Breathing is something we can say we have done and will do every day of our lives. Moreover, we can be sure that we are doing well enough, otherwise we would be dead (or on a ventilator). However, a quick search online yields results that suggest that, like many things we do in our lives, there is room for improvement. There are techniques and exercises. Keeping ourselves alive is just the basics. Breathing better can bring its own rewards.
Before we move on to the techniques and possible benefits of incorporating breathing exercises into our routine, let’s start at the beginning: could a healthy person, with no breathing disorders, be breathing better than they are now? “In many cases it is very likely that yes, [they could]”, says Miguel Soro, member of the board of directors of the Spanish Association of Physiotherapists (AFI). “From childhood we have been given advice on all kinds of matters related to health. As for breathing, we have always been told that the correct way to do this is to inhale air through the nose and release it through the mouth. But other than that, it’s not that common to have learned the right way to breathe,” he says.
The expert explains that in many cases the diaphragm – the main breathing muscle, which contracts and relaxes to move air in and out of the lungs – is underused, which “in other ways affects our breathing mechanisms and our lung capacity”. Still, even with an underused diaphragm, most people won’t find they need to work on improving their breathing. Shallow breathing is almost always sufficient, says Gerard Muñoz Castro, researcher and respiratory physiotherapist and member of the Spanish Society of Pulmonary Diseases and Thoracic Surgery (SEPAR). However, when it is necessary to use the respiratory muscles to make an effort, “it is important to have an adequate breathing pattern,” something that can be trained.
The first immediate benefit of improved breathing, Soro says, is that it is “deeper and more efficient,” which “better oxygenates the body and strengthens the muscles and helps them function properly.” “This applies especially to people with chronic respiratory pathologies,” but, as Gerard Muñoz notes, “the scientific evidence for this improvement in efficiency in healthy people is not so clear.”
Better breathing can also “improve physical ability, and can therefore contribute to better peripheral muscle development,” Muñoz adds. There is even speculation that certain breathing techniques might improve core strength, although there is no “strong scientific evidence” in this regard either. What better oxygenation can achieve is an improvement in sports performance, Soro says. He points out that “training the respiratory muscles is already included in the routines of many athletes in addition to training in their own discipline, because it is another aspect that they must take into account to improve their performance.”
Better posture, less pain
Regardless of whether better breathing can help us in everyday life or during exercise when we do not have breathing problems, there are other benefits to doing specific breathing exercises. According to a study published in 2022 in the International Journal of Environmental Research and Public HealthA breathing exercise program led by a physiotherapist can improve posture, muscle balance and chest mobility compared to yoga and pilates-based programs. However, the exercises performed by the study participants (women between the ages of 20 and 22) did not only consist of lying on the floor and breathing in a specific way, but breathing exercises were performed in different positions and sometimes accompanied by slow movements.
Practicing certain breathing exercises will also help us prepare for surgery. In hospitals, it is common for patients who undergo certain surgeries to also undergo respiratory rehabilitation. In recent years, prehabilitation has also been introduced, that is, doing breathing exercises before surgery. “These respiratory rehabilitation or ‘prehabilitation’ programs have shown a reduction in postoperative complications, a reduction in hospital stay or less functional loss. In more informal language, we could say that if you undergo surgery in ‘better shape’, the ability to recover in the postoperative period will also be better,” says Gerard Muñoz Castro.
Another area that has been much researched is pain. On the one hand, as Miguel Soro says, in many cases a decrease in breathing efficiency is related to neck pain. By training breathing, “we can improve or prevent these types of conditions at certain times.” In fact, lung function in people with chronic neck pain is usually suboptimal, so specific training aimed at improving breathing can help alleviate that pain as well. Similarly, breathing exercises have been found to help reduce pain in other cases, such as lower back pain. Furthermore, because breathing techniques reduce stress and help us relax, they also help relieve pain.
Breathe to relieve stress and anxiety
“Learning to breathe consciously is one of the first therapies used in all interventions for anxiety and stress,” says Ismael Dorado, organizational secretary of the Spanish Association for the Study of Anxiety and Stress (SEAS). As a clear example of how breathing is related to this, the expert asks us to think about when we get scared. “We automatically shorten our breathing,” he emphasizes. “Anxiety and stressful situations are related to breathing rate, so regulating breathing and taking conscious action is one of the first things we can do for our well-being,” he explains.
Much research has also been done on the effect of conscious breathing on our psychological state. A 2015 study concluded that practicing slow breathing (fewer than ten breaths per minute, with the exhalation being longer than the inhalation) can reduce stress and anxiety levels. As for why breathing in a certain way relaxes us, there are quite a few possible reasons. For example, it has been proven that this type of breathing reduces cortisol levels (the so-called ‘stress hormone’) in saliva and can lower blood pressure.
Ismael Dorado adds that this conscious and relaxed breathing “directly affects our brain activity.” This is because “breathing has direct connections with various parts of the cerebral cortex, areas where thinking, perception and imagination originate, and also has connections with processes directly related to learning, attention and especially to memory ( because poor breathing causes poor sleep, which impairs memory).” Controlling our breathing can help improve all of this.
While scientific evidence is slowly showing that breathing exercises can have multiple health benefits, it is also important to understand that there is still a lot of research to be done. Most studies have a very small sample size and focus on the short term. Furthermore, as a meta-analysis published in 2023 warned about the effects of breathing exercises on mental health and stress, we must be careful not to confuse hype and evidence. But also the experts who were spoken to EL PAÍS I believe it can be a good idea to incorporate some breathing exercises into our routines.
The first step, Miguel Soro advises, is to “see how we breathe,” that is, analyze our normal pattern and see what can be improved. From there, he suggests two exercises “that can help us breathe correctly and relax”:
“This exercise involves taking deep breaths using the diaphragm. To do this, sit or lie down in a comfortable position. Place one hand on your stomach and the other on your chest. Breathe in slowly through your nose, allowing your abdomen to expand while your chest remains relatively still. Exhale slowly through your mouth and let your abdomen contract. Repeat this process several times, focusing on deep, slow breathing.
Breathing with apnea
“This exercise involves inhaling, holding the air, exhaling, and holding the air again, all at equal intervals. To do this, inhale slowly for a count of four, hold the breath for a count of four, exhale slowly for a count of four, and then hold the breath for another count of four. Repeat this process several times while maintaining a steady rhythm.
Ismael Dorado, for his part, describes a variation on this last technique, which he recommends doing before going to sleep, if we have a difficult situation or decision ahead. “It’s about filling our lungs to the maximum until we can’t handle it anymore, holding it for three seconds, releasing the air for five seconds and waiting another three seconds before repeating. Maintaining this breathing rhythm for one minute can help a lot,” he explains.
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