Blowing up balloons?

It is the one thing that we know people are asking about us - why do we ask patients to blow up balloons along with the exercises we give them?

At TC Physiotherapy, we take balloon blowing seriously and I am going to explain to you why you should as well. Sure we even got our own printed balloons!

The diaphragm is a muscle that runs 360 degrees around your rib cage from front to back. This muscle has three functions;

  1. Respiration.

  2. Postural.

  3. Excretory (it has an important role in how you digest your food as if has a sphincter linking the esophagus to the stomach).

What purpose does the Diaphragm have?

Ok so the diaphragm is what I call the pump of the human body - it is the piston, the driver of all movements and it will dictate your position (posture), your injury rate, your stride length and your flexibility. Most people in pain or with bad posture have a diaphragm that does not move as it should and one instrument that moves a diaphragm is a balloon. The diaphragm is the key component in maintaining optimal posture/stability and this is challenged more during exercise and in particular, running. Running increases demand and limb movements (e.g. arms moving while standing still) increase postural demands for stabilization. Maintaining an optimal balance of these muscles for both breathing and postural/stability roles is important for performance and injury prevention.

How does blowing a balloon help?

Blowing a balloon causes a forced exhalation which will cause the diaphragm to descend. This descension of the diaphragm causes

  1. Reduction of usage of the accessory breathing muscles of the neck.

  2. Makes the oblique muscles of your stomach work to pull down the ribs.

  3. Diaphragm descension is a key component to keep the hip flexors in a good position. When this does not occur people present with tightness at the front of their hip and also have an anterior tilted pelvis.

Patients we have treated and the role that balloon blowing played in their treatment and recovery.

Here are two images of a patient before and after treatment. This lady was suffering from chronic headaches and neck pain when she first presented herself to us at TC Physiotherapy. By her third session she had reduced her symptoms by 80 %.

The images below show the scm muscle. This muscle is used on inhalation to help the diaphragm get air into the body. In the first picture the muscle is overactive and contributing massively to the client's pain. After three weeks is the second picture, the scm is not as active, this was due to a tailored exercise programme that we implemented with this client. Blowing a balloon is the best way to stop the scm from being overactive.

Here is another client we treated. The photo on the left clearly shows quite a large curvature of the spine and elevated ribs. This has caused a significant anterior pelvic tilt.The muscle most commonly blamed for this position is the hip flexors but we never treated them. The right hand side photo was taken after the client had completed their repositioning programme.If we compare the two we can see his head, neck and shoulders are more optimally aligned with reduced rib flare and reduced curvature of the spine.


Exercises: Note all these exercises performed are very specific to the position and what we find is the problem in clinic. So please don't lie flat on your back and blow a balloon it won't work.

Left hamstring + balloon +reach

Goal: retraining left pelvic rotation

  • Engaging Left hamstring allows the tailbone to tilt underneath removing the anterior tilted pelvis position - offloading the hip flexors

  • Blowing the balloon engages the obliques to pull down the ribs.

  • The arm reach on the right makes his ribs turn to the left to give him more left obliques.

  1. Lie on you back with your hips and knees bent at 90 degrees.

  2. Place your right arm above your head and hold a balloon in your left.

  3. Perform a pelvic tilt (see photo above) by tucking your tailbone upwards and lift slightly off the the floor/ bed note: you should feel your hamstring muscles engage more.

  4. Shift your left knee down so it is below the level of your right, without moving your feet then squeeze your left knee into the ball and take right knee off the wall.

  5. Now inhale through your nose and blow into the balloon, hold for 3 seconds and blow again

  6. Inhale again through your nose then blow into the balloon again - Repeat this 4 times, relax, let the air out of the balloon and repeat the whole process 3-4 times overall.


Step + balloon

Goal: retraining optimum position of the diaphragm

  • Sitting on a step allows the person to get out of the anterior pelvic tilt on both sides - offloads both hip flexors.

  • The ribcage is sitting just above the pelvis so blowing the balloon will now engage the obliques in a shortened position.

  • Also the rounded spine allows for more air into the upper back whilst stretching all of the back musculature.

  1. Sit on a 6-inch step with your feet together, knees bent and knees together

  2. Round out your back and roll your pelvis back, feeling your “sit bones

  3. Inhale through your nose and slowly blow out into the balloon. Pause three seconds, take another breath in through your nose and repeat 4-5 times.

  4. Relax and repeat the sequence 4 - 5 more times.


Lat stretch + balloon

Goal: retraining lat muscle opening and lateral rib expansion

  • By pulling out of the pull up bar you are using gravity to stretch the lat muscle.

  • By having the legs in front on a step it automatically gets you out of an anterior tilted pelvis

  • By blowing the balloon you get the ribs and diaphragm to descend therefore increasing the stretch on the lat muscle.

  1. Place a balloon in your mouth and grasp onto an overhead bar.

  2. Keeping your feet shoulder width apart, place them slightly in front of you and lower your body until all of the slack is taken up through your trunk.

  3. Perform a posterior pelvic tilt by tucking your bottom under you. You should feel a stretch in your armpit area and across the front of your chest.

  4. Maintaining this position, inhale through your nose and slowly blow out into the balloon. Inhale again through your nose. Repeat 4- 5 times.

  5. Relax and repeat process 4 - 5 more times.


Right rib opening + balloon

Goal: retraining right rib lengthening

  • Side lying position allows for the right ribcage to lengthen

  • Pushing the left knee into the cushion engages the left groin to pull the pelvis out of an anterior tilt.

  • Blowing the balloon brings the left ribs closer to the left pelvis giving him more left obliques.

  1. Lie on your right side with your right leg bent at a 90-degree angle.

  2. Slightly bend your left knee and place it on a bolster keeping your left leg behind your right.

  3. Straighten your right arm, keeping your trunk upright.

  4. Drop your right chest wall by slightly bending your right elbow.

  5. Hold balloon with your left hand, inhale through your nose and blow into balloon, let your right chest sink further to the mat. Repeat this 4-5 times


In Conclusion

Blowing a balloon activates and shortens our abdominals, brings our ribs down which allows the spine to bend forward. Most people in pain or suffering from injuries have over active quads, calves and back muscle this is primarily due to over inhalation and not enough exhalation. Balloon blowing increases the exhalation phase of breathing which is what makes hamstrings, obliques, glutes, hip flexors all achieve optimum position.

Think of it this way,

  1. You go for a run or do a warm up you feel great and 20 minutes later your calf muscles are gone very tight and sore. What has changed?

  2. You go to sleep at night and wake up every morning stiff and sore. What has caused it?

The answer is simple you don’t have control of your respiratory system (diaphragm). When running, the increase in breathing demand causes you to go into a bad position resulting in calf pain. When sleeping, your bad breathing pattern causes your body to tense up, not loosen out.

So, in the future think of physio, rehab and pain like this: each of us takes on average 20,000 breaths a day so concentrate on doing exercises that influence your diaphragm, like blowing up big TC PHYSIOTHERAPY BALLOONS.

Tommy Conway