Does Relaxation Breathing Really Ease Pain?

Are You Breathing Properly?

Chances are if you’re sat down reading this then probably not. Sitting inhibits our diaphragm. It’s simply much easier to breathe with your diaphragm when lying down. For those that don’t know what diaphragmatic breathing is, all will be revealed.

Further impairment of breathing comes from stress and trauma. Overuse of our fight or flight response means we habitually breathe in a shallow manner. Keeping us in a state of high alert and anxiety. Looking for things to run away from and meaning we feel pain more easily and to a greater level. As we discuss in our previous article What Is Pain?

On a conscious level most of us are completely unaware of this effect on our breathing. Many of you reading this will probably be thinking “Oh no, that’s not me” when in fact it probably is. Have you never had any stress or trauma in your life? Honestly? Even professional yogi and wind instrument players are limited in the way they breathe somewhere in their body.

But why would stress and trauma affect breathing function. Consider someone who has just had some terrible news. For example the loss of a loved one. The sobbing, the expression of grief has very short impaired intakes of breath. Obviously this is a very extreme example. On a smaller scale day to day this happens to us all the time without us noticing.

Furthermore this stress and trauma, when left unprocessed, can get locked physically in the body for a long time after the initial stress or trauma has passed. Our memory of it remains. Emotionally and physically. As Dr Bessel Van Der Kolk discusses in his best-seller The Body Keeps The Score.

What Should Happen When I Breathe?

Before we move on I’d like to reinforce that breathing in a fight or flight type of way is no bad thing. Sometimes we need to fight or run away order to survive. What’s important is that we can come back out of that state into a more relaxed way of being and breathing.

In pre-historic times this was much more straight forward. Relaxing after the heightened stress of running away from a sabre toothed tiger or hunting for our food. In the modern world stress is more subtle as we’re affected by the cumulative effects of the constant drips of stress from the world around us.

If is this lack of time in a relaxed state that can lead to increased sensitisation to pain, anxiety, depression and a myriad of chronic health conditions. This is why relaxation breathing and taking time out is so important for our work with pain, health and wellbeing.

So we need to get back being flexible in our breathing. Absolutely breathe in a stressed way when we’re stressed but most of us need to recognise when we’re in our fight or flight state better and then reconnect with a more relaxing way of breathing and being.

In a relaxed state breathing should be an effortless natural affair. If you’re interested to try this completely effortless breath try this method of breath here. Breathing provides the mechanism to get oxygen to all of our tissues to keep them, and us, healthy. It is done automatically (by our autonomic nervous system) which is why we breathe when we’re unconscious. We can of course affect our breath consciously too. Interestingly this is the only part of the autonomic nervous system that we have any conscious control over.

Relaxed breathing relies mostly on the diaphragm muscle and so we call it diaphragmatic breathing. We will talk in detail how to do this later. Next in line are our ribs. These will start moving more when we’re stressed or exercising to give the lungs more room to get more oxygen in.

Finally, when we’re really going for it, the muscles in the neck and shoulders work to give that extra bit of room in our upper lungs. So we can squeeze in that final extra bit of oxygen. This is a really great system. There wouldn’t be 8 billion of us walking around otherwise. But it is the overuse of the rib and neck breathing that keeps is an anxious hyper-aroused state.

A great physical example we can all associate with is saying we hold stress in our shoulders. We may associate this with pulling our shoulders up by our  ears which just looks very stressed. But I would say it is more a symptom of the heightened nervous system due to the overuse of the neck and shoulder muscles that increased stress brings.

The Science Of How The Diaphragm Relaxes Us

Many people are comfortable with the idea that diaphragmatic breathing helps us to relax. If you’re not convinced yet hopefully when you will be when you try it shortly. But how does breathing more with our diaphragm relax us?

The answer lies in the Vagus and Phrenic nerves. Vagus means vague or wanderer in Latin. It wanders from the heart, to the lungs and around the digestive tract directly from the brain. It basically wanders around all of our internal organs letting the brain know how they’re doing.

The Phrenic nerve passes from the 3 vertebrae in your neck (C3-5) past your heart and lungs to the diaphragm.

Between them they control the whole engine room of the body – the diaphragm, the heart and the lungs. Two pretty important nerves! These two nerves are parasympathetic dominant. That is they are more active when we are relaxed.

