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Breathing and Exercise: Strength Training for Your Diaphragm (2018) (pennmedicine.org)
327 points by robg 16 days ago | hide | past | web | favorite | 119 comments

Lot of people tend to have respiratory failure before situation gets worrisome and breath exercises are a definite way to help your body do what a ventilator does

In yoga asanas, there are few breathing exercises that existed in ancient India and I myself can attest to it that I was able to overcome lot of allergies practising it,

Here is a resource to follow along. https://youtu.be/iUKjuni-6l8 starts at 9 mins and goes on for 15 mins or so

And yes everyone breathes the wrong way, we pull in stomach when inhaling which is supposed to be otherway round, I know it's surprising to hear that we are breathing wrong. if you want the proof just notice a child breathing that's the most natural form of breathing

If you are looking for keywords to look up, the are anuloma viloma & kapalabathi.

Stay safe, stay healthy.

Yes! Breathing like that will purge carbon dioxide from your blood more quickly and result in higher oxygen levels. There are some really powerful exercises based on oxygen breathing in quite a few different traditions. Some names I've heard of are "holotropic breathing", "circular breathing", "breath of fire", "round breathing", "bioenergetics breathing", and "Wim Hoff method". Wilhelm Reich made use of oxygen increasing breathwork in his orgone therapy back in the mid 20th century.

This stuff can really bring about powerful alternate states of mind, and I've personally experienced some deep spiritual and psychological release from oxygen breathing exercises.

At this point I've come to think that peoples' natural response during an anxiety attack, which is to hyperventilate, might actually be a healthy, desireable reaction. But we socially repress and stigmatize it. Fear and anxiety are uncomfortable to us, so instead of holding space for working through that stuff naturally, we stuff it.

I'm telling you though, the feeling relief that controlled hyperventilating can bring is unbelievable.

The evolutionary history of how we developed an instinct to hyperventilate is an interesting question.

However, I have to put up a warning that hyperventilating doesn't actually increase oxygen levels. It's a dangerous practice because it surpasses the natural drive to breath by depleting CO2 in the blood to abnormally low levels.

Our breath drive depends on CO2 levels and can get fooled by hyperventilation into letting you black out from lack of oxygen. This section on Wikipedia explains the physics of the situation really well: https://en.wikipedia.org/wiki/Freediving_blackout#Shallow_wa...

> The evolutionary history of how we developed an instinct to hyperventilate

Presumably it's a fight or flight response. It's redundant and counterproductive of course in many modern stress situations but if you had to fight off a predator or catch that animal the extra jolt of vascular activity probably makes perfect sense.

That was a really interesting link. It sounds here like hyperventilation, in practice, is dangerous only if you might become oxygen-starved right after (like in diving). A lot of these breathing exercises, like the one in the video above, aren't necessarily dangerous for that reason.

I don't use any particular breathing technique and my blood oxygen saturation is typically very close to 100%, just like most other people without lung disease. If you're getting benefits from breath work then that's great, but it's not because of oxygen levels.

Good point! I was thinking in terms of oxygen/CO2 balance. But strictly speaking, I realize your right in that hyperventilating won't actually increase absolute oxygen levels.

If this is the case, what causes the light-headedness when you hyperventilate?

"Low carbon dioxide levels lead to narrowing of the blood vessels that supply blood to the brain. This reduction in blood supply to the brain leads to symptoms like lightheadedness and tingling in the fingers. Severe hyperventilation can lead to loss of consciousness. For some people, hyperventilation is rare."

I understand the tingling of the fingers to be caused by a reduction of calcium ionization:

"Low levels of carbon dioxide cause tetany by altering the albumin binding of calcium such that the ionized (physiologically influencing) fraction of calcium is reduced; one common reason for low carbon dioxide levels is hyperventilation."

I highly recommend everyone look into Wim Hoff's work. It's not only helpful but he's also a super interesting guy.

This interview shows Wim Hof Guiding someone through a full single round:


Four rounds in a row first thing in the morning blows coffee away by a long shot.

And the free app to make it easy to track progress: https://itunes.apple.com/us/app/wim-hof-method/id890471578?m...

I tried it with them, and you know what? It felt good. That said, there was no shortage of red flags coming from Hof. Expelling the cancer? The bacteria? Hm...

I had to stop when the Russel Brand was trying to explain that the mediation quieted the narrative in his head. Hof attempted to finish his thought in exactly the wrong way, then pulled a 180 upon being corrected. Really had the feel of that guy in the mall trying to sell you hand cream...

The messenger's clothes don't matter if the message is verifiable.

Go read the clinical study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4034215/

Look up his list of Guinness records. Marathon in the desert. Climbed nearly to the top of Everest in shorts and no shirt. World record for longest breath hold underwater. etc.

Only someone who feels strange would even think to try these things.

Hyperventilating reduces oxygen levels in your body due to the Bohr effect. That's why it can cause you to faint.

