Observing Unhealthy Breathing Patterns

by Nina

Trees are the Lungs of the Earth by Melina Meza

Your ability to breathe in a healthy way can be compromised unhealthy breathing patterns, such holding excessive tension in your abdominal muscles. However, by practicing breath awareness with special attention to the movements of your chest and belly, you can learn about your particular breathing patterns and potentially identify any problems. 

In normal, healthy breathing, as you inhale, your chest and ribs will expand slightly and your belly will rise up or bulge forward, and as you exhale, your belly will relax back and your chest and ribs will relax back toward center. 

Although not common, there are two different breathing patterns that occur in some people that can be problematic:

Chest Breathing. Instead of your belly expanding on your inhalation and relaxing back on your exhalation, there is no movement in your belly at all. All the movement during respiration is in your chest alone. 

Reverse Breathing. Instead of your belly expanding on your inhalation, it actually sucks in during the inhalation and your chest expands dramatically. And on your exhalation, your belly rises as your chest relaxes. 

To observe your own breathing patterns: 

1. Start by setting yourself up in a comfortable reclined pose, such as Savasana or Reclined Cobbler’s pose, or a comfortable supported seated pose, such as Easy Sitting pose with your back against the wall. 
2. Take a moment to relax completely and breathe naturally, with an easy, relaxed breath. 
3. Keeping your breath easy and relaxed, turn your awareness to your chest and belly as you inhale and exhale. Just watch. Is your belly rising/expanding/bulging with your inhalation and relaxing back with your exhalation? Or is something else going on? 

If you do identify a problematic breathing pattern—or think that you have—unless you are a very experienced practitioner of pranayama, it’s best for you to work with your yoga teacher or yoga therapist to change your breathing habits. Your present pattern of breathing is likely to be a well-established one. And an expert will not only be able to observe your breathing with a trained eye but will also have techniques available to effectively coach you to change your ingrained habits. 

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Techniques for Supporting Your Respiratory System

by Baxter and Nina

Joy Sassoon, Age 60, photographed by Tanya Constantine

Your respiratory system is essential to life, and a completely healthy chest and lungs make a full life more likely. Today, we are recommending techniques for supporting the health of your respiratory system, whether you are healthy and want to stay that way, or whether you have a respiratory disorder or medical condition that directly affects or may eventually affect your respiratory system. These recommendations apply to people who: 

• Are currently healthy
• Are sedentary but wanting to improve your respiratory system
• Are ex-smokers 
• Have lung diseases, such as asthma, exercise-induced asthma, and chronic obstructive pulmonary disease (emphysema)
• Have been exposed to lung toxins, such as asbestos
• Have heart conditions such as congestive heart failure that directly affect the lungs or heart valve problems that may eventually affect the respiratory system

Start by considering your current condition. If you are currently healthy, you can use a combination of any of our recommended active and relaxing practices. 

For those who have a compromised respiratory system, increased activity could cause unwanted stress on your system. So start with more passive, gentle practices, such as restorative poses, beginning level breath practices (for example, 1:2 ratio breathing) and slow, gentle dynamic poses such as Cat/Cow pose. When you observe gradual improvement in your respiratory system, you can advance your practice. 

If you are currently having trouble breathing, such as from a sudden flare of asthma, we recommend that you focus on stress management practices, such as restorative and supported poses, such as Cobbler’s pose (Baddha Konasana) at the wall, version 4 of Supported Backbend, and version 2 of Reclined Cobbler’s pose, and guided relaxation. (Of course, you should also continue using the protocols prescribed by your doctor for an acute situation.) 

If you have a severe lung disease, such chronic obstructive pulmonary disease (emphysema), unless your doctor says it is safe to advance your practice, you should focus on supported poses and gentle breath work. When you are ready to advance your practice, try a gentle, active practice, as this may provide you with important benefits, including less shortness of breath, better exercise tolerance, and improved sleep. 

