Have you ever watched a sleeping baby breathe? Or a dog soaking in the sun breathe? Notice that their belly, rather than their chest, rises when they inhale and becomes flat when they exhale. This is called diaphragmatic breathing (or also called ‘belly breathing’). The diaphragm is a dome-shaped muscle at the base of the lungs, between the chest and the abdomen. When you inhale (breathe in) the diaphragm contracts and moves downward, allowing your lungs to expand and fill your chest. When you exhale (breathe out) the diaphragm relaxes and moves upward, compressing your lungs.
Under the everyday life stressors many of us forget as we get older that innate ability to correctly engage the diaphragm while breathing and we shift to a shallower type of breathing (‘chest breathing’) depending more on the accessory muscles of breathing like the intercostals (the muscles lining the ribcage).
Breathing is an automatic process, controlled by the autonomic nervous system (or ANS). The ANS is a division of the nervous system that unconsciously regulates many of the automatic bodily functions that we depend on every second such as our heart rate, digestion or blood circulation to different organs. Stressful life circumstances like a concussion, can sometimes hijack the ANS and thus make breathing much less efficient and effective.
At York Region Concussion Clinic we often start rehabilitation by teaching our patients diaphragmatic breathing as it is an easier, more intuitive first step to take and so progress will come quicker which is encouraging. We combine this with mindfulness techniques and biofeedback training.
Proper breathing contributes to maintaining the acid-base homeostasis of the blood. Overbreathing (or ‘over-ventilating’) is a common type of breathing dysregulation that happens when people breathe out too much carbon dioxide (CO2). Many people think about the importance of having enough oxygen (O2), and that too much CO2 is unhealthy. However, we need enough CO2 to maintain proper acid-base chemistry in the blood so our cells and enzymes can work optimally. Breathing out too much CO2 disrupts that homeostasis resulting in physiological, emotional and/or cognitive symptoms like:
- shortness of breath
- heart palpitations
- elevated heart rate
- numbness and tingling in the hands or feet
- feelings of unreality
- muscle tension
- difficulty concentrating
- “foggy” mind
- diaphoresis (sweating) and shivering
- blurred vision
- dry mouth
If overbreathing persists chronically it can lead to or exacerbate chronic fatigue, asthma, COPD, functional abdominal pain, fibromyalgia, hypertension, chronic muscle pain and lower back pain, depression, PTSD, anxiety disorders, psychological stress/irritability, insomnia, migraines, tension-type headaches, TMJ pain and autonomic dysfunction to name a few.
Other than the benefits listed above about regulating CO2 levels to promote ideal blood pH and ionic potentials, diaphragmatic breathing improves O2 perfusion to the organs which in turns can also help with performance and athleticism (Hunt et. al., 2018). Regulating CO2 levels can help alleviate some concussion symptoms. Training diaphragmatic breathing also decreases musculoskeletal tension, particularly around the neck, as it requires less effort and energy to breathe, and through efficient core recruitment, can improve balance. There is evidence suggesting it may even help patients suffering from asthma (Venkatesan et al., 2012).
- First, find a comfortable, quiet space to lie down.
- Can you recognize if there is any tension in your shoulders, neck, chest or core? Consciously minimize that tension.
- Place one hand on your upper chest and one hand on your abdomen (belly) to identify where the motion is coming from. And breathe in.
- Allow the motion to shift to your abdomen while minimizing the motion that takes place from the chest. The hand on your chest should remain still while the one on your abdomen should rise.
- If helpful, you can use visualization strategies like imagining a balloon expanding, or imagining air flowing past your lungs and into your belly to guide your breath.
- Hunt, Melissa & Rushton, James & Shenberger, Elyse & Murayama, Sarah. (2018). Positive Effects of Diaphragmatic Breathing on Physiological Stress Reactivity in Varsity Athletes. Journal of Clinical Sport Psychology. 12. 1-12. 10.1123/jcsp.2016-0041.
- Venkatesan, Prem & Sahoo, Ramesh & Adhikari, Prabha. (2012). Effect of diaphragmatic breathing exercise on quality of life in subjects with asthma: A systematic review. Physiotherapy theory and practice. 29. 10.3109/09593985.2012.731626.