Re-establishing a normal breathing pattern, with proper diaphragm activity, is vital to your health for the following reasons:

1. It provides proper oxygen delivery to your body.
2. It allows you to use your lungs to their fullest extent.
3. The wave-like motion imparted by the diaphragm massages and mobilizes your thoracic and abdominal organs, helping to optimize their function!
4. It helps circulation to and from your heart.
5. It assists circulation of lymph, a key component of your immune system.
6. Bringing awareness to diaphragmatic breathing is a useful stress reduction tool, which can help reduce headaches, anxiety and chronic pain

In my last article (Paying Attention to your Breathing), I wrote about pausing to pay attention to your breathing. The focus was simply on pausing to notice and gently slow your breathing. In this article, I will describe a simple belly breathing exercise that will reintroduce your diaphragm to the normal breathing pattern. I want you to become aware of the quality of movement in natural, relaxed and effective breathing because the loss of the normal breathing pattern has many ill effects on our health.

Some of the ill effects of faulty breathing include: neck and shoulder tension, headaches, general chronic pain, fatigue, anxiety, decreased ability to heal….etc…

Let’s start with a little understanding of the anatomy and mechanics of breathing.

The respiratory diaphragm is your primary breathing muscle. When it contracts, it pulls air into your lungs. The oxygen from the air in your lungs is transferred to your blood. The heart pumps this blood throughout the body to deliver oxygen to all your cells.  The diaphragm is a dome-shaped muscle, situated across the lower rib cage. It separates the chest cavity from the abdominal cavity.   

On the left: diaphragm has contracted – breathing in, the lungs expand.

On the right: the diaphragm has relaxed – breathing out the lungs recoil. 

When you breathe in, with normal and proper function, you are contracting your diaphragm. When the diaphragm contracts, its center (the top of the dome) moves downward. Your lower rib cage expands and your belly moves forward to make room for your stomach, liver and intestines, as they are pushed down. When you breathe out the diaphragm is relaxing. The top of the dome moves upward and your belly moves back in, as your abdominal organs follow the diaphragm upwards. The resultant out and in movement of your belly is why diaphragmatic breathing is often called belly breathing. This pumping action of the diaphragm not only brings in vital oxygen for your body, it provides a massaging effect to your organs. Your heart, lungs, liver and digestive tract actually rely on the massaging wave of the diaphragm for optimal function.

Troubled breathing can be a pain in the neck. There is good evidence that shallow, rapid breathing is quite common. It is a natural response to stress. When you fall into the habit of shallow breathing you are requiring your neck, chest and shoulder muscles to help you breathe. Under normal circumstances, the average adult  breathes in about 22,000 times per day.  Imagine how much extra work (stress) that is for your neck, chest and shoulder muscles, if you are not letting your diaphragm do that work. The diaphragm is the only muscle configured to do the bulk of this work. Many people who suffer from chronic neck and/or shoulder pain and headaches, do so, at least in part, because they’re natural breathing pattern has been altered. When your breathing overuses secondary or accessory muscles, as in neck, shoulder and chest muscles, the diaphragm becomes weaker. Once weakened it is no simple task to regain its strength. Belly breathing exercises are extremely valuable because they train you to primarily use your diaphragm to breathe. This helps regain strength and tone in your primary breathing muscle. It is important to note that the diaphragm has a key supportive function in regulating posture too. This is because it attaches to your spine as well as your rib cage. Therefore, by activating your diaphragm you reduce tension in your neck and shoulder muscles and you facilitate better posture.

Here is how you can start practicing full diaphragmatic breathing.

Important Notice: The following exercises are intended to introduce the awareness of diaphragmatic breath. It assumes the presence of certain normal physiologic functions. If you suffer from any chronic obstructive or restrictive diseases of respiration, or other ailments and find these exercises difficult or distressing, please discontinue and see a healthcare practitioner for guidance on what you can do to improve your breathing. If you find yourself struggling, tensing or feeling short of breath, even if you have no known disease, do not continue without consulting a healthcare practitioner, who is knowledgeable in breathing rehabilitation. The normal breathing pattern may have been lost due to compensation for chronic illness, stress, poor posture or injury. It can take weeks of breathing re-education combined with physical rehabilitation – and sometimes psychological counseling – to undo old habits and re-learn proper breathing patterns.

