Power of Functional Breathing | E055
We’re always breathing, so what’s the big deal, right?
Should you be aware of how you are breathing?
In this week’s episode, Evie and Toréa have the pleasure of talking about functional breathing with Dr. Andy Sabatier of Academy West Performance. For something we do over 10,000 times in a day, you’d think that we were all breathing with correct form! Shockingly, most of us are not using our anatomy in the way it was designed. In this episode you will learn what parts of our anatomy are most important for functional breathing and why this is so important for your health, for your athletic performance and for longevity.
Let’s dig in!
In This Episode
00:00 Power of Functional Breathing
01:40 Breathing is the basis for all pathology
07:15 Mechanics of breathing
11:58 The chemical and emotional side of breathing
17:12 Breathing as a spiritual activity
21:40 How breathing is one of the only things that can keep us present
13:12 Toréa’s favorite thing about cold plunges
34:28 Is mouth tape for everyone?
39:39 Breathing training for athletes
44:11 Where to find more from Dr Andy Sabatier
And if you enjoyed this, Dr Andy Sabatier is doing a live workshop next week on the Wellness Curiosity Collective.
Resources Mentioned
Want even more breathwork goodness? Catch up on Season 3, Episode 5: Breathwork: https://www.torearodriguez.com/wowpodcast/s3e5
Connect with Toréa
Website: https://www.torearodriguez.com/
Instagram: https://www.instagram.com/torearodriguez/
Connect with Evie
Website: https://holisticallyrestored.com/
Instagram: https://www.instagram.com/holisticallyrestored/
Join the Optimized Wellness Community: https://torea.co/Premium
Submit a Question for the Show: https://www.torearodriguez.com/podcast-question
Transcript
Toréa Rodriguez 0:08
Welcome to the Wildly Optimized Wellness podcast. I am your host, Toréa Rodriguez. And I’m joined by the lovely co host, Evie Takacs. Both of us are Functional Diagnostic Nutrition practitioners and we love working with women from all over the world, through our virtual programs, helping women not only feel better, but actually achieve that vibrant, no holds barred version of themselves, they’ve been missing for a long time, and how we actually get there. Well, that is what this show is all about. Now, please keep in mind that this podcast is created for educational purposes only and should never be used as a replacement for medical diagnosis or treatment. And if you like what you hear today, we would love for you to hit that follow button, leave a review in Apple podcast, share with your friends, and keep coming back for more. Let’s start today’s adventure shall we?
Toréa Rodriguez 1:09
Okay, everybody, welcome back to the wildly optimized wellness podcast and I am super excited because today we have Andy Sabatier and he's going to come and talk to us with us, actually, and tell us a little bit more in depth about this thing that we take for granted and both Evie and I think is very much a not talked about health technique to solve a lot of problems called breathing. So Andy, welcome to the podcast.
Dr. Andy Sabatier 1:40
Thank you so much. I'm delighted to be here.
Toréa Rodriguez 1:42
Yeah, that's awesome. I would love it. If you could give us a little bit of an introduction about how you got here and a little bit of the backstory about your company Academy West Performance. How did that come to be?
Dr. Andy Sabatier 1:56
Sure. So a little background on me, I am a doctor of physical therapy and before my career in PT, I was a bit of an athlete, I was a professional skier for a stretch and went to PT school, figuring out would be kind of parlaying that into working more in the sports and orthopedic zone. When I got to PT school, I realized very quickly that that was not the area of PT that connected with me the most. And I sort of fell in love with both pediatrics and critical care. I went on to do some of my clinical training at Stanford University, at their hospital. And when I moved to Oregon, I became the primary PT for an intensive care unit, which actually worked really well with the pediatric background. Because when people have a big enough injury, they sort of regressed to being a toddler. And if it's a massive injury, then they kind of go back to being an infant.
Toréa Rodriguez 2:42
Oh, gosh, I don't mean to laugh
Dr. Andy Sabatier 2:47
So along the way, I really found my groove, you know, as a PT in the ICU for quite a few years and changed the culture and managed to put forth a movement approach to get everybody moving, including those patients on ventilators getting them up and walking, even though they're still ventilated. That took a lot of culture change, and it engendered a lot of trust. So I'd earned a pretty good spot as kind of the the Rockstar PT within my area, and I just casually started getting interested in breathing, you know, I would give people an incentive spirometer, a little plastic device lets them see how big of breath they're taking. And I would just have them take 5 or 10 Deep breaths at the end of every session. Now, I did this for a few months, casually not knowing what I was doing, because we don't really learn a terribly large amount about breathing in PT school. And I figured I better learn what I'm talking about. Because everybody around me is telling me how great a job I'm doing all the surgeons and all the respiratory therapists and the other physical therapists and the nurses and the patients are saying, Great job, thanks for going the extra mile, I thought I don't know what I'm talking about. So I went and found some education, I found a woman named Dr. Mary Massery, who has been leading the fields of research and breathing mechanics in physical therapy for decades. And within 10 minutes of the first course that eventually turned into clinical mentorship, I realized not only have I been breathing dysfunctionally my entire life.
