The Power of Breath

February 25, 2021

By Melisa Abesa PT, DPT, OCS

Did you know that the average adult takes 17,000-23,000 breaths A DAY? We take, on average, 12-16 breaths per minute, every minute, every day. Our breath may speed up when we are nervous – before a big presentation or when startled by a loud noise. It may slow down when we are relaxing – during a massage or while meditating.  The CDC even recommends breathing as a stress management strategy during our current quarantine. Breathing is a dynamic process that we spend most of our life NOT thinking about. Respiration or breathing rate is considered one of the four major vitals – along with heart rate, body temperature, and blood pressure. But do you know why we breathe? How we breathe? And what we can accomplish with the power of breath?

The Anatomy of Breath

The oversimplification of breathing is to inhale oxygen, and exhale carbon dioxide. In reality, “breathing” is only part of the equation. Respiration is actually composed of two parts – pulmonary respiration (or breathing) and cellular respiration (or gas exchange). Our cells use sugar and oxygen to create energy and carbon dioxide; we take in the oxygen from the air around us, and expel the carbon dioxide.

Inhalation

As we inhale, air enters through the nose and/or mouth. It moves down the trachea and into our lungs. Inhalation is driven by the diaphragm – a large dome shaped muscle in the middle of our trunk, between the chest and abdomen. As it contracts, the dome pulls down or inverts, creating negative pressure within the chest that allows air to fill the lungs. Our intercostals (the small muscles between the ribs) also help by creating space within the rib cage. With more forceful inhaling, other accessory muscles join in including our pectorals (chest), scalenes (neck), and sternocleidomastoid (neck). 

Exhalation

Exhalation is naturally a passive process. As the diaphragm relaxes and gently rises, air naturally moves out of the lungs. Sometimes the intercostal muscles can assist here as well, promoting increased rib cage mobility. When we force an exhalation, our abdominals engage.

Try This

  • Take a few regular breaths. Close your eyes, and tune in to your body. Where do you feel the air moving? What body parts are involved? 
  • Now take a BIG breath in. Did you feel your chest inflate? Did you feel your shoulders rise or your neck stiffen?
  • Now force that breath out hard. You might even make some noise. What did you feel? Try it again. Did you feel your abs contract? Simply becoming aware of our bodies’ patterns is a great first step in understanding our breath.

Common Breathing Patterns

At rest, our breath should feel relaxed, easy, and natural. As noted above, inhalation should be primarily driven by the diaphragm, and exhalation should be fairly passive. “Normal” or relaxed breathing is relatively low volume. We only move 0.5-0.6 liters in and out of our lungs per breath – roughly 10% of our total lung volume (~5-6 liters).

Shallow or Rapid Breathing

This can be a temporary or more chronic occurrence, depending on the individual. Quick and shallow breaths can be due to a learned pattern, respiratory diseases like emphysema or COPD, limited mobility, pain, or elevated stress. We correlate this pattern with a decrease in rib cage expansion and diaphragm mobility. Often, we see an increase in neck and shoulder muscle tension. It can also cause an increase in neck pain and headaches.  This breathing pattern triggers an increase in our sympathetic nervous system response, or our “fight or flight” pattern. It creates a vicious cycle – shallow breathing triggers a cascade of physiological changes including elevated heart rate, blood pressure, and the stress hormone cortisol. This in turn triggers an increased state of anxiety or acute stress, and so the cycle continues.

Deep and Relaxing Breathing

In contrast, slow deep breathing can be a powerful tool to help with relaxation and stress management. Unlike shallow breathing, deep breaths promote full diaphragm mobility and naturally stimulate our parasympathetic nervous system or our “rest and digest” pattern. If you’ve ever taken a guided yoga class, breathwork is often at the center of the practice. With sustained exhalations, our heart rate and blood pressure naturally decrease. Our nervous system turns down or quiets, which can have a positive impact on anxiety, stress, and pain.

Why Does it Matter?

Breathing is a central part of our biology. Without it, we could not survive. But it is also closely linked to our emotions and how we experience the world. Breath is a powerful tool that is both influenced by AND capable of influencing our mood, pain levels, acute and chronic stress, and our general health. According to the NIH (National Institutes of Health), relaxation strategies including breathwork can impact a myriad of conditions from high blood pressure to PTSD. Between the demands of daily life and our current pandemic, odds are we are ALL experiencing some degree of chronic stress. Thankfully, we all possess at least one tool we can use to help – our breath.

Try This

Take a few rapid breaths – faster than normal. In order to breathe quickly, you will naturally find your breath more shallow. After 5-10 breaths, relax and take an assessment of how you feel. You will likely feel like your heart rate has mildly increased. You may feel more alert or even mildly agitated or anxious. Your nervous system thinks you are in a state of stress. 

Now, get comfortable. Find a position you can relax in – like lying down on your back with knees bent (or legs propped on a chair) or sitting back into a chair or couch. Start with a big deep inhale into your nose, over several seconds. Pause. Then slowly allow that breath to leak out. Take another big breath, trying to fill your lower ribs and sink into the diaphragm. Pause. Press your lips together and gently blow the air out like you are trying to blow up a balloon. Repeat this breath for one minute. Now how do you feel?

Melisa Abesa is a California transplant who has come to love the Pacific Northwest. Since graduating with her Doctorate of Physical Therapy from the University of Southern California in 2014, she has practiced in the Portland/Salem area. She is a huge advocate for patient empowerment, individualized care, and a holistic approach to health and wellness.

As a board-certified clinical specialist in orthopedic physical therapy, she enjoys working with a large variety of orthopedic and sports related conditions, with special interests including runners, headache treatments, post-operative care, and adolescent athletes.

Related Posts