If you experience pain, compare how it is affected with either 6 breaths/minute for 5 minutes OR focused 3-dimensional breathing OR exhale/pause/inhale breathing.
Set your phone to go off every 30 minutes.
3-dimensional breath: breathe in, exhale completely (slowly), pause before you inhale for 2-3 seconds.
Perform in sitting or standing or lying down.
- One hand on chest and the other on stomach and take 2 focused breaths expanding ribcage front to back.
- Then, with both hands on sides of ribcage, take 2 focused breaths expanding ribcage out to sides.
- Then, with one hand just below neck on collarbone and one hand low in center of pelvis, take 2 focused breaths lengthening spine from head to toe. Feel the breath up into your neck and down into your pelvis.
- Finally, place both hands on stomach and take 2 focused breaths expanding your ribcage in all 3 dimensions (front to back, side to side, and head to tail).
As a reminder this is the 5 second inhale, 5 second exhale.
Are you a vertical breather? Belly breather? 3-dimensional breather?
Any way you look at it, breathing is essential to life and whether you realize it or not breathing affects every aspect of your health positively or negatively. Anything you do 7,000 to 30,000 times a day or two to five hundred million times per lifetime will influence your lifespan.
We will look at some details about breath and anatomy and physiology next but first, I want to ask you a question that may surprise you. Are you aware belly breathing can lead to low back pain? Yes, I know belly breathing has been taught as a way of increasing diaphragmatic function, yet belly breathing can put increased pressure against the lumbar spine, leading to low back pain for some. Another way of breathing that can lead to pain is what is called vertical breathing (lifting shoulders up). Vertical breathing can lead to neck, shoulder, and upper trap pain.
So, what’s the best way to breathe? 3-dimensional breathing is ideal. It promotes optimal diaphragm function, mobilizes the rib cage and thoracic spine, AND helps calm your vagus nerve. It’s a win-win no matter which way you look at it.
Ok, now on to some anatomy.
Breathing and your Lungs
Increasing your diaphragm function with 3-dimensional breathing increases the oxygen that gets to the lower lobes of your lungs which is important because this is where the greatest amount of blood flow occurs. Gravity causes increased pressure at the base of your lungs. Where there is increased pressure, there is increased blood flow. Optimal use of these lobes allows more oxygen into your bloodstream and, ultimately, to every tissue and cell in your body.
Let’s look at exactly where oxygen gets into your cells and how carbon dioxide gets out. Tiny air sacs called alveoli are what your lungs use to exchange oxygen for carbon dioxide.
CO2 exits these air sacs via the venules (the tiniest vessels that connect to veins) and O2 enters via the capillaries (tiny blood vessels with a wall only one endothelial cell thick). Endothelial cells line all your blood vessels and literally make up the tiny capillaries. Their health and function are directly impacted by food. Make sure you watch the Bonus Education in the Private Club; Nourish Away Pain. The healthier your alveolar endothelial cells are, the more oxygen you have available for cell health and longevity.
Breathing and your Phrenic Nerve
Your phrenic nerve orchestrates your diaphragm muscle. See the nerve attached to the diaphragm. This nerve sends a signal telling the muscle when to contract and when to relax. It happens automatically, controlled by your brainstem. All the basic systems of life (breathing, heartbeat, and blood pressure) are managed by your brainstem. You may find it interesting to note that irritation of the phrenic nerve (or the tissues supplied by it) leads to the hiccup reflex. A hiccup is a spasmodic contraction of the diaphragm which pulls air against the closed folds of the larynx.
The phrenic nerve is at the C3-C5 levels (right and left) and injury to the neck may damage the nerve making it necessary to use a ventilator to breathe. You may still breathe if only one side is damaged, but your breath will be labored. Now let’s take a look at those other muscles you may be using at rest if you are a vertical breather.
Breathing and your Accessory Muscles
You have accessory muscles that assist with breathing when you need to really increase your oxygen level in a hurry, like when you are running or exerting yourself. When you lift your chest or shoulders up while breathing in, you are using accessory muscles. The scalenes, sternocleidomastoid, upper trapezius and pectoralis major muscles lift and expand the chest and ribcage allowing more air to enter the lungs when you inhale. The internal intercostals and abdominal muscles push in on the same structures helping to push the air out when you exhale. This is ok when you are in need of increased oxygen during exercise or extreme activity. This is not ok when you are at rest and just breathing in and out at a normal rate. Chest breathing and shoulder breathing are simply not diaphragmatic breathing. People often report shoulder or neck pains which come from using these muscles some 20,000 times a day performing a job for which they are not designed.
Chest breathing is inefficient because it limits air expansion in the lower lobes of the lungs where you just learned the greatest amount of blood flow occurs. Rapid and shallow chest breathing results in less oxygen transfer to your blood and subsequent poor delivery of nutrients to every tissue in the body. It can also decrease your carbon dioxide level. You will learn why this is not a good thing, especially for pain, in just a minute.
