Are you breathing well?

“Breathing is the first act of life and the last. Our very life depends on it”

-Joseph Pilates


As a Pilates teacher and nurse I wanted to learn more about breathing to help my patients and clients, so I embarked on a fascinating journey to find out more. Being a keen skier, biker, climber, hill walker, anything else that involves outdoor activities and mountains, I was also keen to discover if breathing well could help improve my performance in the activities I do.



Have you ever considered how you breathe? Are you breathing well? There are physiotherapists specialising in breathing disorders in athletes, so just because you are physically fit, you may still benefit from breathing education. The results could be less fatigue and faster recovery from sport, improved concentration and sleep and a greater sense of calm.


Breathing should be in and out through the nose, belly/abdominal/diaphragmatic and slow. Of course, during exertion, our respiratory rate will increase, but it is possible to breathe too much. We want to breathe just enough for what our body needs.

Through the nose

Nasal breathing is the foundation of good breathing. Can you breathe through your nose all the time, including at night and during exercise? (except with very high intensity exercise).


I was a nose breather EXCEPT when exercising, where I resorted to mouth breathing. While Munro bagging in Scotland, I made a conscious effort to keep my mouth closed. Initially it felt like I could not breathe, the resistance through my nose was profound and uncomfortable, I felt I was not getting enough air in, my nose would not stop running. I spent some time switching between nose and mouth breathing, gradually increasing the amount of time nasal breathing. Despite the initial discomfort, and realising I could still put one foot in front of the other up the mountain, clearly my muscles were still getting the oxygen they needed, I persevered and soon got used to it. After a few months, I would honestly say I have noticed my exercise tolerance has increased, I am less tired after a bike ride, recover more quickly, less muscle fatigue, ready to go again the next day. Nasal breathing even when cycling up our Peak District hills is now my norm, for life. Even the dripping nose has lessened.


The nose filters out dust and microbes as the air enters the nose, warming and humidifying the air as it enters the sinus cavities, then into the lungs. The sinuses are a huge space behind our nose which produces the gas Nitrous Oxide. Nitrous Oxide may act as an antimicrobial, deactivating germs, therefore help reduce the risk of respiratory infections.


With nasal breathing, Nitrous Oxide follows the airways into the lungs and acts as a bronchodilator and vasodilator increasing gas exchange from the alveoli of the lungs to the blood, resulting in an increase in circulatory blood oxygen.


Carbon dioxide in our blood is the driver to breathe and not just a waste gas. Higher levels of blood carbon dioxide encourages the oxygen from the Haemoglobin, or red blood cells in the blood, to move into the tissues and organs, also known as the Bore Effect. Nasal breathing exerts 50% more resistance to air flow resulting in slower breathing, therefore increasing blood carbon dioxide. This results in more energy and less muscle fatigue.


Breathing Low (Belly/abdominal/diaphragmatic breathing)

We want to direct the air low (deep) to the base of the lungs where most gas exchange occurs. Your belly/abdomen should rise and fall with each breath to make this happen. The Diaphragm is the main breathing muscles. It is a large dome shaped muscle sitting at the base of your ribs /chest cavity, separating out the lungs and heart from the organs of the abdominal cavity. The Diaphragm contracts and flattens during inspiration resulting in air drawn into the base of the lungs where most oxygen is transferred to the blood. On exhalation the Diaphragm relaxes returning to its original position.


Slow and reduced breathing

Generally we breathe too much and too fast exhaling more Carbon dioxide than necessary. We believe or feel that taking a “big breath” is a good thing. A big breath only over inflates the lungs, but no more oxygen is carried into the blood. At rest we should aiming for a respiratory rate of 8-12 per min.


Benefits of breathing through the nose, low and slow

  • Creates a powerful suction effect that draws air into the base of the lungs

  • Uses less energy

  • Slows down the respiratory rate

  • Helps improve venous return

  • Increasing circulating blood oxygen and carbon dioxide

  • Improves lung volume

  • Can help relieve nasal congestion

  • Helps maintain the strength of the diaphragm

  • Makes the breathing receptors in the brain less sensitive to Carbon Dioxide

  • Help the heart beat and respiratory system to work together – as you breath in the heart rate speeds up, as you breath out, its slows down (Heart Rate Variability)

  • Activates the parasympathetic nervous system and reduces sympathetic activation.

The influence of stress on breathing

Stress is a major factor influencing our health today. When we are stressed our breathing becomes fast, through the mouth, using the assessor breathing muscles round the neck, shoulder and upper chest. When this becomes our norm, the chemistry of the body can be reset, affecting both our physical and mental health.


What can you do be breath well?

Learn to breathe through your nose, start at rest, incorporate into gentle walking, then into your normal higher level activities.


Make sure you are using you belly/abdomen. Place your hand on your chest, and the other on your belly and notice the movement of your hands as you breathe. At rest there should be very little movement from your upper chest.


Spend 10 minutes three times a day focusing on your breathing. Aim to take less air in, or reduce the speed of the air entering the nose, and aim to achieve a respiratory rate to 5- 6 breathes per minute to help activate the parasympathetic nervous system which is our “rest and digest”.



Resources/References

  • The Breathing Cure - Patrick Mckeown

  • The Oxygen Advantage - Patrick Mckeown

  • Breath: The New Science of a Lost Art - James Nestor

  • Breathing Matters: A New Zealand Guide - Jim Bartley Tania Clifton-Smith

  • Russo M.A, Santarelli D, M. O’Rourke, D (2017) The physiological effects of slow breathing in the healthy human. Breathe. 13, 4.


About the author

Lorna Nicholson is a registered nurse (previously working as an advanced nurse practitioner in primary care), a body control Pilates Teacher, Buteyko Clinic Certified instructor, BASI level 2 ski instructor and Stress Induces Recovery Practitioner (training).

https://www.sirpa.org/


Visit Lorna's website

http://lornanpilates.co.uk/


Cover photo and article photo by Simon Nicholson



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