My Favorite Breathing Exercise

I’ve blogged about the importance of breathing patterns many times in the past, and for a good reason.  Breathing patterns and the muscles responsible for breathing affect so many things in our bodies, yet we too often ignore their importance.  In the presence of a faulty breathing pattern, accessory muscles will compensate for the diaphragm not doing its job properly.  We then see hypertonic neck muscles (scalenes, sternocleidomastoids, upper trap, etc) which can also lead to neck pain and headaches, referred pain in the shoulder, etc.  But this is only the superficial stuff.

If the diaphragm isn’t working properly, chances are that it’s also not positioned optimally.  We could debate which one causes the other (dysfunction causing faulty positioning or faulty positioning causing dysfunction), but it would be a case of the chicken or the egg.

The thing to keep in mind is that when the diaphragm isn’t positioned properly there are also surrounding structures that are affected.  The lower ribs flare out, the T-L (thoraco-lumbar) junction is stuck in extension, and the whole rib cage is positioned differently.  This in turn will affect the positioning of the scapula because it sits on the rib cage, and therefore the positioning of the whole shoulder girdle will be changed.

Faulty breathing patterns can also affect structures lower down the kinetic chain.  Because of the attachment of the diaphragm and its fascial connection through the psoas, that goes through the hips, the positioning of the hips can be affected.  And if the hips are positioned differently, everything below (femur, tibia, foot) might be in compensated positions.

Not the best picture, but you can still see the convergence of the psoas and diaphragm

Before this turns into an anatomy course, I’ll stop here!  The goal was just to make you understand how powerful breathing patterns can be and how it can affect the whole body.  That is why school of thoughts such as the Postural Restoration Institute put such an important focus on breathing patterns and diaphragm function to treat all sorts of problems (overuse injuries, low back pain, shoulder pain, flat feet, etc, etc).  All of their corrective work involve very specific breathing patterns.  They have a bunch of different exercises incorporating breathing patterns to get you back into a “neutral alignment” as they would put it.

I have learned a great deal from PRI and started including a lot of their stuff with my athletes, which has worked almost like magic in many cases.  Here is one of my favorite exercises that I stole from them to teach proper breathing patterns:

The position: Lying on your back with your feet up on the wall and your knees and hips at 90° angle, squeeze a foam roller or a small medicine ball between your knees.  Dig your heels into the wall and posteriorly tilt your pelvis just enough to get tail bone slightly off the floor.  Get your right arm straight up and reach with the palm of your hand towards the ceiling.

Execution: Take a deep breath trough your nose, Blow out through your mouth as hard as possible trying to inflate the balloon as much as possible.  Blow all your air out in the balloon.  When you have no more air in your lungs, pause for about 4 seconds while pushing your tongue against the roof of your mouth (your teeth should not be clenched).  Then, breathe back in through your nose, and repeat the sequence. You can do anywhere from 5 to 10 breaths, but start on the lower end, and make sure you control everything.

Cues: Make sure that the tail bone remains slightly off the ground the whole time and the heels keep digging in the wall.  When reaching up with your right arm, you only want to reach as high as your arm will go, meaning you don’t want to lift your upper back off the ground to reach higher.  The pause with the tongue against the roof of your mouth is probably the most important step.  Do not repeat on the opposite side.

We only do it on one side because the diaphragm on the right side and on the left side are shaped and positioned differently; we want to facilitate the air going into the right side to re-position you in a more neutral position.  This is again part of the PRI philosophy that the human body is assymetrical for a host of different reasons; we have a heart on the left side above the diaphragm, we have a liver on the right side under the diaphragm, the left side of our brain manages motor control, etc.  I’m not going to get too deep in the PRI philosophy as it could be the subject of an entire different blog post, but hopefully you get the concept a little bit.

Don’t overlook breathing patterns and make sure that it’s part of your assessment protocol with everything else you assess for.

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11 Responses to “My Favorite Breathing Exercise”

  1. Kyle Norman says:

    Very interesting stuff. Breathing patterns are in my view an extremely under-appreciated factor in human function. (That and eyes, the vestibular system, the digestive system…) Thanks for this article.

    Kyle Norman

  2. davidlasnier says:

    Thanks for your comment Kyle! I am at a point with my knowledge that I’m starting to be aware of things like breathing patterns and the vestibular system. The vestibular system though, I will admit, I know nothing about! Any suggested resources to get to know that stuff better?

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  5. Mike Richards says:

    Dave, What are some good resources to get a better understanding on postural breathing?

  6. davidlasnier says:

    Mike, without a doubt anything from the Postural Restoration Institute. They have home study course, although I would strongly suggest you attend one of their courses live. The postural respiration, and the Myokynematic restoration ones are the 2 you should start with. Check their website for more details . We’re actually gonna host the myokynematic restoration at Endeavor in November, if you feel like waiting a couple months :)

  7. Just reviewing the PRI course material, glad to see you’ve seen excellent results with their methodology. What courses have you done? I’m from Australia so I’ll be ordering the 2 distance courses and I might go over to the US to do the others.

    My other issue I’ve noticed is that they have a lot of exercises to choose from – how do you decide which ones to implement?

  8. davidlasnier says:

    Mark, thanks for your comment. I went through the 2 home study courses, and my colleague Kevin also went through impingement & instability, and integration, which I went over some of that material as well. As far as which exercises to use, I would say I had the same dilemma that you’re having. The best way to go is just start with the basic ones they recommend and demonstrate in the home study courses. If they work well after re-testing, just stick with those, if not you can start experimenting with some of the other ones. Kevin was saying that after going to the integration one, they always end up using the same ones, even though they have a wide library. The side lying adductor pullback, and the 90/90 with balloon are 2 that are working really well for us, if that can help you get the ball rolling.
    Hope this helps,

  9. Thanks David, that helps a lot!

  10. Michael Valos says:

    Dear David,

    Thanks for great ideas and PRI links (amongst others) In the balloon exercise I assume we pinch ballon shut when inhaling via nose. If not it seems a hard exercise unless im missing something. Also I looked at PRI site and on a video they said humans are not symmetricial and often underuse right side of diaphrapm. Should we visualise and feel in breath on right rather than left to enhance this exercise Michael Valos Australia

  11. davidlasnier says:

    Michael, you are right about what you saw on the PRI website about humans being asymmetrical and underusing the right diaphragm. It can indeed be helpful to think about breathing through your right side when doing the balloon exercise. When performing the exercise you should not be pinching the neck of the balloon….that makes it indeed pretty hard for people who try it for the first time. The key is to push your tongue against the roof of your mouth while inhaling through your nose exclusively. Your tongue will prevent air from the balloon to fly back in your mouth. It might take a little while before you master this part of the exercise, but once you got it it works really well.
    Hope this helps!

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