Take a breath, see where it goes. Go on now, don’t hold back. Does the breath travel down to your belly? Was there a 360-degree expansion around your abdomen? As women, we can have a higher propensity towards anxiety, panic attacks, and migraines. What if I told you how you breathe can affect all of these factors in your life? We breathe more than any other habit in our life: 22,000 to 25,000 times per day just living. Hello! This is not including a more hard-core breath when we exercise. If we are breathing from our chest instead of deep belly breathing, we are putting our bodies into a fight or flight state activating the sympathetic nervous system. This is totally appropriate to do while exercising, but we don’t want to continue an exertional breath once we stop and go back to sitting at our desk.

Breathing is a beautiful thing. It is one of the only processes in the body done on an unconscious level, like digesting or circulating blood. But our respiratory system can be controlled, consciously regulated, and improved with focus, so it performs better. We teach breathing exercises to every one of our patients, every single day. We start with breathing drills because most New Yorkers are running around burning the candle at both ends, and their nervous system needs to chill out. Learn how to really BREATHE using the exercises below.

Deep Belly Breathing: How to REALLY Breathe

How long has it been since you’ve REALLY breathed? I mean really taken a long, deep breath until no more air could enter, held it, then fully and consciously exhaled? Are you doing it now?

How do we breathe, you may be asking? The diaphragm (the muscle separating the lungs and organs) pulls downward pushing the organs down. This action changes the pressure in the lungs to pull in oxygen as we take an inhale. As the organs are pushed down, there’s an increase in intra-abdominal pressure, pushing the spine out of extension, and creating a downward force on the pelvic floor. The lower ribs expand laterally, the sternum moves forward (but should not be pulled up toward the head). As we exhale, the diaphragm pulls up vertically as CO2 is pushed out of the lungs.

When do we chest breathe? Sucking in and “skinnying up” the waistline as we are often taught as women can lead to anxious chest breathing, using neck muscles such as the scalenes and upper traps to lift the ribs to take a breath. We find in our patients who are excessive chest breathers a higher propensity to having disc herniations, neck pain, headaches, and a weak core. Yikes!

The ideal breath is a diaphragmatic belly breath ‘in’ with 360-degree expansion down and around into the belly. The exhale is ideally twice as long as the inhale. Try for 4 counts ‘in’ to 8 counts ‘out’. This allows your diaphragm to be in the most vertical position possible, leading to decreased chest breathing, less anterior lower rib flare, and reduced anxiety. By breathing down into the belly and expanding circumferentially, you can avoid sway back and increase core stability, letting you move like when you were a baby. This is the quickest way to get out of a panic attack and calm the nervous system back into its rest-and-digest parasympathetic state.

What are the benefits of deep belly breathing?

According to Harvard Health, practicing deep belly breathing, also known as diaphragmatic breathing or abdominal breathing, can decrease stress, lower high blood pressure, improve immune function, and reduce anxiety and depression. As a general rule of thumb, practicing deep belly breathing techniques and exercises signals your body to relax. Often the benefits you reap come from the simple reduction in stress when you take the time to focus on your breath. Even my favorite podcaster and founder of Quest nutrition and Impact Theory, Tom Bilyeu, claims he takes one single diaphragmatic breath to ease his anxiety.

What’s the difference between deep belly breathing and, say, any other type of deep breath?

Every breath is a diaphragmatic breath. In fact, if our diaphragm didn’t contract we would not be alive. But a good solid “belly breath” is when your diaphragm presses downward on the abdominal cavity and causes your belly to expand. This is different from a shallow chest breath when the diaphragm doesn’t contract as much and there is less pushing downward and less belly expansion. The difference? When you breathe from your belly, you are allowing your lungs to fill to their fullest capacity. When breathing into the chest, you only allow the lungs’ upper lobes to fill, and only some oxygen is getting into your bloodstream as a result. When exercising, this could be dangerous and often leads to hyperventilation, lightheadedness, and shortness of breath. Deep belly breathing throughout your day can keep oxygen flowing through your veins so you can go longer and be more productive. If you want maximum results, spend a little time each day intentionally practicing just deep belly breathing. If this doesn’t convince you, there was a study done in 2012 looking at the position of the diaphragm of 29 subjects under an MRI which found that people with a history of chronic low back pain had an abnormal position of the diaphragm, a steeper slope of the diaphragm, and overall less excursion compared to those without a history of chronic low back pain. Was the cause of the low back pain due to the position of the diaphragm or did the diaphragm position change with the onset of low back pain? Who knows but minds as well control the factor we can change which is our breathing patterns and our day to day diaphragm position with the drill found at the end.