Dr. Andy Sabatier 4:04
But I've been coaching all of my patients to breathe dysfunctionally as well. And nobody around me is correcting it. So nobody really has this knowledge. It's kind of missing. It's missing in medicine, it's missing in sports. And so I set about to change that I started taking what I call a breathing first approach, meaning no matter who the patient is, no matter their pathology, I have to start with how you're breathing. We've got to start with your mechanics because if your breathing mechanics are functional, it's going to make everything easier, you're gonna have more power, you're going to feel better, you're going to be more calm, your pain is going to be less. And if your breathing is dysfunctional, then to me there's really no point in starting anywhere else because no matter how good a physical therapist I am, if it's your neck or your shoulder or your back or your sleep or your GI system or your balance. The second that you start dysfunctionally breathing all that good work that I did falls apart. So the first patient that I did this with was a woman who was admitted to the hospital for a pericardial window, she had to drain some fluid off her heart. Because she had terminal breast cancer, she's 36 and she was slated to go home on hospice the next day. And that's usually not a PT diagnosis, that usually means, you know, leave me alone, I'm I want to be comfortable, not get out of bed and work hard. But so you can see how hard of a time she was having of breathing. And I could see that she was on a lot of oxygen. And she was basically just sitting still in her bed gasping. And so that's what I did very first patient, I started with her breathing mechanics first, and we spent about an hour and a half getting her to feel and see and use her breathing a little bit differently than she had before.
Dr. Andy Sabatier 5:37
And when I left, I figured, I hope that worked, I don't really know. And I came back the next day expecting her to tell me to buzz off. And she said quite the opposite, she said, Andy what we did yesterday made me feel better than anything has in the last five years. I want to do this for the rest of my life and so I started my practice that day, I started this little experiment called Academy West Breathing Performance, just so I could see her legally at home and she was my only patient for for a while I saw her all the way through the end of her life. But I had her voice ringing in my ear. And then sure enough, I'd have another patient here and there and it turned into a practice and then COVID hit. And before I knew it, this is all I was doing. I left, you know, I was in the ICU for about a year during the pandemic and doing both. And then I left completely to take this practice full time and at this point have seen more than a few hundred patients with this approach where no matter where they are, no matter what they have going on. That's where we start, we capture their breathing, teach them about breathing mechanics, and then show them their breathing. And they realize oh my gosh, we're doing that 20,000 times a day. Yeah, every time. And so that gets buy in from the patient, and they start to gradually nudge their system towards a more functional state of breathing. And you know, your conscious breathing influences your subconscious breathing. So it doesn't take that many breaths, you know, you can use as few as 30 breaths on purpose each day, to influence the other 20,000. But how we breathe is how we feel. So, you know, people start to feel a little bit better. And that's what keeps them practicing and keeps them using their functional tools. But I'm kind of getting ahead of myself.
Toréa Rodriguez 7:15
That's okay. That's okay. It's it's great, though, because we're talking about basics. And this is something that Evie and I really stress with our clients and on the podcast and and everything that we do is that we need to be able to master the basics before we can move on to the more advanced stuff and for some of us, that's as simple as like, making sure that we get outside and get sunlight on a regular basis and it makes sure that we're hydrated properly on a regular basis. And so this I mean, most people don't think about the air we breathe, they well we do we think about it. And we talked about it a lot in the health industry in terms of the toxins that are in the air, and how clean is the air and what air filter should I get. But we don't actually talk about the process by which we are breathing. And I think it's such a wonderful, untapped part of what you're bringing to the world and so, I want to ask you like, a question that I get and I think Evie gets too because we get we see a lot of patients with anxiety, right? That are dealing with running thoughts in their mind and everything else, and they're getting the panic attacks and I know enough about breathing that it's like, okay, if we slow down the rate of your breathing, you can stop the panic attack in its tracks, which is great. But then that doesn't prevent them from getting it again, that's where you step in. So, yeah, tell us about so like, what, what goes on with anxiety? Like how, how do we get to the anxiety state just through not being aware of our breathing?
Dr. Andy Sabatier 8:53
Okay, great question. And it's a massive answer. So I'm going to try to kind of synthesize a lot of things into a simple package.
Toréa Rodriguez 9:00
Great.
Dr. Andy Sabatier 9:00
So breathing is simultaneously physical, chemical, mental, and emotional. So physically, dysfunctional breathing, we're basically going to break breathing down into two categories, dysfunctional breathing and functional breathing, functional breathing comes down to 10 words. And that means using your system in an optimal way. Basically, kind of how it's designed. If you want to take the take that word and use it. Dysfunctional breathing is an inefficient, ineffective use of that system. So imagine you're driving a vehicle. If you were to just get on the highway and keep your vehicle in first gear and keep the E-brake on it would not be operating very functionally. That's kind of how dysfunctional breathing works. We have all these different muscles.
Toréa Rodriguez 9:39
And that vehicle got stuck in first gear by the way.
Dr. Andy Sabatier 9:43
I bet it didn't last long.
Toréa Rodriguez 9:44
That required the whole transmission overhaul.
