Fun Facts and Heath Hacks with Stefan and Zack
● Fun fact - The margination of blood (margination of cells within the blood). Your blood is filled with all sorts of things including ions, red blood cells, white blood cells, platelets etc. The blood, as it travels through the vessels within your body, is vortexed and spiralled in its flow. This creates a separation in cells, moving some to the outside and some to the middle of the tube. This creates a structural change in the composition of the blood depending on how close you move to the walls of the vessels from the middle. RBCs stay at the center and white blood cells move towards the walls. The significance is that this allows the WBCs to be close to the vessel's tissue (endothelial cells) incase of damage or inflammation, and the RBCs close to the middle allowing efficiency in their flow (12).
● Health Hack - Cold exposure for reducing body fat/Improving Body composition. Cold exposure increases the conversion of white fat to brown fat. White fat is the fat that is more superficial seen in the lower abdomen and behind the arms and is used for energy storage. Brown fat is located around the internal organs, it is metabolically active by enhancing thermoregulation via non-shivering thermogenesis (1,2,3).


Structure of Breathing
Deep Structures:● Movements of the ribs during breathing: *generally speaking, due to so many attachments they are often off their axis - Ribs 11-12 “caliper’s” (transverse plane/Vertical Axis) - Ribs 1-2 “pump hand’s” (sagittal plane/Transverse Axis) - Ribs 7-10 “bucket handle” (coronal plane/AP Axis), - Ribs 3-6 mixed between pump and bucket handles - All of these planes allow the rib cage to maximize its expansion● Movement of the spine during breathing - The spine has both anterior curves (cervical and lumbar) as well as posterior curves (thoracic and sacral) - As we inhale, the curves of the spine become less pronounced and straighten towards the midline - As we exhale, the curves accentuate - A deep breath can help stabilize the spine and help it oppose gravity by filling the lungs with air expanding the ribs and assisting in extension or upright posture in the spine
Intermediate Structures:● Muscles: - External and internal/innermost intercostals both elevate and depress ribs respectively - Diaphragm doming (along with other diaphragms pressure influence including the pelvic, oral and sellar) - Accessory muscles (pecs, SCM, Scalenes, Abdominal wall, serratus muscles) - The mobility and tone of these muscles will impact our ability to breathe efficiently. - Muscles do not just produce one action. They create leverage from both sides of their attachment points depending on which is fixed. For example, the serratus anterior muscle which attaches from the scapula to the ribs can protract the scapula but, if the scapula is fixed (cannot move) the force of its contraction will pull on the ribs creating expansion.
● The Diaphragm: - Motion: As the diaphragm descends, it overcomes the forces drawing back from underneath only to a point when both the stretch of the pericardium from above, and pressure from the abdominal viscera below stops its descent. The diaphragm in a healthy individual still has the ability to contract further which will create an upward motion of the ribs allowing for full expansion of the thorax. This is important for pressure regulation to allow for fluid motion, air transfer and significantly aids in digestive functions by assisting organ secretions (pancreas, liver, gallbladder, etc) and gut motility - Attachments: to the ribs and spine but also to the heart, liver, small intestine and pleura of the lungs.The bainbridge reflex: The heart, being attached to the diaphragm inferiorly, gets pulled down on inhalation creating a transverse compression of the musculature and chambers of the heart. The descent increases the amount of blood returning to the right atrium through the inferior vena cava (and superior vena cava) requiring the heart to beat faster to prevent overstretching of the atrial tissues.The sympathetic nervous system compensates by increasing the heart rate to match the increased availability and pressure of venous blood. There is also a deformation of the chambers of the heart as well during decension which alters the flow of blood through the heart. This may contribute to the increase in heat rate although it is not considered a primary factor in the Bainbridge reflex (5), - Passageway: There are many important vessels and structures which pass through the diaphragm that utilize its motion to improve their function. The aorta, inferior vena cava and thoracic duct use the changes in pressure to improve their blood and lymph flow. The esophagus uses the diaphragm for motility and as a sphincter. The vagus nerve may use its changes in pressure and shape to improve its efficiency in function and axoplasmic transport. Also when physical demand increases, breathing increases, and the movement of the diaphragm changes, this may allow for important sensory information for the vagus nerve to know to shut down digestion (9,10).
