The value of blowing up a balloon

Abstract

Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. A therapeutic exercise that promotes optimal posture (diaphragm and lumbar spine position), and neuromuscular control of the deep abdominals, diaphragm, and pelvic floor (lumbar-pelvic stabilization) is desirable for utilization with patients who demonstrate suboptimal respiration and posture. This clinical suggestion presents a therapeutic exercise called the 90/90 bridge with ball and balloon. This exercise was designed to optimize breathing and enhance both posture and stability in order to improve function and/or decrease pain. Research and theory related to the technique are also discussed.

Figures

Figure 1.

Sagittal view of the Diaphragm. Note the psoas pull on the spine contributing to increased lordosis and faulty rib position. Copyright © Kyndall Boyle, 2007, used with permission

Figure 2.

Sagittal view of Postural Alignment associated with optimal and sub-optimal Zone of Apposition (ZOA) of the respiratory diaphragm. Optimal ZOA is depicted as a dome shaped diaphragm with bony segments in an ideal plumb line position. Suboptimal ZOA is depicted as a more linear/flat diaphragm and bony segments not in an ideal plumb line position, demonstrated by an increased lumbar lordosis and rib external rotation/elevation. Note the effects of suboptimal ZOA on the thoracic and cervical spine positions. Copyright © Postural Restoration Institute™ 2009, used with permission

Figure 3.

Instructions for Performance of the 90/90 Bridge with Ball and Balloon: 1. Lie on your back with your feet flat on a wall and knees and hips bent at a 90-degree angle. 2. Place a 4-6 inch ball between your knees. 3. Place your right arm above your head and a balloon in your left hand. 4. Inhale through your nose and as you exhale through your mouth, perform a pelvic tilt so that your tailbone is raised slightly off the mat. Keep low back flat on the mat. Do not press your feet into the wall, instead pull down with your heels. 5. You should feel the back of your thighs and inner thighs engage, keeping pressure on the ball. Maintain this position for the remainder of the exercise. 6. Now inhale through your nose and slowly blow out into the balloon. 7. Pause three seconds with your tongue positioned on the roof of your mouth to prevent airflow out of the balloon. 8. Without pinching the neck of the balloon and keeping your tongue on the roof of your mouth, inhale again through your nose. 9. Slowly blow out as you stabilize the balloon with your left hand. 10. Do not strain your neck or cheeks as you blow. 11. After the fourth breath in, pinch the balloon neck and remove it from your mouth. Let the air out of the balloon.12. Relax and repeat the sequence 4 more times. Copyright © Postural Restoration Institute™ 2009, used with permission

Figure 4.

Transversus Thoracis (Triangularis Sterni) muscle, located on the posterior sternum and ribs. Image from Wikipedia.com, accessed 8/16/2010.