By now, I’m convinced that poor breathing can contribute to ill-health, not because I’m a yoga teacher and we’re meant to believe in hocus-pocus stuff, but because I’ve spent a lot of my career as a physio observing breath and breathing patterns in my patients. Now, good breathing patterns on their own cannot guarantee good health ( sigh! nothing is THAT simple) but breathing properly has lots of physiological benefits…and it’s FREE! Oh, and it feels good too…..
It all started in college…..
I first learned about breathing in first year physiotherapy college when we were doing experiments in the physiology lab on how to measure lung pressures while we held our breath. I was the class star ( a first for me) because I played the flute and had good lung control and lung capacity despite my small stature. This was interesting, but nothing compared to the joys of the anatomy department, where lines of cadavers were laid out in the dissection room …I can still smell the formaldehyde……. I remember being struck with how big the lungs were and how much room they take up in the chest – from the neck nearly down to the waist. Apparently, if you took all the air-exchange membranes of the lungs and lined them out, they would take up the area of a tennis court! All in just two lungs…amazing. The lungs we observed on cadavers were hard and solid (you could also see specks of ash in those of smokers) however, when we are alive, they are elastic and spongy, made to contract and expand. And they inhale about 6L air/minute. The whole aim is to provide oxygen for your body for it’s cellular activity.
Breathing – an important part of physiotherapy.
As physios , we have to learn a lot about breathing because there is a whole area of physiotherapy that devotes itself entirely to lung health and function. Respiratory physios specialise in teaching people how to breathe correctly. So we teach asthmatics how to exhale efficiently and people with chronic lung disease how to expand their lung space to recruit more airways. There is now a nice bit of evidence to support the use of ‘respiratory rehabilitation’ in these patients. And of course, we help people to clear their lungs of secretions. Yes, I spent many hours in my early physiotherapy years on the medical wards of Limerick Regional Hospital ( as it was known) helping old smokers to cough up phlegm and examining it for signs of infection… not very glamorous I know, but oddly rewarding. Part of our job involves working in the intensive care unit, helping people on life-support machines to breathe deeply with ambu-bags and suctioning their secretions. This is because deep breaths into the bases of the lungs prevent infections from setting in while you lie stationery and unconscious. After operations, people also tend to breathe in a shallow pattern, making it more likely for infections to take hold, so we physios encourage (erm…maybe force!) them to do breathing expansion exercises to increase lung capacity.
Hospice physiotherapy and breathing
Many years later, I was working in a hospice. There were three main cohorts of people requiring respiratory physiotherapy.
1) People with advanced cancer often get more breathless as the disease advances. This causes panic for a lot of people, not surprisingly, and it also severely reduces the ability to walk any decent distance or shower or do your daily tasks of living. By teaching different breath techniques, we help control the anxiety and improve the ability to walk longer distances and move with less breathlessness. This really improves quality of life.
2) End-stage neurological patients with the likes of Motor Neurone disease or end-stage Parkinsons or MS, can find breathing and coughing very difficult as they get weaker. Our job is to help them to breathe more effectively by adjusting their posture or using breath-stacking techniques. We also to find ways to help them cough up secretions, including assisted cough machines.
3) People with end-stage lung fibrosis. This is where the lungs go from being spongy and elastic to being hard: it makes it very difficult to breathe in and out, and many people require oxygen to support their breathing. Our programmes allowed them to exercise safely despite their oxygen needs.
Breathing issues in Musculoskeletal Patients
I never took much notice of breathing in my musculoskeletal patients ( sore necks, backs, sports injuries) until I was on a back-pain course a number of years ago and the lecturer said, in an aside, that he had noticed that a lot of patients with fibromyalgia had very poor breathing patterns, and rarely used their diaphragms to breathe. After that, I started watching for this ( yep, sure enough, I have yet to see one person with fibromyalgia who has a good pattern of breathing) and then with just about everyone. To my amazement ( at the time….. it makes sense to me now), just about EVERYONE with long-standing neck pain or back pain, and with any long-standing medical condition had poor breath patterns. The only ones who bucked the trend were singers, actors and those who played musical instruments…oh, and a few who practised yoga….because they had learned how to breathe efficiently.
