Breathing Techniques for Stress and Pain Relief | Dr. Perry Nickelston | Align Podcast #522
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Welcome back to the line podcast. My name is Aaron Alexander. This conversation is a deep dive into how and why to breathe effectively. What does that mean in the first place? What happens when we exhale? What happens to our nervous system and our physiology? What happens when we hold our breath? What happens when we inhale? How we can optimize our mechanics for breathing, the function of our diaphragm, the function of our pelvic floor,

so much. This is such a rich, important conversation for anyone who has lungs or has blood circulating through their body or wants to feel better or wants to sleep better or wants to have regulation of the nervous system is with Dr. Perry Nicholson. He is a repeat guest on the podcast we've had on a few times now because people tend to really like these conversations.

So they do really well on YouTube and you guys send a lot of great comments. So we had Dr. Perry back on to do a deep dive with us on the nervous system, on breathing, specifically on the mechanics around breathing. Dr. Perry is an absolute masterful wizard on all things biology and physiology. And in this particular conversation, we deep dive on the breath. Also, if you want to go deeper into the mechanics of breathing for yourself, you

as well as learn tactical exercises that you can do to calm your nervous system or stimulate your nervous system for more alertness, we are launching the Align Breathing Program early January.

So if you want to get on the waiting list for that, if it's before January right now, you can jump over to alignpodcast.com slash breath. That's alignpodcast.com slash breath. Jump on the waiting list. If this is after January, then that will take you to a landing page and you can try the free trial of the Align Breathing Program. We break down mechanics, we break down down regulation, we break down up regulation, and then we also provide anatomy and physiology to teach you the things that you ought to know

about breathing. That's it. That's all. I hope you enjoyed this conversation with Dr. Perry Nicholson. What is breath's role in regulating the way a human feels? Well, I honestly think it's everything to tell you the truth. First of all, I think it's important to note the difference between breathing and respiration. They're two different things.

Everybody respires because if you didn't, you'd be dead quick, fast and in a hurry. Right. So that's that old thing you may have seen on social media. Say, you know, you can go a couple of days without water, a couple of weeks without food, but you're only going to go a few minutes without air. So your body's already telling you what's the most important resource.

But respiration, everybody does it. And they usually don't pay attention to their breathing at all. There's no awareness to it. So that's actually what I tell people. The first way that you change your breathing is simply having more awareness of your breathing, because when you're aware of it, it actually changes. And you can't control something until you become aware of it. So it has to be in your sphere. All right. And most people only pay attention to air when they lack it. Yeah.

Right. But breathing is something that takes intention, attention and some conscious awareness to it.

So it's actually the number one way that I tell people they can control their autonomic nervous system, which is their autonomic. Just me. That's the software running in the background as well. So you don't have to pay attention to all these trillions of bits of things happening in your body because your brain just couldn't do it literally explode.

Because you're not paying attention to your food digesting or whether you're sweating or not or what your lungs are doing. That's all going into the background. So your sympathetic system, your fight or flight system, that's the one that most people are stuck in, especially if they have chronic pain.

And then you have your parasympathetic system, which is their relaxation, recovery, healing, regeneration. There's a balanced scale. We'll get into that later that you can't be in both at the same time. Okay. They play off of each other a lot, but one's always going to be going more than the other.

And when you can learn to control your breathing, you can change that thermostat of that fight or flight and take you down into more of the relaxed state when you're in. And when you change your autonomic nervous system, you change how you feel. And when you change how you feel, you change your mood, your emotions. And then that can change how you move emotionally.

But it can also change how you interact with the world and you interact with your other humans. So that's a superpower right there. You know, and then when people discover that, they always say, oh, my goodness. I mean, I had no idea. Where has this been all my life? It's always been there. And Moshe Feldenkrais always called things like the elusive obvious.

This is like, oh, okay, I get it. Right. That's some of the physiological reasons why breathing can make a huge difference on everything. Honestly. How does a person start to create a new breathing set point for themselves? There's probably a version of your autonomic nervous system, almost like a thermostat that you've grown accustomed to as being normal.

And you can temporarily modulate that autonomic system with the breath. And then typically things will start to shift back. Yeah, I think it's important to let you know kind of the scope of the world that I live in most often with the people that I take care of and I treat.

I don't really do a lot of athletic performance type therapy rehabilitation. My patient base and my own experience were people suffering an intense amount of chronic pain or multiple autoimmune disorders, diseases that they've been struggling with, and they just simply have not found help or answers to and

They're literally sinking in the quicksand and barely hanging on. All of those people have what I call maladaptive breathing patterns because I hate the word dysfunctional because the body doesn't do anything dysfunctional. It just chooses options to try to solve a problem. So they're actually quite functional. You just have to figure out why in the world it's doing it. And it's the same thing with the breathing. So

In my sphere of chronic pain or chronic inflammation, people are in a state of what they call hyper-vigilance, hyper-arousal, fight or flight, barely hanging on for dear life, like hanging by fingernails on the cliff above the abyss is basically what it is.

And those are the ones that are struggling a lot with chronic pain, inflammation, and a lot of trauma, emotional trauma. Because that'll put you into that maladaptive state, typically of over-breathing, where you're just breathing too many breaths per second. And they're usually very shallow. And that's kind of the...

that anxiety thing. And you get that way too when you're in pain all the time or when you feel like nobody's listening or people tell you that, hey man, we can't find anything on yourself. It's all in your head. Well, that kind of feeds that helplessness, that fight or flight. So when you're automatically in that sympathetic dominant state, my number one goal is I have to take you out of that.

And the breathing is the way that I can help my patients do that on their own when they're not with me. And that's by really paying attention to how long your breath is in as to how long your breath is out.

And whether you're going in through your nose or in through your mouth or out through your nose or out through your mouth. See, I have to keep my work really simple for people, too, because they're usually completely overloaded with so many things they're trying to do. And they get really stressed about what type of breathing I should be doing because there's five billion types of breathing.

