Triumphant Breathing--Learn how to Breathe

Breath is the bridge which connects life to consciousness and unites your body to your thoughts.                                                                                                  ~ Thích Nht Hnh

Do you know how to breathe? I’d like to teach you. Breathing is effortless, right?  It requires no thought. Many of us only think about breathing when our oxygen is restricted, like that feeling we get when tumbled underwater by a rogue wave or after a hard run.  Mere seconds of restricted breathing can feel like a lifetime. Every cell in our body aches for oxygen, making those singular moments feel like eternity while we gasp for breath.

The body is an amazingly efficient machine. It takes the air we breathe and converts it to food for the body’s cells, then expels the waste through our exhalation.

This is called Respiration. It is performed, controlled, and regulated by the brain, adapting to the body’s changing physical, emotional, and spiritual state. The brain triggers your breathing rate to vary according to your needs. Breathing is the method by which you bring oxygen into your body and how you expel the waste. 

Respiration is automatic.

Your breathing can be consciously controlled.

How you breathe has a major impact on your health and well-being.    Efficient breathing optimizes breathing capacity and increases the amount of rich oxygenated blood that reaches the cells. Efficient breathing allows the body to integrate physical, emotional, and mental clarity. It enhances the interchange between a person’s conscious and subconscious mind and activates mechanisms that promote synergy within all body’s systems. (2,4)

Efficient breathing has been shown to increase motivation, improve memory, and enhance emotional judgements. (3,5) Mindful breathing exercise helps to sharpen one’s focus on a task and improves productivity. (3) Optimizing the rhythm of breathing creates electrical activity in the human brain that enhances emotional judgments and memory recall, (1) and breathing based meditation has been shown to fight depression. (2)

Let’s face it. Most of us breathe inefficiently.  As such, we do not reach our full potential for breathing, cognitive function, posture, energy, muscle development, or stress management. When inefficient breathing becomes dysfunctional, it ignites a downward spiral toward a cataclysmic explosion of physical, mental, or emotional impairment and disability.

Dysfunctional breathing restricts circulation and tightens muscles, weakens abdominals, and impairs posture. Dysfunctional breathing causes physical and mental fatigue, emotional and physical distress, and can leads to lethargy, depression and a plethora of other medical concerns.

  • Our brain uses 20% of the oxygen we consume. With a shortage, the brain works slower, we become foggy, and since the brain affects many other body functions, they too become impaired.
  • The heart pumps constantly, beating about 100,000 times each day. It consumes oxygen whiles it pumps blood to all reaches of the body. When the heart’s efficiency is hindered, circulation suffers and triggers a domino effect of health issues.
  • The muscles require exchange of oxygen for the mitochondria to create energy.

Breathing is the first thing we do when we are born and the last thing we do before we die. The average person takes about 15 breaths per minute increasing to 40-50 breaths/minute during exercise. Do the math. 900 breaths/hour escalating to 2400-3000 breaths/hour during exercise.  That’s a lot of breaths! And every conscious one is an opportunity to improve your heart, mind, and soul.

BEST BREATHING - optimize the air you inhale, maximize depth of exhalation, and do each with minimal physical energy. Make breathing your favorite exercise.

Use the strategies listed below; you can learn to breathe.   You will think more clearly, feel more energetic, improve your posture, increase muscle strength, boost your endurance, strengthen your core. You might be amazed at the changes you feel. You can create synergy within and among all your body systems…all by simply learning how to breathe.

1)     Breathe in through your nose to let your nasal passage filter and warm the incoming air. It traps bacteria and other pollutants and stops them from reaching our lungs. Warm air is easier to breathe. Cold air constricts blood vessels and makes the lungs work harder to get oxygen. (That’s why asthmatics often have difficulty exercising outdoors in the winter.) 

2)     Inhale deeply, expanding your abdominals before your chest. The area of your body from chest to navel is what I like to call your “breathing barrel.” If you breathe from your chest only, you don’t reach the full capacity of your breathing barrel, and the bottom of the barrel never gets replenished with rich new oxygenated blood. You won’t exercise the muscles that help you reach the bottom of your barrel. Your oxygen reservoir goes stale, your muscles eventually lose their ability to reach the bottom of the barrel, and your breathing capacity diminishes.

Imagine that you have been trapped on a desert island and you come upon a barrel filled with water. Now imagine that you can only take one sip of this water using a straw. How far into the barrel would you place the straw to be able to drink it all in?  If you place the straw only halfway down, your straw would only draw half of the water.  You want to place that straw down as deep as you can to drink as much water as possible.

