In this episode, we are sharing highlights from our webinar, ‘Breathwork for people living with MS’ with Dr Véronique Gauthier-Simmons. Véronique is a qualified yoga therapist and follows the Overcoming MS Program and has supported Overcoming MS as a facilitator. She discusses what breathwork is, how it can help people living with MS and ends the talk with a breathwork practice for you to try.
Overcoming MS 00:01
Welcome to Living Well with MS. This podcast comes to you from Overcoming MS, the world's leading multiple sclerosis healthy lifestyle charity, which helps people live a full and healthy life through the Overcoming MS program. We interview a range of experts and people with multiple sclerosis. Please remember, all opinions expressed are their own. Don't forget to subscribe to Living Well with MS on your favorite podcast platform so you never miss an episode. And now, let's meet our guest.
Overcoming MS 00:33
Today's episode features highlights from the Breathwork for People Living with MS webinar presented by Véronique Gauthier-Simmons and recorded live in front of our global audience as part of the Finding Hope with OMS 10th Anniversary Edition series. To join us live for the next webinar or to watch the original presentation, head to our website overcomingms.org.
Véronique Gauthier-Simmons 00:58
Thank you so much for inviting me to this webinar. And before we start, I'd like to mention that I am actually in the south of Portugal. And it's been really, really hot today. Thank you, I'm so impatient to start. So I would like to welcome you all to this webinar. This webinar is about breath work for people living with MS, I think you probably are all aware that breath work has become really popular recently. And there's an awful lot of research about the breath, which is super exciting, especially because of long COVID. So we've got loads of new research going on everywhere. We learn a lot more about the breath and the link between the breath and other systems in the body.
Véronique Gauthier-Simmons 01:51
But the aim of this webinar is not to go into details. The aim is to first discuss what is breath work? How can breath work help people living with MS and then we'll do a short practice. So my actuall objective is that at the end of this will be now you are really hungry for more information. And that you are excited about the potential of using breath as a tool to improve your health and your life in general. So regarding the short practice, you can sit on the chair, on the floor as you wish. And I mentioned in the description that if you've got a Thera band, or belt please have it beside you. But don't worry, if you don't have it, you can just visualize it. It's just for one exercise. And finally, if you have the nice playlist, you've got some music that is relaxing that you enjoy listening to really feel free to play it during the practice. It just helps to create a more relaxing environment.
Véronique Gauthier-Simmons 03:21
Okay, so before starting to talk about the breath, I'd like to tell you a little bit about my journey just for you to understand how I came to breathwork. So I was diagnosed with relapsing remitting MS in 2000 at the age of 34. So you can calculate Yeah, I'll be 56 in August. And the first symptoms that I had where optic neuritis and sensory symptoms and balance issues. I had the symptoms while I was exercising. So I started yoga as an alternative to my physical activity which was like playing squash or going to the gym and step aerobics for instance. So I started yoga. And I found out that yoga is not as easy as I thought it's far more challenging and I became really strong, I think, became stronger, more flexible, happier. So I decided to become a yoga teacher. So I qualified as a yoga teacher in 2008. And I discovered the OMS program in 2012. So I started straight away all the steps and I also founded Taming the Walrus with my husband, my yoga business, I was focusing on encouraging people living with MS to start yoga.
Véronique Gauthier-Simmons 05:12
And then I really thought that yoga has a lot of potential. So I wanted to dig deeper, I wanted to find out why this particular pose is good for these symptoms, or how to manage MS as a whole condition. So that's why I decided to train as well in yoga therapy, which is about applying the yogic tools to specific symptoms or conditions. I became an OMS facilitator in 2017. And I facilitated sessions about the benefits of exercise. And then in 2019, I trained as an MS Get a Head Start instructor. So for those of you don't know, the MS Get a Head Start program, it's an evidence based therapist led exercise program that combines high intensity exercises with management of fatigue, pain, cognitive and mental health.
