To breathe or not to breathe… properly: why is it even a question?

Why does good breathing matter?

It is quite literally a matter of life and death.  We all know this don’t we, even if we don’t quite understand  the physiology of getting Oxygen to the tissues and getting rid of the Carbon Dioxide

There is more to breathing than this though because our breathing, lungs, ribs etc have co-evolved with the rest of the body so the action of breathing affects more than simply gas exchange inside the lungs.  I have written about breathing basics in another blog post

What else happens when you breathe?

This Gif illustrates brilliantly, the connection of the diaphragm, pelvic floor, lower back and abdominal muscles.  Collectively they form the “inner unit” of core stability.  These muscles stabilise the body cavity as you breathe.   For each in breath and diaphragm contraction,  there is a corresponding relaxation in the abdominal wall and the pelvic floor.  With each out breath the abdominal wall and pelvic floor contract back to resting state (if only momentarily).    I cannot stress the importance of this enough.   Breathing well helps to maintain the tone of the pelvic floor.  Pulling or gripping the muscles of the abdomen or pelvic floor isn’t a good substitute

With each breath and rib movement comes a tiny bit of movement in the upper (thoracic) spine.  Each rib joins to a vertebra in two places.  Shallow, inefficient breathing, albeit on a small scale, leads to less spine movement.

Ribs are the cage foundation cage upon which our shoulder blades reside.  Our bipedal existence, so strikingly different to other mammals and even our ape relatives,  derives from our ability to use our arms in the way we do, and for that we need the ribs as foundation

The action of the breathing assists the heart.   The heart  doesn’t pump  the blood all on its own, although  absolutely  it does most of the metaphorical heavy lifting.  It receives an assist from muscle action in the rest of the body, and from the rhythmic action of the lungs

Breathing and with it the contraction/relaxation of the diaphragm assists with pumping lymph fluid around the body and back into the circulation

Breathing wide, full, and deep stimulates the aspect of the nervous system that assists in promoting calm, via the action on the Vagus nerve.    There is a world of nervous system beyond our conscious awareness: the Autonomic Nervous System (ANS).     In very simple terms, the Sympathetic half of the ANS is in charge of our flight/fight/flee response.  The Parasympathetic half the ANS is all about (amongst other things) rest, digest, reproduce.  The Vagus nerve is part of the parasympathetic nervous system and it is stimulated by deep, slow breathing.  It can trigger a reduction in heart rate and blood pressure.  This is a really epic value of breathing properly.  Other things can stimulate the Vagus nerve: singing, chanting, laughing, and very much the zeitgeist: cold water swimming.   A happy Vagus nerve can induce calm and balance emotions.

What happens when breathing is not optimal?

It causes a subtle change in the Carbon dioxide/Oxygen levels in the body.  Carbon dioxide dissolves in the blood to form a weak acid called Carbonic Acid.  To much of that will slightly acidify the blood, slightly altering blood chemistry away from the ideal norm.  In much the same way, too much atmospheric carbon dioxide dissolving in sea water will acidify our oceans.  Our bodies maintain balance as far as possible.  The difference is slight but away from the norm, and the ideal.

Other things too, are  subtly shifted away from the ideal.  Shallow, fast breathing slightly alters the balance within the Autonomic Nervous system activity in the body.  It shifts it to a more Sympathetic state, more ready for action/high alert/sensing danger.  Ideally our bodies should be maintained in a Parasympathetic state: in Rest/Digest mode with the potential to gear up to Flight/Fright/Flee when needed.   It is not good for the body to be permanently on high alert  which we sense as being stressed out.  I’m not suggesting that the breathing causes that, simply that less than ideal breathing will push the body towards the sympathetic state, the high alert state.

Breathing is  fundamental so why don’t we think carefully about breathing well,  what with it being a matter of life and death?

You might well ask

Poor old breathing, it is just too ubiquitous, too embedded, too inner

We don’t ignore our breath as such, more likely, downgrade or fail to appreciate  its importance.  In this regard, culturally , breathing shares the problem with sleep.

