Jill Miller
Appearances
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you have your skin, and then directly underneath your skin, you have... I mean, most people just think this is your fat, your fatty layer, but... It's not. Within your fatty layer, you actually have a continuous membrane called the superficial fascia. And this superficial fascia actually subdivides your fatty layer into two different layers.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Did you know that you have superficial adipose tissue and then you have deep adipose tissue underneath this membrane?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You did. That's great. Of course. But the superficial fascia also spawns these really interesting... poles called retinacula cutis. So we have all these little tent poles between our skin, the superficial fascia, and between the superficial fascia and what's below that, which is called the deep fascia. And so these tent poles are part of what gives our fluffiness, the buoyancy to our shape.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So underneath these tent poles of the superficial fascia, we have
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
sliding layers called loose fascia this is a fascial interface and you can find that right now i'm covered with my jean jacket but you can just pinch your forearm and you could you can actually move this right left up down you can even twist and you can pull it away so we have an area called loose fascia that's between the superficial fascia stuff and what's known as the deep fascia
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The deep fascia is the fascia that I think most people recognize as fascia. And part of that is because this is a lot of the mechanical model of movement. A lot of Tom Myers anatomy trains sort of It pays homage to these continuities of these gigantic collagen strips that run from, you know, foot to face. And you can really see these in dissection.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So the deep fascial tissues, they are surrounding our muscles. But we don't just have one layer of deep fascia. We have multiple layers of deep fascia that glide upon each other. And then we can get into the interior architecture of a muscle itself. Each muscle you have is comprised of additional multiple layers of fascia, and these are subdivided.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Like each muscle cell is surrounded by an endomysium. That's like if you have one little orange, you know, in the orange you have the little tiny segment and it's surrounded by that cellulose filament and inside it's just juice. The same is an analog for your muscle and its endomysial fascia. Then when you have groups of these muscle fibers, you're wrapped in yet another layer called perimysium.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But you must be able to have movement between these epimesial sliding filaments and the paramesium. And then the paramesium gathers together in lots of bundles. And then we have a real muscle, and that's wrapped in even more fascia. That's called the epimesium. And these epimesial bundles is what we call a muscle. And that muscle and its epimesium must move. It must have differential movement.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
amongst the other muscles that it's next to. And this is called glide. We have glide between all these different things. And so when you invest a tool into these tissues, we're stimulating cells called fibroblasts, which produce the collagen and elastin environment. We are stimulating cells called fasciocytes, which are chiefly responsible for keeping you slick inside.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
They produce an abundant amount of a substance called hyaluronan. You're also manipulating fibers. You're creating tension with your compression. You're creating stretch, tension, pull on these different fibers that these fibroblasts are sensing. And when the fibroblasts start to sense activity, they will start to realign things or tear things apart depending depending on what you're trying to do.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So, for example, one of the, I guess, the old myths that people kick around all the time is, is massage or self-massage breaking up scar tissue? Well, yes and no. Scar tissue is comprised of very, very strong fibrils of collagen type 1, and it is necessary to be there to stabilize an area that had been breached. The scar itself on the surface may look bumpy and weird and a little bit ugly.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And there are some things we can do with friction that can adapt that tissue, that can maybe soften the scar a little bit. But the scar is necessary to act as a permanent suture for the rest of your life. But typically what we're seeing on the surface of the body, the scar is really the tip of the iceberg, depending on how far down that wound was into the body.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Now, if we have a breach that goes all the way to the bone, like I'll use myself as an example. I had a total hip replacement almost eight years ago. And so, you know, they had a saw that greater trunk hander off and there were many layers that were breached. So there's a scar path that goes from skin all the way to deep, even though it was a very elegant surgery.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You're left with a scar path post-surgery. And ideally, you want to be able to do movements and massage that that allow the fascial tissues to restore glide so that the muscles can return to their correct length tension relationships. So when we are stimulating these tissues, We're doing many different categories of things.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
One of my personal favorite reasons to do self-myofascial release or to do foam rolling is to enhance one's proprioception, to enhance one's ability to know where they are in their own body and be able to know how to move forward or how to take the next step, to know where you are in space. That proprioceptive enhancement has been shown to also have an inverse relationship to pain perception.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So when we exaggerate or tickle these proprioceptive nerve endings like Ruffini endings or Pacini corpuscles or muscle spindle or even Golgi, it has an enhancement of improving our sensory motor awareness but dampening down our pain perception.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
which is great because we have this analgesic effect and we have a window that we can train in in better coordination, offsetting or at least putting at a distance some of these pain signals. And that means that when we train, we can then train in a better position and over time optimize our physical body so that the pain doesn't have a place to sit in our body. Right?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So when we, hopefully part of your pain management is having healthy muscles, helping healthy, strong movement patterns. And that is one way that doing the foam rolling or self myofascial release or self massage can be a boon to pain reduction. And there I got to include all these different nerve endings as well.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
When we're in pain, we are not at our best in terms of our movement coordination. And that poor movement coordination tends to beget even more movement coordination and leads to accidents. And so we can use the tools like a self-myofascial release tool to essentially have a state change physically from the tissue, but also it helps to create this mental swipe.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And the temporariness of that is, you know, in the research right now is showing that there are a lot of these acute changes and that these things can also happen in long term, but you have to do them again and again. You can't just do it once and hope for the best and it's all good. You need to have a self-rolling, foam rolling, as well as the corrective work.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
the foam rolling in and of itself is not going to take care of everything. You still have to change the body's behavior around why that pain set about in the first place, right? And so that is the physical management that comes along with proper exercise and whatever other things, nutrition, sleep, all of that.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So one of the things that rolling on an area like the foot. So is there a morphological change when I roll my foot? Probably not. The research is showing that you're probably not actually changing the fascial tissues in and of themselves, even though. We can improve glide.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I'm down for all of it. That's great. I'm so glad that you connected with what I was offering because I think what I did and do in the yoga space was very radical and, frankly, heretical back when I started teaching it. And not a lot of people got it. And it's really nice to see that it did finally –
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We can improve a relative glide amongst many different tissues, even in a pretty relatively short period of time, within 60 seconds to two minutes. But one of the things that the research is also saying is probably that one of the things that rolling is doing is it's adjusting your discomfort to stretch. So it's adjusting your pain pressure thresholds. to stretch. So there are these fluid changes.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
There's heat changes. But in a way, you're inoculating yourself to the discomfort of the forward bend. And so that is allowing for a little bit more movement. But there's also some of these neural changes, such as the rolling in is enhancing parasympathetic features. So perhaps there is less muscle bracing in your range of motion check afterwards. So there's a cascade of things that are happening.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I don't think we can only say, oh, it's the fascia that's letting me get that extra range. It's a part of it, but I think there's a few other... things going on neurologically and in terms of fluid mechanics.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's a miracle.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So I haven't seen any research that like they did the rolling and then, you know, they check it five minutes. They check it 10. No time sequence here. They check it 30 minutes. And then you're like – you're also wondering, well – I bet that stretch at five minutes helped with the stretch show up at 30 minutes.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But then they didn't say, okay, now go ahead and go to your classes and come back in six hours and let's recheck you. So I haven't seen something like that. But I certainly know anecdotally with the clients that I work with. We usually are rolling for a considerable amount of time. We're not just doing a two-minute roll and then hoping that our range of motion has changed for the day.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We're doing strategies that are really trying to affect certain conditions or certain systems of the body or certain pain patterns. And people will have... Hours and hours, if not days, of improvement after some of these very deep and disciplined ways of decompressing certain areas of the body or fluffing tissues, as I like to say, offloading compacted tissues.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Let's talk about that.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
