Kathy Dooley: Restoring Authentic Breathing and Core Control

Dr. Kathy Dooley, a lecturer in our Immaculate Dissection video, addresses a reader question: “How can I convince clients that I need to build them from the ground up due to their lack of correct breathing and lack of core control?”

I am very proud to call myself a chiropractic rehabilitative specialist. Rehabilitation requires rebuilding patients from the ground up, starting at the reflexive stability with which we were genetically gifted.

However, my patients are shocked on the first visit, when I point out their suboptimal breathing patterns and lack of core control.

I always get the same retorts: “but I breathe all day. How can I not be good at it?”kathy-dooley-breathing-crunch

“I do tons of crunches and ab work how can my core not be strong?”

It’s hard to admit that we exist in a sub-optimal state of movement. But many of us do.

It’s important to understand that we did not start off that way.

We are the best movers we’ve ever been within the first 4-13 months of our lives. This is when our nervous system didn’t mimic, nor try to derive compensations, for movement. The reflexive stability to earn movement was passed down through our DNA, and at this early stage, our bodies knew better than to interrupt perfection. So, the baby struggles and fails, on repeat, until he figures out the stable way to move.

The longer we live, the stronger our cognition develops. We mimic the behaviors of those in our environment, as more opportunities arise for our innate perfection to be interrupted. And since we amazing humans don’t prefer failure, we derive compensations around our failures.

Make no mistake. Aches and pains are not failures. They are attempts to succeed in the face of failure. This is why aches and pains must be approached as simple compensations, veering away from our innately perfect stability.

In order to tap back into that inborn perfection, one has to regress to achieve the dynamic stability earned at 3-4 months of age. This includes the baby’s boring days of learning how to build trunk stability in positions on the belly, prone, and on the back, supine.

kathy-dooley-breathing-baby-prone-supine

I have the honor and pleasure of co-owning a mid-town Manhattan clinic and gym, Catalyst SPORT, where our utmost principle is: never rob trunk stability to gain fitness. In the eyes of our clinicians and trainers, nothing is more crucial than the maintenance of trunk stability. Trunk stability is the stable platform for all human movement around its center of mass: the lumbosacral spine.

But, trunk stability is not reborn through traditional, widely used core exercises crunches or sit ups. Watch a baby. You’ll never see her do a crunch, especially on repeat for 100 reps.

Babies build trunk stability through breathing.

At 3-4 months, the baby does the boring and endless task of earning trunk stability through the proper building of intra-abdominal pressure. All day, every day, they spend months coordinating the abdominal muscles to build trunk stability around the lumbar spine, in order to support the center of mass relative to the ground.

Think for a second about that. Unless the nervous system is interrupted, the baby refuses to move on an unstable platform. So, he works on trunk stability for thousands of repetitions per day. He knows that ambulation on an unstable platform will only get him hurt.

He doesn’t think about it. He doesn’t walk around his road blocks. He earns every ounce of his strength. When was the last time you did tens of thousands of reps per day, for months straight . . . of anything?

Most likely it was in your first year of development.

At Catalyst SPORT, we start all workouts with breathing correctives, either in supine or prone positions. We know that our clients initially used breathing for core stability at the strongest time in their development. Thus, we use proper breathing to build a stable foundation upon which to build fitness and rehabilitation.

Clients may not be compliant with breathing drills. In that case, it is necessary to remind them that they are amazing humans, who create compensations around potential failures. The auto-pilot breathing patterns they’ve developed may not be the optimal ones they utilized as babies.


But, in infancy, they develop the fastest and with the maximum amount of stability. Thus, regressing to the way the baby breathes can tap us into the trunk stability we earned when we were at our peak of development.

Prone breathing, often deemed “crocodile breathing,” is utilized to tap into posterior abdominal expansion. A stretch sensation is often felt and seen around the lumbar spine, which clients report a feeling of relaxation and stability.

This can be progressed into a prone-propped breathing, as seen in the baby at 3 months. Often deemed “tummy time,” this breathing and resting position is crucial for developing proper spinal extension patterning on breathing. This transfers into proper extensibility and load-sharing with spinal extension in movement.

Also at 3 months, the baby breathes in the supine position, developing proper coordination of crucial inhalation muscles like the thoracic diaphragm and exhalation muscles like the transversus abdominis and abdominal obliques. The four sagittal plane spinal curves are maintained, while one expands the abdomen into a 360-degree push-out on inhalation. Exhalation in performed in a controlled release of air, much like a tire releases air from its valve. This creates core stability around the lumbar spine to permit limb ambulation on a stable platform.

This position is often called “supine 90/90,” with the knees and hips flexed at 90 degrees. The heels can rest on a ball or chair, but ideally, they would suspend in the air, as seen below.

Prone and supine breathing are simple. But, they are not easy positions for most people, particularly those suffering from pain in the spine or limbs.

Typical rehabilitative and personal training strategies may be tempted to focus more on what hurts or what is missing. But without trunk stability, the entire platform wobbles around the center of mass. If breathing is what we used as a baby to stabilize the platform than it must be our primary focus of all corrective and performances exercises.

To learn more about coaching breathing techniques, please check out this helpful video from Catalyst SPORT on breathing:

To learn to teach stability in breathing from the ground up, check out our Functional Anatomy video or the Immaculate Dissection seminar series for a live workshop event. 


Dr. Kathy Dooley is a world-renowned rehabilitative chiropractor, and co-founder of Catalyst SPORT. Dr. Dooley is also an adjunct anatomy professor at two New York City medical schools, Einstein College of Medicine and Weill Cornell Medical College. She is an adjunct professor at New York University College of Dentistry and Sophie Davis School of Biological Sciences, and is a visiting professor for Saint George’s University Medical School in Grenada, West Indies. Dr. Dooley is also Lead Instructor on two different seminar series: NeuroKinetic Therapy (NKT), and Immaculate Dissection, an anatomy and palpation seminar which she co-founded. Dr. Dooley is certified as an SFG kettlebell instructor and RKC kettlebell instructor.

For more of Dr. Dooley’s rehabilitative exercise corrections, please visit her website: www.drdooleynoted.com


There more to learn about breathing at OTP:

Breathing Education Bundle
OTP breathing bundle

Jason Green: The ABCs of BreathingBreathing For Personal Trainers, Understanding Breathing, Breathing Drills For Trainers

Tom Solecki: Effects Of Respiration on The Musculoskeletal System Respiration, Understanding Breathing, Learning Breathing Drills


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