● The organs of our body have connections through ligaments and soft tissues to the musculoskeletal system. This has implications to how each function within the motions of the other. They compensate for the movement restrictions of the other.
● The lungs: - Sit in the chest cavity - Pleura (vacuum ceil): consists of two layers. The parietal pleura lines the thoracic wall in conjunction with deep fascia and muscular fascia. The visceral pleura surrounds the organs themselves. There is then a pleural cavity in between these layers that has fluid. → These layers allow for glide and movement of the tissues. → The two layers of pleura slide effortlessly along each other but there is also a surface tension from the pleural fluid that strongly resists their separation. This allows them to expand and passively recoil closely with the thorax. The pressure within the pleural cavity, the intrapleural pressure, must remain negative to avoid lung collapse. → There are two forces which pull the lungs into a collapse. The first is a pressure within the lungs called the intrapulmonary pressure. This pressure changes with the movements of the thorax so that air may come into the lungs actively and out passively during inspiration and expiration respectively. This pressure must remain higher than the intrapleural pressure or the lungs will collapse. There is also a surface tension created by the alveolar fluid within the lung that acts as a suction cup. This force pulls to collapse the alveolar sacs. The lungs have type 2 alveolar cells which produce a substance called surfactant which works the same as laundry detergent to decrease the polarity of water and therefore decrease the surface tension of the alveolar fluid. Deeper breaths stimulate these cells to release more surfactant.
- Conducting and respiratory zones of the lungs → The conducting zone is all of the respiratory passageways from the nose to the respiratory bronchioles. These provide structurally rigid tubes so that air may reach the gas exchange sites. These structures also cleanse, humidify and warm incoming air. As a result, the air reaching the respiratory zones is cleaner (less dust, bacteria, etc.), warmer and more damp than when it entered the body allowing it to be better “absorbed”. → The respiratory zone consists of the respiratory bronchioles, alveolar ducts and alveoli. This the actual site of gas exchange, at the ends of these passageways. → This is why taking deeper breaths allows for greater gas exchange, because the respiratory zones are at the ends of the passageways. This decreases “anatomical dead space” or the amount of air not coming in contact with the gas exchange sites. → The nose is better at warming, humidifying and cleansing the air then the mouth is due to its internal structure (nasal meatuses, conchae, vibrissae, etc). Also exhaling through the nose allows for more moisture and heat to be recaptured so that we do not have to waste more energy creating heat and lose more hydration.
● The sympathetic chain has their ganglia or cell bodies located just anterior to the rib heads. This means motion of the ribs will influence the stimulation/inhibition of the fight or flight nervous system.
Superficial Structures:
●  The fascia which is not just superficial but connects all the way down to deeper structures● Fascia: properties of fascia are plasticity, piezoelectricity, viscosity and elasticity. This tissue has the ability to change its structure over time to become more rigid or allow more fluid movement (4).● This means the fascia can influence the thoracic mobility and the bodies ability to breathe efficiently● Some of the many potential structural relationships of fascias to breathing include: - At the diaphragm’s central tendon, the fascial connections functionally relate to the lungs by the parietal pleura and the heart by the pericardium. The parietal pleura fascia also connects with the inner aspect of the scalene muscles which are muscles of the neck and upper ribs which act as accessory breathing muscles. This connection shows a relationship between the diaphragm, heart, lungs and neck structurally (6). - The scalenes can decrease the elasticity of the lung pleura with their reflex contractility. This can then compromise coordination of the diaphragm, Transverse Abdominis, and the pelvic floor musculature and fascia. This could result in change of the lumbo-pelvic stability through inefficient inter-abdominal pressure (7). - The attachments of the diaphragm to the lumbar spine (crux) connects with the fascia of the iliopsoas. This means the diaphragm is structurally connected to the lower limb, influencing gaite. The descending psoas also connects its inferomedial fascia to the fascia of the pelvic floor. This means the diaphragm has influences on the pelvic floor top down and bottom up (8).