find those people that it was meant for, and act as a bridge back and forth between training, pain management, yoga, self-care, and all those things.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Okay. So there's a few different things to talk about. One is tool hardness.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And another is it doesn't have to hurt to work.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I am a soft tool champion.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yes. So stress transfer mediums are what we call the tools. This is the mechanical term, the scientific term for self-massage tools or self-myofascial release tools. So you have foam rollers. You have balls of various hardness. You have roller sticks. You have little like pokey things. And hardness matters to everything. your body because you are a living being.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You are an organism that has responses. It doesn't feel good to get poked with something that's hard unless you can attenuate your response to that.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So what a hard tool will do is it will initiate a sympathetic nervous system response. This is called the muscle bracing response. Because your body doesn't want to be deformed by something that might cause pain, that might cause injury. This is a natural autonomic protective response. And this is called the muscle bracing response. So there was... It's just crazy to me.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But in the over 200 and something published papers on self myofascial release, there was one paper that disclosed the hardness of the actual implements used in the rolling. Okay. Just for perspective, you know, foam rollers are, they're dense foam. They are, they're very hard. Even though an individual foam cell, you can compress it, when all those foams are together, that's hard like wood.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's really hard. A lacrosse ball is the same hardness as a bowling ball. Did you know that? Did not. There is no difference in the material substrate of a bowling ball or a lacrosse ball. It is the same thing. The lacrosse ball is interesting, though, because it's covered with this grippy rubber, which I love. I love the rubber of a lacrosse ball. But a lacrosse ball has no yield.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Neither does a bowling ball. Neither does a foam roller or a hard foam roller. These will just keep pushing their weight into you and you either suffer through it or you brace against it. It causes so much discomfort. You're like, I'm just fighting against my own tension. I'm not getting anywhere here. So this one Korean paper says, It was very special for two reasons.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It disclosed what's called durometer. That's the way we measure hardness in objects, right? So, you know, wood is harder than foam. Gum is much softer than a tennis ball, right? So we have this scale of hardnesses that's measured in what's called the shore scale, and you use a durometer to test for indentation hardness.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So this cohort used people with chronic neck pain, and they used a cohort of over 60-year-olds in Korea. So it's very unusual to have a cohort of aged people. Most research in self-myofascial release is on young people in college on foam rollers. Most of them are rolling their cabs, spoiler alert, or their hamstrings, Andy, or their quads. But to find old people with neck pain?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And then to either put them on a lacrosse ball or a soft inflated ball. So what do you think happened to the cohort?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The hardball folks, what they found was there was a thickening effect when they were measuring EMG. The muscles were just in tension. The trapezius muscles braced against the ball. So the ball couldn't even get to depth because the body was protecting itself. Those that used the softball had an increase of... Neck range of motion and a decrease of pain because the ball could get in.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The ball was actually to do the therapeutic work because they weren't fighting against their own neurological tension. So in my book, soft is supreme in terms of working with your nervous system. rather than working against it and creating even more sympathetic stress, propagating even more pain. There is some other research by a guy named Leonid Blum and Mark Driscoll.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Leonid specializes in cerebral palsy, and he works with families to help the children with cerebral palsy to, you know, improve their posture and pain. And he uses only soft implements with these kids. And it really helps them to create a more spontaneous upright posture and have better movement patterns.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But what they did, what Driscoll and Bloom did, is they did some indentation hardness tests with a lot of different substrates. And they made, I think they made like a mock test. not cell culture, but they were able to measure the distance of forces using these different tools into the substrate. And what they found was that the softer tools were able to reach the furthest distance into the body.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So that's one of the reasons why I'm a really big fan of soft tools. They don't have to hurt to work. And when... You're rolling and it hurts. That's great information for you. You know, the rolling isn't about trying to make more hurt. You're actually trying to get rid of the hurt.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But when you do roll into something that does hurt, that also should tell you either it's a protective response or I'm actually... But encountering parts of my body that are inflamed or don't move well, I think it's really good information. But you want to be able to work with that instead of think that you can just beat it out of you.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So, yeah, and the other thing is, you know, your own muscular tension or your gluey tissue from overuse or overtraining, the glueyness coming from... increased viscosity of this hyaluronan that the fasciocytes produce, this is really a hot mess inside of there. And we want to not have that there.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And so when we get that feedback from tools, I think it's really great information that we may be burning ourselves out and setting ourselves up for an injury down the road. So I think it is really, really good feedback when we come across those pain spots. But then I think we need to work in an informed way to reduce that at all costs.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Okay. So foam rolling has become the de facto term that is now used, I think, in most places that refers to self-myofascial release. So self-myofascial release as a category in the self-treatment space or recovery space is where you use and implement foam. which technically is called a stress transfer medium. So we're talking about rolling sticks. We're talking about foam rollers.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah, so I think it's like a therapeutic discomfort. I call it comfortable discomfort, like tolerable discomfort where you can still breathe. You know, you don't have involuntary overflow, meaning you're not clenching your jaw. I mean, some of the things that we see when I'm rolling people out in the classroom is their eyes will freeze open.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Their hands will clench like they're holding onto a gun and a purse at the same time. Or, you know, they'll do weird tics with their jaw. And this just means they're in overflow. They're in sympathetic overflow. They're not engaging a therapeutic response. And they might also actually be, frankly, dissociating from their body. So that, to me, is really a removal of presence.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I think, and this is what I write about in Body by Breath, it's really important that you are present with your entire being while you're doing this work so that you can... Yeah. Yeah. Or I'm just choosing to leave, right? And I'm just going to be a shell on the table, which sounds like totally crazy. But, you know, we can make those choices too.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Like we don't always have to be totally, you know, zen and present and all of that. Sometimes we're like, I kind of want to see what will happen if they just maw on my vastus medialis till I bruise. I just want to see what's going to happen. Will that free up this portion of my knee?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You know what? It is an okay strategy for the fibroblasts and the fascia sites. Those fluids, those fibers, they will respond to that contact.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah. I mean, it's fine. Yeah. But I think if you really want to be in control of this remodel of yourself, you want to be aware. You want to remain aware and pick up on both the subtle and gross sensations that are percolating from these different sensory neurons at different levels within your tissues.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Oh, okay. Right.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yes. So your fascial tissues have the ability to move in every direction. They're vectored in every possible angle all throughout your body. So just squishing them is beneficial, but only squishing them is leaving out the possibility of offloading them or tractioning them in the opposite direction. Right.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We're talking about different balls, even pokey tools, like just single things that have knobs on them. So anything like that is a implement that is trying to influence tissue in a variety of different ways. These implements are trying to mimic somebody's hands, right? So this is something that you can do on your own. You don't have to hire somebody. You don't have to go out of pocket.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So this suction type of thing that a cup can do is just so amazing because it can allow a gapping to occur from bone to skin rather than you just pressing in from skin to bone. And that can relieve a lot of over-compression tension or possibly you have – And some adhesions or agglomerations that can't be helped at a certain vector.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And so doing techniques like I say in the role model, we do this thing called pin, spin, mobilize. And this is a term that I picked up from Kelly.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
right? And so what we're doing is we're using one of the soft balls or any, we can really do this with any tool as long as it has grip, and you place it into your tissue and you spin it, you twist it, you wrangle the tissue until you feel there is a tolerable pinch. Once you have that tolerable pinch, just think about that. That's a vortex of tissue that's whirled into the tool that
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So tremendous amount of stretch. And then from there, you attempt to move the tool or move your body right, left, back, forth. And so then that's moving that twisted knot in a variety of different ways. When I say knot, I don't mean like a muscle knot. It's the twisted skin, superficial fascia, loose fascia, and possibly deep fascia at that level that we're getting all this traction.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And then when you release that, there'll be a ton of perfusion. There'll be a whoosh of warmth. and this sudden onset of range of motion improvements that's local to that joint. So if I were doing that on the rib cage, you will have such dynamic breaths after that. So the pin spin immobilized, that includes this...