Véronique Gauthier-Simmons 06:25
And throughout these years, my focus was really on finding modalities that are inclusive and accessible. So in 2020, I decided to become an ambassador to accessible yoga because I really, truly believe that Yoga should be available to everyone, no matter what the abilities or background. And then I discovered breathwork. So you might have heard of the book by James Nestor, Breath, it just, for me was like, wow, this is really accessible to everyone. From the day we are born to the day, we die, we've got the breath. That's the one thing we are sure we'll have throughout our lives, and everybody has it. So potentially, everybody can do breath work, even more than yoga. And I decided to train with Dr. Ela Manga. And I'd like to mention a couple of words about Dr. Ela Manga. She's a trained medical doctor, she had a very successful practice in South Africa. But she was frustrated, because she realized that the only thing that you could do was prescribe drugs, medicine to patients without really looking at the root cause of their conditions. And she explored different modalities and came to the conclusion that she could help a lot of patients with breath work. And she now has kind of practice that is lifestyle medicine. So she helps people, patients through the breath, meditation, and lifestyle changes. So that sounds familiar. It's very in line with the Overcoming MS approach. And that's why I thought, Okay, I want to train with her. And so I've been training with her for about two years now. And I'm really happy. She's an amazing teacher, an amazing person. So let's now move on to the breath.
Véronique Gauthier-Simmons 08:58
Okay, I think I deserve the Nobel Prize for this title Breath is Vital. I know it's so evident. But you know, so for the general public, we say that we can live without food for three weeks. We can live without water for three days. But only three minutes without breathing. And I think that is kind of amazing in a way. Well, except if you are a diver divers tend to be able to hold their breath much longer. And actually the I don't know if you heard of Stig Severinsen held his breath for 22 minutes under the water without swimming. But in general, without proper training, we would all die. If we stopped breathing for three minutes, so please don't try to check that now.
Véronique Gauthier-Simmons 10:12
We know the breath is vital, we all know. But how often do we think about the way we breathe, we think about what we eat, what we drink what we do, but we don't really pay attention to the to the breath, at least until recently. But thanks to the research that I mentioned earlier, we now understand much more about the breath, when to stand, for instance, the link between CO2 and O2 and the role of nitrous oxide. And we now know what the optimal breathing pattern should be. And the optimal breathing pattern should be breathing through the nose. Through from the abdomen, so starting from the abdomen, when you inhale, feel the abdomen expand. And it should be slow. And in fact, that's the way newborn babies breathe.
Véronique Gauthier-Simmons 11:24
But we often develop dysfunctional breathing patterns. So for example, one dysfunctional breathing pattern would be mouth breathing. So for some reason, some of us switch from nasal breathing, to breath, mouth breathing, would causes loads of issues in the dentition, but also for the whole body. Or it could be paradoxical breathing, where, instead of feeling the expansion in the abdomen of the inhale, the abdomen moves in, on the inhale and out on the exhale. But now, the dysfunction would be the chest breathing, where all the breathing happens here, instead of lower around the waist. And now, so we know what the ideal breathing pattern should be, we know that we develop dysfunctional breathing. And we also know that dysfunctional breathing really affects the us. In fact, dysfunctional really makes the nervous system more active. And this leads to shallow breathing, tension in the body, increased stress, and activates the fight or flight response. Being aware of the way we breathe, is the first step in breath work, we need to become aware of our breathing pattern. And then we can use conscious breathing specific techniques to improve our breathing, improve our health and our physical and mental well being. And in fact, if you do yoga, Qigong, or tai chi, then you know that conscious breathing is already used in these disciplines to support the health.
Véronique Gauthier-Simmons 13:31
Okay, you might wonder now how powerful is this breath? You know, what can we can we really achieve by consciously using our breath? I think it's really amazingly powerful. And it's truly powerful because of two factors. Because every mental, psychological, emotional, physiological state and posture has a corresponding breathing pattern at an opportunity. Just for a moment to think about how you breathe, when you fall in love, how you breathe, when you're worried or anxious or stressed. When there's suddenly a noise, yeah. So we might think that all the rest are the same but they are not they are different qualities, different patterns, we might have a slightly longer exhale, inhale or a pause or oneness relative order so they are different. And also, the second reason why the breath is so powerful is that the breathing system is the only system in the body. That is simple, both conscious and unconscious. We know all the systems in the body, digestive nerve center Primus all tend to be interlinked. But the the breathing system is the only one that happens naturally, thank God, we don't have to breathe all the time, we don't have to think of the time that oh, I need to breathe in, I need to breathe out. It happens automatically. But we can also tell the brain step here, I'm taking over the control, I'm in charge now. And that is the only system in the body that can do that. And that gives us the power to change how we feel. Because the systems are connected, and we can use the breath nearly as a language to communicate with the different systems in the body.
Véronique Gauthier-Simmons 16:00
For instance, we can't tell our heart, please heart, can you beat for 60 beats per minute, we don't have a direct line to the heart. But we can use the breath to find the proper breathing pattern that will allow this heart rate the same, we can't work backward anyway, maybe some of you can, but I can't tell my digestive system, please now break down this food. But I can use the breath to trigger the rest and digest system and to give the perfect condition for my digestive system to work. So this is why the breath is so powerful. By changing our breathing pattern, we can change our state. And for me that really is truly amazing. That is such an incredible opportunity to improve our health, our mental and our physical health.