Dr. Andy Sabatier 9:49
Think of your breathing, not about lungs, not even about air. Think of it about movement. Okay? The muscles and structures that accomplish our breathing stretch from the nose to the base of the skull to the tips of the shoulders wrapping around the thorax, wrapping around the abdomen all the way to the bottom of the groin. It's more than 100 muscles and structures that work in coordination to manage all these different pressures in your body. Those muscles also can send signals to your brain. And the pattern with which you breathe send signals to your brain as well. So when we're breathing primarily with the abdomen, and then the chest, we expand the lower part of the lungs first, those have receptors in the lung fields for our autonomic nervous system that's going to be the rest and digest or the fight or flight, the bottoms of lungs, where most of your loans are, that correlates to your rest and digest. So when you breathe deep breath, first with your abdomen, expand the lower part of your lungs, you tell your brain everything's okay. The opposite is true with the upper part of the lungs. If you breathe vertically, if you breathe up with your neck, chest and shoulders, which often happens when we breathe with mouth, the faster you send the opposite signal, you send a signal to your brain of panic and fear because you've expanded the upper part of the lungs. In addition, our neck and shoulders play a really big role in this. So our neck and shoulders are upper trapezius muscle, that's our shoulder, shrug your muscle and then the sternocleidomastoid, that's going to be the head turning muscle. These two muscles are not wired into your spinal cord. In fact, they're the only muscles below your face that don't connect to your spinal cord. Instead, they connect directly to your brainstem, I don't know if you can hear that,
Toréa Rodriguez 11:22
Totally can.
Dr. Andy Sabatier 11:23
Making shoulders jump,
Toréa Rodriguez 11:24
So good.
Dr. Andy Sabatier 11:25
Yeah. So think about if somebody were to just come up right behind you and clap their hands, the first thing that happened is your shoulders would come up and your head would turn, right that's our startle reflex, very old reflex is one that we can't get rid of. So when somebody is moving those muscles in their neck, chest and shoulders, it's actually sending a little signal of pain and fear and stress directly to the brainstem. So someone who's having a panic attack, who's told just breathe, can open their mouth, breathe vertically, use their neck, chest and shoulders and actually make things worse.
Toréa Rodriguez 11:57
Oh, fascinating. Okay.
Dr. Andy Sabatier 12:01
So that's the physical side, the chemical side is that breathing faster, more shallow breaths, lowers carbon dioxide. You know, carbon dioxide is that thing that we breathe out, we breathe in, we get an oxygen we breathe out, we let go of co2. So if you were to hold your breath, co2 builds up and it makes you feel pretty stressed out makes you feel like you're suffocating. So co2 is simultaneously this thing that can make us freak out. And it's also the thing that can make us calm down. Because somebody is breathing really fast, chronically dysfunctionally breathing, means they lower their overall co2 levels all the time. So anytime they get a little increase in carbon dioxide, they feel all kinds of things, they feel panic, they feel fear, they feel shortness of breath. Because the oldest trick in the world for somebody having a panic attack, it's been used for like 100 years, is give them a paper bag. The reason that works is because somebody puts a paper bag up to their mouth, and they breathe in and out of it. They exhale carbon dioxide, and then they breathe it back in, and they exhale and breathe back in. And that co2 lowers their heart rate. It opens their blood vessels. It's their natural anti inflammatory, it kind of calms them down. So simultaneously, this thing that we feel like, I can't tolerate it, thing that makes us feel short of breath and anxious and tense is actually the thing that our body needs.
Dr. Andy Sabatier 13:17
So by teaching somebody to slow their breathing down all the time, not just slow it down, but make it deeper and more functional. They're gaining more tolerance to carbon dioxide. Somebody can train themselves to hold their breath for like, five minutes before they even do brain damage this free divers do. But we can also train our bodies to not tolerate co2 at all, which is what people with dysfunctional breathing do and panic and anxiety, because they walk around breathing shallowly all day, so their co2 remains low. So we gradually train them to basically do the dishes while breathing slowly take a walk while breathing slowly, all of a sudden their co2 tolerance starts to go up. So it's the chemical side. The mental side is, what are you saying to yourself? What's the dialogue in your mind, because when you're in that fight or flight state, you're saying things that have to do with shame and guilt and fear. When you're in that rest, digesting grow mode, you can access more of the joy, love purpose, kind of calming yourself down the way that you would want to be calmed down if you were like a five year old kid. And then that leads to the emotional side. Dysfunctional breathing and functional breathing allow us to feel different emotions and feel emotions differently.
Dr. Andy Sabatier 14:25
So when you're breathing dysfunctional, you're basically in that fight or flight mode. It's like tunnel vision. So you can only see what's right in front of you. And it makes you panic even more. Most human emotional responses, lasts 30 to 90 seconds. So all you're trying to do is manage those 30 to 90 seconds without getting worse. Because that's actually what people do is they escalate 30 seconds and this motion, and then this one, and then this one, and then this one and then this one, and you can even hear my voice. It actually makes anybody listening more tense, than that same time. They can calm themselves down and manage that window and all of a sudden, they can shift out of that fight or flight mode. Lower that threshold for stress, just, you know, just the shade. And all that, excuse me raise that threshold for stress, just a shade. And all of a sudden, they've got access to different emotions. So I like to tell patients, biologically speaking, you breathe, how you feel, you feel how you breathe. So if you can control what your breathing is doing, you can actually influence how you feel when you need to do, which is in that panic attack mode.