Or, imagine your body as a barrel filled with your favorite cookies. Every time you eat some cookies from the barrel, it gets replenished. But if you don’t reach to the bottom of the barrel, the cookies down there will eventually go stale. You probably don’t want to eat stale cookies; you certainly don’t want to breathe stale air!

3)     Exhale on Exertion (a phrase commonly used in exercise) Exhaling on exertion helps prevent you from holding your breath and protects your body from excessive stress and intra-abdominal pressure. 

4)     Exhale through Pursed Lips to control the exhale, improve exhalation endurance, and promote diaphragm strength. Think about blowing out candles on a cake, one candle at a time.

5)     Engage Abdominals on your Exhale This phrase is often misunderstood and erroneously performed.  People use a myriad of terms to describe the desired action. Engage, tighten, contract, activate, or draw your abdominals are used interchangeably and can be confusing. Engage, activate, draw? What DO they mean? 

The physiological action of the abdominal muscles is flexion and compression; they compress toward the spine. You can actively engage your abdominals by pulling them toward your spine. I prefer the instruction “blow your abdominals toward your spine,” to avoid a client from holding his/her breath.

The principal muscles of expiration are the abdominals. When they contract, they pull the ribs down and create pressure that pushes the diaphragm up, thereby increasing the force of expiration and the capacity for subsequent inspiration. These muscles only come into play during exercise or forced breathing maneuvers, so they need to be trained to help you achieve your best breathing. Regardless of your position, when you activate your abdominals, they move toward your spine, they should NOT poof out.

6)     Exhale Twice as long as you Inhale the muscles of exhalation (abdominals and diaphragm) get stronger and develop more endurance with exercise.  Using the best breathing technique will strengthen the depth of your inhale and improve the endurance and efficacy of your exhale. 

7)     Consciously Lower your Ribs when you exhale. This aligns your diaphragm to improve the quality of your inhale. (Place your hands on your ribs for feedback)

8)    Focus on the Quality of your Posture and Breathing BEST breathing should reflect optimal spinal postures. Your body tries to compensate when it body perceives exertion. You need to train and strengthen your posture to prevent your body from cheating.

Breathing may seem easier if you allow your head to move forward, compensating without realizing it. Tiny muscles in the neck that attach to the ribs, collarbone, and breastbone can hyperactivate in an effort to increase inspiration.  These muscles can become tight and compress nerves that travel through the brachial plexus, leading to pain, trigger points, nerve entrapment syndromes, and loss of sensation in the arm.

 Shallow breathing causes the chest to heave and creates a big barrel chest. The rib cage tilts backwards from incomplete or incorrect exhalation. Your thoracic spine may curve too much and your lumbar spine flatten, or vice versa.

 Uncontrolled exhalation allows your pelvis to tuck (pelvic tilt) and psoas, a deep hip flexor, to restrict. These muscles shorten in response, and in turn decrease breathing capacity. The muscles of the ribs, diaphragm, and psoas are intricately interconnected and directly affect your breathing capacity, posture, and daily function.

9)     Breathe Rhythmically Everything has a natural rhythm, the ocean waves, the seasons, and the moon. Our bodies are no different. Your entire abdominal wall should rise and fall in synchronization. With practice, you will be able to breathe correctly within the natural rhythm of your body.

10)  Breathe Mindfully No matter what we do, we do it best when we do it mindfully. Focus your attention on your breath. Notice, be aware, and accept your breathing pattern. Then allow your body and mind to relax and accept the gentle rhythm of your new and improved breathing.

Exhale on exertion, twice as long as your inhale.

Every time you exhale, tighten abdominals toward spine.

Keep your ribs down and body long.



Practice. Make it a habit. Exhale





1.      Boston University Medical Center. "Twice weekly yoga classes plus home practice effective in reducing symptoms of depression." ScienceDaily, March 3, 2017.

2.     Mesquita MA, Baptista J, Crasto C, de Melo CA, Santos R, Vilas-Boas JP.. “Abdominal Muscle Activity during Br­­­­­eathing with and without Inspiratory and Expiratory Loads in Healthy Subjects.” Journal of Electromyography and Kinesiology, vol. 30, 2016, pp. 143–150.

3.     Northwestern University. "Rhythm of breathing affects memory, fear: Breathing is not just for oxygen; it's also linked to brain function, behavior." ScienceDaily, December 7, 2016.

4.     Szczygieł E, Blaut J, Zielonka-Pycka K, Tomaszewski K, Golec J, Czechowska D, Masłoń A, Golec E, “The Impact of Deep Muscle Training on the Quality of Posture and Breathing.” Journal of Motor Behavior, August 18, 2017, pp. 1-9.