I blame the Enlightenment.  Ok so I’m being a bit sarcastic but there is  truth here.  The enlightenment is/was the intellectual changes in Europe from the Renaissance onwards.  It ushered in a sense, still with us today of the supremacy of the brain, of thought, of ideas.  To put it another way: the  mind/body split.  I’ve written about this years ago in a blog: https://www.pilates-leeds.com/cognito-ergo-sum-vel-potius-o-domine-cartesie-sentio-ergo-sum/

This is a European focussed behaviour.  We are “in” our heads, our thoughts, our ideas and less “in” our bodies.   Not all cultures are quite so caught up in their head.

It was not always this way: the Latin word Spiritus is the root of both Spirit in English and also Respiration.  At some point Europeans recognised the connection.

When is Breathing not so good?

Living creatures are all hard wired for survival.  Our bodies know what to do.  However, there are things that make our breathing less optimal and crucially, we can modify some of those factors. Other factors are harder than others to change

Tricky to change

Age related curvature of the spine and stiffness of the spine makes breathing harder.  The upper back is not so responsive which impacts how the ribs expand and the diaphragm moves.

Easier to change

Poor posture and alignment of the head, neck and upper back..    You can’t expand the ribs so easily if you are permanently rounded forwards.  This is similar to the above age related issue but in a younger body, it is more fixable

Sucking in the abdominals or wearing restrictive clothing around the waist.  If you block the abdominals from contracting and relaxing then you block the breath

A tendency to breathe into the upper chest, rather than breathe into the ribs and with the diaphragm.   This can be a consequence of the sucking the belly, of poor habit, of anxiety.   The latter is a kind of chicken and egg situation.  Anxious over breathing can  lead to the development of poor breathing habits .  Poor breathing habits of  breathing with the upper chest whilst not a primary cause of anxiety, certainly will not alleviate it

A tendency to hold the breath  I have noticed that I hold my breath if I’m watching TV and there is a suspenseful moment.   Anyone who has ever done exercise has probably noticed the tendency to hold the breath.  Or have you?  Notice what you do next time, especially if what you are doing is new or particularly difficult.   I can find no literature answering the question of why does this happen.  It does though, and good habits can over come it.    By habits I simply mean remembering.  Or having a teacher that reminds you!

Over breathing – the tendency too breathe to quickly.  This is metabolically unhelpful: the gas exchange systems don’t have time to function optimally.  This is often connected with breathing into the upper chest.

Mouth breathing Our nose is designed for breathing.  Our mouth is not, but it can be used if the nose is blocked: a somewhat vital escape route for the air.  The nose moistens the air and has an antibacterial filtration system.  The mouth does not.  Humans are designed to breathe in and out through the nose.

Factors beyond our control

If you are diagnosed with COPD, that is Chronic Obstructive Pulmonary Disease  your breathing is specifically impaired.  COPD is an umbrella term to describe diseases such as Bronchitis or Emphysema.   Asthma also is a disruptor of breathing.     Intervention if you have one of these diseases is specialist and beyond the scope of this article.  I don’t want to seem dismissive of these conditions.  Absolutely I am not, but I lack the specialist skill to talk about breathing with COPD.  I’d be fearful of getting something wrong or inaccurate

Other diseases are major breathing disruptors. To name a few: Pleurisy: infection of the lining of the lung cavity. for most, a temporary but painful illness.  Removal of all or part of a lung, for cancer for example.   Open heart surgery where the rib cage is cut open, bent back and then sewn together again.   these are all traumatic but recovery does happen.

Living at altitude where the air is thinner affects breathing, This is not an anatomical issue , it is due to less Oxygen being present in the air.  Anyone who has holidayed, in Peru will tell you this: the adaptation is unpleasant.  Eventually it becomes the norm if you live in Peru.  Athletes utilise this adaptive response and train at altitude.

How to do good breathing properly

This is really good news. It isn’t particularly hard.  In some ways it isn’t hard at all, given that breathing is central, crucial and innate.

Post pandemic society has become more aware of  life support, ventilators and what happens when the system is heart/lungs are overwhelmed and cannot cope and Medicine and Doctors have to intervene.     To be really clear, I am talking about breathing on a day to day basis by people who are not in the grip of acute illness and not affected by disease that affects the lungs or the lung/heart circulation.

Start by Noticing

The main thing is to notice.  Observe your breath.  By that I mean an inner kind of listening, rather than with your eyes.  You can lie down, and close your eyes but it is not essential.  If you are unused to focusing on your breathing at first it is easier to start sitting or lying.  I find sitting a touch easier because my lungs are orientated the “correct” way and when the diaphragm contracts downwards, it is kind of in the same direction as the body.

