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Webinar with Dr. Cobb

Low Back Pain Exercises (Our Favorite Brain Training Strategies – Part 6!)

Video Highlights

- How to add resistance to your breathing
- Tips on technique and which part of the respiratory cycle to focus on
- Recommendations for reps, sets, and program length

Hi. I’m Dr. Eric Cobb of Z-Health Performance. And today, we are talking about respiratory muscle strength training and low back pain. 
If you are new to Z Health, we have for the last two decades has been working with world-class doctors, coaches, and therapists around the world. 
So if what you hear today is interesting to you, you’re interested in brain-based training, make sure to check out all free resources and subscribe to this blog because we have a lot of them. Alright.

For the last five weeks, we’ve been going through a series on back pain. And one of the things that I keep emphasizing is that there is no set or perfect protocol or set of exercises that are ideal for every back pain presentation.

We’re trying to give you ideas of different things that you can do as well as a lot of brain tricks, if you wanna call them that, that you can use to enhance the exercises you’re already using to help manage whatever it is that you’re experiencing.

So today, I wanna talk about something that’s maybe a little bit more unusual and that is what is called resisted respiratory strength training.

Whenever we look into the research literature, very often when we hear people talking about breathing for low back pain, it’s focused on abdominal breathing, diaphragmatic breathing, which is great, and also a lot of focus on relaxation and relaxed styles of breathing, which can definitely help reduce stress in multiple ways, which will in many cases impact on low back pain.

But there is also a growing body of evidence that says, you know what? if we can train the respiratory musculature to be stronger, that can also have a very positive impact on low back pain. because when you look at all the muscles that are involved in breathing, there’s a lot.

And all of them are related to how much stability we have through the chest, through the low back, and through the pelvis.

So what I would recommend is that you pick up a respiratory muscle strength training device.

This one is called The Breather. It has little dials on each side, and you can one says exhale, one says inhale.

So basically, you can decide how much resistance you want to create in breathing, both on inhalation and exhalation.

Now most of the research to date looking at respiratory muscle strength training for low back pain has focused on the inhale.

So what we’re going to look at today is the basic protocol, but with a little tweak from a Z-Health perspective. Alright?

So if you have one of these devices, great if not, you can start off just by breathing through your hand, make a very small hole, and you will be sucking air through a small aperture.

You can also use a straw. Whatever, we just basically want the air that’s going to be going in to be harder to bring in or inhale than normal. So normally, what I recommend people do is if you have a device or you’re starting off, you use a low level of resistance just to get used to the process. Alright?

So whenever we do inspiratory muscle strength training, we want the inhalations to be forceful and fast. So notice how I do this first. That’s about a four or five second inhalation, and that is not what we’re looking for. Alright.

The goal here is not to maximally inhale all the air that you can, but instead to within one to three seconds inhale as much as you can. So it should be sharper and more forceful.

So this is what it should feel and sound like. That’s it. Now for a lot of people who have low back pain, a very forceful inhalation, my induce pain.

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So you’re going to have to grade this based off your level to handle that type of intensity.

Now from our perspective, the most important part of all of this is to make sure that you’ve watched video one in this low back series and that you do your breathing practice in your safest posture.

So in other words, in video one, I talked a lot about finding your foot position, knee position, pelvis position, and spine position. where you were most comfortable.

So if for instance you found that internal hip rotation with a tucked pelvis with left rotation was where you felt, hey, my back feels pretty good here.

That’s where I would actually have you practice your inspiratory muscle strength training. you may find that you’re stronger in that position and that you’re able to create a more intense inhalation without inducing any pain.

So this is going to be a really important component in the low back rehabilitation process.

I’ve been working with low-backs since really about 1990. And invariably at some point in a rehabilitation process, we have to look at the breathing.

With my classic training I did a lot of diaphragmatic breathing, a lot of relaxed breathing, but also now what I want you to focus on is respiratory strength. The basic protocol for this is 30 breaths twice per day. Ok?

That’s three zero inhalations against resistance, two times per day, five to seven days per week.

In general, when they look at these protocols, they’ll last anywhere from six to maybe ten weeks.

And when measurements are done, it’s very noticeable that the strength of the respiratory muscles has increased, and it also can create some kind of cool changes in respiratory function itself.

So if this makes sense to you, I would love for you to give it a try and let us know how it works for you in the comments. Thanks.

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