When we use the diaphragm to breathe this stimulates the parasympathetic part of these nerves. The Vagus nerve also impacts our hormone levels due to the amount of organs is ‘wanders’ past. Causing more release of our relaxation hormones (e.g. noradrenaline, serotonin) and a reduction in production of our stress hormones (e.g. adrenaline, cortisol). This change in the soup of hormones permeating through our system further perpetuates the feeling of relaxation.

What Are The Implications Of Not Breathing Well?

70% of the blood supply to our lungs is in the lower half of our lungs. If we do not use this part of our lungs by not breathing well with our diaphragm we simply don’t get as much oxygen in. Oxygen is what gives energy to the power houses of all our cells (mitochondria) and in turn gives us energy. So in the short term we have less energy.

The long term effects are wide ranging. In this great TED Talk by Joe Di Stefano he talks about the long term affects such as long term stress, back pain, restless leg syndrome, anxiety, acid reflux, migraines and even a link with increased likelihood of cardiac mortality.

Why Should I Breathe Better?

Because it will make you a better lover! Well at least it might increase your sex drive at least. The reason being is that when we become more relaxed – parasympathetic nervous system dominant – we look to repair ourselves, digest our food and start thinking about procreating to expand the population. If we’re in the middle of running away from stuff the last thing on our mind is getting jiggy with it!

Hopefully you can see what I’ve done there. I’m working on your motivation to actually do the breathing exercises to help yourself. There’s a really nice article here from Psychology Today with more health based motivation as to why you should look to get your diaphragm and vagus nerve feeling happier about life.

For those of you working in big business there’s another great TED Talk by a gentleman by the name of Max Strom here. He does a lot of work going into big corporations extolling the virtues of breathing exercises and helping them to work more efficiently and make better decisions. Simply by working breathing exercises into the culture of the business.

If you need any more convincing in his TED Talk we linked to above Joe Di Stefano explains how breathing better moves organs around more. The kidneys for example move 2-3 cm during a big diaphragmatic breath. Better movement leads to better function and better detoxifying of the body.

He goes onto say that even if you don’t feel an easing in pain you should still feel less hampered by it. Can you see why we focus on breathing work at the clinic?

For those who aren’t in pain and a bit more athletic he claims it should even improve your flexibility. To the point he has replaced stretching with his professional athletes with breathing. After all what do you do in yoga to get more range of movement?

I’ve tried to appeal to your love life, stress levels, work ambitions, organ health and athletic ability. I hope you’re feeling suitably motivated to incorporate this into your life? Or at least give it a go if you’re new to this.

Real Life Breathing Examples

Here’s some real life examples of what we consistently see improving when we focus on the breath work. None of this is guaranteed. But with a combination of breath work and relase work we consistently see improvements that tie in with the following research:

• Belisa Vranish in another TED Talk talks about tension in the shoulders, loss of sleep, back pain, digestion issues and reduced immune function.
• The Positive Effect Of Abdominal Breathing On Acid Reflux – when we’re stressed that heart in the mouth sensation literally pulls our stomach up into our oesophagus and gives us acid reflux symptoms. When we relax our stomach drops back down again.
• Asthma
• Migraines
• Breathing Is Effective For Calming Stressed Out Students
• Dysfunctional Breathing Can Be Worse Than Asthma In Terms Of Affect On Anxiety, Depression and Brain Function

Lastly, the final TED Talk I’ll mention, is all about Breathing Happiness. This inspiring talk shows how breath work helped a group of American Veterans completely remove their anxiety – not only during the course of the exercise but for a year afterwards. It also speaks about some amazing research which found that different emotions evoke a different breathing pattern in all of us!

How To Breathe Better

The average person breathes 23,000 times a day. That’s quite a lot! We want to help you breathe better in every one of those 23,000 breaths. Just think how much more oxygen you’ll be getting. Positively impacting your brain and muscle function.

We like to think of breath work as weight training for the diaphragm. Getting it working better for you. But, even more important, we want to work on becoming more aware of how we’re breathing day to day. Enabling us to stay in calmer states and not getting stuck in fight or flight anxious mode.

Just a quick refocus into the diaphragm and we start to feel calmer straight away. We’re able to make better decisions and deal with stressful situations with greater clarity. Of course we need to know where our diaphragm is and how to use if first. So let’s make sure we can access our diaphragm and this relaxation breathing. Here’s a video of your truly demonstrating how to start practicing:

This is a great entry level way to learn to access your diaphragm. Once you have access to this way of breathing try progressing onto what we call wave breathing. That is initiate your breathing as above with the diaphragm and then allow your rib cage to expand. Like a wave running up the body. Ideally smooth. You may feel the odd bit of tension here and there that doesn’t feel smooth. These are the kind of areas that we release in the clinic to help you breathe more easily and in so doing calm the nervous system and often reduce pain throughout the body. But with time and practice you can release these yourself. You may even find that during a session of relaxation breathing those limitations just disappear.

