How To Breathe Properly

When I grew up, little thought was given to the idea of how to breathe. I was introduced to breath training around the age of 18 when my mother brought me to my first Chi Kung class. In many ancient Eastern cultures, health and wellness practices of energy cultivation and body control are historically common. In these practices, meditation combined with specific breathing or chanting exercises are necessary to access higher levels of consciousness. Internal mindfulness and a holistic view of the innate interconnectivity and balance in the natural world guide medical treatment in eastern medicine. In the western world, each body part has a specialized doctor and the body is seen as the sum of it’s parts. Very little attention is placed on the breath in western medicine except when pathologically concerned with lung cancer, emphysema, TB and asthma.

Breath in Western Medicine

Managing the care of chronic respiratory diseases is one of a Pulmonologist’s main duties. Pulmonologists use antibiotics, steroids and other medications, delivered in pill or injection form or through inhalers. Pulmonologists can offer palliative care such as breathing machines and oxygen to patients in the advanced stages of emphysema, chronic obstructive pulmonary disease and other chronic illnesses. Still, the Western medical focus is more on ameliorating a disease than normative lung function and the affects of breathing on the healthy body.

Cardiologists are somewhat concerned with lung pathology because of it’s direct connection to heart function and blood volume but in all cases, allopathic medicine places very little focus on preventing lung disease except for anti-smoking campaigns or when disease has already set in.

Lung Function

Most people know the lungs function to reintroduce oxygen to the blood. The heart then recirculates it through out our bodies via the cardiovascular system. The diaphragm and Transverse abdominal muscles pair with the pelvic floor and the multifidi of the back to create intrinsic core stabilization. This group of muscles creates the stabilization necessary for spinal rotation and movement of the limbs. When breathing is functional, the organs are manually stimulated, mobilized and massaged due to the position of the diaphragm and the intra-abdominal pressure it creates. This gentle motion supports circulation and organ function. Full breathing also increases pressure in the pulmonary system that increases blood flow to the brain and body. When breathing is dysfunctional, your muscles and nervous system work with a higher baseline of stress. This stress becomes chronic and manifests in physical and even emotional signs and symptoms of dis-ease.

Emotional Posturing

Psychologists and actors interested in mind body connections have long observed and recorded faulty breathing patterns related to stressful states of mind / being and have even mapped them out in relation to physical postures.  Examples of commonly observed postures that reflect the emotional state are fight or flight which looks like the shoulders up by the ears and a sunken chest slouch looks like depression. Panicked breath is rapid and sorrowful sobs are all familiar postural responses.


Neuroplasticity describes how our brains can relearn through conditioning. The good news is that the entire nervous system down to the DNA molecules are read-write programs like a flash drive and dysfunctional programs can be overwritten. This means that the same dysfunctional chronic spiral that can get worse and rob us of our abilities as we age is subject to alteration. We can create habits that restructure our bodies and minds in a physical way that beneficially changes the structure of our brains as well as our bodies.

The importance of breath

Breath is the most basic form of nutrition to us humans. We need breath more than anything else to live. 

Breath Potential Actualized

The World’s Record for breath holding is 24 minutes! It shows that we as a society haven’t even tried to unlock our breathing potential. The World’s Record for fasting is 382 days. This not so trivial fact shows that breathing is top priority in sustaining human life. Breath is the only life sustaining function that we can control. Imagine if you could tell your heart or digestive organs what to do? You could reverse hypertension and IBS as easily as scratching your nose. Western medicine looks outside of the body for tools to treat dysfunction. Self healing via mindfulness is not viewed as medicine in Allopathic medicine. Even though well documented cases of internal feats of self control exist, they are not impressive enough to sway a skeptical medical community. Western Medicine is historically reluctant to change the way they practice and leads with pharmacological and surgery to treat disease.

How to breathe

There are many breathing techniques and exercises. They are commonly practiced in Yoga, Chi Kung and Zen meditation practices. The breath I teach promotes a Parasympathetic state of healing in the body and regulates your CO2 and O2 levels, maximizes the side of your airway and creates tone in the muscles of the airway. The breath thereby supports function in the body and brain and creates a supportive healing environment. This decreases the stress response in the body and promotes balance via hormone regulation all while decreasing the demand on the organs. Breath is the most basic form of nutrition our bodies use and if you can make changes to how you breathe, your breath will become more automatic and you will have less pain.

