Asthma, a therapist’s perspective

While the causes and pathophysiology of asthma are complex and much discussed, there are a number of straightforward techniques that can relieve some of the most bothersome signs and symptoms.

Asthma is a disease of respiration – breathing. And yes, while at the tissue level the absorption of oxygen is affected resulting in very laboured breathing, the discomfort associated with this process is largely musculoskeletal i.e. Bones and muscles.

And this is the domain of the clinical therapist.

As an Athletic Therapist and Massage Therapist I treat a number of body systems, but the bones and to a larger extent the muscles, are my area of expertise. The muscles of respiration work much like the muscles of the arms and legs – except they work almost exclusively without us consciously instructing them to do their job. They are subject to the same tightness, strains and holding patterns that the muscles elsewhere in our body exhibit. However, because we are less conscious of these muscles, their symptoms of strain are often less defined but extremely worrisome when they do occur.

But herein lies the salvation! They can be treated much like other muscles and relief
absolutely achieved, usually in one treatment.

The most important muscle we use for breathing is the diaphragm. It sits like a thick umbrella spanning the torso midline and attaches to the boney structures at the lower level of the ribcage i.e. The Thorax. Diaphragm tightness can result in discomfort in this entire area, including low back pain. Digestion can be affected because the esophagus, which leads from the mouth to the stomach, passes through the diaphragm. A constricted diaphragm will constrict the esophagus.

The intercostal muscles fill the gap between the ribs. They too can be tight resulting in heaviness in respiration even when the patient is not experiencing an asthma attack at the time. The best analogy would be that of a thick rubber band wrapped around the ribcage. Another muscle group not often considered is the scalenes. These are actually neck muscles which, because they attach to the upper ribs, assist breathing in extreme situations. This is why someone who is out of breath has the urge to hold onto a fence – this enables these scalene muscles, which are in the upper body, to do their job more effectively. The scalenes are notorious for referring pain down the arm and to the chest which, if the patient is uninformed, may lead them to think they have cardio issues as well.

Hands on treatment techniques are varied depending on the muscle concerned, but very
successful regardless.

Treating the diaphragm includes a number of approaches. It is a very large muscle that may require a lot of attention. One method, which can be done seated, releases the habitual contracted state of the diaphragm. This can also be done as a self help technique for the patient to do at home. Other direct releases address the restriction of the tissues that package the muscle – tissue known as the fascia. This is very effective for the diaphragm, intercostals and the scalenes. Because the neck is a very mobile body part, the scalenes will respond well to positional releases which are very gentle and effective.

Asthma is a bedevilling condition that, if uncontrolled, can be debilitating. Fortunately
there are options available whereby relief is available – especially from complimentary health care. The techniques I employ are virtually side effect free, gentle and proven effective.

Jonathan Maister is a Canadian trained Athletic Therapist, Massage Therapist & Sport Massage
Therapist. He has been practicing for over 15 years primarily in the York Region area. In addition to a
successful clinical practice, he writes extensively & has taught courses on Sport Medicine & Sport Massage across Canada. He can be reached at 905.477.8900

Leave a Reply