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
vector called shear right so shear is where we're getting basically horizontal stretch but you know cupping cupping is is an additional local traction that really stretches skin superficial fascia all the retinacular cutis and then can even grip into deep fascia and create a force vector maybe even to the periosteum so that's the skin the fascial skin around the bones
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And there are, of course, nerve endings and blood vessels all the way at depth that are being teased in a novel way that they're not getting day to day. Because most of gravity is pushing us into ourselves instead of, like, I mean, there's a good reason. Like, we don't want to float off of ourselves. But just think of that.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
That feeling you get when, I'm thinking about my husband, when, just think about when we walk the dog and I grab him by the scruff of his neck, you know, where that coat hanger area is, right at the base of the neck, the upper trapezius, and I just traction him right in that dowager's hump area. He doesn't have one, but you know what I'm talking about?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Just like I would lift a puppy by the scruff of its skin. It feels amazing to have stretch in that direction. We just don't get it. So I try to do that using two balls in different areas of the body to also create that type of offloading traction rather than a compression traction.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I think you'd have to look into the cupping literature to see other benefits of what that offloading type of stretch does. And I haven't really looked into that.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You can do it any time of day you want, wherever and whenever you need it. So what are they doing? What are these implements doing? They are... sometimes compressing tissue. Like you said, they're inducing local stretch. So if I just lay on a ball or lay on a foam roller, I'm really just putting pressure into that local region.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
During the pandemic, I was in peak stress, just like everybody else. I was homeschooling a five-year-old, a kindergartner, and a three-year-old preschooler who had never had a computer in front of their face in their whole lives. And all of a sudden, their schools were on Zoom. And we were pivoting our company and filming all this content. And it was so stressful.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I started to have – and also I was writing a book, of course, about stress regulation. And I started to have panic attacks, which is not – and that is not in something that I'm not used to. I definitely had panic attacks in my life. But this was horrible. Yeah.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
and I had come across just some anatomical body part that I'd read about before, but sometimes a body part, especially when it's fascial topography, doesn't stick the first time, doesn't stick the second time, doesn't stick the seventh time, but finally the eighth time, I became fascinated by this particular area of the thoracolumbar aponeurosis called the lateral raft.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So the thoracolumbar aponeurosis is the... the plane upon plane of flat epimesial fascia that is the tendon of your lats. It's the tendon of your external abdominal obliques, your internal abdominal obliques, your transversus abdominis, your erector spinae. There are also layers that... enveloped the psoas and quadratus lumborum.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we have a layer cake of deep fascia on the back called the thoracolumbar aponeurosis, all right? And within this, there are these little seams where all of the layers of the thoracolumbar aponeurosis come together, and these are called the lateral raff or lateral raffae, if I'm pronouncing French correctly. Mm-hmm. So I wanted to see if I can massage that lateral raffae.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And so what I did was I had these tools called gorgeous balls. And they're soft, inflated rubber balls. And the ball feels like a human hand. It's very grippy. And they're very gushy, these balls. And so I placed them on either side of my lower back, right about where the lateral raffae is. Where is that? Just above the... pelvic bones connecting to the 12th rib. So we had this little zipper.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
This is where this lateral raft is. And I laid on my back and I had these gorgeous balls on the girth of my low back. And my sacrum was on the floor. These balls were on the sides of my low back, rib cage and head was on the floor. And I laid there and I breathed for many, many minutes using my diaphragm as an internal massage tool to reach my way into this thoracolumbar aponeurosis.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I experienced a lot of pleasure over the many minutes that I was there. And that pleasure was I could feel from my sacrum to the crown of my head, my entire spine was lengthening while these balls were broadening me from side to side. When I, there's a lot more that happened there, but when I finally took the balls out, I could feel that my little body, I'm a little five foot two girly.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But what happens if I stroke that implement with my body weight, either in a reclining position or up against a wall or in myriad other arrangements? What happens if I take that implement and I move it along the line of pull of a muscle or across the a pull of a muscle? Or what happens if I do a different type of compressive rolling?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I took those balls out and I swear to God, I had grown an inch. All of my discs had reperfused. My anteriorly tilted pelvis was no longer just passively hanging out an anterior tilt in a reclined position. And I know this is the experience you had because I did this with Andy. And after he did this decompression, he's like, oh, my lumbar spine is not extended anymore.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It just feels, quote, unquote, neutral. It doesn't feel like it's hypertonic in this. And so I had that same experience. And part of that... back tension that I had was all the emotional stress of carrying this business, of carrying this family, of not having a way out. So there was a lot of emotional release that went along with this decompression because I was just holding on to so much.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So this is a way that one can painlessly address back pain that can address arthritis in the spine that's, you know, making you hold your body in a certain way. And that isn't a rub out. It's not like a roll out. I'm not like creating aggressive friction. This progressive position anchors these layers of thoracolumbar aponeurosis and the
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Breath is the tool that's creating this almost like this squeegee swipe balloon action inside your body and creating this progressive stretch from bone to ligament to disc to fascial layer to muscle. to induce a better glide throughout the entire axis.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And then within that little capsule, that little position, there are so many little micro-movements that one can do to address very nuanced things as well. But also you think about this decompression of the spine isn't just decompressing the spine, it's also decompressing all the visceral organs that are hanging out just on the front side of your body that are also like...
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
dealing with how they process stress or how they're processing your posture at all times. I think there are many different things that are decompressing. That is the overall emotional feeling of release. So I heard you say release when you were leading up this question. That word release in the self-myofascial release literature
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Unfortunately, we have this term self-myofascial release, although I think foam rolling is a horrible term also.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But you feel this ephemeral, psychological, almost spiritual sense of something has released. Some heaviness that I felt before or some strain that I was preoccupied with has evaporated. Why? I just laid on two gushy air-filled balls, and I breathed. I didn't even move.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And nothing hurt, and my breath was the movement. How subtle and amazing that is.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
What happens if I pivot the implement or pivot my body so that it creates traction and creates like a pinching sensation? What are all those things doing? They're affecting different stretch receptors in different ways, and they're affecting different layers of your body in different ways, from skin to deep. And one of my deep interests is in the fascial tissues that it annoys.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I think I propose like myofascial... What did I propose?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Well, I think massage is actually... Okay. I think that's actually a right word.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We'll acknowledge... Like manipulation.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Exactly, myofascial manipulation. I described how I came. A lot of how I came about the rollouts that I do, so many of them are about stress regulation, but they happen to be so helpful for people with pain and so many other different syndromes. But I wanted to point out about this spinal decompression exercise.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
What's so notable, by the way, it's called the lumbar hammock for short, but in Body by Breath it's called spinal decompression via the lateral raft. It's really embarrassment. I can't believe I over-titled that, but it's just a lumbar hammock. You're just setting up a hammock. But there is a researcher...
