BREATHE EASY
Auckland Herald 21 September 2002

Everyone knows how to breathe, right? Well, no, reports Tim Watkin, we may be making a hash of this natural instinct.

He talks to the experts about asthma and breathing. Body Text THE receptionist flicks through the appointment book at the Remuera Rd clinic. Pencilled names fill every available space. Every week the physiotherapists receive phone calls from 10 people wanting to begin treatment, she explains.

``We could fill them up every day, but we like to give them an hour here,'' she says, pointing at the time put aside for lunch, ``just to give them a bit of breathing space.''

Which is sensible, given that breathing is what this place is all about.
You might think breathing is the most natural thing in the world, something
we're all expert at given we've been doing it since birth.

But Dinah Bradley and Tania Clifton-Smith beg to differ. They say many of us have developed bad breathing habits and our health is suffering as a consequence. They say many people breathe too much, throwing the body's metabolism out of kilter.

They've been called ``the breathing divas'' and they have embarked on the ultimate ``back to basics'' campaign teaching us how to breathe - but properly this time.

The internationally recognised pair who set up this, the first breathing pattern disorders clinic in Australasia three years ago, have both written books on the syndrome. Now, in a book launched this week, they have taken aim at New Zealand's bad-breathing epidemic - asthma. Breathing Works for Asthma is a handbook that provides information, tips and exercises for asthmatics wanting to alleviate their symptoms, and to maximise the effects of their medication, by natural means.

In their Remuera rooms, Clifton-Smith and Bradley, both trained physiotherapists with more than 20 years' experience between them, say their basic thesis is that, like most mammals, we should breathe through
our nose to our diaphragm. When resting, adults should take 10-14 breaths a minute and children 15-25.

Breathing more often upsets the body's ph balance, filling us with more oxygen than we need and not enough carbon dioxide.

``People are doing it too hard, too fast and too much,'' says Clifton-Smith. Bad breathers - asthmatics especially - will also tend to breathe through their mouth rather than their nose, and from their upper chest, rather than all the way to their diaphragm, the muscle responsible for pumping oxygen throughout the body.

That wears out the upper chest, neck and shoulder muscles and weakens the lower chest and diaphragm muscles that should be used.
Clifton-Smith says people come in who breathe with their mouths hanging open and their shoulders hitched up around their ears.

``If you breathe like that, that's a major stressor in itself.''

Bradley wiggles her nose with her finger, like Tabitha in Bewitched. ``This
is our air-conditioner.'' While breathing through your nose can be harder - the breath meets 50 per cent more resistance than through the mouth - it moistens, warms and filters the air we breathe in, removing impurities.
The pair say we are ``hard-wired'' to breathe through our nose to our diaphragm and do so for the first few months of life. But problems soon creep in. Bradley and Clifton-Smith say the tendency to breathe through our mouth probably begins in our first year with the development, and consequent blockages, of our sinuses and as we learn to speak.

While no one can pinpoint where bad breathing habits begin, as we grow older there are any number of possible triggers. Respiratory problems such as asthma cause obvious problems. For example, if you get wheezy and in response start breathing from your upper chest, the habit might continue even after the wheeziness passes. But even non-asthmatics can be affected - by fear, stress, pollution, and hold-your-stomach-in vanity.
Clifton-Smith says some people get so busy they almost forget to stop to take a breath. The good news, she adds, is that good habits can be relearned in six to eight weeks. ``It's simple, but it's not easy,'' she
warns. ``To retrain a bad pattern is not as easy as people think.''

But the pay-offs are huge. ``It will make you feel soooo much better. If you breathe properly, every system in your body has the chance to work more effectively.''

While that all sounds logical, this is where the questions about breathing techniques arise. Those possible triggers and benefits are vague, to say the least. The symptoms that suggest your breathing might need attention include fatigue, muscle tightness and lower back pain - symptoms of any number of ailments.

As Dr John Kolbe, associate professor of medicine at the University of Auckland says, it's hard to link cause and effect when you're trying to improve your health by better breathing. There's no research into how widespread a problem bad breathing might be and what percentage of the population might benefit from these techniques.

``The science in this is rather limited,'' he says. ``This is a notoriously difficult area to study because, as you probably know from school science, once you try to measure something you immediately alter it.''
So it's just another fad? No, Kolbe says the duo have a ``very, very valid point''.

The commonsense and anecdotal evidence is compelling - breathe in a way that cleanses, relaxes and strengthens the body and it makes sense that better health will follow. Yes, the symptoms are non-specific, ``but they often improve as breathing improves. But the mechanics of that, I don't know what they are.''

Despite the lack of research, hospitals around the country offer breathing lessons on the public health budget - as opposed to the $98/hour or $60/half-hour at Breathing Works - and Kolbe has seen the benefits. ``The proof of the pudding is in the eating,'' he says. ``Symptoms can be reduced and quality of life improved.''

Kolbe says when people turn up at hospital with breathing problems, it can be difficult to tell where asthma ends and bad breathing begins. As a result, asthmatics can be mistreated. ``The easiest way to sort that out is to make sure they all breathe properly, then you can deal with the asthma issues that are left,'' he says.

Pam Young, a physiotherapist at Green Lane, agrees. She uses the same techniques as her Remuera counterparts, but says people having breathing problems should go to a doctor and get a clear diagnosis before trying them. They are not a cure-all and not a replacement for medication.
``The techniques are very good, but I still have that basic concern that you have to have eliminated any pathological causes before you embark on them.''

Bradley and Clifton-Smith, unlike purveyors of some breathing techniques, agree that improved breathing is no magic bullet that will have asthmatics throwing their inhalers away. While Bradley, who spent nine years at Green Lane before moving into private practice, has seen dramatic improvements in some patients, and significantly reduced use of inhalers, medication is still a vital part of asthma treatment, alongside good nutrition, rest, exercise and other commonsense measures.

But, she says, they are re-dressing the over-reliance on drugs that has built up in the past generation. Good breathing used to be taught as part of physiotherapy and medical training before inhalers appeared.
``As drugs got better and more efficient, those breathing lessons and physiological coping strategies were lost,'' Bradley says.

Judging by that appointment diary and the success of the pair's earlier books, they are strategies that are coming back in a big way. So stop, take a deep breath - through the nose - and keep doing it.

Breathing Works for Asthma, by Dinah Bradley and Tania Clifton-Smith
(Random Press $24.95).

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