Breathing for Overall Health and Pain Control

Breathing is the basis for everything we do. It is a natural and an involuntary process. Normally a person takes 10-14 breaths per minute, so up to 30,000 + breaths per day! So how then, can breathing affect us on a deeper level?  

Breathing plays a role in regulating mental and emotional states, helps modulate the autonomic nervous system, regulates intra-abdominal pressure needed for physiologic stability of the spine, and provides the foundation for functional movement patterns. Over time, and for various reasons, people can develop dysfunctional breathing patterns. Since breathing is our fuel for movement, dysfunctional breathing can lend to poor movement patterns, musculoskeletal pain, and increase vulnerability to injury. Basically, if breathing is not normalized, no other movement pattern can be.  

Dysfunctional breathing is present in a number of musculoskeletal conditions. Persistent pain leads to dysfunction of the autonomic nervous system (sympathetic = fight or flight and parasympathetic = rest and digest). When the body is under stress, breathing rate increases with a decrease in volume. If this heightened state continues the sympathetic nervous system is in an up-regulated  state. The consequences of this heightened state include mood swings, muscle pain and tenderness, changes in appetite, fatigue and weight gain, poor sleep, GI and digestive issues, inability to focus and concentrate, depression, and dysfunctional breathing.  

Normal breathing patterns can stimulate the parasympathetic nervous system which puts us in a relaxed state. This can help with pain control and allow our core muscles to work more efficiently, enabling normal movement patterns, which in turn helps decrease pain with activity.  

So how do we breathe “normally”?  Exhalation or expiration should generally be 2-4x longer then inhalation or inspiration. This is how we set up a parasympathetic (relaxation) response. Breathing through the nose and out through the nose or mouth is preferable. Nasal breathing helps our bodies clean the air as well as allowing combination of nitric oxide with the air which increases oxygen binding capacity.  

  • Sit or lie comfortably, with your knees bent and your shoulders, head and neck relaxed. 
  • Place one hand on your upper chest and the other just below your rib cage/belly. This will allow you to feel your diaphragm move as you breathe. 
  • Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible.
  • Pause for 1-2 seconds after breath in, then exhale for 2-4x longer vs inhale. Again the hand on your chest should not move much.  
  • Practice for 5-10 minutes 1-2 x per day 

Jennifer Jung, PT, OCS

Jennifer is a board licensed physical therapist with 20 years of experience in orthopedics and sports medicine. She received her Masters Degree in Physical Therapy from East Carolina University in 2000 and undergraduate degree in Exercise Sport Science from Elon College (now Elon University) in 1997. She is one of our Physical Therapist in the Los Gatos clinic.

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