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
A professor in Wisconsin who is forming some cohorts right now in the firefighter community, she's had an N of 1. She has a firefighter that she's been working with who has been doing these type of rollouts, very gentle, non-painful rollouts. Not aggressive rolling.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And she was really having trouble with a stress test that they regularly have to go through, I guess, to maintain their certification. They have to run up stairs with a heavy pack, many, many, many flights of stairs. And she kept breaking down. She was having difficulty in her preparation for the test. And the professor said, give me a month.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Let me work with you on some stress relieving techniques. And she shared this and a number of other body by breath techniques. And she was able to run the test with energy to spare and with no pain. And so now she's creating a cohort of firefighters to test out some things. But the same researcher has also been doing this work
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
in a much older population, in a population of folks with Parkinson's disease. And all of them say they have immediate postural improvements, their tremors stop or diminish greatly. So there are a lot of other autonomic nervous system benefits that this type of work does that isn't just necessarily tissue dependent.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But there are other shifts, I think, that are happening throughout the body that are notable and can be very helpful and low to no cost. If you don't have balls like I'm describing, what I've done as a substitute is I've rolled up yoga mats. I mean, most people can find yoga mats or something. Towel or something. Yeah, but the grip is important. So you need to find something to put over the towel.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
That's going to create the grip for you, so you have to experiment in your house. I like, you know, bottle openers that you use to open a mayonnaise jar. Those are good. You have to have a few of those, and you can put those on some rolled-up towels. But the grip is really important, again, because we're talking about this layer cake. We're talking about trying to create—
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
horizontal forces, shear forces that are going from skin all the way to bone. But we're not just doing it with compression, like you said. We're not just pressing in. We're trying to traction and offload. So you have to look for that in your house.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I have many on Instagram. I have many free videos on YouTube. And I have this, I think I have a nine-minute version on YouTube of this one.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
What is it doing to those tissues? It's doing a lot of different things. So I recently wrote a narrative review of the scientific research on self-myofascial release. And there are a lot of things that these implements are doing to your body. One of the, I think, things that we can... almost all the systematic reviews can agree on is it improves range of motion very quickly.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's so cool. I had to write a 480 page book about it. I love the diaphragm.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Oh my goodness.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yes, the respiratory diaphragm, the respiratory diaphragm. Yeah, this is this interesting horizontal muscle, this sort of misshapen parachute inside of the rib cage. You have this partition between the abdominal organs and your heart and lungs. And this muscle acts as a a pump for both the viscera below it as well as the lungs and the heart above it. And it's also keeping those things separate.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
If you didn't have your diaphragm, your small intestine would be coming out of your nose, most unattractive and disgusting. So it's there for that reason. The diaphragm Let me just rewind just a little bit.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
When you're doing that decompression exercise, one of the cues, one of the attention cues that I gave to you and to the other folks here at the Perform podcast was to, once the balls were in place, was to deliberately breathe south of the rib cage, right? To breathe in a guttward direction. direction to breathe the energy of your attention into the balls that are on either side of your low back.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And what that enables is you to begin to sense the actual excursion, the downward movement of your diaphragm on inhale.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And then it's relaxation on exhale. And this was basically a slow forced inhale, meaning you're deliberately inhaling. And then I asked them to not force the exhale. So the exhale was just what we call passive recoil in the diaphragm space, or rather in the fascia space. So we have this inhalation where you're feeling the movement of the diaphragm into the right and left ball. But what
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I also asked them, especially Andy, to pay attention to was I wonder if you feel any difference in the movement on the right side versus the left as you're here breathing. And was there a difference for you?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Totally different. These are two hemispheres of one muscle. We have a right diaphragm and we have a left diaphragm and they're innervated separately by a right and left phrenic nerve. And your right diaphragm is a little bit higher in your body and the left hemisphere is a little bit lower. But you can't sense it. You can't feel your diaphragm. This partition is devoid of muscle spindles.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So it's somehow dampening some of the sympathetic feedback into your body. So you can very quickly improve your sit and reach test or shoulder overhead or spinal movements or even jaw movements. It just depends on what is your target. What is your joint target? What's your tissue target? What's your intention? So that range of motion improvement is really exciting.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you can't really ever know. Like I can say to you right now, Andy, can you tell me the degree of contraction in your right bicep? Or can you tell me about, you can tell me about the position of your elbow by thinking about your right bicep. But if I told you right now, if I asked you right now, where is your diaphragm?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You have no proprioceptive awareness of this muscle. Thank God, because if you had to feel it 20,000 times a day, descending and ascending, you'd go mad. You can't afford that. This breathing is happening automatically for you most of the time unless you're taking control of it. This is a skeletal muscle, and we can control it. It's amazing.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We can do things with this skeletal muscle that directly impact every system of the body. The diaphragm is a node that spawns responses automatically. all over our body. But for me, one of the most practical things that I do with my clients regarding the diaphragm is inducing pressures into all the tissues that connect to the diaphragm so that they can build a better mapping of it
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And at the same time, they can release tissues that, unbeknownst to them, are inhibiting the diaphragm from its full range of motion or from its potential range of motion. Now, I will say one more thing. The diaphragm, you do feel the diaphragm in one particular activity, and that is when it goes into spasm, and that's the hiccups. All right.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So that's really the one time when you like feel the diaphragm. Other than that, it's really hard to feel. So we have to make it visible through pressure, through novel breathing strategies with pressure. When I talk about pressure, I'm talking about using the, especially the gorgeous ball or the different therapy balls that I use in different ways and trying to
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
enlarge your proprioceptive and interoceptive awareness of the relationship of breathing to the diaphragm. And so one of the key places we go, there's a lot of key places, but one of them is below the diaphragm will go into the gut because the diaphragm is sewn into the same exact fascial fabric as the transverse abdominus. And so if your transverse abdominus is very rigid from overtraining or
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
or from sucking your stomach in. These are things that will create adaptations in the collagen network of your fascia and create a lot of stiffness. And your diaphragm, as it descends, There should be a corresponding ballooning of everything that's below it, right?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So as your diaphragm presses down, this is called intra-abdominal pressure, your organs are gonna be, they're gonna bob down because they're being pressed from above by the diaphragm. Your pelvic floor will have a stretch and there'll be a circumferential stretch The abdomen will stretch forward.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The waist and that thoracolumbar aponeurosis that I was trying to get you guys to perceive should also have a corresponding distension.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But some of the other research that really excites me, especially I know I'm on the podcast called Perform, and people want to get more out of their workouts here, is that not only is the rolling improving this range of motion, but it's also improving performance. force output. It's improving torque. And that's really helpful, especially if you want to be able to lift more over a range, right?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
That's right. But most people are missing this horizontal movement because of just the way life creates so much tension in our back body. low back pain is the most prevalent cause of pain worldwide. And I'm here to solve that problem. I wish.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So by going into the transversus abdominis with the cordius ball, by the way, if you've never gone into the gut to massage, I don't advise going into the gut to massage. I always advise a sideline position first. to attenuate your pain pressure response.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Because when that ball or when that object goes into the abdomen, we could go back to this muscle bracing response, your body will do anything to get to the next breath. And if your transversus abdominis is compromised by pressure, your brain is going to start to signal pain, and that's going to get you off of the object. It's going to be so uncomfortable.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we have to figure out stealth ways to acclimate your body to this uncomfortable pressure that is threatening the diaphragm's movement. So there's a lot of paradoxes in here. So in Body by Breath, one of the things we do is we work with mindset. So we'll actually self-suggest things to ourselves in order to welcome this discomfort in a tolerable way. Like I'm a student of my breath, right?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we might say something to ourselves like I'm a student of my breath or my breath is welcome here. Things like that can be really helpful because you want to be a student of this – relationship of the diaphragm to the transversus abdominis. And by the way, it's not just the transversus. There's other stuff there too. But visceral pain is also very real when you put an object right into your
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And to your small intestine or your large intestine for the first time or your bladder, there might be some kickback.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Of course you did.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah, Andrew has a quote, never skip diaphragm day. I don't know if he made it up. I have it in my book. I think it's hilarious. Okay. The diaphragm is probably working. If you're alive...