Toréa Rodriguez 15:25
What I was saying is, that's really cool. And thank you so much for that detailed description of anxiety and all the different mechanisms that are going into that state of leading to a panic attack. And it's fascinating because of course, Evie and I really work with our clients in terms of what are these thoughts that you're constantly having, and maybe we need to work on changing some of those thoughts that you're repetitively repeating to yourself over and over again. But to know that we can start to shift some of these things from the neuroscience way of if we are breathing in a correct fashion, we're also sending signals to the brain to be able to elicit emotions that aren't necessarily in anxiety and panic and worry and freakout. That's what you're saying, right?
Dr. Andy Sabatier 16:15
Yeah, well, in a way, okay. You and I've had enough conversations offline. And I know that that Evie and I, we're just kind of getting to know each other. But one thing to learn about me is that I really care about the language. And you will never hear me say to somebody that they're breathing incorrectly, they're breathing. They're breathing improperly, they're breathing badly. All of these imply judgment. And, you know, to the point that you said about the things that we say to ourselves, in our head, we judge ourselves enough. There's enough judgment going on, if I could read everybody's thought bubbles, there's some pretty terrible stuff going on. And we're actually never going to lose that judge, that judge is always there, the judge that that sort of got installed by, you know, whatever we kind of went through in our childhood for seven, which sort of hardwires how we talk to ourselves. So that voice is always there. So I'm gonna give people a different voice, I'm gonna give him some some different tools, or how to talk to yourself, how would you talk to yourself if you're trying to be supportive, but at the same time, I'm never ever going to tell them that they're breathing wrong.
Dr. Andy Sabatier 17:12
Because if you're alive, you're breathing, right? I've seen enough people die. I've seen enough people, you know, in the ICU, go through the end of their life. And, you know, if you if you're breathing, it's a success. It's a celebration of the fact that you are alive, no matter what you're doing. But asking them to shift that idea of, am I breathing functional, because when it comes down to it, I can give you all the knowledge in the world. But it's your breathing. Nobody can do it for you. I mean, you're in the ICU. Yeah, we can intubate you. And that's a conversation I've had with a lot of people to try to get them to understand that this is something that you get to own. It's not me, it's not your physician. It's not your respiratory therapist, it's your breathing. And it's your breathing, because you're breathing. And it's amazing. And it's empowering. And it makes you have to be accountable. But at the same time, it gives you this thing, this thing that you can control, because every single muscle that we talked about all the way from the top of your shoulders to the bottom of your groin is under your conscious control. So when you can control your breathing, you now have agency, you have agency over pain control over your heart rate, over your digestion, over your emotions. And it's literally with you all the time. This is a this is probably what made that first person say that to me, you know, this is the reason I felt better than I have in five years is, all of a sudden, something that she's doing is having an effect. It's not a medication. It's not a surgery. It's not a procedure. It's not something anybody's doing to you or for you, it's done by you and in you. And it's it's why there's such a connection to breathing and spirituality.
Dr. Andy Sabatier 18:52
You know, this is so far from my zone, right? I kind of came in the back door to understanding that breathing is important. You know, a lot of people come here through meditation and mindfulness and wellness and yoga, all terms that really frankly, make me uncomfortable, including wellness. I came here through shock and grief and death every day. And just happened to back into the idea that this thing is not only helping my patients feel better and healing them, but it's healing me as well. You know, the root of the word spirit is the Latin word Spiritus, which is Latin for breathing. So anything can be a spiritual activity, if you're focused enough on your breathing, a walk through the park, laying down totally still, you name it. If you're focused enough on your breathing, you can't focus on anything else, including that negative voice in your head that's telling you stories about the future in the past those thoughts, they're invasive. Your breathing is a sound, your breathing is a sensation. And if you can walk into that thing, you're gonna get somewhere. One of the things that used to drive me crazy when I'd hear about meditation and say like clears your mind. Yeah, that's impossible. Just You know, we have, you know, we take 20,000 breaths today we take 70,000 thoughts in and out of our mind every day. So to ask yourself to not think is impossible. But to arrange your autonomic nervous system in such a way that it can let those thoughts kind of pass by and receive them and still come back to this thing that's happening right now, you breathing. That's kind of a magic trick, you know, thoughts or stories about the future and the past, breathing is only happening right now. And if you can feel it, and you can hear it, and focus on it and understand it, and kind of own it, you've got, like the speed pass, to calming down and feeling in control again.
Toréa Rodriguez 20:41
Yeah, it's pretty empowering. Actually, I can just imagine how many of your clients have been empowered by the work that you do with them, from giving them those tools.
Dr. Andy Sabatier 20:53
I think the one thing I'll say about my patients is that they are as varied as you can imagine, you know, everywhere from COVID, to professional athlete, to professional patient, you know, 30 years of pathology going from one provider to the other provider looking for all kinds of different solutions to their problems. Through everyday kind of weekend warrior doing a bunch of different things at the same time. surgical, medical, performance wise, totally spiritual person, completely not spiritual person. It's, it's appropriate for any human being who is curious, who is motivated, or who is suffering. And frankly, after the last few years, we're all suffering. And that's pretty clear.
