Just Breathe…

What is one of the first things that people tell you to do when you are stressed out or upset? Probably, you’ve heard “just take a deep breathe!” But, does this advice actually make sense on a physiologic level? Yes and no. As you know, breathing mechanics are really important not only as an endurance athlete, but for your optimum functioning (and health) as a human being! Also, using breathing practices or meditation to help with active recovery can help reduce body stress and promote positive training adaptations.

But, just like most advice, the “take a deep breath” is well-meaning but may miss some of the nuances of what could actually be helpful in terms of active recovery and relaxation. In order to best leverage our breath work and its potential to down-regulate stress (and reduce sympathetic nervous system activation), we want to be aware of not only the depth of breath, but the inhale to exhale ratio and rates and where we are generating that conscious breath from (i.e., upper chest vs. low belly/diaphragm initiated). Furthermore, it may be helpful to think about other relaxation techniques like yoga or meditation that often incorporate breath work as part of their practices.

Different Types of Breathing*

· Diaphragmatic Breathing: Focusing on using your diaphragm preferentially by breathing lower in the abdomen/belly vs. having the chest and ribcage expand out

· Paced Breathing: slowing down the breath rate intentionally or reducing breaths per minute

· Box Breathing (aka “tactical breathing”): intentionally controlling breath with timed inhale, exhale, and breath holds that are equal, making a “box” if charted using line segments to represent timing (e.g., 1 second inhale/1 second hold/1 second exhale/1 second hold

· Physiologic or Cyclic Sighing: breath practice that emphasizes prolonged exhales

· Cyclic Hyperventilation: breath practiceusing long inhales, breath holds, and short exhales

· Mindfulness meditation or breath meditation: bringing awareness to the present moment, which could include your natural breath pattern (i.e., not trying to change your breath in any way, just noticing it as an experience).

*Also, see figure below from Balban, 2023 Article:

There is some data to suggest that even just slowing down your breathing (i.e., < 10 breaths/minute) as is practiced in many forms of meditation or yogic breathing practices may help tap into the, “rest and digest,” or parasympathetic nervous system and could increase heart rate variability (a marker of recovery), promote relaxation and alertness, and reduce depression and anxiety (Zaccaro, 2018). Also, diaphragmatic breathing has been found to reduce stress and improve mood in as little as one 20-minute session and across many different populations and practice settings (Chen, 2017; Hopper, 2019).

Mindfulness Meditation vs. Controlled Breathing Exercises

Also, mindfulness meditation has been found to lead to slowed breathing rate (though breath control is not the goal of meditation!), improved HRV, and an improvement in physiologic recovery (Chang, 2020).

A recent article looked at the effects of mindfulness meditation compared to three different breathing techniques on markers of physiologic recovery and down-regulation. Researchers found that as little as five minutes per day of breath work like cyclic sighing could improve mood and reduce stress to a greater degree than meditation and the longer participants had been practicing the breath work (consecutive days), the greater the improvements in mood (Balban, 2023)!

Why is breathing important for runners?

As mentioned above, breathing can be an important (and quick) way to improve recovery in runners and endurance athletes. Breathing practices, or awareness of contributors to optimal breathing mechanics can also improve running economy and ultimately running performance. Posture and breathing mechanics are intimately related such that the position of one’s body affects the ability to breathe most efficiently and practicing healthy breathing mechanics can also improve muscle, tendon, and skeletal alignment and tissue health! Some key factors to keep in mind while trying to optimize position and breathing during running are these (adapted from Greiwe, 2022):

1. Avoid excessive forward lean and excessive upper cervical (head on neck) extension

2. Allow appropriate trunk rotation to facilitate arm swing and transverse plane motion

3. Optimize/normalize hip extension and ankle dorsiflexion

Each of these factors alone, if found to be deficient, could contribute to increased injury risk from a musculoskeletal perspective. If we integrate what we know about the relationships between posture, alignment, muscle length-tension relationships and forces transmitted along myofascial lines, these postural points of emphasis (and if not present, postural “faults”), could greatly impact a runner’s breathing mechanics and running economy. This is one of the reasons it can help to work closely with a physical therapist, who is specifically trained in running form and biomechanics; they can address each of these factors and give you the best chance to reduce your risk of injury, treat any current aches/pains you may have, and get you back to performing at your best!

I hope this blog has helped you think about one of the functions that we often take for granted (breathing) and how some simple awareness and exercises related to breathing may help us feel better in our daily lives and perform better as endurance athletes!

-Dr. Leda McDaniel, PT, DPT

References:

• Balban MY, Neri E, Kogon MM, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine. 2023;4(1):100895.

• Chang KM, Wu Chueh MT, Lai YJ. Meditation Practice Improves Short-Term Changes in Heart Rate Variability. IJERPH. 2020;17(6):2128.

• Chen YF, Huang XY, Chien CH, Cheng JF. The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety: The effectiveness of diaphragmatic breathing relaxation training for reducing anxiety. Perspect Psychiatr Care. 2017;53(4):329-336.

• Greiwe J, Gruenke J, Zeiger JS. The impact of mental toughness and postural abnormalities on dysfunctional breathing in athletes. Journal of Asthma. 2022;59(4):730-738.

• Hopper SI, Murray SL, Ferrara LR, Singleton JK. Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database of Systematic Reviews and Implementation Reports. 2019;17(9):1855-1876.

• Zaccaro A, Piarulli A, Laurino M, et al. How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Front Hum Neurosci. 2018;12:353.