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Your diaphragm's working.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's doing its thing. But your intercostals may not be rhythmically moving very well. You may have inappropriate stiffness in this relationship between the transversus abdominis. And the diaphragm, you may not be getting good rib excursion or you may be over breathing by using what we call accessory breathing muscles. In body by breath, I break breathing into three different zones of breathing.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
There's zone one, which is this area that we've been talking about, this very relaxing gut expansion, diaphragm descending. Zone two is the area of the intercostals. in combination with the diaphragm. So we have rib upward rotation, rib downward rotation. And this is, you know, you have 12 sets of ribs on one side and 12 sets of ribs on the other, and they've got to be moving well.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But if you are a person who is under A lot of stress and diabolical stress. Eventually, if you're only doing rib breathing all the time, which is over time this is a sympathetic breathing style, you'll probably end up defaulting into what I call zone three breathing. And that zone three breathing is face, neck, shoulder type of breath where you're... You're really gasping for air.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So maybe you're deficient in your overhead and you're overusing certain muscles again and again. But what the rolling does, it'll restore a range of motion. Plus, you'll be able to get more out of those muscle fibers. They'll be able to pull more or push more depending on what it is, the movement that you're trying to do. The rolling also happens to dampen sympathetic overflow.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And you can see this in asthmatics. You can see this in sudden onset of panic. But this is also not always necessarily a harmful breath. You'll have this type of zone three breath in an orgasm, like a really heightened sense of delight. So you'll hear these air-filled type of breaths that are very, very shallow. But it's not a long-term strategy for health.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So the way we test for it is through responses to touch in these different areas. So I think that neck and shoulder pain are very common. And I think with the use of tech, it's gotten worse and worse and worse because you have the hand-to-eye positioning that comes from holding cell phones.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we can be in the cast of a Zone 3 breather more often than probably our ancestors because of our close environment with work and with tech. Yeah.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And so these tensions in the face, neck, jaw, eyes, shoulders, all the way through the brachial plexus down into hands and fingers, I think are providing more sort of a simulation of zone three armoring that is really unnecessary for efficient length tension in zones one, two, and three.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Chronic neck pain, jaw pain, headaches. That would be somebody – or hand pain, right? So anything that is coming from this – all the areas that I described. So this would be – we would be addressing that in zone three. What do we do for that? Well, typically, I'll do some zone two work first.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
first because you don't really get your shoulders to sit on top of your rib cage well unless your rib cage is able to upwardly and downwardly rotate well. So I'll do a lot of sideline positions on the gorgeous balls on the rib cage. And I'll train people to use the ball as an elastic biofeedback. So they'll do breathing in sideline, also in front line.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So they'll place the ball on their sternum with their body weight and feel the intrathoracic pressures changing as they breathe into the tool. And so you start to pick up on the movements of breathing. And these sensing of the movements of breathing helps you anchor you into more and more appropriate
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
long-term healthy breathing patterns, which is zone one, zone two is really where you want to be most of the time. And you want to use zone three in case of emergency. You're trying to cross the finish line by all means. Breathe however you need to breathe. Breathe however you're going to breathe. So we need zone three to be facile.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But if it's always armored, if it's always in this high stress position, you can see, right, we're on camera. If you're looking, I've got my shoulders pinned up into my ears and my head is being thrust forward. My upper back is rounded. You know, I've got nowhere to go.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Or even apneas, sleep apneas, right? So this nighttime unconscious mouth, jaw, tongue behavior that is deadly.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
One and two.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah. Yeah. So I call this playing your wind instrument. So by becoming aware of the feedback of the soft tissues in these different zones, you can really make choices about, I mean, obviously your physiology is your physiology. I live in LA. We had fires in LA. I couldn't believe what happened to me psychologically when this devastation was going on. So doing practices that
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
familiarize you with your own zone one, zone two, zone three, and that you have ways to at least flip the stress switches now and again and bone up on practices that build your recovery resilience or at least fill up your parasympathetic cup rather than continue to overload the sympathetic cup. I think this is what I'm referring to in terms of playing your wind instrument.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So the tools happen to increase parasympathetic reactivity. So that's really beneficial if you're trying to calm down, you're trying to gather your thoughts, you're trying to minimize your anxiety. The balls and tools and foam rollers, I always say the balls because I'm a ball dealer, but I have to note that these things also happen with foam rollers or rolling implements.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But for me, pressure is always a part of that because that is what's giving you the biofeedback about which zone is my home? Like where am I mostly breathing into?
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
This can change within two minutes.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah. And you want to do the other side, obviously. You want to do both sides. But I like to do a lot of contract relax type of exercise there because that also plays with some of the baroreceptors in the aorta. And so we get a really interesting, I think, vagal vagal rush from doing some of these breath, hold, contract. Let me describe that to you.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you're laying on your side, and I have many videos on Instagram that cover this, and you can put like a block or a pillow underneath your head, and you have... a soft, gushy ball like gorgeous or something else underneath your ribs. And you take a dynamic breath, a zone two breath that really broadens the rib cage like Popeye. You hold your breath and then you stiffen.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You activate those muscles that moved your ribs apart. And then you exhale and let go. So you can exhale passively and just let it all go. But you can also build on the exhale strategy and try to void your lungs of air. So let's say we inhale, hold, contract. And then exhale. And then once you think you're empty, then blow out four more candles on the birthday cake.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Blow out six more candles on the birthday cake till you get to such a absence of intrathoracic pressure that you have a spontaneous... inhalation. So there's lots of different tricks to work on creating this elasticity of the rib cage.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I do find that doing both ends, this dynamic inhale, hold, and then the exhale with the really forcing the air out, forcing the air out, not in a way where you're pinching your face and scrunching your eyebrows and going into a zone three reactivity, but truly using the intercostals and the diaphragm and the transversus abdominis to get the air out.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
This is a really great way to build that, just the costal recoil. And when you do that, you do the both sides, this really helps the costal vertebral joints also. So you're going to find that your thoracic spine, your whole spine is going to have better mobility, especially rotation, like transverse plane rotation. It's amazing what it does.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Once a day. Do you want me to prescribe? Everybody, get down a little bit every day. Oh, it makes such a difference.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I like, if I'm going to only do it once a day, I'll, boy, that's a really hard call.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah, you got to do this in the morning. Well, okay, okay, excuse me. You need to do it at night and the morning.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
No, because one of the things pre-bed, and I've seen this happen in my students, doing many of these parasympathetic exercises. So all of it, by the way, all these exercises that I'm describing are going to do what I call turn on your off switch, they will accelerate a parasympathetic dominant state. And again, keep pushing off this weird sympathetic overflow.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So when people have the jaw grinding happening at night, they get incredibly... incredible soreness in all the muscles of the face. A lot of this is beyond your control. This is just happening unconsciously.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
They also improve your vascular flow. So when the rolling implements interface with fascial tissues in specific ways, your fascia releases nitric oxide. So we get these local improvements of vascular stretch and nitric oxide release. I could go on. There's many, many other benefits to rolling.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But what I have seen in students that do a number of these exercises, also exercises for the face, neck, and head, not just a gorgeous ball in the rib cage, but we need to address the temporomandibular joint, the temporalis muscle, other muscles that are floating in the the superficial fascial layer of the face, this is very interesting, can help to adjust that sympathetic switch.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