Another breathing technique is called 360 degree breathing. Thinking of the diaphragm as a balloon that inflates. Not only pushing out the stomach but pushing out in your low back and sides too. Basically in all directions.

Personally I find a combination of both these approaches most relaxing for me. There are lots of other variations to try also. You can do what is as 4 4 4 – breathe in for four seconds, hold for 4 seconds, breathe out for 4 seconds. Alternatively you can try a 5 (in), 7 (hold), 8(out) pattern. You can try to exhale twice as long as the inhale. Do whatever feels most comfortable for you.

If you’re struggling to get a hang of it, and many people do initially, simply focus on breathing out for longer than you breathe in. The out breath is our access to the calming part of the nervous system. This is why a ‘Friday evening sigh’ feels so good. And conversely how hyperventilating can lead to the onset of panic attacks.

Don’t worry if you lose concentration and your mind drifts of. This doesn’t need to be perfect. If your mind wanders simply bring your attention back to the in and out of the breath.

Once we have an approach that works we just need to build this into our daily routines. Here’s some ideas of how to do just that.

Start with just 2 minutes each time you do the exercise. You may feel quite dizzy and light headed. This is Oxygen! It might have been a while since you’ve had this much. You can increase this quickly by a minute each time you do to the exercise if you’re not getting any dizziness or light headed sensations.

Then we need to get disciplined. The more we do it the more relaxed we become. The more we practice the more it becomes instinctive and the less we have to think about it. Also the easier it becomes to notice when our nervous system is winding itself up and moving towards rib breathing.

Routine is key when developing a breathing practice. Here’s our favourite options:

• First Thing As You Wake Up – We’re on our backs anyway. It gets us breathing to set up our day and put us in the right frame of mind to deal with what the day throws at us.
• After Dropping The Kids Off At School – for the parent who has some quiet time after the chaos of the school run.
• During Our Working Day – find a quiet spot in a meeting room or on your bed if working from home. Make sure you won’t be interrupted. Great for when you have a bit of a block on a specific piece of work or are just too stressed to work effectively.
• Breathing On Our Commute.
• At The End Of Our Day – whether that’s a whole day with the kids or high powered executive meeting or everything in between. It’s nice to put a full stop on our days and welcome in the evening with some relaxation to bring the level down of our nervous system down. It’s cheaper and more effective than booze!
• Before We Go To Sleep – Great for helping us drift off at night and starting us off in a more relaxed deeper sleep. Great if we tend to wake in the night or grind our teeth.

Try to do at least one of these per day. If you can do 3-4 per day that will be amazing. The key thing is doing it every day as part of your routine.

All of these exercises are great as we said to build up awareness or ‘weight training’ in your diaphragm. The real changes start happening when we notice when we start breathing more shallowly, have a word with ourselves, and just take a couple of relaxation breaths and go again. Great for meetings, dealing with the kids, contemplating appropriate responses to our other halves or deciding if you really need another drink.

The way we recommend to do this is with what we call check ins. Ask yourself every time you think to. How am I doing? How am I breathing? Can I sense if I’m stressed or not? How tight am I holding my body? Some people take to this like a duck to water. Others, like myself, need more encouragement.

A good option can be to have a regular alarm that goes off on our calendar on our phones. Or structure our days a bit better to ensure we’re finding time for wellbeing – as we discuss in our previous article Peak Performance.

So Get Breathing!

For me the evidence is compelling. What we see clinically is backed up by an increasing amount of good quality research. More detailed and larger studies are still required to increase our understanding of the far reaching implications of good and bad breathing function but I see this as further concreting what we are already seeing on a consistent basis.

Is breathing the answer to all of the ills in your life? Well quite possibly. A calmer nervous system can be a large factor in curing a whole manner of ills. Not least of which long standing pain – our specialism. It might not be the sole answer for you an your pain but chances are it will help. Or get you in a better position to be helped. We generally find that people who have a regular breathing or yoga regimen are more malleable and easier to lead down the pain free road.

What are you waiting for? Get breathing!

If you feel you’re not making any progress or feel there is something stopping you get that fullness of breath or simply stuck in pain then get in touch by filling out the form here.