Evie Takacs 21:40
One of the things that you've touched on that I really that Toréa and I talk a lot about, and really what drew me into focusing in on breath is just that it is something that it's one of the only things that actually keeps me in the present moment, like you were talking about, you know, the thoughts will take you anywhere and everywhere. And so that's one thing that I really, that's one thing that draws me to continuing to, you know, work on breathing and being conscious in trying new modalities and learning more about it is because it's one of the only things that just silences everything else out. And so I think when people get a taste of that, then they buy in, because a lot of times I've heard people say, Well, why do I need to work on this, like, I breathe all the time, like I'm, I'm breathing right now. And so it's like this, there needs to be this buy in almost. And once to me, I've noticed that that is the experience for a lot of people is when they get that experience of how the whole world went silent. And all I did was breathe, and I feel so much better. Like that's that switch for them. Because Toréa and I know that and that's why we do it. And that's why like another thing that we have taken with the breath work is, you know, I got into doing cold plunges two years ago, right. And it's like, for me, everything is silent once I'm in there, because all I'm doing is focusing on my breath. So again, it comes in different modalities, like you said, but that's the biggest takeaway for me personally. And once I see clients get in on that, I'm like, Yes, this is why we focus in on it. And you're gonna have all the sciency reasons why we need to do it. But for you know, the layperson, like this might be the only time for them where they feel like they're in control of something.
Dr. Andy Sabatier 23:11
So what I liked, what I liked about what you said was that it's an experience, because oftentimes, you know, I can educate somebody about their breathing, and then that's great. But until they get an experience, even if it's short, where they can feel something different. That makes a difference. Now, I do want to circle back on a couple of words that you used, because you use two of my least favorite words.
Dr. Andy Sabatier 23:34
Oh, okay.
Toréa Rodriguez 23:34
Oh here we go. I knew this was coming.
Dr. Andy Sabatier 23:38
Right and you walked right into my spider web.
Toréa Rodriguez 23:40
Sorry Evie I didn't give you a warning.
Evie Takacs 23:42
Okay.
Dr. Andy Sabatier 23:43
Here we go. This is good.
Dr. Andy Sabatier 23:44
And I'm and you'll get an insight into how crazy I'm here. Okay. So, two words, that you will rarely if ever hear me say, breath and work.
Evie Takacs 23:58
Okay.
Dr. Andy Sabatier 23:58
So here's why. Let's say work. First of all, who wants to work? Like, nobody wants to work? I don't want to go to work. I love what I do, and I don't want to go to work. Okay, so the second that you start calling something work, you lose a lot of people. Time to work. We got to do the work. You're not doing the work. You now. Correct. So thrown out work. Now breath. This one is the one that's like my pariah i, this drives me nuts. So typically, we use the word breath, which is a noun, right? It's a thing it has. It has a beginning and an end. It's finite. We take 20,000 breaths each day. Here's one breath. There's another breath. Right? Oftentimes, we're using this term in these situations, out of breath, shorter breath, losing my breath. None of those are accurate, because if you're out of breath, you're actually dead. Right? I've seen plenty of people who are out of breath and trust me, you're not. We also say things like bad breath. Like that's talking about the smell of my mouth. That's totally not what you we're talking about there.
Dr. Andy Sabatier 24:20
That's a whole other term. That's Halitosis folks.
Dr. Andy Sabatier 25:06
So probably the most problematic way that I hear used is the breath, the power of the breath. Because that evokes this image that it's somehow separate from you. And your breathing. Because you're breathing. Yeah, but the breath evokes this like mystical image, this thing that's like, hiding at the top of some cloudy staircase, like, it's impossible to get to that I have to like work to get to hence breathwork. And breath work is a really vague, nonspecific term for basically anybody out there that's peddling something about breathing. There are people that are trying to help that are doing breath work. There's also people that are trying to make money doing breathwork. And I've only had a tiny little bit of experience in this zone, because I'm, like I said, I kind of backdoored my way in here, right? I'm kind of coming from the science background, like I never had any of that. But I went to a breathwork thing. Because I was invited there, I was in an article with a local fella who does breath work, that's what he does, he has 300 people laying down in a convention center room, hyperventilating for 29 minutes with their mouth open. The complete opposite of what I do, I spent my entire career in the ICU trying to get you close your mouth and stand up because life is up here. And I did that I trusted, I went there, and set off a three month stretch of cluster headaches. Because doing that can actually do all kinds of terrible things to your body. I'm not saying there are people that gained some healing from all these different practices of breathwork. But what I'm finding is that the language that's being used is either non existent, it's saying, trust me just breathe. Or it's giving incomplete explanations like saying belly breathing, or that kind of thing, which nobody's trying to harm. But I have patients who have been re traumatized by breathwork. I have patients who have actively done years worth of harm to their body because of what they learned in breathwork. Right, I had one patient that he had these two strokes about 10 years apart, they're like, Jeff, it's really important that your belly breathe. And so that's what he did. He locked his chest in place, and he breathed with his abdomen for a few years. And now he's shaped like a sea and he can't swallow.