5.      University of Wisconsin-Madison. "Have trouble media multitasking? Mindfulness intervention helps sharpen focus, study shows." ScienceDaily, April 19, 2016.


Mindful Body Awareness in Exercise

A majority of injuries treated in physical therapy practice could have been prevented with proper form and technique.

Exercise is Medicine

Regular physical activity is one of the most important things you can do for your health. Moreover, it is crucial to ensure that your body is strong and healthy enough meet the challenges that you set for it. Exercise and physical activity keeps our body limber and strong, and our minds sharp. The many benefits of Exercise include:    

Weight control

Stress Relief

Reduced Risk of Cardiovascular Disease

Prevent, Reduce, and Control Inflammation

Decrease Type 2 Diabetes and Certain Metabolic Syndromes

Strengthens Immune System

Strengthens Bones and Muscles

Reduces Risk of Certain Cance

Improves Balance and Reduces Fall Risk

Improves Mood and Mental Health                                              


I am not telling you anything you haven’t heard before.

With the changes in our HealthCare Payment system, insurance costs continue to rise and out of pocket expenses have increased. One good thing coming out of this is that people are realizing that they need to take better care of themselves and exercise more. A-not-so-good consequence of this is that people often embark upon an exercise journey that might not be the best for them, and/or they take exercise advice from under-trained sources.

MINDFUL BODY AWARENESS                                                                                                                                                                                                            

EXERCISE is one of the BEST things you can and should do for yourself. And you should do it everyday, but you need to do it correctly for your individual needs. Prior to embarking on a new exercise journey, you should consult a medical professional such as your doctor or physical therapist, optimally both. You need to be aware of your own body and your optimal body alignment or posture. Make sure you learn the proper exercise technique and understand what the goal of each exercise is. Finally concentrate on yourself, your body, your exercise technique. Make sure you "feel it" in the correct places. Do not misinterpret the adage "no pain; no gain." Muscle activation and/or muscle "burn" should not be painful.

Look for someone who is educated, skilled, and experienced in the 1) physiologic processes of the body,  2) anatomy and physiology, 3) injury pathology and prevention, 4) Effects of illness or medications on exercise response, and 5) appropriate adaptation for age, conditions, and illness. Realize that certain medications change the way your body responds to exercise, and your exercise intensity may need to be adjusted, to prevent a potentially life-threatening response.

Use caution, however, and do not assume that just because someone has the degrees after his/her name that they have the knowledge and experience. Ask questions and research the person to whom you are entrusting your health.

When you are learning and participating in an exercise or exercise class, make sure you are performing each and every exercise with the correct technique. If working with a personal trainer, you want to make sure he/she stops, interrupts, and corrects your form if incorrect. Otherwise you are not only wasting your time and money, but you increase your risk of suffering an injury that may put you on the sidelines.

Just because you sweat doesn’t mean your exercise is effective.


Happy Baseball and Spring Sport Season!!!!

CT High School Spring Sports season is here!!!!! Baseball Pitchers and Catchers officially began their season this past Monday, and all players in Spring sports begin their seasons in earnest on Monday March 23.

Hopefully, throwing overhead athletes (Baseball, Softball, Lacrosse, Shot Put, and Javelin throwers too) have been preparing and conditioning the tools of their trade before now. I'm talking about their shoulders! The tiny muscles under the shoulder blade (sub-scapular muscles) have to work harder than people realize to maintain balance and control of the throwing arm.

There are some simple, yet necessary, exercises that all throwing athletes should perform to condition, properly strengthen, and maintain crucial balance in their arms. These exercises are simple, yet necessary, and should be done daily.

Check out our SCORE Scapula, Rotator Cuff, and CORE exercise program


Embrace the snow!

With my children grown, I don't often get the opportunity to go sledding, or participate in many of the fun activities that made us love the snow when we were kids.  But I live in New England, where winters are cold and often harsh, and staying tucked indoors waiting for the cold to break make the season seem that much more interminable.

No!  I needed to find a way to embrace the snow, something to make my heart skip a beat when I see those first flakes float down from the gloomy gray sky.  I need something akin to those ocean-loving dudes in California and Hawaii closing down shop with the cry “Surfs up!”

I am a runner, but too consciously cautious of the injuries that might befall me running on icy terrain, and if I get hurt, I wouldn’t be able to enjoy running for a long time. But…what if I run on skis?  I don’t mean to imply the activity where people gracefully meander through beautifully groomed trails. No. I strap on my skis, jump onto the Linear Trail in my town, and traverse the snowy path, moving along as fast as I can, which isn't always that speedy. 

