Just Take a Breath - The Essentials of Diaphragmatic Breathing

Breathing, as a subject, tends to be either largely ignored or completely dogmatised. There are dozens of different schools of thought and many would-be experts teaching and preaching all things breath. Sometimes the messages align, and sometimes they are flat-out contradictory. My position on the topic is fairly much my position on all things physiological: 

It’s complex, and it’s context dependent. 

That said, something that is complex from a physiological systems perspective, doesn’t necessarily require a complicated and convoluted approach in practice. 

The physiology of respiration is incredibly complex and, frankly, tedious to study. Sifting through research papers on respiratory or pulmonary physiology often makes me want to stab myself in the eye with a pencil (a tip of the hat to those who excel at this branch of physiology, I don’t know how you do it). There is still a great deal about this topic that is just not understood, and what you “should be doing” with your breath is highly context specific. Breathing isn’t just one thing. On top of this, many popular and established breathing practices have poor scientific backing. Of course this doesn’t mean that these practices don’t work - anecdotally, they do. However, the theories around the physiological mechanisms through which these practices work have not been extensively investigated. 

Breathing is arguably the most essential of our physiological functions - you can survive for days without water, but only minutes without air.  Breathing stands alone in terms of being both entirely autonomic (i.e. under the control of the automatic or subconscious part of the nervous system) and simultaneously under full (or near full, anyway) voluntary control. It is this characteristic of breathing that makes it such a powerful tool for helping to regulate our physiological state. It is, in essence, a bridge between the conscious and subconscious aspects of our nervous system.  

When it comes to working with breathing, we need to consider two different but interrelated aspects: the anatomical aspect and the physiological aspect. Whether you are focussing on breathing in the context of a movement practice, or in the context of a breathwork practice, paying attention to the anatomy/the mechanics of breathing really ought to precede any attempt to manipulate the breath for whatever physiological purpose your heart may desire. 

To have any type of meaningful breathwork practice, the physical mechanics of the breath has to be as optimal as possible. Significant compromises in the mechanics of your breathing will potentially have a negative effect or limit the effectiveness of your breathing practice. 

In the context of a movement practice, the mechanics of breathing - in particular diaphragmatic breathing - play a central role (some would argue the central role) in the body’s innate stabilisation mechanisms. The diaphragm, which is our primary muscle of respiration, is also highly influential in regulating the overall function of the muscles in and around the trunk and pelvis (the “core”, if you will). These are the mechanism that stabilise the spine during movement. So let’s talk about the diaphragm. 

The Diaphragm

The diaphragm is a large dome-shaped sheet of muscle that sits at the base of the ribcage, and separates the thoracic cavity (where your lungs are) from the abdominal cavity - kind of like the roof of a tent. It has extensive attachments to the lumbar spine, the lower half of the ribcage (typically ribs 7-12) and the sternum. It also has direct fascial (connective tissue) connections into the tissues around the lungs and heart, and can be argued to have functionally significant connections to the muscles around the pelvis, including the illiacus, the psoas, the adductors, and the muscles of the pelvic floor. 

The diaphragm is the primary muscle of respiration - i.e. its main function is breathing. When the diaphragm contracts, it descends downwards into the abdominal cavity (range of motion has been measured around 4-5cm). This movement creates negative air pressure inside the thorax, which results in air moving from outside the body, into the lungs - hey presto, inhalation. When the diaphragm relaxes, it moves back up into its resting position, and air is expelled from the lungs. 

The descent of the diaphragm into the abdominal cavity is not just important for breathing, it is also a key part of the mechanisms that stabilise the spine in movement. When the diaphragm descends with inhalation, there is a downwards pressure into the abdomen. Under normal circumstances, this will result in an expansion of the abdominal wall - what you would see from the outside as a rising of the belly with inhalation. There is also a downwards movement of the pelvic floor (which you can think of as the pelvic diaphragm - kind of like floor of the tent). The function of the diaphragm is directly linked to the function of the pelvic floor - a topic that generates more than a few furrowed brows.

The expansion of the abdomen with inhalation is normally quite obvious in small children, but often not as obvious in adults who, for various reasons, tend towards actively holding in their belly. Excessive tension in the abdominal wall, especially any active “pulling in” of the belly button will impede the descent of the diaphragm. This tends to have a couple of consequences of note from a mechanical perspective:

1. When the diaphragm cannot descend freely, the spinal stabilisation mechanisms of the body are impeded. This has flow-on effects for movement, as efficient movement is dependent on the stabilisation of the spine and pelvic region. The diaphragm is also influential in maintaining dynamic balance. How this happens is not a short story, so suffice here to say that if you don’t breathe diaphragmatically, your “core stability” will be compromised. Ditto for pelvic floor function. There is a common misconception that “pulling your belly button to your spine” stabilises your spine. It does not. 