Dr. Andy Sabatier 27:36
Because that's an incomplete oversimplified version of a complete explanation for breathing. Now, I know that not everybody's trying to do what I'm doing. I know I'm the only PT that's like, beyond obsessed with breathing and how we talk about it and how we feel and how we use it and, you know, see it. But if I can pick off one thing after another after another after another, that's keeping this thing a problem. It's specifically how we talk about it. So the first step that I take with any of my patients is I want you to lose the word breath. And try to substitute the word breathing. Because breathing is a verb. It's actually technically a noun and a verb. But it's implying that this thing is ongoing. You're breathing, you're breathing, I'm breathing. And guess what, it's my breathing. And it's your breathing. It's not your breath. Right? So they get that idea, oh, this is an action. This is a movement. This is something I'm doing right now. And now they start to see, okay, 20,000 times a day, I've got this opportunity to make an impact, rather than, Oh, I lost my breath. Where is it? Which one were we talking about? You know, all those little things, I think add up to either a greater understanding of breathing or a gross misunderstanding. So that would be my I'll step off my soapbox of language. But yeah, I'm all about. I'm all about breathing. Definitely not about breath work.
Evie Takacs 29:07
So you probably don't like the book breath by James Nester.
Dr. Andy Sabatier 29:11
Interestingly, I love that book.
Evie Takacs 29:12
Oh, just not the title.
Dr. Andy Sabatier 29:14
Correct. Well, and here's here's my take on breath. I so I got a chance to talk to James Nester right before the book came out. People had sent me this article that appeared in NPR and the Wall Street Journal and same day and most of the time people send me stuff and it's usually junk. You know, it's, it's, it's one nonsense article after another, I got this. And I was like, wow, this person is writing about something that I care about a lot. And he's writing about it well, so I tracked him down. We ended up talking on the phone. And, you know, the conclusion that he comes to at the end, I'm not gonna spoil the book for everybody, but basically this is it. Breathing is super important. And we don't know how to remember it. Like he goes to such amazing lengths to explain all All of the different physical and chemical and mental and emotional aspects of breathing. And evolutionarily like how we're evolving into a more dysfunctional breathing species ones that use that uses its mouth rather than its nose. I mean, it is. It's a super important book that I recommend to all my patients. But I basically put it to him to say, I know how to remember this. You know, the thing that is sorely lacking in his book is just a really clear explanation of the anatomy of how, how does this all work together as a system, he's got why dialed, he can tell you all these amazing reasons why functional breathing and dysfunctional breathing are important. But there's just not a clear delineation of what one is versus the other. So I gather that up in 10, words, functional breathing in the nose, diaphragm, first, chest, second shoulder stay still. So my patients that I'm like, if you can get these 10 words, you can change your life. And that book is enough to really get somebody understanding that breathing is really important, but it's just not quite enough to give them a way to change it. Because we go out there and try to just close your mouth, like he did for that impressive experiment where they, for those of you that haven't read the book, for 10 days, he and Anders Olson, cover their mouths and just breathe through their nose. And then for 10 days, they plug their nose and just breathe through their mouth. And you see all this catastrophic stuff happen, when they stop using their nose, their blood pressure goes up, their sleep falls apart, their digestion is a mess, they're angry at each other like It's wild. But if you just go out there and try to use your nose, it's really hard and frustrating. And it actually doesn't usually work. Because everything underneath that stuff that goes from your neck down to your groin, that's the stuff that really matters. And it's also the part of the body that we're not keen to talk about. Right?
Dr. Andy Sabatier 31:51
We live in a society that says suck in your gut, we live in a patriarchy that has all kinds of shame and guilt and fear around the abdomen and the chest. So our breathing structures are hidden under our clothes. They're hidden. Anatomically, it's hard to like, look down and see my breathing structures. They're also hidden, because they're a reflection of our nervous system. How somebody breeds is how somebody feels. So if somebody has a life full of trauma, it shows up in their breathing. So it gets kind of confusing when we kind of cover it all up. And it's really personal. So we don't want to talk about it. So it just becomes this cycle of oh, just breathe. Because we don't want to get into that hardcore conversation, flip all those rocks over and find out what's underneath. But ultimately, it's all wound up in how somebody breathes. And in order to fix it, they've got to be able to look at themselves in the mirror. And that is hard to do. For many people, the story we tell ourselves about the person in the mirror is often the worst possible version. So if I'm saying your breathing wrong, you're breathing wrong. And that person goes to the mirror and sees something that's wrong. Well, yeah, that's where it's gonna go. But if we can divorce that judgment, get them to understand this is what functional breathing looks like, feels like and is doing to your body. And this is what dysfunctional breathing looks like, then they start to gradually change. I don't know if I completely answered it. But I totally love that book. I just want to force him to write a second copy that has this explanation in the end. And actually, what I really want to do is write my own book, so I just gotta find it.
Toréa Rodriguez 33:20
I was just gonna say you need to write the follow up for him. Yeah. That's right. That's right. You mentioned the the experiment that they talked about in that book, which leads me to one of my questions that I had for you. So what are your thoughts on this thing called mouth taping? And is it for everyone? And could you let people know who haven't heard about mouth taping? What, what the hell is taping? And why is this such a popular thing that we're seeing lately?
