressors, the lung energy becomes stagnant. If you think of a stagnant pond, this is what happens to the air, oxygen, fluids, etc. within the lungs. Toxins build up and energy is created, but cannot be dissipated away or let go. Qi is good, but when it cannot flow and move freely, it can become toxic cesspool of energy. In order to stimulate your internal lung Qi and bring about positive emotions of letting go, joy, courage and righteousness, follow the Healing Sound/Movement for the lungs below.

While performing this Qi Gong movement, follow these simple recommendations in order to best benefit the process:
1. To be done sitting or standing
2. The best time to do it is 1-2 hours after eating (aid with digestion)
3. Wear comfortable clothes to allow freedom of movement
4. If you can, perform outside in bare feet
5. A great environment is to perform it in the same place each day or near water if accessible
6. As well as make sure that you are in a quiet environment.

How to Perform Lung Healing Movement: Begin by sitting upright in a chair with palms up on lap (one of each leg) or standing with eyes closed, focusing down on the lungs. Begin by taking a deep breath in, moving the hands up in front of the body, as if you were picking up the lungs. Continue to inhale and as the palms come into alignment with the mouth, begin to turn the palms up to the heaven and breathe out. Once you have fully exhaled, move the palms back down to your lap again (palms up). Repeat this step 3-9 times, or as many times as needed. When you are completed, end the session by smiling down at your lungs. This will restore and maintain the Qi within the lungs, as well as calming them down. If you are a sound oriented person, put your teeth together with the tongue behind them and make the Sssssssssss sound as you exhale during the movement. Everything in life vibrates at a certain frequency. Using the Sssssss sound, you tap into the internal nature of the lungs and are able to communicate/resonate with them. The lungs are associated with the color white, symbolizing air, letting go and peacefulness inside. If you are a color oriented person, picture a big white light radiated up from the lungs and out the mouth as you inhale and exhale (7).

Working with an asthmatic can be challenging, but even more challenging if you follow societies convention methods of care. Cardio, exercise, basic nutrition, and Rx meds all have there place in the course of treatment. At times I have found that these treatments sometimes add to and exacerbate symptoms. The above recommendations are sometimes hard for clients to grasp. Your goal is to educate yourself, do the research and then educate you clients. I can guarantee that the above will lead your asthmatic client towards a life of increase health, vitality, and longevity.

Works Cited
1. Chek, Paul. Nutrition & Lifestyle Coaching Course, Level 2. C.H.E.K Institute. Vista, CA. 2004. Go to www.chekinstitute.com or call 1-800-552-8789 for information on this course

2. Chek, Paul. Scientific Core Conditioning (Correspondence course). C.H.E.K Institute. Enincitas, CA. 1998. Go to www.chekinstitute.com or call 1-800-552-8789 for information on this course

3. Chek, Paul. Scientific Back Training (Correspondence course). C.H.E.K Institute. Encinitas, CA. 1993. Go to www.chekinstitute.com or call 1-800-552-8789 for information on this course.

4. Chek, Paul. How to Eat, Move and Be Healthy. San Diego: C.H.E.K Institute Publication, 2004.

5. Chek, Paul. C.H.E.K NLC 3 Certification: Understanding Human Life. 2005

6. Cosmic Inner Smile: Love, Joy and Gratitude for Your Internal Ograns. Mantak Chai. Tao Garden. 2005. DVD (www.universal-tao.com)

7. Chia, Mantak. Taoist Ways to Transform Stress into Vitality: Inner Smile – Six Healing Sounds. Thailand: Universal Tao Publications, 1985.

8. F. Batmangheligji, M.D. Your Body’s Many Cries for Water. Second edition. Global Health Systmes, Inc. 1997

9. Kendall, Florence., Kendall McCreary, Elizabeth., Provance, Patricia. Muscles: Testing and Function. Fourth edition. Williams & Wilkins. 1993

10. Sears, JP. “Breathing for Optimal Health Part 1 and 2.” www.PTontheNet.com

11. Qi Gong Flow For Beginners. Lee Holden. Pacific Healing Arts Production. 2005. DVD (www.pacifichealingarts.com)

12. Qi Gong Institute. www.gigonginstitute.com. August, 2005. Internet.

With Qi,

Joshua Rubin