Véronique Gauthier-Simmons 17:10
And that I think we are not producing enough yet, let's come to a definition of what breathwork is, at least for me. Breathwork is using breath awareness and conscious breathing for healing and transformation. In this webinar, we're not going to focus too much on the transformation part. Because it's more like an advanced breathing technique. But you might have heard of rebirthing or holotropic breathwork. And the use of connected conscious breathing where you put your body in a state of really intense stress, quite intense, intense, intense, and then you kind of unlock some some tension or you discover some tension that you are not maybe aware of. And it can release trauma. And it can also have a profound spiritual experience. But this is something that we only facilitate in a very protective, safe environment one to one or in group but with another facilitator. So I'm not going to try this online when I cannot see you.
Véronique Gauthier-Simmons 18:37
So as I said the there is there was there has been a lot of research on the potential benefits of breathwork. There's been some research as well, for MS about the use of some pranayama techniques for MS. So for those of you who don't know yoga, don't practice yoga. Pranayama is the field in yoga that looks a lot of it, breathing techniques. But prana is not just the breath, it's actually energy. So the yogic vision is that we are made up of loads of elements and atoms and so on. And try not is this kind of life force that helps us to take this shape that we are in the moment. And when this life force is strong, we're healthy. When it's getting weak. We get sick, and when it leaves the body. The body is desintigrates, we die. So that is the focus of pranayama. And they are research papers about pranayama and MS. But I haven't found anything yet about breath work, and MS. Based on my own experience, and what I learned in with Dr. Ela Manga, I listed a few areas where I think breathwork can have potential benefits for people living with MS. I shared it with Dr. Ela Manga, and she agreed that these would be definitely potential areas of interests. So the first one is respiratory function breathwork can help optimize the respiratory function by improving the strength of the respiratory muscles and expanding our lung capacities. And in MS, sometimes, the MS itself might cause damage to the phrenic nerves that are linked to the diaphragm, the big respiratory muscle, and that might lead to a dysfunction in breathing, or maybe just the stress of having MS. Or maybe if we feel down, we know that we might kind of slip a little bit forward and that will affect our reading. So breathwork can help us optimize the way we breathe. Also, there is a really interesting link between breathing and inflammation. I'm sure you've all heard about the vagus nerve. And we can stimulate the vagus nerve with breathing. And this way reduce stress and inflammation, we know that stress leads to inflammation. So there is an indirect way to reduce inflammation via the vagus nerve with breath work. Brain function, so you might already have experienced or tried some breathing techniques that help to improve memory and focus. We'll do one later that that is used often to improve memory. In the general public as well. And neuroplasticity, we know that breath awareness, deacons, gray matter are the benefits we can use the breath to modify our perceptions, our perception of pain. So how it was directly affects how that is something hurts, which for those of us who experienced pain is also an interesting to breath, breath work can improve sleep and also then energy level and balance so there was research only recently that shows that balance is better both with the eyes closed and open when the diaphragm so the big breathing muscle is thicker, and moves more freely during quiet and deep breathing. So these are the the areas where I think breath work can be really beneficial for us living with MS.
Véronique Gauthier-Simmons 23:58
So the last one I mentioned diaphragm so my, students, my yoga students know that I really love working with the diaphragm. And for me that diaphragm is one of these that too often ignored muscles. So diaphragm is really an important muscle, not just for breathing, but also for our well being and for our balance and it is just one muscle like any muscle in the body. We need to strengthen it. We need to keep it flexible. We need to keep juicy and strong. The diaphragm is this big, dome shaped muscle that you see under the heart. You see the heart in the middle the lungs and the heart. You have these diaphragm that has the shape of a dome and is attached to the ribcage, to the front to the side and to the back. And then when we inhale, the diaphragm flattens, and that pushes the belly out, that draws the extent in a way the lungs, so there is more air that can come in. And when we exhale, it goes up again, it goes up and help to, to kind of push the air out of the lungs, this movement of the diaphragm helps to message the internal organs, it gets this movement up and down. But it also massages the heart. So when I was saying earlier that we can use the breath to change your heart rate. It's thanks to this movement that you actually help the heart to pump and the rhythm that you you want.