Positioning yourself

•Lie on your back on the bed or floor with a comfortable mat. •You may rest your head on a pillow for comfort. •Place two pillows under your knees. – This is important to help remove any tension from your abdominal, back and leg muscles. •Rest your hands on your belly or place a light book on your abdomen just above your navel (belly button). •Bring your lips together gently and breathe through your nose. •Rest your tongue on the roof of your mouth, with its tip just behind the top teeth. – This is the position your tongue goes to when you swallow. It should be the natural resting place for your tongue when you breathe through your nose. •Begin to notice your breathing as you relax for a few moments, without trying to do anything to control your breath. Just enjoy doing nothing but noticing your breath for one or two minutes.

The exercise

As you settle in to a resting state, and relaxed breathing, notice if your belly rises when you are breathing in. The book ( or your hands) you placed on your abdomen is there to provide a little visual and perceptual feedback. Your exercise is to quietly pay attention to your breath and what the book and your belly are doing. Continue to just notice your breath for 1 to 2 minutes, without trying to change anything.  With a normal breathing pattern, at rest, you should see the book rise as you breathe in and come back down as you let your breath out. At rest, there should be expansion of your abdomen and lower rib cage as you breathe in and very little movement of your upper chest.

Are you using your diaphragm?

If your upper chest is rising more than your belly, you are not using your diaphragm correctly. To determine whether you are belly breathing, you may place one hand on your breast bone and one just above your belly button to compare which moves more. To encourage your in-breath to lift the book ( or move your hand) on your belly, visualize a balloon just behind your belly button. When you breathe in, allow the air to go directly into that balloon, effectively lifting the book as the balloon fills. Do not try to take in a lot of air. Just breathe in comfortably, without effort. Settling into diaphragm breathing can and should be deeply relaxing. Try practicing 5 minutes, twice daily. If you find this relaxing, by all means, enjoy it for 10 to 20 minutes! Otherwise, practice for short periods frequently. It should become easier with practice. Be patient.

Remember, if you feel any distress or discomfort when trying this exercise, discontinue the exercise, resume breathing naturally and contact me or your healthcare provider for guidance.

If you can do the above mentioned exercise easily in the supine position, you can and should practice this in sitting and standing too. You will need your hands over your belly for the feedback the book provided while you were on your back. Be forewarned that while it may be easy to do when lying on your back, it is different when sitting or standing. Future articles will address some progression ideas. 

If you have difficulty allowing your belly to rise as you breathe in, try this:

As you lie on your back, clasp your hands on top of your head. Resting the weight of your arms in this way takes tension away from tight upper chest muscles. Does this make it easier for the book to rise on the inhale? Tense upper chest, shoulder and neck muscles can interfere with the normal restful breathing pattern. You can practice diaphragmatic breathing with your arms in this position, at first. Eventually, you will want to be able to place your arms to your side. If you can’t let the tension out of your upper chest, neck or shoulders, consider getting some bodywork and/or coaching in relaxation and breathing re-education.

In conclusion

Shallow breathing and other breathing pattern changes, develop from the accumulation of stresses of daily living, following injury or illness, and also from poor posture. Many ailments are in some manner affected by your breathing. Sometimes your breathing contributes to some of your ailments. It definitely requires time and repeated practice to reestablish effective breathing patterns. So, play and explore with your breath. Let me know what your experiences are. If you experience discomfort or unease while exploring your breath, hands-on bodywork or physical therapy may be of valuable help. At times, some type of cognitive therapy or coaching is also needed to learn how to cope with your reactions to the world around you.  This article is only a small piece of the intricate puzzle of breathing and its effects on your health. In my next article we will delve deeper into how breathing patterns affect your health. In the meanwhile, send me your feedback on how the suggested explorations feel for you or any questions that arise. 

Disclaimer Suggestions made in this publication are no substitute for medical advice. If you have any pain or difficulty performing the described exercise, seek advice from your appropriate health professional.

About the Author

Domenic Lopez B.Sc., Certified Clinical Exercise Physiologist and Licensed Massage Therapist, is owner and operator of Healthy Moves, a private practice where massage therapy and movement and self-care education help you achieve better living.