By the way, these muscles of the face that I'm describing, they also share source nuclei in the brainstem with the vagus nerve. And so this is another way to just stimulate the vagus from a palpation point of view, combined with this breathing type of exercise that also is... pushing the gas on your off switch.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So I think the more you can dose up on a parasympathetic stimuli prior to bed, you may find over time that you have less and less of this unconscious clenching overnight.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But I would say if you know you have pain in the morning every day and you want to go work out, just do a little bit of the work and then it'll free up so much of your range of motion and change the pain as we described, you know, we talked about earlier. So why not do a little bit in the morning and do a little bit at night?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Turn on the off switch.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yes. Yes. So one of my goals with writing Body by Breath was trying to sell this notion of parasympathetic tolerance. I think that we are, we're not in a parasympathetic dominant society. We're not parasympathetic dominant beings. We're sympathetic dominant beings. But without doing, without investing in our own recovery, it's hard to keep producing. It's hard to Stay creative.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's hard to keep thinking clearly. It's hard to make decisions for your family. It's hard to pick out which freaking color curtain you want to have in your new office. So it really is important to be able to create the... physiological ability to allow parasympathetic virtues to arise within your body. So I call this parasympathetic tolerance capacity.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I personally need it for my own well-being. Otherwise, I will just grind it out. I will just go nonstop. I think that's just part of my own family lineage. Like you just, you go, go, go, you produce, you produce, you produce.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So, and I think that one of the things that I've also picked up from the fascia research space is that when we are constantly in a sympathetic aroused state, exposed to shots of our own adrenaline and cortisol constantly, that There are adaptive changes in our fascial tissues because of it.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So namely, your fibroblasts, it's been shown when they're exposed to adrenaline, don't have an immediate change. But after 24 hours, the fibroblasts... They convert due to the presence of something called TGF beta. They start to convert into like a gremlin version of a fibroblast, which is a myofibroblast. And a myofibroblast becomes a contractile cell within the fascial network.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And these myofibroblasts actually have myosin in them, and they are prevalent in people who have... thickened fascia, non-gliding fascia. This was first found in thoracolumbar aponeurosis. This was first found in people with low back pain, this high prevalence of these myofibroblasts. But it doesn't happen immediately.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you can be startled, and then you can calm down and get on, but these repeated insults. So the presence of adrenaline... over a course of 24 hours, the fibroblast will start to uptake TGF-beta, and this will convert into this myofibroblast. But what happens with that is it starts to shrink the tissue, and it's at a very slow rate.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you don't all of a sudden become tight, like I said, in a day, a day and a half. But over the course of a month, you will have one centimeter of tensioning in these tissues. So exposing yourself to stresses is very important for adaptation and for health, but the chronic soaking in a stress response will change the nature of your connective tissue and you will have tissue thickening.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And this can lead to pain problems. So exposing oneself to parasympathetic practices as a way to offset and refill your cup, so to speak, I think is a really great way to consciously balance our life because there's never not going to be enormous amounts of stress showing up in our life. But having this as a respite that's within you, like this is your own internal medicine chest.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
In Body by Breath, I talk about the five Ps of the parasympathetic nervous system. There's really five Ps that this is a self-produced recipe that will change state guaranteed every time. So the first P is perspective. And so this is that mindset piece. There's a top-down appreciation that you are willing to create conscious change or conscious awareness.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So that top-down is a host for the experience. So if you just go into rolling willy-nilly, will it do something? Yes. But... If you're really trying to, I think, improve your parasympathetic tolerance, you want to be there to receive the information that your body is going to start to share with you.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Because one of the things that happens when you turn on your off switch is quite frequently in the off switch, your emotions arise. And those emotions can be pretty unpleasant and intolerable. But it's very important because that's what's in the way of, for many of us, of communication, of growth, of relational safety, all those things. So perspective.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
For example, one of the perspectives that I worked with when I released the book is all of me is welcome here. Because releasing a book, and you know, because you've written books, you are... That's my entire brain. That's my... Everything I feel, think, and perceive is, like, in that book. And so it's really scary to... you know, what if this word is wrong?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
What if I got this theory, you know, what if I misappropriated something or, you know, it's, so all of me is welcome here. And that really helped me with a lot of the public speaking that I did post that book. But something more simple than anybody can do is like, I embody my body. I love that one because it's just like, okay, I embody my body.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And so it allows you to be a student of this internal process. Parasympathetic dominant state is not a loud state. It's very quiet. So you really have to put yourself into a state of deep listening and sensing in order to have it manifest. So perspective. The second P is place. And place... Ideally, for true quietude, for true parasympathetic arousal, you need to have a place where you feel safe.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And that could be indoors or outdoors, but it should be relatively quiet. Ideally, for the relaxation response to occur, it should be on the darker side, so not in the presence of bright lights, not in the presence of a lot of noise like clanging kettlebells, you know, and things being slammed here and there.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But when we work with teachers, we tell them how to set up environments where they're able to establish place for their students so that their students feel like they can let their guard down, right? Because you can do this stuff in a gym. You can. You can also do it in a war zone. We have people working in refugee camps doing this type of work.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So it's just about setting up parameters of like, here's our space to let go, to be able to be vulnerable. So your perspective, you have place. The third is position. And position is can change your physiology immediately. As soon as you recline, there's just no more postural stress on your heart and your diaphragm, and you're able to not have as much sympathetic tone in your body.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we always encourage people to typically to recline or to even boost that by going into a gentle slope position, which takes advantage of the baroreceptor reflex. So if we can put people in a position where their pelvis is just a little bit higher than their heart, higher than their head, right? And a little bit of a gentle slope. That'll really enhance a vagal dominant state.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you've got, and also just getting on the ground feels so good. And of course, there's all this research about earthing and whatnot. So go with gravity. Perspective, place, position. Four, pace of breath. Pace of breath or pneumatic pacing, if we want to have two Ps there. Breath pacing exercises can alter your state.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I'm sure you've talked about this on your podcast, but slow, deep breathing is primal. You know, the HHP Foundation, I know you are aware of the health... Human Performance Foundation, which is a great amalgamator of all breath research, and it's free and available online. Tanya Bentley is their founder, and Brian McKenzie is also one of the co-founders.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So they recently put out a systematic review on all the breath research that was targeted towards anxiety reduction. And what they found in, you know, running all the numbers on the different papers is that slow deep breathing— was for five minutes daily is really the sweet spot. You can do a mix of fast-paced breathing with slow breathing, but you mustn't only do fast breathing.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Fast breathing alone is not going to alter your stress response. You must include the slow-paced breathing. So I really appreciated this paper from them because it certainly validated my instincts and what I've seen in my clients. So extended exhales tend to be really beneficial, but you can also do extended inhales. Just make your breathing slow paced.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I would add to that, let's also not use our zone three muscles for that breathing.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So, I mean, obviously, slow breathing is going to be involving zone one, zone two. And then the fifth P is palpation. And we've been talking about this palpation via self-myofascial release, you know, the whole time that we've been talking, as a way to dampen sympathetic outflow and to enhance sensory feedback.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
both proprioceptive and subtle sensing interoceptive feedback into the body, and this all enhancing the relaxation response or this parasympathetic dominant state. So for me, this recipe of the five Ps is something that's very doable and can happen in a very cohesive timeframe of this five-minute timeframe.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Like the simplest thing I could suggest to your listeners is you can just get down on the ground and put your pelvis up on something like a gorgeous ball because that's going to give you traction so that there's the palpation piece and you're already, you know, positioned in the recline and you do very, very slow breathing there. You're hopefully in a safe place where you're doing this.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And then you say to yourself, you know, my breath is home. or I embody my body. One of those things. And there you have it for five minutes.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So one of my friends, Katie St. Clair, calls the respiratory diaphragm the thoracic floor, which I think is hilarious. And this pelvic floor is another tissue that has horizontal fibers, you know, crisscrossing at this bottom of the bony funnel of the pelvis.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yes, and it's going to have movement that mirrors the action of the thoracic diaphragm, of the respiratory diaphragm rather. So as the diaphragm descends and applies pressure into the viscera and provides this distension, the circumferential distension to the core, there should also be a little bit of stretch in the pelvic floor. Unless your pelvis is akimbo, unless your pelvis is rotated inwards,
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
pretty far out of the pressure wave of the diaphragm so if the diaphragm isn't able to exert this rhythmical pressure down into the pelvic floor it's probably going to exert it elsewhere and so one of the classic shapes is you see the kind of the banana back, that rib thrust, anterior tilted pelvis.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So if the diaphragm isn't pressurizing down to create stretch in the pelvic floor, which is very healthy for it, it's going to pressurize forward into the front of the abdomen, into the rectus sheath, into a strong ligament called the linea alba, which... often is breached and creates what's known as a diastasis recti. So these are fascial systems upon systems.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
These are connected sheaths that rely on the correct amount of integrity in all layers for this great global response.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Again.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Low back victim yet again.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yeah. I mean, there's so many different things to discuss here. It's like, oh, well, you've got... Chronic hip pain. That's going to move your pelvis a little bit away from your center of mass so that you're not putting as much weight on that uncomfortable hip or knee or ankle or whatever it is. But, you know, people are perfectly imperfect. We're incredibly...
