The practices that are perhaps most known for focusing on breathing are pilates, yoga, and meditation. In these activities, the breath is used as a way to count repetitions or hold patterns, ensure the people aren’t holding their breath, improve mobility, and decrease stress through the mind and body. Breathwork is of course used with many other sports and activities - in boxing the exhale is used for core stability and to avoid breathholding, swimmers usually time their breath with a certain number of strokes, and powerlifters use it for core bracing under heavy loads, just to name a few. You may be surprised to hear that breathing exercises are often given as homework in PT - but here are a few reasons why it can be so important!
When we’re stressed or tense, say hello to the sympathetic nervous system, our fight-or-flight response when the brain senses a threat! This is an important response when it’s needed, but the way we respond to being chased by a bear should be a bit different than how we feel when we’re stressed about sitting in traffic - and our nervous system can’t always tell the difference!
In this state of stress response, usually our breathing is more shallow and quick, our heart rate elevates, and our blood pressure also increases.
It’s okay if this happens intermittently for short intervals of time, such as when we’re startled by a loud noise or have a really chaotic shift at work. It’s not great if we’re living in this heightened state of stress/arousal basically all the time!
When we’re in pain, we’re often feeling a lot of the same things as above - stress, higher heart rate, higher blood pressure, and maybe some anxiety. This applies to acute-onset, new pains but also to more chronic issues. Like I mentioned above, chronic pain leading to chronic stress and heart rate/blood pressure always being elevated isn’t good for our bodies!
Breathing exercises can help to decrease heart rate and blood pressure changes that happen in these states of stress and anxiety
If we’re able to slow our breathing and slow our heart rate, we can have a positive effect on the body’s stress hormones
So, if we can work on breathing to affect our vital signs and hormones, then we can even start to address our pain a bit too!
Here are some examples of how to work on breathing to reap the benefits of what we were just talking about!
If you can, start in a comfortable position lying down, maybe with your legs relaxed supported on a chair or pillows, with your knees bent, or with your legs out straight
Inhale through your nose trying to breathe into your belly (hello, diaphragm!) pulling in as much air as you can, and then slowly breath it all out through your mouth
Using this idea of in through the nose, out through the mouth slowly, there are a couple of other breathing patterns you can give a try!
Box breathing, or 4x4 breathing - this is a bit more challenging than just trying to practice more controlled breathing
Inhale for 4 seconds
Hold your breath for 4 seconds
Exhale for 4 seconds
Pause for 4 seconds
Repeat, take it from the top!
4:7:8 breathing - the numbers say it all! This focuses on even longer holds and exhales, so try to master box breathing first!
Inhale for 4 seconds
Hold your breath for 7 seconds
Exhale for 8 seconds
With all of these examples, give it a try for 7-10 breaths and see how you do! The breath hold may be a bit uncomfortable and the slow exhales difficult, but this is ultimately what helps to slow down your breathing rate, heart rate, etc.
If you’ve ever followed along with the breathing exercise on the Apple Watch, you’ve probably noticed the inhale and exhale are a bit longer than what you normally do without thinking - same idea! This is a great tool!
Some common times I tend to work on these breathing exercises:
When I’m in the waiting room for a doctor’s appointment
When I’m having one of those nights when I’m lying in bed with my mind racing and can’t fall asleep