If you are using these accessory muscles at rest then you may have chronic obstructive pulmonary disease (COPD). You may have chronic asthma, emphysema, or bronchitis. The good news is this will not stop you from the benefits of 3-dimensional breathing. You will definitely reap benefits from improving the use of your diaphragm. I have taught many, many patients how to use their diaphragm properly and they had serious respiratory issues, many on constant oxygen. It is never too late to breathe better!
Now let’s look at how optimal breathing can actually cause relaxation and positively impact chronic pain.
Breathing and your Autonomic Nervous System
Breathing has much more to do with life than taking in oxygen. Much of your nervous system responds to the way you breathe. If you breathe vertically into your chest you stimulate the organs and muscles of action. Do you breathe in an unbalanced and labored manner? Are you stimulating the organs and muscles of action? Think of it like keeping your gas pedal floored day in and day out, with one foot on the brake. Your engine is constantly at a higher rev than needed.
Let’s look at how breathing can lead to a more relaxed state with less tension and pain.
You have a Central Nervous System (CNS) which is made up of your brain and spinal cord. You also have a Peripheral Nervous System (PNS) which is all the rest, including the Somatic (Voluntary) and Autonomic (Involuntary) nervous systems.
The Somatic system enables you to react consciously to environmental changes. It includes 31 pairs of spinal nerves and 12 pairs of cranial nerves. This system controls movements of skeletal (voluntary) muscles. You are using this system when you consciously practice your 3-dimensional, diaphragmatic breathing.
Your Autonomic Nervous System (ANS) maintains homeostasis (internal equilibrium such as temperature and blood pressure). As its name implies, “independent” of the conscious mind, this system works automatically, without voluntary input. Your ANS communicates with your CNS and the rest of your body.
This communication with your body is further broken down into two more systems. The Parasympathetic and the Sympathetic. Stay with me now, we’re almost done. The sympathetic nerves mobilize energy for the ‘Fight, Flight, and Freeze’ reaction during stress or danger, causing increased blood pressure, breathing rate, and blood flow to muscles.
Conversely, the parasympathetic nerves have a calming effect; they slow the heartbeat and breathing rate and promote digestion and elimination. The targets affected in this system are smooth muscle, cardiac muscle and glands, all structures that function without conscious control. An example of autonomic control is movement of food through the digestive tract during sleep.
The sympathetic component controls the delivery of oxygen and nutrients to virtually every organ, including your brain and every structure of the musculoskeletal system. But without the parasympathetic component for balance, it can overwhelm your system with an overabundance of energy causing dizziness, decreased ability to concentrate, confusion, fear, anxiety or other forms of hyper arousal and distress.
When you breathe properly with your diaphragm at a rate of less than 10 breaths per minute, you are causing your ANS to prompt the parasympathetic system to “slow everything down” and relaxation is now enhanced. Conscious 3-dimensional breathing is extremely relaxing for your body and your muscles.
Breathing for Oxygen (O2) and Carbon Dioxide (CO2)
CO2 levels can affect muscle tension but you probably believe O2 is the only reason we breathe, so let’s take a look at one of the roles it plays before we look at CO2.
Germs, viruses and bacteria are anaerobic; they cannot survive in a high oxygen environment. Yes, this means that the more O2 you get, the better your body can fight the “bad guys”! The stress of unbalanced breathing can break down the body’s resistance to disease by using up valuable O2 needed for healthy metabolism as well as cause the vital organ system to overwork and become vulnerable to disease.
O2 is life giving. O2 is necessary for life. We can survive for forty days without food. We can survive for days without water. We can only survive for minutes without O2! O2 is required by every single cell in your body. Without O2, cells die. So, it makes sense that getting more O2 to your cells will help your cells to be healthy and function at an optimal level.
Oxygen is so necessary for life that if you are not breathing optimally you can experience negative symptoms such as fatigue, fuzzy thinking, dizziness, headaches, yawning, chronic depression, apathy, tension or restriction felt across your chest or abdomen, slouched posture, hoarseness, low and/or mid back pain, raspy, thin or weak voice, and even memory loss!
How’s that for motivation to breathe better? Now let’s look at the important role carbon dioxide (CO2) plays, especially regarding pain.
CO2 is essentially a natural muscle relaxant. This means healthy breathing can release muscle tension. But what if you are part of the 90% that research studies show are suffering from the effects of chronic hyperventilation? Hyperventilation causes CO2 deficiency (hypocapnea) which leads to muscle cells becoming irritated or abnormally sensitive and predisposed to spasms and twitching.
This also includes all smooth muscles of blood vessels, lymph vessels, the heart, respiratory muscles, muscles of the digestive tract, etc. This means breathing correctly and restoring correct CO2 levels to relax muscle cells may even improve constipation!
Breathing 3-dimensionally, expanding your rib cage, and using the right muscle (diaphragm), will keep you in a more relaxed state at rest, decrease the workload for your heart, diminish muscle strain in your neck and shoulders, and much more.
The Breath & Pain Video provides details on 3 ways you can breathe to positively impact pain and enhance Parasympathetic function. Be sure to view this video and take the quiz.