And they all work. It just depends on is it what you need for you in this moment, because it might actually change in the next hour. But to simply answer your question now is that I have to get people to make their exhales longer than their inhales. That's the number one goal. Like I just tell people, can you start there?

And just pay more attention to that during the day because you'll often find you're not doing that. And then this is when they say, well, how many seconds? And I say, first of all, breathe, relax. Don't get caught up so much into that. Try to go for like four seconds in through your nose. I'm not a big mouth breather at all. I don't have anybody breathe through their mouth in my work.

Unless they can't breathe through their nose, which we can get into later. And then I say, try to reach six seconds on the exhale. But listen, man, some people can't do that because if I try to get them to go six seconds, they get a little bit of anxiety because they're trying to reach six seconds because they're not able to.

And then I just say, listen, just follow what you feel here and feel first, think second, and try two seconds in and four seconds out. And then they automatically just relax because they're like,

Like, really? I can do that? Yeah. You know, just start there and then we can work up to the more complicated ones. Because I'm going to tell you right now, that will physiologically make a huge shift in your biochemistry for healing from inflammation. Yeah, that's with most of the different breathing patterns, like 5-7-8 or box breathing or, you know,

one-to-one ratio breathing or whatever, whatever kind of breathing you're doing. The perfect breath, you know, whatever. There's a lot of different things. Ultimately, what they are

Is just when you are exhaling, you're taking yourself, you're slowing your heart rate down. It's like the sinus respiratory arrhythmia thing. And you're putting yourself more into a calm state. So you're tapping into like that parasympathetic bucket. And then when you're inhaling, it's super healthy and natural and beautiful. You're speeding up your heart rate.

through pressure of your diaphragm and shrinking blood vessels and expanding blood vessels when you're inhalation, exhalation. And that's causing things to

raise up a little bit, you're pressing the throttle down, you're going more sympathetic. And I think people get lost in the idea that I'm doing this perfect ratio of breathing or it needs to be seven seconds. Every person is completely different. You can just explore your own. But the important thing to know is that when you're exhaling, you are kind of slowing things down a little bit. And when you're inhaling, you're speeding things up a little bit. Both are really powerful and meaningful and important things.

And you can leverage the inhale and the exhale if you understand, you know, what's happening with that. Yeah, that's so well said, right? Because every breathing technique works for someone.

It just depends on, like I mentioned before, is it what you need for you? I have to meet you where you are right now. And see, many people, because you can use breathing techniques to put you into a more sympathetic state, get you ready. Okay, I'm ready to take on something. I got to go on the field and be hashtag beast mode monster. I can't do that, at least at this stage for my patient base, because they're going to get worse.

That's going to put them in the quicksand. They're going to sink. So they just can't do that now. And see, an overwhelmed nervous system is very easy to overwhelm. And breathing is also a stressor to your system, especially when you're trying to establish a new one. So I can send you further into fight or flight because I'm just making things way too complicated for you.

So I'm always about basics and fundamentals first. And once they can own paying attention to longer exhales and inhales and not getting so much anxiety about the seconds. And I have them do that too, because when you're focusing on your breathing or you're focusing on your count and your mind, you're then not focusing on whatever the catalyst was that set you off in your life. It's usually a thought.

Or something that happens out in the exterior world that someone says to you or does to you. And then you go down your rabbit hole of emotions and you reflexively react to that. And the reason that you do that is because you're stuck in fight or flight. So that's your natural response behavior.

to be on guard, right? So I first tell people to don't beat yourself up. If you find yourself really sucking at the breathing things in the beginning, that's okay. That that's natural. Eventually,

You're it's like putting reps in at the gym. The first couple of times you go, you're like, man, I'm not noticing anything. But then you start to feel different slowly. Then you start to look because that will happen, too, when you change your breathing, because when you change your breathing, you change the immune system and the nervous system and you change the amount of inflammation in the body. And then before you know it, you'll physically change.

mentally and emotionally begin to feel a difference. And listen, here's the thing that's so powerful about breathing is that I had a neuroscientist who's a very dear friend of mine. His name is Bo Lotto. And I read something in one of his books because he teaches all about perception. And it really stuck with me. And he said the number one stressor for the human nervous system is uncertainty. Yeah. Like,

not knowing, lack of control. And that makes sense, right? Because you get a little nervous when you don't know what's headed your way. And here's a beautiful thing about controlling your breathing. And I picked that word for a set for a reason because you're controlling it. So there is absolute certainty to your breathing. So guess what you just did? You took yourself out of a stress mode, one, because you're really having awesome breathing patterns, but

You're driving the bus now. Nobody else is. So then you start to become empowered too, right? And that's honestly, people say, can it really be that simple? And my answer is it usually is, honestly. Yeah.

Because people overcomplicate breathing patterns a lot, at least in the sphere that I'm in for the patient base that I see. So something that I think is very common is in the world of breathing is it's a lot around techniques and a lot around timing. And there's not a lot around structure.

And so it's a lot of like the function, which does end up informing the structure and changing the structure. But I don't see so much structure to function. And I wonder if you have any thoughts or ideas of maybe like techniques a person could do with themselves, like manual hands-on kind of techniques, or maybe places within the ribs or the diaphragm or the neck or the clavicle or the

the nasal passages or any of that, or the pelvic floor that would actually just naturally organically end up causing the breath to be regulated into a more healthy environment.

homeostatic state through actual like manual intervention? Yeah, that's a great question. And I agree with you there. And but the beautiful thing is, is when you start to watch your breathing and you try to pay more attention to the longer exhales than the inhales, you'll physiologically change your body and you will automatically decrease tension everywhere.

And the reason that's happening is because you're going to be out of fight or flight more often and more towards a parasympathetic system where you can chill. It almost like softens the clay in a way of the nervous system. Like if you were hypertonic, you can start to become more, you know, a healthy tone of your connective tissue through the breath. And then from there, it opens up the space to create structural change. Is that right?