I particularly noticed that anxious people had particularly poor breath patterns. They either tend to hold their breath a lot or they breathe too quickly, or both. The average rate of breathing is about 12 breaths a minute, anxious people often have high breath rates of over 20 at rest. Also your exhale should be approximately twice as long as your inhale at rest and my finding is that anxious people have short and sharp exhales, missing all the soothing properties of a slow exhale. Consequently by teaching them to breath slower and with the bases of the lungs, it somehow causes them to chill and relax within a few minutes….This has led me to always ask about tension, stress and psychosocial factors in my patients…but that’s a discussion for another day….
Athletes are another interesting bunch. You’d be surprised at the very fit people I see who have really poor lung expansion…probably exercising with less than half of their available lung capacity! Imagine how easy it would be for them to run with full lung expansion, they would have less neck pain for a start. And the diaphragm ( the main breathing muscle for your lower lungs) is also a stability muscle for your core. There are quite a few strong athletes who cannot breathe when doing something strenuous, because their diaphragm is busy propping up their core…so I try get them to separate these out and breathe during core exercises.
Breathing in breast cancer patients
Fast forward a few years and I now find myself working with women after breast cancer surgery and, hey presto, I find that many of the anxious individuals ( and let’s face it, most people after cancer surgery are anxious) have really poor patterns of breathing, mostly in the upper part of their lungs. So myself and my work-partner Kathy routinely check their breathing pattern and provide breathing exercises for relaxation. Not only that, but deep breaths enhance the stretching of the ribcage, which really enhances the effect of the stretches that we prescribe to improve rib cage mobility and shoulder range…..two birds with one stone.
So, as a physio, you can see that I keep coming back to breathing……
Breathing as Yoga Teacher
After training to be a yoga teacher, I was drawn `to the subset of yoga known as pranayama. This is specific breath control exercises that are designed to do a number of things, depending on the technique: expand your lungs, excite your nervous system, improve digestion, relax the nervous system, clear your head to help you meditate easier, clear your lungs, warm you up or cool you down. A vast cornucopia of delicious techniques…man, was I excited! AS part of this training over 9 months, we had to practise techniques daily and measure our heart rate and respiratory rate before and after. Most of the techniques reduced heart and breathing rate and gave a very pleasant feeling. Heaven! If I had a blood pressure monitor, I would have loved to see the effects on that too because studies have shown that it has a positive impact on blood pressure.
The beneficial effects of deep breathing ( those that I know about!)
IN my next blog, we’ll have a look at some of the effects of breathing and explore it more.
But here it is in a nutshell: (drumroll please…..)
· Breathing into your lung bases improves oxygen exchange and reduces breathlessness
· Deep breathing stretches our fascia
· Deep breathing improves the effects of stretching on your muscles
· Some breath techniques specifically reduce feelings of anxiety and stress, lower blood pressure and pulse rate
· Deep breathing reduces the strain on your back and neck
· Deep breathing massages your internal organs
· Deep breathing assists lymphatic flow
So by now, you may agree with me that breathing is the best kept secret our bodies hold. All of the benefits are free, and all at our disposal…so how come more people don’t use it??
People are starting to notice
Thankfully, people are starting to notice the magic effects of breath…. Mindfulness and Stress relief programmes now routinely use breathing exercises to induce a parasympathetic state of the nervous system ( relaxation, to you and me). Specific techniques, such as the Buteyko method are being used for asthma patients and more recently for Long Covid patients who have problems with breathlessness. The scientific evidence for breathing exercises is improving, thank goodness. But wouldn’t it be lovely if we could realise the potential of breathing to maintain health too?
If you want a 1:1 zoom consult on your breathing, get in contact (sinead@yogaphysiozone.com)
Here’s my youtube video, teaching you how to breathe the correct way.
Here’s my youtube video on Ujjayi breath, a really good relaxation breath that we use during yoga.
Here’s my youtube video on how to expand your lung capacity.
Join me on my next blog for the detailed lowdown on all of the benefits of breathing, and some well-known breath techniques.
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