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
adapted to our asymmetries and that's for the best but there's probably better and better ways and I think this is one of the places that I love talking to Kelly about is you know looking for being able to centrate joints so that they have more options of movement because if you have rotated off of axis so considerably that your range of motion in as we account for joint by joint
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
then we can get into a lot of trouble. And that's where doing, you know, some really good fascial work, self-myofascial release in very specific joints and very specific ways can allow for a restoration of elasticity and muscle function in tissues that have been compromised by position.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So this is something I, I mean, I love working with people to, you know, tune up these little areas that have become messed up by, you know, scar tissue or positioning or injury? Because you see this remodeling happening over time. The remodeling is the collagen network adapting to your new normal.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
My friend Katie Bowman, she wrote a book called Diastasis Recti, and she's one of my favorite movers and thinkers in the movement movement space. And her book, one of the things that she talks about is that diastasis recti is a whole body issue. It's never just that you have this overstretch syndrome in the abdomen, but there are probably things that...
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
led up to your body harboring more anterior pressures. Although if you are carrying triplets and twins or if you have over-tensioned your abdomen through over-training, this can also be problematic when the time comes for the abdomen to stretch. So let me backtrack a little bit. Diasysis recti is a breach of the connective tissue link between the right and left halves of the anterior abdomen.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we have these deep fascial layers that lock themselves around the rectus abdominis, the obliques, the transversus abdominis. And they all zip into a common ligament called the linea alba, which connects from the bottom of your sternum all the way to your pubic symphysis. And this is an incredibly—a lot of integrity in this system. And this is how you get your core force production.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We've got the right half and the left half of our abdomen working well together to stabilize our spine, our pelvis, and do all the things, help us to breathe.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Five and five. I mean, I've seen dissection where you've literally got one rectus abdominis from soup to nuts on one half. And then the other one, you had one divided by a small tendonous inscription. I've seen so many anomalies in the rectus. So you can't get a six-pack, boys. It's because you've got a one-and-a-half pack by birth, okay?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Really, 100% of women get a diastasis recti during pregnancy.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And that is granted by the amount of elastin and relaxin that's produced from your growing fetus and all of the hormonal changes that happen within you. that change the elasticity of the tissue, you must enlarge in order for the fetus to grow. And so the accommodation we have is we have these elastic changes in our fascial tissues.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The problem with a diastasis recti is after birth, for some women, it can take many, many months. There is never a resealing, so to speak, of the... you know, the heat seal, like as if you were a meat packer, that it never gets reinforced. And there is a very wide gap.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And that gap is then filled in with superficial fascia, adipose tissue, and collagen, but it doesn't have the strength or integrity that you had pre-birth. And so this is very problematic for force production through the core. We're not getting transfer of forces from right to left or from top to bottom. We have a proprioceptive deficit. And, you know, it is integral. I mean, I've seen these.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I mean, you've got it's a good connection between the right and left in terms of the fatty layer that has filled it in. But we don't have the muscle force production in a cooperative way. And so these women can have symptoms for years of back pain, pelvic pain, incontinence, prolapse. But people who are more lax in their connective tissue tend to be more prone to get these symptoms.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
um, diastasis that linger. So most will close about 66% will end up after a year. They'll have almost no legacy of a separation. And then you have this, this, this, you know, third of women that are outliers.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So we go back to this discussion on the fibroblasts. They're a slow-moving cell. They are going to repair you. But you need time and you need consistency to allow that collagen remodeling to occur.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It will or it won't. I mean, sometimes it just doesn't because there's pathology or there are, you know, maybe you have hyperlax tissue. Right.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
One of the things that Katie talks about is that the diastasis is a whole body thing, and we really need to address hip pelvis, low back, and we really need to address shoulder ribcage to adjust the position of the ribcage to try to optimize consistently the position of ribcage to pelvis and then do exercises that... co-occur with breathing rhythms.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Because by the way, your breathing is the lining of your core. These breathing muscles are the lining of your birthday suit. And we need to use them appropriately to try to build correct tension over time. But it's not something that can be rushed, but it's definitely something that needs to be done. I mean, you really should be doing these type of breathing exercises during pregnancy as well.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I mean, hopefully. And the It's a longer story. It's a much longer story. Sure. I do have a chapter in Body by Breath that covers diastasis recti and also self-massage application for that.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And I will say this is one of the warnings I have if somebody does have a diastasis recti is you don't want to put a ball right in the center of the area that is overstretched, but you want to really think about creating movements that would move the core muscles from the side to the middle.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So you think about creating vectors of pressure that don't necessarily scrub over the midline, but they move from the side to the middle and doing that in a variety of different ways with different breathing exercises and then with tension-based exercises to try to rebuild tension on axis.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So this is not something that's easy to describe in a podcast, but it's very personal because each woman will have a different level of stretch. Some people have just more of their right side moved away from the midline. Maybe it's not both sides that moved away. Maybe the baby was sitting in a way because babies sit weird in your uterus, man. They just do weird things.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
you know, just sort of jammed up against the right side of your abdomen with a little bottom there for the last two and a half months. And it just puts so much stretch load on, you know, the external abdominal oblique and the transversus. Maybe the, you know, you don't have that much gapping. Anyway, there's different ways to measure this with fingers and you definitely need to get
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Get it checked out by a pelvic floor PT. They're the ideal people to diagnose and to give input on that. But these things are a fascia-based injury.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Yes, and I would also, if you know you're pregnant or you want to get pregnant, I would get Diastasis Erecti, the book by Katie, because she talks about exercises pre, during, and post. It's an excellent book.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I consider the pregnant body on the hypermobility spectrum. And when we have pregnant students, we treat them like a hypermobile client. And there are differences in terms of rolling with a hypermobile body than a non-hypermobile body, for sure. I love working with the hypermobile population. And just FYI, according to Jessica Eckel's research, 20% of people have some degree of hypermobility.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
This is not to say that it's pathological. It's not to say that it's Ehlers-Danlos or Marfan syndrome, but like 20% of the population is pretty loose. So I've come up with a framework for rolling with hypermobility. And one of the Other clinicians I follow, I love her work. I wrote the foreword to her book is Libby Hinesley.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
She wrote Yoga for Bendy Bodies, and she's got great information in there for practicing if you are hypermobile. And so I would include the pregnant cohort in here also. Number one is breath. use a conscious breathing practice while you're rolling because it will tune you into interoceptive feedback. It'll also put you in touch with a calmer nervous system.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Hypermobile bodies tend to be higher in anxiety in general. And there are changes in brain regions. This is the work of, like I mentioned, Jessica Eccles and Hugo Critchley. You When you're rolling, if you know that you are hypermobile, you should stay towards muscle bellies. So these are all Bs. We've got breath, belly. Stay in the belly. Don't go rolling at the joints.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Why don't we just want to roll at the joints? Because...
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Bony junctions are where dislocations happen. So that's one of the third Bs. Avoid bony junctions because you couldn't easily dislocate because there's just less muscle mass there and you're hanging out in your joint capsules and your ligaments there. Regarding rolling in the bellies, the other thing about rolling in the bellies is...