Yeah, and that's a great phrase, too, because it actually physiologically does open up space. Yeah. Because when you're tense, you close space. And when you open up space, everything can relax. And then people always ask me what relaxes in the body, and my answer is yes, everything. Muscle, fascia, ligament, viscera, eyeballs, I mean, you name it, right? It all relaxes down. Like opens you to love. Yeah.

Yeah, it is hard to love when you're in fight or flight. Because the reason being is it's hard to love anything when you're dead because you got to not die first. But let's say that the thoracic diaphragm, for instance, that's underneath the rib cage here and below the lungs and sits above your abdominal organs. All right. That's a muscle. And you need to remember that.

And muscles get really, really tense and tight when you're in sympathetic dominance, including that one. And if you have any inflammation around the organs of your body, which if you have chronic pain and an autoimmune disease, I already know the answer. It's yes, they do.

And when they're inflamed, muscles around them go into what's called a muscle guarding reflex because their job is to protect and to isolate and not have things move because there's inflammation there. Does that make sense? So, and when you can just get this basic relaxation one down, you'll start to relax your thoracic diaphragm more, which means that that muscle can physiologically now move more.

which means when you inhale, especially through your nose, that tends to typically drive engagement of the diaphragm muscle more efficiently. So it contracts and it pushes down towards the floor, pushing your organs toward the pelvic diaphragm or pelvic floor, which hopefully is strong enough to catch it. Right.

Then when you exhale, then the diaphragm muscle relaxes and then it ascends, comes back up. Then the pressure in the abdomen decreases. And then now the organs ricochet back up and then the pelvic floor ricochets back up. But when you also use your nose as opposed to your mouth, you typically have a much better cervical spine alignment.

which will help the nerves in your neck and in your brainstem that supply how the diaphragm and the abdominal organs actually function. So it's a top-down approach. One is your phrenic nerve, which we can get into later. The other one is your vagus nerve that goes to the organs.

down there. So that actually can help things move more efficiently. But here's what I find. People are so tense and tight from the maladaptive breathing. They're very shallow. So they use way too much of the neck muscles.

And they use way too much of the upper trapezius and the pectorals and the shoulders do a lot of the motion here. They don't use as much as they should down below in the abdominal region or the rib cage along the sides and along the back because you have a posterior part of the diaphragm too with the lower part of the thoracic spine in the back.

So those are really, really tense and tight. They're hunched over typically in this kind of fetal, almost cashew nut position because one of sedentary posture, we sit a lot, but two, that's a natural protective response when you're in fight or flight.

You curl forward for one single reason. You're trying to protect the most vulnerable structures of the body that if a predator took them out, you would be dead quick, like your throat and your abdomen, right? One swipe, you're done, right? So you get really, really tense and tight there. So they don't have the ability because they just simply can't

even feel it because they're so tight of expanding the rib cage anywhere except up.

They can't feel it go out. They can't feel it go forwards and back on this so tight in this region. The neck is a hot mess and a half because my people usually breathe through the mouth all day long. So they've automatically lost any stability in the cervical spine and neck, which is going to just crush their brainstem and blood flow to the brain.

And they've got a lot of inflammation in the abdomen. So even if they wanted to take a nice deep breath in or breathe with the four and six out, they're so restricted that the body just says, you know, physiologically, I'm having difficulty giving you your motion. Can you go in there and relieve some stuff? So that's where in my world.

I do a lot of stuff to the cervical spine for sure to help release the tension in those accessory muscles. For those that are listening that will want to know, that's usually your sternocleidomastoid muscle and your scalene muscles. And they can cause a lot of neck pain and headaches and sinus issues when they get set off. I have to get rib cage motion in every direction.

And including the sternum, the actual rib articulations on the sternum and on the thoracic spine are locked in stone. And then in the lower part of the abdomen, the fascia, connective tissue, abdominals from your oblique muscles to your transverse abdominis, if anybody cares about the anatomy.

is really super tight under the margins of the rib cage there. So then it's very difficult for the diaphragm to drop even when you do it. And what's even worse is

is the back part of the rib cage where the kidneys are located and the lower ribs there because they have such tight, tense fascia there called the thoracolumbar fascia from the lumbar spine and the thoracic spine. That's the fascial bridge from one shoulder to the opposite side hip that should be working well when you walk, if you're actually walking.

And they're not able to move in that posterior diaphragm whatsoever. And that's where a lot of issues happen. So I will tell you probably one of the biggest things that I neglected early in my career was looking at the role of the rib cage in general for its motion. I looked at the spine a lot.

Because my background is chiropractic. I mean, that was kind of my playground. But the rib cage itself is a huge player. So if you can go in there and do some releases, soft tissue releases or mobilizations, either seeing someone or there's a lot of things you can do for yourself. And you combine that with the breathing exercises.

that we've talked before, you'll typically notice a huge difference in your breathing, but you'll also notice a huge difference in how you feel virtually everywhere. ♪

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Part of my curiosity with talking to you about breathing is we're launching a breathing program that focuses specifically on structure and function. Oh, great. Yeah. And so that's the thing that I see as a deficit in the realm of the breathing conversation and the Wim Hofs and the holotropics and all the different things. There's not a lot around how to actually train the body, like a movement perspective, to actually get the orientation to be able to access breath.

So you mentioned the posterior diaphragm. Can you talk a little bit more about that, what you mean by that? And where are people restricted within their diaphragm most commonly and how can we address that and start to free the diaphragm up? And why does that matter? Yeah, well, having adequate diaphragm motion is just critical for your body to be able to control pressure throughout the entire body.

So in my world, the diaphragm is super critical because whenever you inhale, you increase pressure in the body. Whenever you exhale, you decrease pressure in the body. And that functions exactly like a pumping mechanism. Yeah, it's great that you're going to get oxygen in your body. OK, but oxygen takes a back seat if you don't have good blood flow.