In the clinic, we also teach a deep belly breath with a brace on the exhale for when you pick up something heavy, like when you lift weights. Olympic weightlifters are masters of this concept. As they step up to the bar with their weight belt, they take a deep breath in and make themselves look like a fat kid in their abdomen. This abdominal expansion is them finding full intra-abdominal pressure to protect their spine and joints, simply using their breath. The other masters of this are babies, who look swollen or bloated from too much milk but are actually breathing and bracing as they learn to roll over, rock, crawl, and kneel. Check out the intra-abdominal brace here:

Can I practice deep belly breathing for stress and anxiety?

Yes! Stressed at work? Are the kids fighting, the laundry piling up, and you just received a call from the mechanic with bad news? Breathing exercises may not cause your work, fighting kids, laundry, or car problems to disappear, but it can help you handle these stressors better. Students who practiced deep belly breathing techniques on a regular basis experienced “perceptions of decreased test anxiety, nervousness, self-doubt, and concentration loss,” as shown in the Teaching and Learning in Medicine International Journal. Assessments of the effects of deep breathing on anxiety and smoking withdrawal symptoms show positive results. Time and time again, deep belly breathing exercises have been proven an effective way to manage overall stress and benefit the body at the same time.

Take a breath with a yogi

The funny thing is, yogis have been practicing breathing exercises for centuries. Nadi Shodhan Pranayama is described as a “guidance of breath” creating a “subtle energy clearing.” The alternate nostril breathing technique promotes relaxation and helps release accumulated tension and fatigue. You can try it!

• Sit comfortably and erect, relaxing your face into a gentle smile.
• Place your left hand gently on your left knee, palm upward and relaxed or gently connecting the thumb and index finger.
• Using your right hand, place your index and middle fingers in between your eyebrows, your ring and pinky over the left nostril to open and close it, and the thumb over the right nostril to open and close it.
• Press your thumb down on your right nostril and breathe out gently through the left.
• Breathe in from the left nostril, then alternate, breathing out then in from the right nostril.
• Complete nine rounds (an exhale and inhale from both sides equals one round) while keeping your eyes closed and taking deep, relaxed breaths.

Deep belly breathing exercises

Do this exercise to reset your breathing after a long stressful day at work and contact us to further perfect it:

• Lie face down and make a pillow with your hands to support your forehead.
• Place your tongue on the roof of your mouth an inch behind your teeth: this will help guide the breath downward.
• Breathe in slowly through your nose. Send your breath down to the fronts of your hip bones as your belly expands, then start to breathe your waistline wide, sending your breath lateral. Lastly, concentrate on sending your breath down into your low back.
• There should be a natural, gentle rhythm of the pelvis as you breathe. As you breathe in, the tailbone will tip down towards your heels, into counternutation, or a posterior pelvic tilt, and as you exhale the natural curve of the low back will return.
• This kind of concentration on the breath is putting an eccentric load on your transverse abdominus and is giving you the baseline for good core stability.
• For maximum benefits, do this for 12–18 breaths (which is about a minute) 2 to 5 times a day.
• For an extra challenge, keep the brace on the exhale: keep pushing your belly out by at least 50% on the breath out. This is your weightlifting breath. Bravo, you have just mastered what we teach each patient in the first 10 minutes of their treatment part of their first appointment.

Best in health,

Dr. Emily Kiberd