SPEAKER_05 3:57–6:38
Sometimes what can happen is you get what's called a non-union, which is it's either an incomplete or not even a fusion of the sternum back into its previous state. And of course, it's not going to be in its previous state, so we need to understand that too. But if you get any sort of a hingey kind of relationship now, you don't get the coordinate expansion and compression kind of thing because you got an extra hinge in the middle. And so that makes it very difficult to create internal pressure. So if you were a singer and you had the sternotomy and you had a non-union, you wouldn't be able to sing. You cannot project your voice when you don't have this normal behavior of the sternum. So there's a sweet spot between this stiffness and this mobility that we need under these circumstances. So again, you think about like a higher force exhalation kind of a strategy, like if you were trying to project your voice and you had this spot that gave way, now you've got a weak spot in the system and therefore the pressure does not ramp up under normal circumstances. Secondly, if it's stiff and it doesn't turn, now we have the limitation in our ability to change shape that's associated with that, and you're going to have some form of restriction. So just think about normal breathing. If I have to breathe in, I should have this pump handle that can move. And if I don't have that, then I'm going to have to create a substitution to breathe in. So a lot of people that have anterior compressive strategies, they're committed to people say, oh, you're breathing with your neck. So you'll see all of this extra accessory muscle activity that's associated with trying to lift the rib cage upward to create the expansion versus the anterior-posterior expansion. So the question is, is this an influence for you or is it not? That would be the step one. Based on your age that the surgery was done, it's in your favor that it's not that much of a deal because when you're as young as you were when it happened, chances are you were still mostly cartilaginous as it were under those circumstances. And so because you weren't fully calcified, the chances of it being in limitation is probably slim. Now, your physical structure lends you towards certain strategies, right?
sternotomy complicationsrespiration mechanicsnon-unionrib cage mobilitybreathing substitution