Stability Vs Mobility
● Inhalation gives a greater amount of stability to the ribcage and thereby the spine through inflation of the lung tissue, helps to support against gravitational forces. Weakness in some of the “core” musculature could require a recruitment of a breath during movement, lifting or holding posture which can lead to altered breathing patterns over time and changes in posture - Can over inflate lungs and ribcage causing limits in global flexion and broad chested appearance, can also lead to limits in rotational motion - Over emphasis of abdominal breathing can likewise affect overall posture by limiting the tidal pattern of extension in the spine with inhalation into the ribcage. This can lead to changes in posture and encourage flexion in T spine ● Exhalation coupled with flexion/inhalation coupled with extension→ having good mobility in the ribs cage will allow for more mobility in the spine and vice versa - Inhalation = counter nutation of Sacrum, relative flexion of the lumbar spine, relative extension of the T spine, relative flexion of the C spine - Exhalation = nutation of the sacrum, relative extension of the L spine, Flexion of the T spine, Extension of the C spine● Rib motion is required for force absorption and for rib thoracic vertebrae independence. If ribs can't move, this will impact the vertebrae movement and force distribution. Same the other way around, if the vertebrae is stuck flexed or extended, the ribs lose ability to move (pinches rib head in place)


Structural Importance
● As personal trainers, manual therapists or even for your own body, the structure is what we have access to. It is important to also think about how our structure impacts our function.



Resources:
Tensile network of fascia


References:
1. Buijze, G. A., Sierevelt, I. N., van der Heijden, B. C., Dijkgraaf, M. G., & Frings-Dresen, M. H. (2016). The Effect of Cold Showering on Health and Work: A Randomized Controlled Trial. PloS one, 11(9), e0161749. https://doi.org/10.1371/journal.pone.0161749
2. Brown adipose tissue Recent insights into development, metabolic function and therapeutic potential Kristy Townsend &Yu-Hua Tseng Pages 13-24 |
3. Cold-Activated Brown Adipose Tissue in Healthy Men List of authors. Wouter D. van Marken Lichtenbelt, Ph.D., Joost W. Vanhommerig, M.S., Nanda M. Smulders, M.D., Jamie M.A.F.L. Drossaerts, B.S., Gerrit J. Kemerink, Ph.D., Nicole D. Bouvy, M.D., Ph.D., Patrick Schrauwen, Ph.D., and G.J. Jaap Teule, M.D.,
4. https://www.tamiapland.com/blog/2018/7/26/collagen-mechanical-properties-of-fascia
5. Pakkam ML, Brown KN. Physiology, Bainbridge Reflex. 2020 Jul 10. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 31082061.
6. Myers, T.W., 2009. Anatomy Trains, second ed. Churchill Livingstone, Edinburgh.
7. Richardson, C., Hodges, P., Hides, J., 2004. Therapeutic exercise for lumbopelvic stabilization, second ed. Churchill Livingstone, Edinburgh.
8. Gibbons, S., Comerford, M.,Emerson, P., 2002. Rehabilitation of the stability function of the psoas major. Orthopaedic Division Review Jan/Feb, 7–16.  
9. Chighizola M, Dini T, Lenardi C, Milani P, Podestà A, Schulte C. Mechanotransduction in neuronal cell development and functioning. Biophys Rev. 2019 Oct;11(5):701-720. doi: 10.1007/s12551-019-00587-2. Epub 2019 Oct 15. PMID: 31617079; PMCID: PMC6815321.
10. Wang SZ, Li S, Xu XY, Lin GP, Shao L, Zhao Y, Wang TH. Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. J Altern Complement Med. 2010 Oct;16(10):1039-45. doi: 10.1089/acm.2009.0577. PMID: 20954960.
11. Marieb, E. and Hoehn, K., 2016. Human Anatomy & Physiology. 10th ed. Pearson Education Limited, pp.425.
12. Fedosov DA, Gompper G. White blood cell margination in microcirculation. Soft Matter. 2014 May 7;10(17):2961-70. doi: 10.1039/c3sm52860j. PMID: 24695813.