Breathing mechanics 

Do this before and during all exercises (and try to breathe this way all day long)

a. Lips Together to create an airtight seal. if you find  your lips keep opening, use a band-aid or paper first aid tape over the lips to help keep your mouth sealed (don’t use other types of tape).  

b. Place your whole relaxed wide tongue up on the roof of the mouth covering the hard palate. 

c. Open jaw: gently smile with a relaxed mouth and teeth apart (no teeth touching) . Feel the spread of the soft palate in the back of the mouth open into the sinuses. 

d. Inhale and exhale through the nose only.  No Mouth Breathing at all! Breathe smoothly and continuously in or out.

e. Silent breathing : Eliminate excess chest and throat noise and quiet the breath. Block your ears with your fingertips or ear plugs to monitor how loud the breath is. Keep your breath smooth and soft. 

Tooth clenchers place a pen or a straw behind the eye teeth (canines) prior to doing a-d and gently close your lips around it

Do you use a night guard/ oral apparatus? Do these before bed with it in only in a supine position.

Although sleeping supine is advised, if you snore or have apnea, avoid sleeping on your back on a high pillow or wedge. Breathe right strips may help additionally open the airway and are recommended while you’re training the breath.

Don’t close your eyes during practice unless you fall asleep. 

Regardless of the length of the inhale, the exhalation should roughly be twice as long. If your exhale is short, audibly hum all of the exhales out loud and count the in and out breaths. 

If you still have difficulty extending the breath, try holding the breath out after the exhalation as long as you can without stressing yourself and allow the inhalation breath to rush in naturally and silently. Repeat this with every breath. 

Phase I

Intrinsic Core Reboot

The goal of these exercises are to retrain the lost ability to belly breathe as a primary component of a full healthy breath. The culprit is often overcompensation of  the diaphragm via chest breathing and breath holding. The intrinsic core depends on the interplay between the diaphragm, pelvic floor, multifidi and transversus abdominis muscles. The breath triggers and influences the coordination of these important core muscles. When one of these muscles is dysfunctional, the core is unstable. The diaphragm often stays contracted and doesn’t allow for a full breath in or out. The progressions below are designed to help retrain you how to relearn how to breathe fully and automatically. Do one retraining exercise at a time until you have mastered it. Each phase may take a week or more to train. Progress yourself when you can handle a tougher exercise. Go back if you can’t do one.

Belly Breathing

Lay flat on your back, stand or sit straight back in a chair. Make sure your low back is relaxed. Place your tongue on the roof of the mouth so it covers the hard palate effortlessly.  Relax the jaw so that the teeth aren’t touching and keep the lips sealed shut. Keep your breath silent. To check your volume, stick your fingers in your ears or use earplugs to train your breath. If your breathing is loud, you are unconsciously compressing your airway instead of relaxing it when you breathe. Relaxed breath should be slow, smooth and silent and occurs without tightening the mid chest or neck.

Level 1: Find your belly

Place one hand on your chest and one just below your navel. This will help you feel what is happening. As you inhale throughout the nose, relax the chest and the rest of the body completely and let the belly rise. Completely exhale through the nose until you feel the hand below the navel pull towards the spine. Keep the ribcage, chest, stomach and diaphragm free from tension. Transition smoothly to the next inhale by releasing the navel. The longer and deeper your exhale, the more automatic the inhale will be. Repeat the exhale, drawing in the belly as much as possible but don’t squeeze. Gently draw the navel inward toward the spine to extend the exhale. Release the navel to inhale then lead the breath inward as the belly rises like a balloon. Repeat for a 2-5 minutes.

Born to Belly Breathe

Level 2: TVA Activation

Place your palm over your belly button and stack the other palm on top. If you are lying supine, you can use a 2- 5 pound barbell weight plate or a bag of brown rice on the belly instead of using the hands as resistance. (Do not use processed rice or sugar- for energetic purposes.) Continue to practice belly breathing using stacked hands or weight to guide the breath to activate the back muscles of respiration. The weight resists belly expansion when you inhale. Try to feel the back expand backward. Slowly release the air through the nose while keeping the chest soft. Consequently feel the weight resist the belly coming forward on each inhalation and feel the weight guide the belly towards the spine on the exhale.