Like it doesn't matter how much oxygen you got if it can't get anywhere. And if you have poor pressure control in your body,

You're going to have poor fluid dynamics in your body of being able to get the vascular supply to things through the arterial system, the arteries, arterioles, capillaries. That's the piping mechanism that takes in big blood down to one single cell that gets through at a time, because that's what you have to remember is that one red blood cell gets out at a time.

That's it. That doesn't happen very easily for most people either because the blood's usually too thick. But then you have the venous side, the vein side, and that's the one that's the...

a waste removal side, if you will, because that takes the carbon dioxide out again. All right. But the veins are the reservoir fluid holding system of the body. That's why you have twice as many veins as you do arteries. So in my world, veins are more important than arteries because the body will not let you put anything in that it can't get out. So if you're stuck full of backflow, you're going to struggle no matter what you do with your breathing techniques.

And then you have the lymphatics. We've talked about lymphatics before. That's the top of my wheelhouse. And breathing is a huge player in the lymphatic function because of pressure. So if you're restricted in your diaphragm, because I don't look, I look at the whole thing, right? You have a right side diaphragm, you have a left side diaphragm. They function together. And yes, you'll have issues with lymphatic

right side vagus, left side vagus, that thing, and right phrenic nerve and left phrenic nerve. But...

They'll usually free up both sides all the time of the diaphragm. And that's underneath that anterior margin of the ribcage when you're looking at somebody from the front. And then the reason that matters is, and where I find, honestly, probably most of the diaphragm, they're almost said dysfunction, where it's not working at optimum is the right side because that's the liver side.

And many people, well, if you're coming to see me in my office, I know you have a liver that's a hot mess. So there's a lot of inflammation in there. And then the liver actually has what's called visceral ligaments. They're not like ligaments in your ankle. They're not made of the same thing. But they're tethered like ropes that attach the liver physically to the diaphragm. I think it's in like five places. Okay.

And then on your left side, you're going to have your spleen, stomach, pancreas side. Because there's a lot of issues with the liver on the right, that's the side that spasms the most.

in my world. And yeah, there's anatomically a difference between the size of the right lobe of the diaphragm compared to the left lobe of the diaphragm, just because the sheer nature of the organs tucked up underneath there. And you have to remember the organs are packed inside of that diaphragm like a can of sardines. There's no big, empty space in there like you see in your anatomical pictures on your favorite anatomy app. It's

It's not like that. I mean, they're right up against each other and they need to have fluid in them, this viscosity, so they can slip and slide over each other. And that usually doesn't happen. So if I have people who have restrictions in the organs underneath, then the diaphragm can't

do its thing. So that's why working on that abdominal region is great. I used to do that a lot. You know, it's just a matter of simply just kind of massaging underneath your rib cage, rubbing around your belly and rubbing around your navel, which most people never pay attention to those areas at all. And if they do, they never rub them.

So you just start there. Some people can lie on things, you know, like they would lie on a nice rolled up cowl. I know Jill Miller has her great courageous balls. They're freaking awesome. She's talking about this stuff for a long period of time. But I neglected the back as well near the posterior diaphragm. And that's that lower rib cage here, especially near the kidney region and

The kidneys are huge in my world because they're going to filter out the waste that comes from your lymphatics. So if you're restricted in the posterior diaphragm because of the really tight fascia in that lower rib cage, it's going to be very hard for you to actually expand.

back there in that region. Once you free that area up, it can make a huge change in the front part of your diaphragm. And that's really easy to do. I mean, if you are a body worker of any type, you just simply place your hands on the lower part of the rib cage on the left side and the right side, one at a time, and just start to give nice, easy, sustained movements

pressure in different directions for a little bit. And you'll usually feel the body just start to actually melt away and the breathing pattern changes. And I'll tell you another physiological reason why that's so important in a moment. But, you know, I put up videos on my YouTube channel where I show people, you just take a towel that you shower with.

Roll it up and don't make it too high and just simply lie on it on the left side, one rib cage side at a time, a little bit towards the back and let that pressure easily go in there and just hold it. And when you do that, trust me, you're going to change the blood flow to your kidneys and your adrenal glands like there's no tomorrow. And it's going to feel really, really good.

Now, another reason that's really important is because your sympathetic fight or flight nervous system resides in a very specific place in your body, and that's your thoracic spine. So fight or flight lives from thoracic one to lumbar two. If you have risk and everybody's restricted in the thoracic spine, everybody.

And at the lumbar one, lumbar two, lower thoracics, that's that lower rib cage region there. And if you know your physiology, holy cow, that's like where the attachment of the diaphragm muscle

is to the actual spine. And why does it sit there? Because it's supposed to help stabilize, control it. It doesn't get all sloppy motion in there. But why is that important? Because that sweet spot at L1, L2, that's that sympathetic nervous system big response is going to send stuff all the way down to everything in your lower body.

So you will suffer from, ah, I got pain down on my feet and no matter what I do to my feet, you're just not getting any better. Plantar fasciitis, Achilles tendonitis, whatever, shin splints, hips,

You can treat all that. But if you're not getting better, most likely you are going to be stuck in a fight or flight of some type. So I have to go. And if I help your breathing and I free up that back part of the rib cage, just lying on a towel, putting a little pressure on there, no pain, nothing really forceful. And you free that area up. Most people say, Todd, that's the craziest thing in the world. But all I did was work on the breathing.

And I did a little stuff to the rib cage there. And then my dot, dot, dot in my lower body feels better. Does that make sense? Yes, it completely makes sense because that's just the physiology of how the body works. So the thing that, you know, I have this phrase all the time that I say, and I'm going to say it now because it,

It bears repeating. That's going to help tie in together why I bring so many different things into an answer to a question. Is it no system in the body ever works alone, never gets injured alone, never heals alone? There's no such thing as an isolated injury in the body. There's no such thing as isolated healing. It's all or nothing until lights out. So when you're talking about the thoracic diaphragm muscle, you're not just talking about the thoracic diaphragm muscle.