Dr. Andy Sabatier 33:51
Okay. Mouth taping is the practice of closing your mouth with some kind of tape or adhesive or what have you at night while you sleep. The idea is that a lot of dysfunctional breathing happens at night, when somebody just hangs their mouth open, which increases the respiratory rate, and it increases the shallowness of their breathing, and also opens the mouth up for infections. It's linked to cavities, it's linked to facial deformities. It's linked to allergies. I mean, there's nothing good that happens when you start opening your mouth to breathe. So if you're doing it all night, it's problematic. And it increases sleep apnea as well. Now, is it for everybody, it is not for everybody. I'll be the first to say that every person is their own little experiment. So we get into a little bit of a liability conversation here because if I just tell you Yeah, everybody go out and do it, then somebody is going to you know, have some bad reaction and then wonder why I told him to do that. If you read nesters book what he'll tell you is get cleared by an EMT first to make sure that you don't have any structural problems in your nose. That being said many people have structural problems in their nose and have no problem taping their mouth at night. There is an argument to be made for simply trying to get the mouth shut to bring the jaw forward and open the airway. A closed mouth means that the jaw is forward and the tongue is up against the roof of the roof of the mouth, which kind of expands the palate and opens the airway. When the mouth hangs open, our tongue slides back and causes a closure to the airway, which we have to then snore to get around. So I would advise that anybody who is trying to experiment with mouth taping, do so by finding an appropriate tape that you like. The one that we use here is Kinesio tape, just snip off a little piece that only stretches in one direction, not the other, press their lips together. So they're kind of smushed, not pouty all the way out and not curled all the way in and sort of pressed together.
Dr. Andy Sabatier 35:55
And then take the tape applied over the mouth, you can do it in an X, you can do it in a little vertical strip, I like to do it most in a horizontal strip, that kind of covers the whole thing. And then wear that for a little while while you're awake. While you're reading your book, while you're moving around the house while you're watching TV, you know, because it can be a little bit weird to feel like you've got your mouth tape, like it can feel a little suffocating and a little bit scary. But if your nose works, you're not gonna have any problem breathing through your nose. I think that it's worth a try, for most people who have some kind of snoring problem or have issues with their mouth hanging open or dealing with panic attacks or any this stuff. But at the same time, if you have concerns, and you're worried about it, as you put it on, guess what you're going to be more worried out. So the best thing you can do is quell those concerns. If you have a medical provider, whether that's a pulmonologist or an ear, nose and throat doctor, or even just your primary that you want to ask, is this, okay? Do that. Because at the end of the day, your breathing, your head is gonna be on the pillow. And what we're trying to do is get you to be more calm. It's the thing that you're doing is evoking more of a panic response, well, then it's probably not worth it.
Toréa Rodriguez 37:11
Cool. I want to be cognizant of our time. So I'm curious with my last question here, it's it's kind of twofold. But who's your typical client? Are you really working with athletes and people who are trying to boost their performance? Are you working with patients that have medical diagnoses that the hospital still like? What's your typical client? And how do they work with you,
Dr. Andy Sabatier 37:38
I don't have a typical patient at this point, I tend I always use the word patient. First of all, because I well, you get to taking the sample. It's true. It's my privilege. So I get I get to do that. So I consider everybody to be a patient. And I want them to care for themselves that way. So a lot of my patients are suffering from lung COVID. And they don't necessarily look like you think they look, I don't know what the image you have in your mind is, but it's everybody. It's a variety of kids who are 15 all the way through people in their 70s. I worked with a lot of chest wall injury people, whether that's traumatic stuff, you know, through breaking ribs, from car accidents, or mountain bike accidents. But I also work with elective chest wall surgeries, somebody who's planning to get valve replaced in their chest, or somebody who's suffering from something on slipping rid syndrome, which isn't really talked about, it's basically where one of the ribs, either eight, nine or 10, either pumps off or disrupts from the costal cartilage, and then they get stabbing pain all the time, which I think is made worse by their dysfunctional breathing, if not even caused by it, you know, repeatedly bringing the abdomen inward instead of outward when they breathe. We work with people who simply are suffering from panic attacks, you know, people that are dealing with trauma from Vietnam or from Iraq or from a variety of things. You know, whether it's military based or just from their life, I work with people with fibromyalgia, chronic pain, where it's basically the body is in a constant state of inflammation. I work with people with autoimmune diseases, IBS, rheumatoid arthritis, I work with people that are trying to just get themselves as ready as possible for joint replacement. It's how you breathe, it's how you feel and how you move.
