Are you breathing? No, the right way.
One of my New Year’s resolutions this year was to put as much effort into improving my breathing as I do into improving my health through exercise and trying to eat right… two months without soda, and I’ve only fallen off the wagon in a couple of weak moments! Breathing the right way has many benefits, such as encouraging relaxation and lowering heart rate and blood pressure.1
I want you to do a little experiment with me. You will need something to time yourself. Your phone’s stopwatch app works perfectly! I’ll explain it first: you’re going to take 3 normal breaths in and out; and on the third exhalation, plug your nose and hold your breath for as long as you can comfortably. That’s the keyword – comfortably. When you get that first urge to breathe, go ahead and unplug your nose and take a breath.
Okay, here we go. Remember: 3 normal breaths and hold your breath AFTER your last exhale. Ready?
Breathe in…out…in…out…in…out… Now plug your nose, hold your breath, and start the timer!
PHEW. That was uncomfortable. Well, it was for me at least. What did you make it to?
5? 12? 20?? 35?!
I made it to 22 seconds – which is TWICE as long as where I was the first time, I did this test.
The goal is to make it to 25 seconds.2 If you made it, congratulations! You passed this test… but would you pass a different breathing test? If you didn’t make it to 25 seconds, you are included with me in being characterized as having “dysfunctional breathing.”
I know what you’re thinking. “I can’t hold my breath for 25 seconds, so that means my breathing is dysfunctional?! It’s not like I’m a swimmer or Harry Houdini, why would I ever need to hold my breath for that long?” I get it. That’s exactly what I thought when I was first introduced to this test. But it’s not just about holding your breath. It’s about what not being able to hold your breath really means.
Dysfunctional breathing is a change in normal breathing patterns that cause intermittent or chronic problems, which may or may not be respiratory in nature.3
So, not being able to breathe the right way has consequences. These can include anything from low back pain, shortness of breath, anxiety, poor body mechanics, and even impaired motor control which can cause injury. To understand dysfunctional breathing, first, we need to understand functional breathing.
What part of your body is rising and falling when you breathe in and out? I’ll give you a hint – it shouldn’t be your chest. When you breathe in, your belly should expand with relatively no movement from your chest. This is called diaphragmatic breathing, more commonly known as belly breathing. When we inhale, our diaphragm contracts and descends, allowing air to fill our lungs. As we exhale, our diaphragm relaxes and rises back to its resting position. Any other breathing pattern is abnormal. Some of these dysfunctional patterns include upper chest breathing and paradoxical breathing, which is the reversal of the normal rise and fall where upon inhalation the belly is drawn in and then pushes out during exhalation.
So, how do we improve our breathing to make it more functional? Practice makes perfect! Research has shown some promising results for improving breathing through exercise.4
Let’s go through three of these exercises.
The first one: Start by laying on your back with your knees bent up. Place one hand on your chest and the other on your belly. During this breathing exercise, the hand on your belly should move up when you breathe in, and down when you breathe out. And the hand on your chest should be still. This takes practice to get down, so don’t be discouraged if you have trouble at first! Your body may be used to breathing through your chest; we just have to reteach our body how to breathe the right way.
In this position, breathe in and out through your nose. Breathing in should take about 3 seconds, slow and controlled. Pause for 1-2 seconds before breathing out, then exhale for 4-6 seconds again slow and controlled. Pause again a little longer, 2-3 seconds. Then repeat this pattern for five minutes.
The second one: Lay on your side with your top knee bent up, resting on a pillow/towel roll. Give yourself a hug with your top arm, holding onto your ribs. Breathe in through your nose (feel that hand rise) and as you exhale, rotate your body back like you are trying to get your shoulder on the floor. Stay in this position and continue breathing, and on each breath out try to rotate closer to the floor. When you feel like you cannot go back anymore, take 3 belly breaths in this position, then return to the starting position. Switch to your other side and repeat.
The last one is a little harder, so do this one after you have mastered the other two. Position yourself on your hands and knees. We will use the same breathing pattern from the first exercise: in for 3 seconds, pause 1-2 seconds, out for 4-6 seconds, pause 2-3 seconds, and repeat. However, this time we will pair the breathing with movement. When you breathe in, you are going to extend your spine from your neck to your low back, bringing your head up, belly down, and hips tilted toward the floor. When you breathe out, you are going to flex your spine from your neck to your low back, bringing your head down toward your chest, arching your back up toward the ceiling, and “tucking your tail.” Repeat this for 5 minutes.
This is by no means an end-all-be-all. Improving your breathing takes time, effort, and awareness of an abnormal breathing pattern. The easiest way to self-assess is just being mindful of how you’re breathing. In the middle of your day, think about where your breath is coming from. Is it primarily chest? Can you consciously change that and begin belly breathing? The goal is to get to a point where we don’t have to think about breathing. It should be natural. It should be coming from your diaphragm. It becomes unnatural and not from your diaphragm for many reasons – pain, injury, stress – but that’s a topic for another day.
When I started, my breath-hold time was 10.74 seconds. Doing these breathing exercises, being more mindful of my breathing at rest and during stressful situations (such as driving down the interstate in a snowstorm or the middle of a workout) and trying to improve my overall health has really helped me get closer to my breathing goal – but I’m still working on it.
If you’re interested in learning more about breathing or have any questions, please feel free to email me at mbgarner@rehabilitationperformance.com; I would love to chat with you!
References:
- https://www.health.harvard.edu/lung-health-and-disease/learning-diaphragmatic-breathing#:~:text=Diaphragmatic%20breathing%20(also%20called%20%22abdominal,lower%20or%20stabilize%20blood%20pressure.
- Kiesel K, Rhodes T, Mueller J, Waninger A, Butler R. DEVELOPMENT OF A SCREENING PROTOCOL TO IDENTIFY INDIVIDUALS WITH DYSFUNCTIONAL BREATHING. Int J Sports Phys Ther. 2017;12(5):774-786.
- Depiazzi J, Everard ML. Dysfunctional breathing and reaching one’s physiological limit as causes of exercise-induced dyspnoea. Breathe.2016;12(2):120-129.
- Kiesel K, Burklow M, Garner MB, et al. EXERCISE INTERVENTION FOR INDIVIDUALS WITH DYSFUNCTIONAL BREATHING: A MATCHED CONTROLLED TRIAL. Int J Sports Phys Ther. 2020;15(1):114-125.