There's so much stuff happening there. I mean, I could keep you here for a week. All the physiology that you're changing in there just by freeing that area up a little bit. Aaron, here's the thing that just still blows my mind.

You know, we're in this, we're in a sphere of people who educated a lot about the body and in fitness and about the value of breathing. And then we make this mistake of thinking that everybody else out in the world has to know this information too, because it's just so amazing and it's so powerful. And you've had New York bestseller times books on there from Nestor and all these things and all these podcasts. And you get out there and nobody knows. I

I mentioned diet. Did anybody check your diaphragm? Anybody check your breathing to people that have been through every specialist you can known to man, every world class center you can think of. And I'll even speak to other health care professionals. As soon as I mentioned diaphragm or breathing, it's like I'm talking Martian. You know what I'm talking about? So that's the value of this stuff and why I'm so happy that you're continuously talking about it, because the world doesn't.

know about these things at all. I have a sidetracked question. Why are people peeing their pants so much? Why is the adult diaper industry such a big industry? That's a really good question. Didn't expect that one.

Well, I'm thinking about it. It does track. I'm thinking about diaphragms and like pelvic diaphragm, respiratory diaphragm, associations of breathing, associations of sitting, how that kind of the maladaption of that to potentially cause a person not be able to maintain continence. Is that associated to that pressure system that people are peeing themselves? Yeah. And that's another pet peeve of mine. It depends on if you get a really good and gifted pelvic floor specialist.

Like that's their world. And they'll look at the pelvic diaphragm, which is also a muscle. And you got many different parts to that. And you can have just like your thoracic diaphragm. One part of it can work well. Another part doesn't. And so there can be an imbalance in the pelvic floor. Many people have pelvic floor muscles that maybe are weakened, if you will. Sometimes they are neurologically not engaging the way that they should be.

And then you have the inability to maintain the urination and control and even through defecation. But that's also part of your parasympathetic sympathetic nervous system. I mean, that has to work so you don't pee yourself just having a conversation and you got to be able to relax in order to urinate, in order to defecate and things like that.

So many people who have pelvic floor issues have autonomic nervous system dysregulation from the parasympathetics that we mentioned before. And the parasympathetics are primarily located in your sacrum, your sacrum 2, 3, 4. So that's the tailbone. And then up in your brainstem, okay? Up in the brainstem, what's called cranial nerves.

And then you have your sympathetic nervous system that we mentioned before, you know, about the sympathetic ganglia that are going through. So you have to actually, if you have nervous system dysregulation because of fight or flight, that can manifest over to the pelvic floor issue.

But the pelvic floor musculature, pelvic diaphragm musculature only functions as well as the thoracic diaphragm one above it. You can't just look at the thoracic diaphragm and then not look at the pelvic one. You can't look at the pelvic one and not look at the thoracic. And you also have to address the sympathetic and parasympathetic system. And like I said before, that's going to reside in your thoracic spine and your brainstem. So you need to look up top too.

at your neck. But problem is many people don't do that. And the specializations, they just isolate in that region. And, um,

See, you have to also look at, well, technically, what is a diaphragm? So a diaphragm in my world is just a structure in your body that controls pressure. OK, the thoracic diaphragm is the one that most people are familiar with. And maybe you've heard about the pelvic diaphragm. But in osteopathic medicine, they have other diaphragms that control pressure.

And one of the biggest ones that they talk about is at the collarbone. It's called the thoracic inlet slash outlet diaphragm. That's a pressure controlled zone of connective tissue fascia here that controls the difference in pressure from your thorax, your rib cage to your neck. Because if that wasn't there, there'd be a lot of problems you'd have in your brain here. And with

circulation. Okay. So that is probably one of the most neglected diaphragms in the body in my world. And here's why, because nobody even knows about it or they don't even think about it as a diaphragm. But in classical osteopathic medicine, they've been talking about that for a long time. So let's revisit this.

What happens if you're breathing a lot, like we mentioned before, of too much motion in the shoulders, too much motion in the pec, your mouth is wide open, your head's forward like this. You have a lot of tension and tightness in the cervical fascia. You don't have good cervical spine stability. So this area is on lockdown. This thoracic diaphragm gets tense and tight. Why is that a big deal? Here's why.

Because two very important nerves pass through that diaphragm. One is your vagus nerve, your left vagus and your right vagus. That has to pass from your brainstem, out of your skull, down your neck, in through that

fascia down, wrap around your esophagus, going down and exiting to your organs. If you get really tense and tight right in there, you get vagus nerve compromised, which is going to make a difference in what system? Your parasympathetic system.

And that also controls the inflammatory reflex in the body. Now, another nerve that sits next to there that you better own it or you're going to have a diaphragm problem for sure is called your phrenic nerve. So you have a left phrenic and you have a right phrenic, and they originate from your cervical spine, cervical 3, cervical 4, cervical 5. It's called C3, C4, C5. Keep the diaphragm alive because that's the motor nerve, which means it's the nerve that tells the diaphragm to contract the move.

and it comes from your cervical spine. So what you need to know is that your diaphragm descended from the upper part in your neck and came down.

Right. So because you weren't always this big. I don't know if you knew that or not. You weren't always this big. You were really, really tiny. And all these organs were jammed up right close to each other. And then they spread really far apart. But they still talk to each other like they're jammed up next to each other.

So if you get a compromise in that phrenic nerve up top because of that fascia or tightness or tension, and don't even get me started if your lymphatic system is backed up here because that's where the lymph drains. And if the lymph doesn't drain, you're going to have inflammation right here. And both those nerves are going to get massacred.

then you've automatically destroyed all pressure systems in the body right from the get-go. And your lower thoracic diaphragm is not going to function at optimum. If that's the case...

then another diaphragm has to try to step up. And maybe that's your pelvic diaphragm. And then that's the person who can get pelvic floor pain because the pelvic floor muscles are over-contracting because they have to do three times the work. So that's why you have to think of the bigger picture and everything in relationship to pressure because your pelvic floor muscles

your thoracic diaphragm, and the one at your collarbone, they all need to work in unison at the same time like a smooth piston, like a plunger. One can work more than the other, and instead of a smooth plunger motion, they bang up against each other. And when pressure bangs up against each other, guess what you create? You create stagnation and backflow, and then that's when you have fluid flow problems.

