What inspired me to write about breathing this month is that earlier in July two of my younger athletes came into the clinic and during their sessions said “ Breathing? Why do we need to spend time focusing on my breathing?!”
Believe me when I say I almost hit the floor when they said this. I had felt like I had failed them as their physical therapist because they did not understand the importance of diaphragm breathing as a part of their training. Especially me, Ashlyn, known for my rants about the importance of diaphragm breathing to all my clients and even past co-workers. Sarah actually eye rolls and chuckles when I start talking about any breathing techniques because yes there is more than one or two! Needless to say when I disclosed to her that it was going to be July’s blog she was not surprised. Her response was “I’m surprised it wasn’t our first blog.” And yeah, same.
As humans we can last about 7-10 days without water in a comfortable environment. There are factors that can affect this and make the time period go from days to hours. These factors are strenuous exercise and heat. There was an instance recorded where someone in a jail cell went 18 days without water, but was unsure if it was actually 18 days because he may have been licking the condensation off the wall. As for humans lasting without food, they say its 21 days as that was Gandhi's longest fast; however, the longest recorded time which someone survived without food was 74 days and this fast ended with his death.
Now for breathing. The rule is 3 mins (on land). As humans we are able to go without breathing longer when underwater as we have a mammalian diving response which kicks in.
So, let’s dive in, (but keep breathing please).
The importance of diaphragm breathing.
Did you know there is SO much science behind breathing? If you type in “diaphragm breathing” into the search bar on PubMed over 65 pages come up, with 650 resources?! Crazy right? I will try my best to sum this up for you in the simplest terms.
If you are reading this blog and have an infant at home I want you to stop reading and go watch them breathe. The pattern you will typically see is their belly rising and falling. Infants innately know how to appropriately use their lungs and diaphragm to get the air in and out efficiently. So why does it change as we get older? That’s simple, stress! Yes seriously. Our lifestyle, posture and stress significantly influence our breathing.
You know how you can reduce stress and improve your posture? Ironically, through diaphragm breathing! There is plenty of evidence to support that diaphragm breathing can stimulate the vagus nerve and specific parts of our brain, both key components in our nervous system; Because of this utilizing this technique can assist in bringing the individual into a rest and digest response vs a fight or flight response. As for posture, the diaphragm and lungs are located within our rib cage. Learning how to properly inhale and exhale using your diaphragm over the accessory muscles, which are in your neck and chest, can help improve your thoracic and cervical mobility which are common known areas of concern when assessing posture.
Now, there are many different approaches for diaphragmatic breathing
I know you just read that and asked “what do you mean different approaches?!”
There is more than one way to attack diaphragmatic breathing. The four types I will go over are the ones we most commonly use with our clients. Keep in mind that we pick the technique based upon the client, not just the diagnosis. We try to make it as individualized as we can to maximize the results. The instructions I provide below are pretty basic, but it could vary client to client and change based upon the presentation in that given moment.
The Basic Breathing
We will typically advise patients to perform any of the breathing techniques laying down with knees bent or supported. We do this so they don’t have to worry about posture and can focus on breathing. Sometimes, we will change the posture, but that is client dependent.
With basic diaphragm breathing we just have clients focus on an inhale through the nose as if they are smelling flowers and exhale through the mouth as if they were blowing out birthday candles. We have them practice this anywhere from 2-5 mins to get the rhythm, awareness, and control. The timing of each breathing technique can vary as well. Sometimes we will instruct to perform for reps, other times we will instruct for time, other times we will instruct until you feel comfortable and calm!
Rib Cage Breathing
In this breathing technique, the client is focusing on the ribcage external and internal rotation with breath. They will utilize their hands on their ribcage for a cue. On an inhale through the nose the client wants to feel their ribcage rise and push out into their hands (external rotation). We will ask them to pause and hold this breath for a second or two. On an exhale through the mouth, the client wants to feel their ribcage drop away from their hands and feel tension through the abdomen since it will be facilitating internal rotation of the rib cage as it drops down and in. Sometimes we even cue them to give their ribs a gentle push toward midline to assist with this mechanism on exhalation.
In this breathing technique, the client is focusing on the inhale and exhale with a specific count. The inhale will be for 4 seconds through the nose. The pause in between will be for 2-7 seconds (this depends on the person) and the exhale will always double the inhale so we tell clients 8+ seconds through the mouth.
360 degree breathing
In this breathing technique, the client is focusing on breathing into their entire abdomen and that includes their back! A lot of clients have difficulty with this breathing technique so the posture and how they are supported is very important. Once you master this technique, you will have impeccable control of your diaphragm, pelvic floor, and core! Clients have to be incredibly mindful and intentional with this breathing. We cue the inhale through the nose but it should be directed into the abdomen and pretend the belly is filling up like a balloon and with that the rib cage, pelvic, and lower back should gain pressure. On the exhale we cue an exhale through the mouth and feel contractions through the abdomen as the air is released
Benefits of diaphragm breathing
Diaphragmatic breathing is widely known for its ability to reduce stress and its use in meditation/yoga. It actually has more benefits as it helps with people with irritable bowel syndrome, COPD, depression and anxiety, and sleeplessness
Here are more benefits this type of breathing can have:
- It helps you relax, lowering the harmful effects of the stress hormone cortisol on your body.
- It lowers your heart rate.
- It helps lower your blood pressure.
- It helps you cope with the symptoms of post-traumatic stress disorder (PTSD) and anxiety.
- It improves your core muscle stability.
- It improves your body’s ability to tolerate intense exercise.
- It lowers your chances of injuring or wearing out your muscles.
- It slows your rate of breathing so that it expends less energy.
If breathing techniques are something you are interested in incorporating into your daily regimen we recommend you consult with us or any healthcare professional so we can best advise the right approach!