Véronique Gauthier-Simmons 26:12
The problem with the diaphragm is that we are not very much aware of it, and that it can get tense. So because it's linked with the vagus with the psoas muscle, which connects the upper body and the lower body is also connected to the to the fascia. So when we spent many hours sitting, when we are stressed, everything tightens everything gets tense. This affects the movement of the diaphragm and our breathing.
Overcoming MS 26:53
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Véronique Gauthier-Simmons 27:11
So I could really spend hours talking about that. But if I'm in particular, but I'd like to move on to the practice part. In this setting, I cannot see you so I really rely on you to pay attention to your to your breath. To notice if anything that I'm asking you to do feels uncomfortable. Please don't continue. Just listen to your own intuition. And only do whatever you feel is good for you right now. If you've got the belt, or theraband, I'd invite you to wrap it around your waist and cross it but we'll use it later. If you are sitting on the chair, make sure that your feet are flat on the floor and that your feet and your knees are hip's width apart.
Véronique Gauthier-Simmons 28:16
And then bring your awareness to your sits bones. Whether you're sitting on a chair or on the floor, notice if your sits bones are equally pressing on the floor and if not, then maybe move a little bit your your legs so you're sitting more comfortably. Lengthen the back of your head and fold into the chest that what we want to do is to stretch the pectoral muscles just literally. So inhale and while the shoulders back, feel the stretch. And then on the exhale, roll the other way round. Feel the stretching the back. Again, you know opening the chest, exhale one small you inhale and exhale. Then come back to the starting position. Now I'd like you to place your right hand on your left shoulder. So just place it just on the top of your shoulder and relax the arms of the arm It's a little bit heavy and you feel a little bit of weight on your shoulder. And then turn your head to your left. Bring your awareness to your breath. Inhaling, then expand and on the exhale, the navel towards the spine just pay attention to your breath to the movements of your arm all the parts of the upper body such final breath and then we'll change side place the left hand on the right shoulder. Agenda had to do what again, becoming aware of the movements in the after party just a small exercise methods to connect again with your breath is very useful. So if you've got your Thera band, just hold it if you don't have it, just visualize the large band around your waist and think of the movement of your diaphragm. So remember, when you inhale, the diaphragm pushes the baby out. But also, it's a touch around the edges of the ribcage so the front of the side and the back so you can extend everywhere. So I'd like you to focus on that and expanding on the inhale, not just the front, but also the side and maybe even the back to the bottom.
Véronique Gauthier-Simmons 28:41
So if you hold your camera then then it's easier to become aware of the movements as you inhale and exhale. The upper chest and the shoulders are completely relaxed is no tension whatsoever in the neck. Breathe into the band giving your diaphragm a nice little stretch. So now we're going to eat it through the mouth. So it's I said optimal reading is through the nose but for exercising purposes, we also use the mouth. So in any through the mask as much as possible. Imagine you put a straw and you really want to inhale and then exhale with a sigh inside. So when you enough neti neti nasal, you really push your diaphragm down, stretch it down, and then exhale, let it come back up on its own. So we'll do three of these. Inhaling through the mouth as much as possible. Know the Excel Excel to a sigh. Again, inhale and sigh another one, inhale sigh. Stretch to diaphragm down on the inhale next to the other way around. Let's exhale as much as possible. So pushing the diaphragm up until you need to inhale. So just one thing. It's actually not possible to completely exhale to enter your lungs. There will always be one, one liter of air, so don't worry. Even if you exhale, don't panic. Things always air left. So exhaling through the mouth as much as possible.
Véronique Gauthier-Simmons 35:08
Speaking off, that when you need to inhale, lead the inhale happen. Again, exhale through the mouth and see if you can feel the movement of the diaphragm.When it goes up and needs to inhale, we need to last one. Nice, so that must have wakened your, your diaphragm. So next what I'd like to do is to, to measure your Bolt score. So in breath work, especially when we're working with functional breathing, so trying to improve the way you breathe, we can use different parameters to assess where you're at, and what your breathing is like. So the Bolt score is, stands for the body oxygen level test. And there will be a poll at the end. So I'll ask you to give your, your your Bolt score in the poll. So the aim of the poll score is not to say is not to measure how long you can hold your breath. It's not the aim. The aim is to, see when your your body reacts to the lack of air. Yeah, so we're going to inhale through the nose, exhale through the nose, and then I'll ask you to hold your nose. And then whenever you feel the need to breathe in, so when it might be that you need to swallow or manage if you needed a contraction in your abdomen, then release. And that is your Bolt score. So you count in seconds. So don't try to hold your breath as long as possible. When you release your hands, you should still be able to take a normal breath. What you shouldn't be gasping for air. Yeah. So are you ready. And then showing them learn can can share the results of the poll. So let's start now take a normal breath through the nose. And exhale through the nose. Pinch your nose and counting seconds. Until you feel the first sign that you need to read to read the Bolt score.