And that's what being unable to control your bladder is. It's a pressure problem. You have to look at all the different systems of the body. So my takeaway from this one is, is that if you have pelvic floor issues, don't just look at your pelvic floor. You have to look up at the cervical spine and the neck and the brain. But it also goes the other way, folks.

If you have a brain issue and you have a cervical spine issue, don't forget about your pelvic floor and your thoracic

thoracic diaphragm either. I'm going to take a moment to share about one of the things that I find to be absolutely the most important quote unquote biohacks that you can possibly have. It's not a biohack at all. It's completely natural. It is utilizing red light therapy in your daily life. If you're a person that has any types of aches or pains or injuries, red light therapy is fantastic for wound healing and tissue repair. If you're a person that cares about the health of your skin, you want to look more youthful and vibrant and fresh, it is very supportive for collagen production and repair.

pair as well. It reduces swelling and inflammation, improves joint health. It's fantastic. It's really great for sleep as well. I will use my panel from Mitre Red Light. That is my absolute favorite company. I'm such a big fan of these guys. I have several of them in my house. I've been using them for years and I think they're the best in the game. And I'm just such a huge fan. I can't say enough about using red light therapy. I use it with any professional athlete that I'm working with. I recommend it to all my clients and I use it every single day.

Mito Red Light is my go-to company. You guys want to try it yourself. You can get a 5% discount by going to mitoredlight.com and use Align code at checkout for 5% off site-wide. So that's M-I-T-O-R-E-D-L-I-G-H-T.com. Use promo code ALIGN, A-L-I-G-N.

at checkout and you will get 5% off site wide. For starters, I would at least get the portable travel red light for my red light. That for me is an absolute must. If I'm traveling anywhere, I will always grab the portable red light because it's awesome. You can lay it on a joint if you're having any kind of issues. I use it as a nightlight if I'm in a hotel room or anywhere where they have some kind of crappy blue lights.

So at least grab that guy, get the bigger panels, get all the guys. I think red light's amazing. Mitre red light.com. He's promo code aligned for 5% off. Can you say more about the thoracic spine being the real estate responsible for the sympathetic nervous system and how a person can be able to regulate or modulate or affect that within themselves without seeking out a professional to, to, to help? Dude, I'm going to tell you that.

When you realize and you understand and you just let this soak in, that your sympathetic nervous system, fight or flight system lives from thoracic one to L2, that'll change your life forever. This is one of the most important pieces of information you're ever going to learn in your entire life if you let it sink in. Why?

Because people are stuck in fight or flight. Now, you can be stuck in fight or flight because something's freaking you out. But when something freaks you out, where in the hell are the signals going? That's what you need to figure out. They're going to go to that thoracic spine and they're going to send things out to stuff. Right. Now, the most important thing you do to understand about the sympathetic nervous system is that controls the vascular system.

Sympathetics cause vasospasm. They contract vessels. They contract arteries. They contract veins. And they contract lymphatics because they're supposed to. But they're not supposed to stay that way. You're supposed to have the parasympathetics too. So when you have the sympathetics in your spine lit up like a Christmas tree,

Because you have poor posture, poor breathing, zero motion in your rib cage. You have almost no likely thoracic spine rotation at all. And you're probably stuck in segments you didn't even know you had. Then that sympathetic nervous system is always getting poked. Something's always going at it. And when you do that, it's going to get ticked off, man.

And it's going to send all these signals out all the time, nonstop. And then you're going to restrict blood flow 24-7. When that happens, I'm going to tell you something right now. Something's going to hurt you.

Pain is coming. Is that like a polyvagal theory lens on or when you say sympathetics, can you elaborate for like an elementary school person or middle school person? What do you mean by the sympathetics being in the thoracic? So the sympathetics, remember, we discussed it in the beginning. That's your hyper-abysmal, hyper-arousal, fight or flight.

So your brain and your body will turn that on and it does a couple of things. It's doing that so you can fight or you can flee and you can run. So when it does that, it actually shunts blood from places and to places. So it's going to pull the blood away from the abdominal region.

Specifically, definitely your gut and your digestive system and your liver and your pancreas and your spleen and all that stuff.

The reason being is that those are all for digestion. That's a parasympathetic state. So your nervous system says, dude, I'm not going to let you use that because you don't have time to eat right now. You have to not be eaten by something. You need to not die. So where does the blood go? It goes to the muscles in your arms and your legs so you can fight or hightail it and run. But it'll also pull it away from your joints.

So blood flow gets decreased to joints because it's going to muscles. So when you are in that state for a long period of time, the sympathetics are just your survival. When you're locked into that state all the time because of the stressors of life, even just going on, you know, social media for just a little bit can put you into a severe fight or flight response these days. Okay. This is, that's what happens to you. And people get stuck into that state for decades, right?

That's why everything begins to decay in the abdomen. And I'm going to contend as one of the biggest reasons why we have so many gut issues, because the gut just can't breathe, man. It's not getting blood flow. And if you're not getting blood flow in, guess what? You're not getting it out either. So it just pools there. And that's not going to work out well for you. And your lymph pools there, too.

So your polyvagal is trying to go after the parasympathetic side. So that primarily focuses on the vagus nerve, cranial nerve number 10, which you can really influence through your breathing. And one of the reasons that you can influence it through your breathing is because when you breathe, you move your organs around, hopefully. And when you move your organs around, you stimulate your vagus nerve.

And so it's a two-way street, right? But the other parasympathetic is up in the brain step, okay? Yeah.

