Breathing: It's Free and Life Changing
Breathing is not a novel concept. We all do it to survive. However, the importance of practicing “breath work” can unlock significant advantages for our mental and physical health.
For the purpose of this blog, the emphasis will be on how breathing can improve our physical health and performance rather than the deep physiology surrounding breathing and the mental health benefits.
First, a couple of introductory lessons to set the stage. Breathing consists of two main components: inspiration and expiration. Inspiration is the idea of inhaling air through our nose and/or mouth to deliver oxygen-rich air to our lungs. From here, our respiratory and cardiovascular systems work to deliver oxygen to cells throughout our body. Once the oxygen has been delivered, we then begin the expiration process, aka exhale air through our nose and/or mouth to release the byproduct carbon dioxide.
If you are a “good” breather, it doesn’t mean you are necessarily fit or unfit. What it does indicate is that you have strong neurodynamic control of your diaphragm. This is significant because if you can control your breathing mechanically and chemically, you are able to unlock your parasympathetic nervous system (rest and digest) and utilize more oxygen in the body. This results in being able to reduce our level of stress hormones released, improve muscle function during activity by increasing the body’s ability to utilize oxygen, and decrease heart rate and blood pressure, among many other things.
Being able to reduce our level of stress hormones with proper breathing can have a direct impact on the type and intensity of pain that we may be experiencing. The physical pain that you are experiencing is nothing more than what your brain is perceiving in your body. Yes, that means all the pain that you feel comes from your head. If our sympathetic nervous system becomes activated or is continuously overriding our parasympathetic nervous system, our brain becomes significantly more sensitive to all inputs in the body. This means that if there are pain signals coming from your lower back, your brain will become hypersensitive to these pain signals which may result in an exaggerated response of the amount of pain that the nervous system is now interpreting. Remember, the sympathetic nervous system is “fight or flight” so it’s best served in very quick bouts and works against us over prolonged durations. On the contrary, if you are experiencing low back pain, and can activate your parasympathetic nervous system by efficiently utilizing your diaphragm, your brain will now become less sensitive to those pain signals, resulting in less perceived pain. I use this analogy a lot with my patients, and it seems to help this concept click with them: Imagine our autonomic nervous system as a highway filled with cars that travel to and from our brain to areas throughout our bodies. These cars on the highway then serve the purpose of delivering messages to the brain so the brain can interpret what is going on. When the body is in a sympathetic state, all those cars have the pedal pressed down. This results in them moving very fast and as a result, delivers excessive input to the brain. When parasympathetic nervous system activity is increased, those cars now are using the brakes, leading to a lot less input to the brain. It is important to understand that most often we want a 1:1 balance when it comes to the parasympathetic and sympathetic nervous systems. However, in some situations where we are dealing with pain that is not harmful, the sympathetic nervous system begins to override which leads us to perceive more pain than we are actually in. A perfect example that’s been around for many years is the Lamaze breathing method during childbirth. By putting a strong emphasis on proper breathwork to increase parasympathetic output we can work to decrease the amount of pain.
From a performance perspective, breathing via nasal only has much superior benefits compared to breathing with your mouth. The most important benefit of nasal breathing is it increases the amount of oxygen delivered to our lungs. On the contrary, breathing through your mouth can lead to insomnia, high blood pressure, snoring, bloating, and poor oral health. Being able to nasally breathe during activity can lead to increased aerobic capacity because of the body's ability to utilize oxygen by becoming more tolerant to carbon dioxide. If your body becomes more efficient in using oxygen it not only keeps you more focused but allows you to increase your muscular endurance. More on this soon. Another benefit of breathing when it comes to performance is that when you use your diaphragm to breathe you enhance the stability surrounding your spine which allows you to handle increased load. Picture a time when you had to push or lift something heavy. Often before we do this, we will take a big breath, hold the breath, and then perform the activity. Intuitively we are using breath in this scenario to increase our functional capabilities.
Alright, now for the fun stuff. If you have been skimming through so far, stop and take this part seriously. Here I will provide some actionable tests and exercises that you can utilize to enhance your nasal breathing strategy and how your diaphragm mechanically and chemically can improve important parts of our lives such as pain, sleep, and exercise capacity.
Here is a simple test you can use to determine where your carbon dioxide tolerance is at. This test is important for two reasons. 1: It will give you a level of awareness towards your body's ability to tolerate carbon dioxide in the body. The lower the threshold we have, the more likely our body is sensitive to stressful stimuli. 2: Breathing exercise can improve your carbon dioxide tolerance and your score on this test will allow you to know what parameters you use when performing the exercise.
Carbon dioxide tolerance test:
Take three easy, calm breaths in and out through the nose
Take one full nasal inhale, filling the abdomen, upper chest, and lungs
Start a timer as you exhale through the nose, as slow as possible
Stop the timer when you run out of air, swallow, or feel that you must take a breath in
How to interpret your results:
0-20 seconds = Low Tolerance of Carbon Dioxide – Use 3-4 seconds
20-50 seconds = Moderate Tolerance of Carbon Dioxide – Use 5-6 seconds
50+ seconds = High Tolerance of Carbon Dioxide = 8-10 seconds
Okay! Great work. We have your results now, let’s put them towards some actionable exercise that you can use to improve your carbon dioxide tolerance.
Exercise 1: Box Breathing
My favorite exercise for this is called “Box Breathing.” Box breathing is the idea of inhaling through your nose, holding, and exhaling through your mouth for the same duration. For example, if you scored 19 seconds on your Carbon Dioxide test, you would use 4 seconds for the boxed breathing exercise. This means inhale through your nose for 4 seconds, hold for 4 seconds, and exhale through your mouth for 4 seconds. I recommend performing this for 2-3 minutes at a time at least 2 times per week. You can certainly go for longer and perform daily.
Video for reference:
https://youtu.be/bF_1ZiFta-E?si=n6FUH7ob50d9Oan4
Exercise 2: Physiological Sigh
As described above, being stressed will increase the amount of pain signals interpreted by the brain resulting in us feeling more intense and prolonged pain. My favorite breathing activity to reduce the level of stress in our body is to perform a “physiological sigh.” This will assist in promoting a “rest and digest” response in your body and rid your body of excessive carbon dioxide. To perform you inhale through your nose, then without exhaling or holding, you take another inhale through your nose trying to sneak more air in – so in essence a double inhale – and then finish with an extended exhale out your mouth. This will sometimes only need to be performed 3-4 times and you will already feel more relaxed!
Video for reference:
https://youtu.be/rBdhqBGqiMc?si=4s2IyXfCVVvArici
I hope you enjoyed this lengthy blog on how breathing can physically help us. Breathwork is a beautiful exercise we can perform to link our minds and our bodies. Breathing can be expanded into much more detailed and specific practices such as meditation and how it can improve mental health. This blog only scratches the surface of the power of breathing! For the readers who deal with high levels of stress and/or persistent pain, I highly encourage you to set aside a few minutes a day to try these breathing exercises. You won’t be disappointed with the results if you are able to commit.
*Credit to Built To Move which is a book released in 2023 by Dr. Kelly and Juliet Starrett that goes into much greater detail about how breathing is one of our most important “vital signs.” I highly recommend this book if this blog serves any interest to you.
As always,
Dr. Ryan