Dr. Andy Sabatier 39:13
So it's a tremendous help with pain management. You know, what we've noticed that across the board, with whichever physician is referring that patient, to me, their pain, the way they deal with pain is drastically changed by how they breathe. You know, some of these patients are dealing with chronic pain, they're calling the physician all the time and then they come in here, get evaluated, get some tools for their breathing, to sort of get them ready for surgery and they stop calling their physician. It's amazing. Overall, you know, the athlete side is is interesting because oftentimes athletes come in with something where they're like, I'm trying to not get as short of breath when I do XYZ, you know, whether it's an ultra runner or a professional skier, or you know, I work with person who's a big wave surfer who wants to be able to hold his breath longer. But all of these people also have underlying Things like GI issues, anxiety issues, you know, things that can be related to their breathing that they don't realize. So we work with everybody, basically using the same sort of curriculum and tools, where we're going to kind of tailor it to what you're doing. But by the end, everybody's got a pretty wide array of tools that are applicable in different situations, whether it's when you're out for a run, or trying to recover or trying to go sleep or trying to deal with grief. It's the same basic tools, you know, I, I had somebody asked me what breathing exercises do you do, I really thought about it, I was like, Well, I basically do one in the nose, diaphragm, first chest, second shoulder stay still, I just show you how to apply that to a lot of different situations. And I typically work with people every couple of weeks, whether that's in person, or virtually, I work with somebody, get their breathing, evaluated, get them to nudge the system from dysfunctional functional, and then we keep meeting up sort of, at regular intervals, to then apply it to their life, whatever that means. Sometimes they have something totally in mind when we meet, and sometimes I kind of know what I'm doing. But in general, I'm set up to help you in the long term. You know, a lot of what PT does right now is sort of in that, okay, well, let's do these three visits four times a week, and excuse me do visits two or three times a week for six weeks. And here's three sets of 10, do these four times a week, a lot of counting. I, I know you're taking 20,000 breaths today, and tomorrow, and the next day, and you're gonna take a few 100,000 before the next time I see you. And it's your breeding. So I want to give you as much as I can, that'll help you use every one of those you think of to help nudge the system towards more function. And so by the time people have all those tools, then I just sort of tail off and see them, you know, every few months and eventually not at all.
Toréa Rodriguez 41:51
Cool. So for people who are listening to this podcast, do they have to be physically with you to do that initial evaluation? Or can you work with somebody 100% virtually.
Dr. Andy Sabatier 42:04
So interestingly, that I do kind of three different types of care. One is individual care, which is either done in person or virtually, I do a lot virtually on individual care, because we're able to see your breathing through dementia, and also leave group classes. That's usually in person. But I can do that for for organizations and things like that, I'll go out and sort of speak to everybody and get them all to sort of understand their breathing and start working with it. But I also offer a host of online courses, which are done entirely on your own, where we're going to give you that knowledge, to be able to see feel us and understand your breathing a little bit differently. And you can then basically fix yourself, not that you're broken, but you can improve your breathing, just by using the simple tools that we're going to show you. And with each of those online courses, what I do is I cue people Look, before you do this, film, your breathing, film your breathing so that you can get a good look at it after you've taken this course. And then you'll be able to understand what's going on with Ray have you actually been through this process, which is nice to sort of have somebody who's on the inside track. But it gives them the option to then look at themselves. And if they want to, they can send it in to us. And we can kind of break it down for you know, it's a little bit like, I don't know if you've ever seen somebody you know, like trying to hit golf balls or something like that, but they're usually filming their golf swing, because it's hard to know what's going on when you're the one doing it. But when you stand back and look at it and sort of break it down, you can see some of those nuances and subtleties that you wouldn't otherwise be able to see because you're really close to the project. So the online courses are by far the most cost effective way for somebody to do this because for for a small price, they can basically go in, do it themselves, pause it when they need to. And then if they need more help, well, that's why we're here. You know, the vast majority of dysfunctional breathing problems are intervened upon and improved, not by hands on skills by a PT, but just by knowledge and understanding, understanding that this is how the system works. And this is under your conscious control. And here are a few little sneaky tips on how to just nudge it into more function. I would say the vast majority of humans out there would benefit from that alone.
Toréa Rodriguez 44:11
Fabulous. So that of course leads to the last question, which is where do people find you? Where did they find out about these courses? How can they get more information, follow you, etc?
Dr. Andy Sabatier 44:23
Sure. Well, the easiest thing to do is you can visit our website. That's AcademyWestPerformance.com long website. You can also follow us on Instagram, Academy.West and our phone number because actually a lot of people want to talk. You know, sometimes they're wondering, is this a breathing problem? I don't really know. I'm kind of friends and they just want to talk to a human. My phone number is 541044676 and frankly, I can't wait to talk to you about your breathing because it's my favorite thing to talk about. You're breathing.
Toréa Rodriguez 45:02
Awesome. Anything else Evie?
Evie Takacs 45:04
No, thank you so much.
Toréa Rodriguez 45:06
Yeah. Andy, thank you so much for coming on and giving us a little bit of a primer, I can totally tell there's so much under the covers that we can go into. So we'll probably have to have you come on for a follow up episode. So thank you very much.
Dr. Andy Sabatier 45:21
You are so welcome. It would be a privilege to be on. Anytime. i This is this is great. I love what you're doing and I'm excited to be a part
Toréa Rodriguez 45:35
Hey, thanks for joining us for this episode of the Wildly Optimized Wellness podcast. If you’re ready to dig deeper into your health, stop playing the Whack-a-Symptom game, start testing to get better guidance, you can find more about Toréa at torearodriguez.com and you can find Evie at holisticallyrestored.com. Want a peek into what it’s like to work with us? Come join us at our Optimized Wellness Community. You can find the invitation link in the show notes below. And if you have a question for the show, you can submit your question under the podcast section of torearodriguez.com. Finally, if you found something helpful in this episode, don’t forget to leave a review, hit that follow button or share it with a friend. They’re gonna love that you thought of them. Until next time, see you outside!