So I think it's, if I remember the cranium, there's three, seven, nine, and 10. So that's the oculomotor nerve. So, you know, that's going to be mostly the one to control constriction or dilation of your eyes, which your pupil, which is a big thing that I look for. We can talk about it later. Seven is the facial nerve. So, um,

you know, moving the face, making smiles and stuff like that. That's why they talk about the face musculature and the polyvagal theory. And then you have the glossopharyngeal nerve, which is tongue and pharynx means throat. So that's another reason why when you gargle or you sing, that helps you feel better because you're stimulating your glossopharyngeal nerve.

But you're also stimulating your vagus nerve, which is going to supply part of your tongue and one of the muscles in the back of your throat. And then that is the parasympathetic. What do you think of the test? People can look at their little bell thing hanging down the back of their throat, the glottis. And if it's pulled off to a side, that could be an indication that there's some type of dysregulation with your. What is that? If a person wants to look into their throat right now and see how their vagus is done.

Yeah. So you have a right vagus and you have a left vagus. And then the uvula in the back, the little thing that hangs down there. Okay. When you go and you go, or I have people go, it's going to contract those muscles at the back above the tongue there. And it should elevate up and pull the uvula straight up. Right? So the uvula hangs down. And when you go, ah,

The muscles on the left and the muscles on the right should contract in unison and lift the uvula straight up, okay, away from the tongue. Now, if you have a deviation in that, that means that one side of the musculature at the throat works well and the other one doesn't. So one side will lift and then the other side doesn't lift.

So when one side lifts, it pulls the uvula sideways because it lifts it up only on one side.

So that's one that I actually look for on everyone, that if the uvula deviates to one side. So let's say that you're looking in somebody's mouth or you're looking in the mirror of your own, which you can do, shine a light in there, and you see the uvula deviate up to your right. So that is the functional, that's the good side.

The low side is the side that there's not much happening there. So that can indicate an issue with, in that case, it would be left vagus nerve issues. Probably low, they call it low tone. Tone is basically the ability for a nerve to send and receive a signal. An electrical impulse is called signalization that comes from your brain.

to a target and back from a target. That's a person that would likely have vagus nerve issues on that one side. Now, that's really important to understand because if you have vagus nerve issues on one side, remember, that's parasympathetic, right? That's supposed to decrease sympathetics. It's supposed to help lower sympathetics.

What if that vagus nerve doesn't work well, in this case, on the left? That means your left sympathetics work too much.

That's a person that may have issues where they always have pain on just one side all the time. My left shoulder, my left elbow, my left knee. That's not a usual compensation pattern for pain. When the body has issues where it's trying to help fix itself, it zigzags. You know, it lowers this here, it tweaks it up there, it goes bing, bing, bing, bing. If you have all issues on one side, you're

That's brain and nervous system, my friend, straight up. OK, so sometimes what will happen is that people say, I can't see it lift really at all. Well, then that means you got two vagus nerves that don't work well.

left or right. So that's the stuff that you can look at. And why does that matter? Because that's going to make an influence all the way down to your toes, man, because that's a parasympathetic state and you can be locked in more of a sympathetic state. So in order to help people heal from injuries, you need to understand where are these cysts, where is the real estate for these systems? Like where do they live?

Why does that matter? Because if you have inflammation along your thoracic spine, because you have poor mobility in your thoracic spine, why might you have inflammation in your thoracic spine? Because you have poor mobility in your spine. When you have poor mobility in your spine, you have poor movement. When you have poor movement, you don't get good move. You don't get good fluid flow in those areas. And then you get inflammation and that inflammation happens.

stimulates the sympathetic nervous system. And then you feel it everywhere else, everywhere. So you have to help the thoracic and you can do that many, many different ways.

One, you can do a lot of thoracic spine, rib cage, mobility drills that just start to pick some that you might see on YouTube. I know you've shown a lot of different great things and you'll probably have some of that in your course. You can certainly see a professional to get you some good rib cage motion in there. I mean, there's a lot of great techniques out there that can help you with whatever

rib cage motion. Okay. What I like to use is my two favorite things, honestly, are vibration and red light. So I have people just use a vibration massage ball. That's probably my favorite therapeutic tool. Just use a vibration massage ball along the entire thoracic spine and then throw some red light on it for about 20 minutes. You're going to feel a difference.

And like everywhere, because you're just starting to settle things down and get more motion, you know, because we don't really pay it. Nobody really pays attention to the thoracic spine because it usually just doesn't hurt. And the other one that you can pay attention to is the brainstem up top here. That's where the parasympathetic. Now, here's probably one of the most important things. The upper thoracic spine.

thoracic one through thoracic four, T1 through T4. So if people are watching on video, they can see me here. If you're listening, this is the one where people get this big, giant, puffy hump at the top of the neck. It's called a Dowager's hump. And it looks like there's fluid in there sometimes. It means dignified elderly woman, Dowager. Yeah. Or if you're watching me on video, most people, when I told you before about posture, they round forward,

The mouth is open because of poor breathing. They're looking down at a phone and the head translates forward. So this is how people look. And this gets massacred, that upper thoracic, because what happens is that your tongue should be at the roof of the mouth, the tip, the middle and the back. Your mouth should be closed. You should be breathing in through your nose. That'll pull your head back.

centered more over your spine. It'll open up the back of your head at your occiput to allow your vagus nerve to travel more evenly down your neck. And you're not gonna choke off blood flow to your brainstem in the back, but you're gonna alleviate pressure at the top. Now, why does that matter? 'Cause where I'm gonna send it home. The upper thoracics T1 through T4 is the sympathetic fight or flight, basal spasm, basal constriction control for the head, neck and face.

Those are the people that get stuff up here all the time and they do everything up here. I get headaches all the time. I get nerve pain all the time. I get burning tongue stuff. I got my neck doesn't hold anything. That's because you have to go a little lower, right? So you work on those upper thoracics and that's because that's where the signal comes from.

It goes from here, then it goes to the neck, and then it goes up. It's the relay station. So what you need to do is you just need to see people know about

You should have good thoracic spine mobility. You should have good rib cage mobility because it's going to make you a better athlete. You're going to get great rotation and you get transverse playing because that's where power lives. So I can throw or punch or kick. And that's great. But that's not the big reason why I'm looking there.