Véronique Gauthier-Simmons 38:23
The average is usually around 10-15. So that is really what your result shows too. But the ideal score is 40 if you want to, you know to exercise and to run for instance, 40 is a good score. But even athletes can have a low quality score. So there are ways to improve your Bolt score because it's important. It means that you can you won't be out of breath as fast. It will you'll you'll be less fatigued. Let's start improving your Bolt score is a nice, nice thing to do. And there are practices to to improve. So there's one technique the box square we're going to do it later. You might have heard of Wim Hof it's good practices where to improve your Bolt score. Something else you can do, which is very accessible is when you when you move so could be moving your upper body moving your walking. Just hold your breath. So inhale, exhale, hold your breath move and then when you need to breathe again, let go. And little by little you'll improve your board score. And I did one breathing session with some some
Véronique Gauthier-Simmons 39:59
I yoga students recently and it was quite incredible how, in 30 minutes, their Bolt score improved. So it's really very easy to improve and it makes a difference to your well being. So now, why I'd tuned tonight was to help you play around a little bit with a breath. And we have different tools, we can use the inhale, the exhale, the pause, after the inhale, the pause the exhale, or we could also play with the left nostril, the right nostril. We can play with inanimate through the nose, or through the mouth, then loads loads of options, but I decided to focus on the pause. I prefer not to use the term to hold the breath, even if sometimes I do not pay attention. Just because holding the breath, sometimes lead to tension up like I need to hold the racket.
Véronique Gauthier-Simmons 41:06
Whereas pausing, we tend to be more relaxed, and one tip than the divers chair, because they practice holding their breath very often is to smile. So if you inhale, exhale, and you hold your breath, and if you Oh, it's not easy smile, and I swear it helps. So we're going to play with different shapes. And we start with the triangle breath. So you see the triangle, I'd like you to visualize that you the triangle as you inhale, exhale through the nose, inhale for three seconds, pause for three, except for three. So we all have different capacities. So respect the the ratio, but you can count faster or slower. So it's if your Bolt score was under five, then count 123123123 faster if your board score was no more than 123 is the right rhythm. If you had like over 20, you can really say one, two, three, ya. So I do a count just for the normal the average Bolt score. And we can start now and just before we start, at the end of the different breathing practice, there will be a second poll where I'd like you to say which of these breathing shapes that we did you prefer so pay attention to how you feel while you are doing these breathing shapes here. So let's start now. Inhale and exhale. And let's start. Inhale, two, three pause. 123 exhale. 123. Inhale. 123123, exhale. 123. Another one. Inhale, 123 Pause. 123 exhale. 123. Come back to your natural breath. So we don't very short practice, but that gives you an idea. And this time, we're going to move the pause. So instead of having a pause after the inhale, we'll have the pause after the exhale, and that feels different. So now the next step first, and inhale. 123 exhale, 123. Pause. 123 inhale. 123 exhale, one, two, three pause. One, two. Inhale, one, two, through. Exhale. 123. Pause. One, two, to come back to your natural breath. Now we're going to move to the square or the box breathing, which is the breath that I mentioned is really good to increase your focus on your attention and was made popular by Mark Devine was, was an ex Navy SEAL instructor and use the it to train the soldiers before action, so it's really to improve the focus and the attention. Now this one, we have a pause both after the inhale and after the exhale. So we go to do the four or five rounds before moving to the next one. So again, pay attention to how you feel when you do these breathing techniques. First, starting with an inhale and an exhale inhale 1234 Pause 1234 exhale 1234 Paus 1234 inhale pause exhale pause inhale exhale pause.
Véronique Gauthier-Simmons 46:55
Come back to natural breath. Again, noticing how you feel. The last one we're going to do is called the coherent breath. And this time there is no pause at all. We move directly from an inhale into an exhale. So take an in and an accent now. inhale 12345 exhale. 12345. Inhale. 12345 exhale 12345. Inhale exhale inhale exhale and come back to your natural breath.
Overcoming MS 48:24
Thank you for listening to this episode of Living Well with MS. Please check out this episode's show notes at overcomingms.org/podcast. You'll find useful links and bonus information there. Have questions or ideas to share? Email us at email@example.com or you can reach out to Geoff on Twitter @GeoffAllix. We'd love to hear from you. Thanks again for tuning in and see you next time for tips on living a full and happy life with MS.