I don’t listen to music; I don’t need conversation. The woosh-swoosh sound is music to my ears, as I dig my poles in, kick back my skis, and leave behind parallel trails of my stress.  Back home, I peel off my sweat-soaked layers and bask in the afterglow of a work-out well had…until next time.

Be safe in winter sports and make sure you remember to dress appropriately for the weather, and in layers, and don't forget to hydrate.  See American College of Sports Medicine recommendations here.





Shoulder Pain? Don't be so quick to get a cortisone injection.

Physical Therapy has been found to be just as, or more effective, as corticosteroids, and is a less costly, non-invasive option.

Many times shoulder pain is the result of overexertion and/or imbalance of the shoulder muscles. The classic case is the overhead athlete (baseball player, especially pitcher, swimmer, tennis player, etc.) However, many of us provoke shoulder pain/injury doing less obvious activities such as yard work, housework, painting, even carrying a briefcase.

What to do if you feel pain?

STOP doing the activity that provoked the pain. Then apply ICE to the painful area.

There is an acronym to remember RICE: Rest, Ice, Compression, Elevation

Some people may tell you to apply heat to a painful injury. I disagree. Ice will never harm you, if you apply it correctly. Never apply ice directly onto skin; it can burn you. Always place a protective layer between your skin and the ice (a paper towel or pillowcase works well)

 The Body’s Healing Process

From the moment a muscle strains or a ligament tears, your body goes to work to repair the damage. Here’s what happens at each stage of the healing process:

At the moment of injury: Chemicals are released from damaged cells, triggering a process called inflammation. Blood vessels at the injury site dilate (enlarge) to increase blood flow needed to carry nutrients to the site of tissue damage.

Within hours of injury: White blood cells (leukocytes) travel down the bloodstream to the injury site where they begin to tear down and remove damaged tissue, allowing other specialized cells to start developing scar tissue.

Within days of injury: Scar tissue is formed on the skin or inside the body. The amount of scarring may be proportional to the amount of swelling, inflammation, or bleeding within.

When to seek medical care?

There are some situations where you should seek immediate medical care. If you suspect a broken bone, or can see a bone protruding through skin, there is obvious need for immediate medical attention. Other signs of a broken bone include: immediate profuse swelling and/or bruising at a joint, limb/joint looks out of place or seems to be at the wrong angle, numbness in the limb, inability to move the limb or joint.

If you do not start to feel a reduction in pain or swelling using the RICE concept within 24 hours, you should seek medical care. A physical therapist can evaluate your injury and provide information, guidance, and treatment to expedite your body’s healing, and restore your function.

If your pain is so severe that you are unable to perform the exercises your physical therapist prescribes, it may be necessary to have a cortisone injection. However, the purpose of that injection is to reduce inflammation and pain so that you are able to tolerate the exercises that are necessary to achieve full recovery.

At Mrowka Physical Therapy, we developed our SCORE Shoulder Program to target the Scapula Stabilizers, Rotator Cuff, and CORE to correct the muscle imbalance and core weakness that makes people susceptible to shoulder pain and injury. We have helped scores of people with shoulder injuries--from the average Joe to professional athlete. We can help you too!

FLIP FLOPS from a Physical Therapist???

Most of us have heard that wearing stiletto heels are not great for our feet, legs or back.  Is it safer to go with flats? Perhaps a nice, natural-feeling flip-flop? Sadly, think again.

Physical therapists treat women with pain in the foot, knee, hip, and back—many times caused by a summer season spent in flip-flops.

Research from Auburn University suggests that wearing flip-flops can cause temporary or even long-term damage to the musculoskeletal system.

Most flip-flops lack proper arch support, causing your full body weight to exert pressure on the plantar surface of the foot.  Without proper support, your arch collapses and can cause Plantar Fasciitis, Bunions, and even Achilles Tendonitis.

For years, I have advised my patients against wearing flip-flops, until now.

We are happy to announce our association with SOLE Supports, and they have a great new line of Summer slides and Flip Flops. SOLE flip flops contour to your foot, and provide excellent arch support and cushioning. And they’re APMA approved!

We now offer the full line of Sole Supports, including their footwear!

So Come in today -- Get your Flip Flops and get ready for warmer weather!!

Strain or Sprain??

The difference between a SPRAIN and a STRAIN? 
People use these terms interchangeably, but they actually refer to different injuries. A SPRAIN is an injury to a Ligament; A STRAIN is an injury to a muscle. Regardless, the immediate care and injury guidelines for each is similar. The sooner you reduce the inflammation, the more quickly you'll recover and be able to return to your activity. For more information follow this link.