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
A lot of times, like you were mentioning, there will be these hypertonic areas in people with hypermobility, and we want to be able to restore good length tension so they can really get appropriate strength in agonist-antagonist relationships. And so rolling within the muscle bellies might help us to decouple some inappropriate trigger points or inappropriate hypertonic regions.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So that's the aim. The fourth B is brace. So using contract relax techniques. You're not always trying to roll to the bone. You're not always trying to get all the way at depth. So I can do rolling that can address some of the more superficial tissues by creating a little bit of muscle bracing.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And that's going to allow me to roll superficial fascia and also to roll loose fascia transition with the deep fascia. So I can, where normally I would say contract relax, relax. to amplify parasympathetic values in most bodies.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
When I'm dealing with a hypermobile person, especially let's say they have hypermobility in certain spinal segments, I actually want them to keep some amount of tension in there while they're rolling so I can get some of the benefits, some of maybe the parasympathetic benefits of rolling, but I don't want to lose some of my support benefits. So it's very personalized there.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And then, yeah, to avoiding going all the way to depth and, again, dislocating. So the bracing can be very important. Staying superficial. So this takes us back to superficial fascia. We can reap a lot of the parasympathetic benefits of rolling and the proprioceptive benefits of rolling by staying in the skin, the fatty layer, and the superficial fascia.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The majority of the sensory neurons within the nerve net That's associated with the fascial tissues. The majority of them are in the superficial fascia. And so I can get a lot of proprioceptive bang for my buck by staying on the surface. And that might be all it takes to give that proprioceptive feedback to a very loose person to improve their positioning.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So a lot of times, and this goes along with the contract relax also, a lot of the time with the very hypermobile person, they have a really hard time sensing where their joint junctions are. They blow past them, which isn't good for overall stability. I mean, they can go there and they should occasionally, but maybe not load in a really weird vector, right?
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So working superficially and working with the contract relax can then heighten my proprioception of my body. And then I also say with hypermobile people, like when in doubt, don't roll it out. You can cause injury. You don't necessarily always know until it's a day too late.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But I do encourage people who are hypermobile to roll out, especially if they are the highly anxious type or also have digestive challenges. So, you know, in hypermobility, when you think about super loose people, super bendy people, it's not just the fascia that's comprised of collagen, but all of your organs are comprised of collagen. And there are...
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
you know, your eyes are comprised of collagen. So there are so many other weird symptoms that hypermobile people will have. Breathing problems, autoimmune challenges. A lot of them have mast cell activation challenges and IBS symptoms. So there's just like a host of things. So
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Tamping down the sympathetic overflow, putting them into a place where they can be reflective and calm is, I think, very, very helpful for all of that.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Oh, I love all movement. I love static stretching. I love isometric work. Where does it fall for people who are very muscle-bound or maybe even what we would call scar tissue-bound? So somebody who maybe has overtrained, like say they want to have a really big bubble muscles, I call these people, where you have just... more bias up than is necessary for general health.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But they've done it by really overtraining. I think a combination of rolling and static stretching, what we see with the rolling can actually allow for that temporary elasticity to show up. You can actually improve joint positions after rolling. So I'd recommend that as a prescriptive for them. and you can roll the bicep.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You can do techniques called stacking where you have the balls like a vice on either side of the bicep. You can also just lean against the wall with a block between your rib cage and your
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And you have a ball here and you have a ball here and you just lean and create like a pancake of your bicep and then do different movements of the elbow, different movements of the shoulder and create different vectors. And that can increase elasticity so quickly. And then I would work on static stretching just to do that. long-held traction within the fascial tissues.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But I would also work on the antagonist. So there would need to be some tricep work. I'm just thinking about this particular model. But you also need to work into the form because you've got myofascial expansion into the membrane between the radius and the ulna. This basically is periosteal sheath. So there's a lot more to it.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But I've seen this in many clients, and they're always shocked that after a few days of rolling and static stretching that they gain generalized improvements in range of motion all over their body. But they're really not going to do it on their own. They need to...
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Some of these people, they just they just they need to be led day after day. And then their mind is blown and then they go right back to their overtraining after that.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
One of the best ways to use the rolling is to offset delayed onset muscle soreness. So what they found, what Jan Wilkie in Germany has found, is that the inflammation of your delayed onset muscle soreness isn't in the muscle cells, but it's actually in the fascial fabric surrounding the muscle. This is called the epimesium.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
There are so many benefits to self-myofascial release. Now, mind you, I already mentioned I have a bias. I'm a ball, softball person. This is the evidence from all the literature. So this is a combination of rollers and sticks and tools. This is not about vibrating tools, by the way. So this is like just really cheap implements that anybody can do home care with.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So it improves movement coordination. Yeah. You just gain better proprioception by rolling. It improves range of motion and mobility, and those changes can be obvious very, very quickly. Either rolling along the spine, you can change your shoulders. Rolling around the knee, you can help your hip, you can help your knee. So it works everywhere.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
The surprising, I think some of the surprising thing is that the rolling improves torque. So when you roll, the muscle that you're targeting will be able to generate more forces afterwards. And this is specifically with rolling, not necessarily static compressive. So that I'm not sure of. I don't think anybody's done that research with torque necessarily.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
That's great. It decreases pain.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
You woke up, you're sore, get on the ball, roll yourself out and go practice again. It reduces arterial stiffness and improves vascular endothelial function. It's really good. You know, we don't want to have sticky vasculature, that's for sure. So getting stretch through this pressure and ringing, very helpful. It decreases delayed onset muscle soreness.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So whether that it times it out so that you get it on day three instead of day two, or you just had less of that inflammation. So that's a good thing. It induces physiological relaxation and parasympathetic features, which is One of my favorite parts about it.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's a chill pill without taking a pill.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It reduces lymphedema and decreases local tissue inflammation. And there's some really cool research out of Harvard. Bo Ruscio did some research. Research with very, very soft tools.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I'm talking about the amount of pressure that a pencil eraser would exert if you dropped it into your hand when they destroyed some anterior tibialis of mice, and they did these very gentle oscillations using this implement. The mouse can't do self-myofascial release, so this was administered through these little tiny vices. But it was a very, very soft latex, not a hard...
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
But what they found is people who did rolling prior to a workout had less of this inflammation in that 48-hour time frame afterwards. And one of the other fascia jokes that the fascia researchers say is we shouldn't be calling this DOMS. We should be calling it DOFs because the inflammation really is in this fascial envelope. And that's also where these pain-sensing neurons are picking up on that.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So, I'm extrapolating here for that because the mouse did not roll itself, but it was a tool.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
There's some research out of Germany. Dr. Robert Schleip is one of my favorite fascia researchers. He's one of the originators of the Fascia Research Congress and the Fascia Research Society. He has found with this group he's working with in a mental health institution there that the rolling is helpful for major depressive disorder.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
They're doing surveys, you know, very regarded surveys, you know, before and after rolling around affect, around memory and cognition. And they're finding that the rolling changes some of the tissue mechanics as well as improves their emotional affect. And then finally, it's helpful for interoception and sustained attention. So there's some work there. out of Canada.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I'm blanking on that researcher's name.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
We do. The fascia researchers are very interested in it.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Andy, so good to see you.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Thank you, Andy. Your work has been life-changing for me, and I love being a friend of yours, and I also love being a student of the education that you offer.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So if you want to... offset your delayed onset. You can roll afterwards. You can roll the next day, but really it's what the research is showing. It's better to roll prior to, to offset the DOMS.
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Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
I think we have to start with describing some of the elements of fascia in general before we go into what is the tool doing to the fascia. Because I think what a lot of people may not understand is how alive your fascia is. I mean, your whole body is alive. There's nothing really inert inside. or fixed about your body in general.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
And your fascial tissues are comprised of so many different cell types and so many different fibers. And even though it's in general a slow to change tissue, it is very active. Fascia is your seam system.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Fascia connects everything in your body from foot to face, cell to skin, and everything in between. It suspends your structures. It interconnects them. But it's not just seams. It's also the stitches of the seams. But it's also not just stitches or seams because it's not just fibrous. It's also fluid and it's cell-filled. It is also invested with 250 million nerve endings. Wow.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So your fascial tissues are also a major sensory organ of your body.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
It's mind-boggling.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
So the fascia, yeah, in your— original model, you could say the fascia is the in-between all of it stuff.
Perform with Dr. Andy Galpin
Jill Miller: Increase Flexibility & Relieve Pain with Breathwork & Myofascial Release
Toe to chin, everything within. So we can think of fascia in a few different ways, and there are many different fascia researchers that model it in different ways. I like to think of it like a strata or like a lasagna. I think this is an easy model for people to grasp.