Deep, Diaphragmatic, Belly Breathing: Same or Different?

 

Deep, diaphragmatic, belly breathing…these are all terms we have used to teach proper breath or cue our clients for optimal breathing.  The effects of breathing, whether it be for stress management, improvements in posture, improved oxygenation or lymphatic circulation, are well-known and well-popularized.  

We have known for a long time that an optimal breathing pattern is important to reap all of these benefits.  Breathing that is too shallow, “chest breathing” as we like to call it, does not allow us to tap into the power of breath.

But I will argue that 

 

perhaps we have been focusing on the diaphragm and the belly to the detriment of the rib cage and spine

 

As a matter of fact, full rib cage involvement is essential for efficient breathing in everyday life.

In this article I will discuss:

– movement of the abdominal wall AND the chest in breathing

– practical ways you can manipulate breathing to fit the needs and objectives for the client

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BREATHING – NOT JUST THE BELLY

You know how we sometimes say things like: “You can survive X days without food but only X days without water”?  (Where X = whatever the person making the statement believes to be true).  

On 27 March 2021, Budimir Šobat broke the record for the longest time breath held voluntarily (male) with a staggering time of 24 minutes 37.36 seconds.  While this is truly impressive, either way you look at it, you can survive exactly ZERO days without breathing, and that’s not up for debate! 

Breathing will always be the #1 priority of the nervous system.  So long as the breathing pattern is not optimal, the nervous system will be in a state of relative threat.  

But how do we breathe exactly?  

During inhalation, the diaphragm contracts and moves downward. The external intercostals contract to pull the rib cage both upward and outward.  This increases the space in the chest cavity which the lungs expand into.

Essentially, 

 

breathing involves a 3-dimensional movement involving regions of the chest and the abdominal wall

 

Normal breathing involves a combination of abdominal and thoracic movement. So, while we do not want breathing to be shallow, occurring at the chest only, we also do not want to restrict movement of the rib cage.

 

THE IMPORTANCE OF THE RIB CAGE AND THORACIC SPINE

Not only is thoracic and rib cage movement a part of normal breathing, it is actually quite important.

Some studies support that movement restrictions of the rib cage or thoracic spine due to age-related decreases in chest wall compliance (1) or scoliosis (2) can actually contribute to the mechanical inefficiency of pulmonary function.  

In fact, every breath is a natural mobilization for the spine.  As you take a deep breath in, allow the diaphragm to descend and the chest wall to expand, the thoracic spine will move into extension.  As you exhale deeply and relax, the thoracic spine will flex.  Breathing can actually be a great tool for mobilizing the thoracic spine, as explored in this article.

While we want the breath to travel beyond the chest, cues that involve inhaling into the abdomen by pushing the belly out can be counter productive.

In an attempt to focus on pushing the belly out, people may be restricting the very natural and energy efficient movement of the rib cage that we need for everyday life as well as performance.

Perhaps the simplest strategy for drawing the breath deep without restricting the rib cage (and without pushing the belly out) is simply learning to inhale slowly through the nose.

 

Nasal breathing increases the depth of inhalation and solicits and strengthens the diaphragm

 

Instead of a belly out strategy, I like to use crocodile breathing, which is essentially breathing from a prone position.  From this position, client can feel an expansion of the contact area of the abdomen on the floor and I use this cue rather than having them focus on inflating the belly or pushing it into the floor:

Crocodile breathing image

I typically have clients breathe in this position for 2-3 minutes if breathing at the beginning of a Movement Optimization sequence, or up to 5 minutes if the time/context allows for it.

 

MANIPULATING THE BREATH

Because there are so many positions in which we can breathe, we can manipulate these to fit the needs and objectives with each client.  

​​First, let’s take for example the client who presents with kyphotic posture, rounded shoulders, forward head.  This may be a client who is not able to get out of this posture to assume a different one, such as overhead movement.  

You might be working on thoracic spine mobility already…

 

Bad posture Image 1

 

But in this posture, the chest is depressed, the intercostal spaces are diminished and the internal intercostal muscles are held in a shortenend or facilitated position. 

For this type of client, it would be beneficial to manipulate breathing to focus on movement of the rib cage using an exercise like breath coordination, for example:

With breath coordination, we use the “cogwheel” relationship between the head, rib cage and pelvis moving with inhalation and exhalation.  With inhalation, the rib cage rises and the head a pelvis tilt anteriorly.  With the exhale, the head relaxes and tilts posteriorly, as does the pelvis, while the rib cage descends.

But what if the needs are different?

 

Bad posture Pic 2

 

Let’s take the client who has excessive lordosis. Say this is a client who tends to hyperextend through their low back, excessively tilting the pelvis anteriorly to stabilize utilizing form closure of the lumbar spine.  This is the client who may complain of low back pain.  

This is the client who needs lumbopelvic, or core, stability.  They need to learn to keep the diaphragm and pelvic floor parallel.  

Because breathing is a part of core stability, breathing for this client needs to focus on that.  A great tool would be 90-90 breathing, gently pushing the heels into the bench to unload – not lift – the pelvis.  The pelvis is maintained level, parallel with the diaphragm as the client breathes through the nose.  Now the focus is less on emphasizing movement of the rib cage and more on maintaining lumbopelvic stability with the breath.

90-90 breathing

 

MAKE SURE TO WATCH THE MAIN VIDEO OF THIS ARTICLE TO SEE HOW BOTH OF THESE EXERCISES ARE PERFORMED

 

DIFFERENT PERSON, DIFFERENT SOLUTION

Not everyone needs to focus on the belly or the diaphragm for their breathing needs, and not everyone will benefit from the same solution. 

 

quote

 

In fact, involvement of the rib cage is necessary for energy efficient breathing, especially outside of relaxation environments.

Most definitely, not everyone needs to be pushing their belly out.  I have seen from experience that this can go quite wrong and really restrict the movement of the rib cage.

Different clients will require different breathing solutions.  Just like anything else we do in training, the goal is to create effective breathing strategies that fundamentally translate to our clients needs.

One thing is for sure, finding these solutions is certain to create a cascade effect of benefits for your clients.

 

REFERENCES

  1. Kaneko, H., & Horie, J. (2012). Breathing movements of the chest and abdominal wall in healthy subjects. Respiratory care57(9), 1442–1451. https://doi.org/10.4187/respcare.01655
  2. Leong, J. C., Lu, W. W., Luk, K. D., & Karlberg, E. M. (1999). Kinematics of the chest cage and spine during breathing in healthy individuals and in patients with adolescent idiopathic scoliosis. Spine24(13), 1310–1315. https://doi.org/10.1097/00007632-199907010-00007
  3. Ragnarsdóttir, M., & Kristinsdóttir, E. K. (2006). Breathing movements and breathing patterns among healthy men and women 20-69 years of age. Reference values. Respiration; international review of thoracic diseases73(1), 48–54. https://doi.org/10.1159/000087456

 

 


 


Mai-Linh Dovan M.SC., CAT(C)
Certified Athletic Therapist
Founder of Rehab-U

 

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