Cautions: In general, if you become suddenly short of breath, stop whatever yoga practice you are doing, sit down with some support, in a chair or against a wall, and see if reducing activity quickly resolves your symptoms. If not, seek prompt medical attention. Shortness of breath can be the sign of more serious underlying problems, such as a dropped lung (pneumothorax) or a heart attack. On a less urgent level, be mindful that Savasana or other reclined poses (supine or prone) could make breathing more difficult for a person with lung disease. Adapt supine poses by raising the torso with a support, such as using a bolster under your back in Reclined Cobbler’s pose (Supta Baddha Konasana). Adapt prone poses by finding more space for the belly to move, for example, by widening your knees in Child’s pose. If these adaptations do not improve your breathing, skip these poses for now and practice meditation or breath practices in a seated position. 

How Often to Practice. If you are healthy, practice up to six days a week, alternating days of active practice with days of gentle and restorative practice. If you are currently experiencing respiratory problems, try practicing four days a week, also alternating between active days with restorative days. If you see positive changes, slowly add more days of practice. 

Breath Awareness. Practicing simple breath awareness can reveal breathing habits that you are not currently aware of. You can practice breath awareness in both active poses and relaxation poses to reveal breathing patterns you might want to change, such as chronic shallow, rapid breathing that might not be so healthy during Sun Salutations or physically demanding postures. You may decide to skip this technique However, if you are experiencing shortness of breath, such as an acute asthma episode, you may wish to skip this technique, as focusing on your breath may make you more anxious. 

Balanced Practice. Because one of the primary benefits of yoga asana for your respiratory system function is releasing any tension in the muscles and fascia around the chest region, we recommend practicing a balances sequence that includes: forward bends to open your back, backbends to open your chest, side bends to open the sides of your torso, and twists to release tension from the diagonal muscles and fascia around your chest. Include a mix of both dynamic and static poses. If you have been sedentary for a period, an asana practice that includes these elements can help you regain strength in all the muscles that assist in breathing and improve your overall lung capacity. Round out your practice by including breath practices, restorative poses, and stress management practices.

Breath Practices. Since there are times in your everyday life when you need to breath fast and deep and other times when you should be resting and breathing comfortably, your breath practices can help support whatever context you find yourself. So you should do both stimulating as well as relaxing breath practices. For relaxing your respiratory system a good way to start is by using a 1:2 ratio breath or by slowing and slightly deepening both your inhalation and exhalation equally. To improve your total lung capacity, start with an even breath of 2 seconds in/out,. Then, gradually over time work up to 6 seconds or more in/out, up to your tolerance. 

Dynamic Poses. Focus on dynamic poses that stretch and strengthen the muscles and tissues around your chest area. For example, moving with your breath between Mountain pose, Arms Overhead pose, and Standing Forward Bend and back stretches and strengthens both the front and back of your chest. Moving between Arms Overhead pose to Crescent Moon pose (the side bending version of Arms Overhead pose) stretches and strengthens the sides of your chest. And a dynamic seated twist stretches and strengthens the diagonal muscles of your torso. 

Start with 6 rounds in and out, and work up to 10 rounds. Initially move at a comfortable breath pace. Experiment with slowing down your breath and movement pace or speeding both up gradually to train the body for different situations. 

Static Poses. Focus on poses either stretch or strengthen your torso, including forward bends, backbends, and twists, or standing poses that include or combine those movements. Some examples are Standing Forward Bend (Uttanasana), Triangle pose, Extended Side Angle pose, Warrior 1, Cobra pose variations, Marichyasana 3 or Easy Sitting Twist. While passive stretches such as a Supported Backbend will only improve flexibility, many active poses can improve both flexibility and strength. For example, Triangle pose strengthens some muscles along the slides of the torso while also stretching others. So for improvements in flexibility, combine those active poses with passive, supported stretches, such as a Supported Backbend or Reclined Twist. 

If you are new to practice or have a respiratory condition, start off with short holds 10 seconds. Then gradually work up to 30 seconds. From there, to maximize improvements in strength in flexibility and strength, aim for eventual holds of 90 seconds or more. 