The biggest reason I'm looking there is because I know that that's the place where you need to work if you stand any chance whatsoever of controlling chronic inflammation in the body. If that area is a mess, I will tell you right now, you do not stand a chance. It's not happening. It's just physiologically impossible. So it's a big thing to work in that region, and it doesn't take much.

And you'll notice things pretty quickly, honestly, and how you're feeling. Trust me, you will. Is that something that is why that's so such a massive culprit or foundation for inflammation? Is that because of impingement on specific nerves or is it because I'm sure it's a combination or is it because of pressure dysregulation as a product of like the thoracic inlet?

kind of being closed off and that's sending, you know, dysregulation of pressure through the whole body. Not so much impingement because impingement, that's pretty acute. You'll really feel that. Very hard to move. That's more of a dysregulation on the pressure because

What we didn't talk about is the pressure from your breathing also moves the fluid that coats your brain and your spinal cord called your cerebrospinal fluid. So if you have dysregulated breathing, your brain and spinal cord fluids flopping all over the place and stagnated. The biggest thing that you're impacting in all those regions is fluid flow. You have to remember that your spinal cord has a lot of blood flow to it and away from it.

And it has lymphatics. And it has the nerves that surround it, sympathetic nerves.

So what happens, honestly, is you just get trapped inflammation in that region because of excess tension. And I posted on my Instagram today that tight tissues don't accept blood flow well. And what happens is stuff gets stagnant. And then when it gets stagnant, I don't want to go too deep down the biological rabbit hole, but you induce inflammation and you get what's called cytokines, inflammatory proteins.

particularly interleukin number six. And trust me, that one's going to make your life miserable. And then what usually happens in the chronic pain people is that the inflammatory cytokines travel up into the brain and that's how they get up there. And then it goes back and forth.

So it's more just lack of motion of the fluids in and out. You get trapped inflammation. And then that's when the pain begins to show up somewhere. Just concentrating on there. And like we said earlier in the show, create space. I don't care how you do it. Just know you should be doing it.

So it seems inseparable to create, we need to both address the structure of the body as well as the body.

function or like having specific breathing techniques are very supportive and they can kind of like soften the structure to create space to create change. And we also need to stack that with integration of better movement patterns. Yeah, because it all works together, right? So you'll have, you'll have it where the structure of the body is,

can influence where fluids move, right? Does that make sense? Because that's like if I have a rock in nature, that's going to influence where fluid moves. But it also goes the other way. When you've had stagnated, poor fluid flow for a long period of time, you get inflammation and that causes fibrosis. And it changes the shape of cells themselves, right?

So what happens is the poor fluid flow also influences structure. It's both. So that's why the work in the structure is great. And then working the breathing pattern, because now you're going to change these flow routes and change things in the body. And then because I always ask people, I mean, what the hell are you breathing for in the first place? Like, why are you breathing?

Because you're trying to get oxygen in the body, right? Because if not, you're dead, like quick. And so you have the oxygen. And then that's when the next question is, well, how's the oxygen going to get to where you want it to go to? And then your next answer should be blood flow. And then I'm going to say, what happens if your sympathetic nervous system is stuck in fight or flight and your blood flow is constricted? How well is that going to work out for you? It's not.

And then I say, but what if we help free up your ribcage and I teach you a breathing technique that can actually help calm your sympathetics? And we just freed up the tension in space so your blood flow can move. Do you think you might feel a little bit better? Yes or yes? Yeah, it's good. Yes, you are. So to trace it back, in my world, the number one cause of chronic pain and chronic disease is chronic inflammation.

And chronic inflammation happens when you're stuck in hypervigilant sympathetic dominance for too long and you can't get out of it. And breathing is one of the best ways that you have available to you that you might not have known to help you decrease that. It's an absolute life changer. So good. Thank you so much, man.

You're welcome. I appreciate making time for this. Where can people go to learn more about your stuff? Or is there any suggestions you'd have of like, where could folks be pointed if they want to go deeper into your work or just anywhere in general that would like to point people from here? Well, first of all, I'd like to just sincerely thank you very much, my friend, for having me on your show so often. I really always enjoy our conversations and I'm grateful for your listeners that

They like some of the things that I talk about. So thank you very much. I'm pretty easy to find. I've been doing this for quite a while. All you have to do is type in stop chasing pain on any search engine or social media platform, and then I'll show up and you just kind of pull a thread and go wherever you feel like you want to learn. I have many different ways that you can learn from me, but that's how the journey begins.

Thank you, brother. I appreciate you. Thank you for tuning in. That's it. That's all. Hope you guys enjoyed that conversation. As I had mentioned briefly in the conversation, we recently have launched the Align Breathing Program. If this is before January, then you can go to the waiting list for it. If it's after January, then it's available as a free program.

to start so you get a free seven days in that trial. You will learn fundamentals on breathing mechanics that really everyone needs to know, in my opinion, and few people do. If you've ever been to a yoga class or a breathwork class, most people are breathing in a way that is actually disadvantageous for their health and can even be preposterous.

the same issues that they are coming to classes like that in the first place, such as feeling anxious, feeling overwhelmed, feeling stressed out, feeling like it's hard to sleep, feeling like they're not able to get a full inhalation or full exhalation. There is a mechanical conversation in that that is not talked about enough. And that is the purpose and function of the Align Breathing program. And we also get into principles on how to breathe more effectively.

So we break down exactly what happens when you exhale, what happens when you inhale, what happens when you hold your breath and really teaches you the fundamentals and the principles to be able to create your own breathing programs. So I'm so excited about that. If you want to check that out, go over to alignpodcast.com slash breath. That's alignpodcast.com slash breath. Breath is spelled B-R-E-A-T-H. That's it. That's all. I hope you guys enjoyed that conversation and I'll see you next week.