2. In terms of breath, the show must go on, even if the star has broken a leg. If the negative air pressure needed for breathing cannot be created through the downwards pull of the diaphragm, the body will create this negative pressure by using muscles around the neck and ribcage to pull the ribcage upwards. This can be seen from the outside as the chest and shoulders moving upwards as someone inhales. In addition to being inefficient for breathing at rest, long-term breathing in this pattern drives significant tension into the neck and shoulders. 

Obviously (or maybe not obviously) altered breathing mechanics will not only have consequences from an anatomical perspective, but also from a physiological perspective. Persistent short, shallow breathing has longer term effects, which include a decreased efficiency in terms of oxygenation and feedback loops with emotional states such as anxiety. This is covered in more detail in the next article on The Physiology of Breath.

So, all that to say: it is important that we establish a good diaphragmatic breathing pattern at rest as a starting point. We can then learn to integrate this basic pattern into our movement practice, whether we’re doing pilates or powerlifting. It also bears mentioning that breathing at rest should be  nasal, unless you absolutely cannot breathe through your nose. There are key differences between nasal and mouth breathing, both in terms of mechanics and in terms of gas exchange, and it is always better to breathe through your nose if you can. 

Practicing Diaphragmatic Breathing

To start practicing diaphragmatic breathing, it is usually easiest to start by laying face up, with you knees bent and your feet flat on the floor. From here, place your hands on your belly, either side of your belly button. Take a breath in and notice if you can feel your belly rising under your hands. You don’t need to actively push the belly out, just let the abdominal wall relax enough to allow it to move out as the diaphragm moves downwards with inhalation. The shoulders and upper chest should be relaxed, with nil upwards movement of the chest towards the shoulders. You also should not feel your lower back tilting up and away from the floor. At may be useful to think of a ball inside the belly, inflating in all directions as you breathe in - so that the abdomen expands upwards, downward and into the sides. On the exhale, just let your belly relax back down. Exhale all the way out so that the diaphragm can return to its resting position.

Once you have established a decent diaphragmatic breathing pattern and you are happy with the anatomical aspect of things, you can start to introduce some basic breathing exercises. The exercise I generally recommend as a starting point is a simple resonance breath. Resonance breathing is essentially slowing your breathing rate down to 5-7 breaths per minute (which is less than half of what people typically breathe at rest). This corresponds to a breath cycle of between 8-12 seconds, so:

4-sec inhale : 4-sec exhale

5-sec inhale : 5-sec exhale

6-sec inhale : 6-sec exhale

A common mistake is to breathe in too much air - to hyperventilate. Breathing “deeply” here is more about breathing down into the belly than taking a big gulp of air. The idea is to take in less air overall, and both the inhale and the exhale should be slow and smooth. If you are taking in too much air, you will likely experience a lightheaded feeling. 

If you have difficulty with this, there are two simple thing you can try: the first is to make your exhale slightly longer than your inhale, for example: 

4-sec inhale : 6-sec exhale

5-sec inhale : 7-sec exhale

The second is to use an alternate nostril breathing technique. Breathing in through only one nostril at a time will help to limit the volume of air you take in, making it less likely that you will hyperventilate. You follow the same breathing ratio as for the resonance breath. 

To start with alternate nostril breathing, follow this pattern:

Gently close the right nostril, inhale through the left.

Switch to closing the left nostril, exhale through the right.

Inhale through the right nostril, switch over and exhale through the left.

Inhale through the left nostril, switch over and exhale through right. 

Continue this pattern of switching sides at each exhale. 

It is essential that the breathing ratio feels comfortable, so that you don’t begin to feel lightheaded, stressed or anxious. You also shouldn’t be gasping for breath at any point. A simple tool to help you get started is an app, simply named The Breathing App. It was developed by a yoga teacher named Eddie Stern, and is available free of charge. The app has set breathing ratios you can pick from, and you can set a timer from 1-30min. Of course you can also just count out your breaths, and use a timer on your phone. 

When you first start, aim for 5 mins and see how you go. You can then increase the time as you feel comfortable, if you want to. To begin with, I don’t recommend that you incorporate breath holding. Breath holding can be useful in breathwork for the purpose of influencing physiology, but the primary aim here is to improve the mechanical aspect of your breathing. 

Once you are comfortable with the mechanics of diaphragmatic breathing at rest, you can start to work with diaphragmatic breathing during dynamic movement practices. This is a whole other kettle of fish, and what exactly you do with your breath - and your abdominal wall - will depend on what type of movement or exercise you’re doing. However, no matter the physical practice you choose to pursue, all functional breathing in movement starts with functional breathing at rest.