Restorative Poses. In general, restful poses are beneficial to the overall functioning of your respiratory system, as they rest your overall respiratory system and lower stress levels. We recommend practicing restorative poses that gently stretch and open your torso area but do not trigger shortness of breath, such as Supported Backbend, Childs’s pose with or without a bolster, and Legs up the Wall pose with arms to your sides or overhead. If focusing on your breath in these poses causes anxiety, try any focusing instead on a different physical sensation, an image, or a mantra. 

Stress Management. Reducing stress has positive effect on your immune system, which could lower your chances of getting infections of the respiratory tract, from the nose and mouth all the way into the deep lungs. In addition, your lungs need downtime to rest and repair, so spending time in Rest and Digest mode provides a beneficial break for them. And for those with chronic respiratory system conditions, practicing regular stress management can improve the quality of your life by reducing anxiety and fear. Use any of the stress management practices we have described elsewhere (see The Relaxation Response and Yoga) that you can tolerate and that also lead to improvements in your breathing.

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Friday Practical Pointers: Your Posture Affects Your Breathing!

by Nina

Supported Backbend is
Excellent for Improving Posture

Did you know that your ability to take a deep, full breath is influenced by your posture? Because when you inhale, your rib cage expands to its maximum to make room for your lungs to expand. And if the muscles that allow your rib cage to expand are tight—due to habitual slouching or other postural problems—your lungs won’t be able to expand to their maximum because there just won’t be as much room within your chest cavity for them. If you have long-time poor posture, you might not notice this problem when you’re sitting at your desk. However, in physically demanding situations, you will likely notice that your breath is restricted. 

And if some of your chest or back muscles are weak, your endurance will be affected. That’s because if the muscles that allow the rib cage to expand are weak and therefore tire easily, you’ll run out of steam when you are in a physically demanding situation that requires rapid or deep breathing. 

To maintain good posture for optimum respiration, cultivating both the flexibility and strength of your torso muscles is vital. In general, a well-rounded asana practice that includes standing poses, backbends, twists, forward bends, and side bends, will help you maintain the flexibility and strength you need. 

However, you can also use asanas to target specific problem areas. For example, if you are developing more rounding of your thoracic spine, adding more back bending poses to your practice will help reverse this trend. If the sides of your chest are tight, you can lengthen them with full side stretches, such as Crescent Moon pose, and partial side stretches, such as Triangle pose. And if your back muscles are tight, forward bends, such as Standing Forward Bend and Child’s Pose, will help release them those muscles.

You can also use asanas to strengthen weak muscles around your lungs. To strengthen chest muscles, practices poses where you lift your chest away from gravity, such as Plank pose and Downward-Facing Dog. To strengthen the sides of torso, practice poses where you keep one side lifted away from gravity, such as Side Plank pose variations and Triangle pose. And to strengthen back muscles, practice active backbends, such as Warrior 1, Cobra pose, or Upward-Facing Dog.

Medical conditions that influence posture, including kyphosis and scoliosis, also restrict your breathing capacity by limiting space in the chest wall . So for these conditions, it is especially important to maintain both the flexibility and strength of your torso by doing poses appropriate for your condition. For scoliosis, there is even early evidence that certain yoga poses can help reduce the curve of your spine (see Side Plank Pose (Vastithasana) Could Reduce Spinal Curves in People with Scoliosis!). Work with a yoga therapist or teacher who is an expert in your condition to find the poses that are right for you.

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Breathing, Chronic Obstructive Pulmonary Disease, and Yoga

by Shari

In my “day job” as a home health physical therapist, I see a lot of clients who have significant breathing difficulties. One of the most common breathing ailments is Chronic Obstructive Pulmonary Disease (COPD). COPD is similar to asthma in that some of the symptoms are the same but the etiology of the disease is different. Most significant is the inability to get air out and not being able to get enough oxygen in.