Upon inhalation, lead the breath downwards. This leads oxygen into the bottom of the lungs and pulls the diaphragm downward without the belly exaggerating outward . The goal is to be able to take a full breath that integrates all the accessory muscles of inhalation including the posterior back muscles and the ribs, neck and chest after the front to back breath is trained.

Muscles of respiration (excluding quadratus lumborum and serratus posterior inferior and superior)
Quadratus lumborum and serratus posterior inferior and superior

Level 3: Full Breath

• Standing with your feet shoulder-width apart, knees slightly bent, eyes level and chin retracted slightly. Shoulders remain down. Do not allow them to rise.

• Sitting or lying on your back works too

Sit out near the edge of a fairly hard surfaced chair, stool or arm of a couch with your feet flat on the floor, or stand. Both of these positions need an erect but not stiff posture. If you stand, bend your knees slightly so as to unlock them.

Let your tongue touch the roof of your mouth and open your jaw. Relax your belly. Place your thumbs below the lower back ribs just above your pelvis. Wrap your fingers around your sides with your fingertips facing your belly button. Grip your sides gently. Focus long slow deep breaths between your squeezed fingers and try to force them apart with your inhalation. Make sure the exhale is twice as long as the inhale. Count silently to make sure the exhale is at least twice as long as the inhale. Don’t tighten the belly to extend the exhale. Simply slow the speed of the outgoing breath. Always keep the chest relaxed.

GOAL: Fully Integrated Breath

Inhale through your nose but your intention is to initiate the breath from below the bellybutton towards the spine. Gently lead your breath with the intention of inflating the belly from the center outwards in all directions, ascending to the lower ribs and finally the chest. Imagine the navel is attached to a pump and you are inflating the torso in every direction like a balloon. The chest should fill up last.

Phase II

Muscles of Inhalation and Exhalation

Continuing what you did above, shift your focus to the muscular contraction of the abdominal muscles that assist deep breathing.

Transverse Abdominis Activation

Transverse Abdominis

The transverse abdominis muscle is activated when you fully exhale to blow out candles, cough or sneeze. When TVA is fully contracted, you will feel the low back flatten and the pelvis tilt back slightly. Keep the breath as silent as possible and your mouth closed. Use ear plugs to monitor the noise you make while breathing. Keep the chest relaxed and focus on the navel. Continue for 20 or more breaths when possible. Continuously pull the navel towards the spine as you exhale as long as you can Your exhale should last twice as long as your inhale. You get better results seated against the wall or a chair then on your back. If you still have a short exhale, hum your exhales and hold the notes as long as possible. Use this breath with all the progressions below.

Multifidi and TVA Activation: Pelvic Tilts.

To isolate the multifidi muscles, do an anterior pelvic tilt pressing your tailbone into the floor creating an arching of the low back on the inhale. On the exhale, tilt the pelvis posterior and flatten the back arch on the exhale. You should be laying completely flat and still except for your pelvis. Remember to breathe correctly before you start tilting. Don’t tighten the pelvic floor like she says to do. Don’t go continuously for 3 min as indicated in video, just do one set of up to 20.

At New York Orthopedic Massage, we recognize that functional breathing is the basis for balance in the musculoskeletal system. All other systems are influenced by how we breathe. We teach clients how to breathe properly as the foundation that all movement comes out of. Clients leave pain free and most importantly, understanding how to stay healthy.

2 Comments on “How To Breathe Properly”

  1. Hi! Am I supposed to relax the TVA when inhaling or is there some activation that remains in order to maintain some intra-abdominal pressure? It makes sense to contract on the exhale by drawing the navel to the spine, but I’ve always wondered what to do with it while inhaling. Herniated my L5/S1 last year and am still recovering. Thanks!

    1. And when I say maintain intra-abdominal pressure above, I mean: when I fully relax the TVA when inhaling the belly seems to expand but I get no expansion in my back or sides. When I feel like I’m holding a bit I can mirror the sensation of having weights on the stomach as you mention and feel expansion in all directions. But basic question still remains: should the TVA only be activated when exhaling, or is there some activation throughout the entire breath? Thanks!

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