The mere act of noticing can mean that the breath slows down a bit.  You may find it easier to breathe more deeply.  Breathing more slowly and more deeply are sort of 2 sides of the same coin really.    If sitting, some people find it helpful to breathe into the back of the chair, or to breathe metaphorically “into the pelvis”.  Popping your hands around the rib cage can help: Fingers around the front , thumbs at the back.  An Exercise band tied around the ribs works brilliantly too.

That’s about it.  It is that simple.  Other little things: If you are seated, can you sit tall?  If you are lying, can you soften your body in to the floor.  It doesn’t matter if you are on your back, front or sides.    Lying on you front sounds counter intuitive but severely ill Covid patients were nursed in the position periodically, to assist with  their breathing.   Relax the jaw and have the teeth slightly apart and the lips softly closed.   If your mind wanders, counting your breath can keep you on track.  You don’t have to focus solely on the breath.  You can multi task: whilst out walking, driving, waiting for the bus. Dare I say: being in a meeting?!

Breathing and Pilates

People who do classical Pilates often aim for a more  full on breath when they are working.    They have a maximal inhale and maximal exhale with a far more overt sense of the engagement of the chest and abdominal muscles as you breathe.  One of the many elements of Joseph Pilates’ genius is that he recognised the value of the breath so early.

There is really nothing wrong with this.  It is all about context.  In the midst of an advanced Pilates exercise then you may need to forcibly breathe deeper into the exhale and inhale.

However, this is not appropriate for daily life or for more gentle Pilates.    I wonder too if the action of the abdominals has become confused, to the point that they are almost seen as the primary driver of breathing.  They are not. The diaphragm and the intercostals of the ribs are the main muscles.  The abdominals are involved. Absolutely.  The deeper you breathe, the more they are involved but it is dose dependent.  You don’t need an extreme breath for a gentle exercise, or daily living.

Specialist Kinds of Breathing

I would actually include the classic Pilates breathing as specialist on account of it being a little extreme.  It gives the impression that breathing is faintly complicated and a bit hard to do.  This is really the last impression that should be disseminated regarding the breath.  We need to understand that, in individuals with no lung disease or acute illness, it is simplicity itself

There are loads of other special types of breathing and they are utilised widely in Yoga.  Yoga really did nail the vital nature and vitality of the breath millennia ago.  Here is one example: Ugaii breath

Like any kind of breath work it takes a bit of time to master especially if you are not used to the breath as particular focus.    For more detail read this blog.  It is succinct and informative: https://theyogaspace.co.uk/uncover-the-mystery-of-ujjayi-breath/

Hypopressive Breathing

Speaking from Experience, this is harder  than the Ugaii breath.  It is of particular interest if you have issues with pelvic floor weakness or abdominal separation (Diastasis Recti)  following child birth.  In essence it involves holding the volume of the expanded rib cage whilst you exhale.  That is in marked contrast to the normal expectation that the ribs return to normal on the exhale.  There is more info and a Youtube clip here: https://www.bodyharmonics.com/three-reasons-to-consider-trying-hypopressive-breathing/

Breathing Meditations

Breathing is central to the practice of meditation.   There are  loads of different meditative practices, some demanding: of time , awareness and skill.  Yet others really simple, and they all involve the breath somehow.  At its simplest, merely quietly sitting, closing ones eyes and noticing the breath or counting it is introductory mediation.  For sitting you can substitute another body position and you don’t need to have your eyes closed.  You may be simultaneously seeing, hearing nature, for example

I am simply going to share one which harnesses the power of awareness and the value of slowing down the breath .  In addition you increase the length of the out breath (again, back to Vagal tone)

Sit or lie, perhaps close your eyes and count to 5 on your in breath, hold your breath for 5 and breathe out for 8.  It is simply by design but not necessarily easy to do.  If you find it tricky then jettison the breath hold initially

It is a strange one, the breath.  So central, so vital, so permanent, and yet somehow ignored, or perhaps taken for granted, for those of us fortunate to have healthy lungs.  It deserves focus and I would urge you to do just that.  Maybe just for a few minutes a day.  This health and wellbeing benefit comes for free and it comes for life.