Let me give you a bit of background about breathing and normal airways. Air travels into the lungs via the trachea. It goes down a series of branching airways called bronchi. These bronchi branch into smaller bronchioles and then into millions of tiny air sacs called alveoli. Oxygen in the air passes through the thin walls of the alveoli into the tiny blood vessels nearby, attaches to red blood cells and is carried into the blood vessels to the rest of the body. Carbon dioxide is passed out into the alveoli from the red blood cells and is breathed out. But breathing doesn’t always depend upon the oxygen needs of the body. Breathing can be related to emotions, body tension, sensations of pain, pleasure, and body movements.

Breathing is composed of two main parts: inhalation and exhalation. Inhalation is the process of taking air into the lungs. It can occur with different amplitudes or volume of air. It can occur at a variable rate, and it can be less active. Exhalation is the process of letting air flow from the lungs back outside the body. It can vary in amplitude, rate and effort. You can stop your breathing but, of course, not permanently.

There are two main types of breathing: costal (ribs) breathing and diaphragmatic breathing. In costal breathing the ribs open and close primarily and in diaphragmatic breathing the abdomen changes shape.

The volume of air that one breathes in inhalation is called “tidal volume” and in rest or relaxation it is at a minimum. When we do moderate activity, we increase the amount of air that is bought into the lungs but this doesn’t change the tidal volume.  When we maximally exhale the air from our lungs, there is always some air left in the lungs and this is called residual volume.

Other factors that influence the depth of our breath include rib cage flexibility, (the more flexible the rib cage, the more we can increase the amplitude of our inhalation) and muscular strength of the muscles of exhalation. The diaphragm is the primary muscle of inspiration. The secondary or accessory muscles of respiration include many muscles of the ribs, neck, chest wall, and trunk (abdominal muscles).

The Diaphragm (with ribs cut away)

When we breathe, the diaphragm contracts and moves downward if the abdomen is relaxed. The belly will then gently expand outward and the lower regions of the lungs expand downward. When we exhale, the diaphragm relaxes and moves back up, the belly moves in a bit.

An individual with COPD works very hard to breathe. Often there are postural changes that occur over time that may be structurally compromising the ability of the rib cage to expand and return to resting position. If the anterior chest wall is collapsed and tight, then we don’t have the rib or thoracic flexibility to encourage the lungs to fill to their capacity.  Breathing involves muscles, skeletal and joint articulations and is an interface of organs and movement.  But breathing is also an emotional activity.

Because an individual with COPD is chronically short of breath, they fear movement because it makes them short of breath, so in turn they become chronically deconditioned, and weak due to immobility. The fear of not being able to breathe leads to increased anxiety, depression and more fatigue and stress. Here is where the practice of therapeutic yoga can be so beneficial for an individual with COPD.

If we consider the individual fully and address their physical, emotional, neurological and spiritual nature, we can assist them in learning to move again within the confines of managing their respiratory issues. Learning to observe one’s breathing pattern and to gently try to increase the exhalation compared to the inhalation is quite beneficial for someone with COPD. Gentle asana practice that addresses areas of chronic tightness and postural awareness with improved skeletal flexibility allows more freedom of respiratory movement. Please see all our wonderful prior posts for gentle seated practices and safe gentle yoga poses. Also please reread the pranayama posts because these can be adapted to a COPD breathing pattern if the emphasis is on the exhalation with no retention holds at either the end of inhalation or exhalation. Lastly, trying to walk with good self pacing and breathing awareness (sort of like a meditation practice) is a wonderful way to begin to address the poor endurance that plagues someone with COPD. If you yourself have COPD or know someone with COPD who wants to study yoga, I would recommend individual private one-on-one yoga sessions to start, and then, if and when possible, moving on to a gentle yoga class that is slow paced.

Note: November 16, 2013, Shari and her colleague, Bonnie Maeda, will be teaching a workshop in Brentwood, California on Yoga for Breathing and Sleep Apnea, which covers COPD and other topics. For further information or to register for the workshop, see brentwoodyogacenter.com.

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