I'd also suggest practicing nadi shodhana pranayama with breath retention. There is some evidence that holding your breath in a controlled way exercises your spleen, like endurance divers train for, which injects oxygenated red blood cells into circulation. [1][2] It obviously has an effect on respiratory capacity as well. [3]

There are plenty of resources on Nadi Shodhana -- I'd suggest Iyengar's "Light on Pranayama" -- but I'd recommend starting with a 1:1:1 ratio of inhale:hold:exhale counts through alternate nostrils, then moving on to 1:2:2 and then 1:4:2.

[1] https://vcresearch.berkeley.edu/news/enlarged-spleen-key-div...

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3694106/

[3] PDF warning: https://physoc.onlinelibrary.wiley.com/doi/pdf/10.1113/EP086...

> we pull in stomach when inhaling

Wat? My stomach goes out when I inhale. I could not find any way to pull in my stomach and inhale.

It is a common dysfunction in western cultures to lift and try to expand the ribcage when breathing in, while dragging the gut in. It results in a much smaller breathing volume, lots of weird, unnecessary physical stresses. Kind of the same kind of thing as people bending their spine weirdly backward when told to stand up straight.

I used to do this as a kid, and noticed it at one point and thought it weird. I must have subconsciously corrected it over the years since then cause it's not how I breath any more …

I wonder is it related to prevalence of sitting?

Simply “fill” your chest while inhaling and your stomach can’t not go in.

Imagine a cartoon of someone taking a deep breath before blowing out a candle or something.

It's unhealthy but anatomically possible to breathe while your abdomen is pulled in. https://www.medicalnewstoday.com/articles/319924

Try it. You end up breathing using your rib cage instead of your diaphragm.

That unhealthy form of breathing is called vertical breathing. The correct form is horizontal breathing [0] helpfully shared elsewhere in this thread.

0: https://www.artofmanliness.com/articles/how-to-breathe/

I upvoted. HN hates comments like this but I've also had similar experiences. Asthmatic as a kid, high blood pressure in my 20s. All of that disappeared.

> HN hates comments like this

Surprised you haven't got the old "anecdata is no data" response yet …

post hoc, ergo propter hoc.

yeah working out muscles makes them stronger. Must be a myth.

It was about asthma and hbp, not some stronger muscles.

try it sometime.

>And yes everyone breathes the wrong way, we pull in stomach when inhaling which is supposed to be otherway round, I know it's surprising to hear that we are breathing wrong. if you want the proof just notice a child breathing that's the most natural form of breathing

Interesting as in martial arts the kiai is from the base of the stomach clenching with a breath out.

More so as I breath in via the chest not the stomach, not given that much thought, though did a lot of competitive swimming and that may of played a part, not something I considered.

> And yes everyone breathes the wrong way, we pull in stomach when inhaling which is supposed to be otherway round

This statement confused me, so just to be clear, this video: https://www.youtube.com/watch?v=ldNnKVGxabA demonstrates the correct way to breathe right?

Wrong - pull in stomach (breathe with chest)

Right - expand stomach

Yes I am so sorry for the confusion.

When we breathe, first the lungs fill up, as adults we exhale at this point. We should continue breathing until full lung capacity i.e until it pushes the diaphragm down which in turn pushes the stomach giving a sense of pot belly, if you have a pet or a child notice their stomach while they breathe.

There seems to be little confusion about chest/stomach breathing. We draw air with lungs which reside in the chest, its just that we are training our body to take deep and longer breaths we get a feeling that we are drawing with stomach

As PG says one needs child like curiosity, we need to child like breathing :)

Your interesting tidbit about breathing led me to pay attention to my style. Seems I am doing the "right" way, stomach distends on input and vice-versa. It seems impossible to do the other way. I wonder how people get into that habit.

That was quite helpful thanks.

Extracting from (with slight modification re retention) https://www.amazon.com/Wellness-Sense-practical-emotional-Ay...

>>> Respiratory cleansing purifies your entire body. It pacifies the three doshas and strengthens the seven dhatus. It flushes your lungs and blood with fresh and excess oxygen that results in definitive strengthening of your immune system and your overall wellbeing. Respiratory cleansing has a calm effect on your mind as well. It improves your memory, virility (or fertility) and strengthens your neurological system. According to the yogic texts, it allows the practitioner to live longer and healthier. It is called pranayama. Prana means vital life force and yama means to elongate it. The science of pranayama is a different subject matter and is not part of the mainstream Ayurveda.

Prerequisites For all the breathing exercises, it is more rewarding to sit cross-legged. Sitting in this posture allows you better control on the flow of the vital energies in the body. In case, you can't sit cross-legged, it is okay to sit in a chair. Breathing exercises should not be done while lying down. In all the exercises, your back and neck should be in one straight line. Your posture needs to be firm and straight but not tense. It is best to do these exercises on empty stomach in the morning. If you are doing it during the day or at night, make sure there is a minimum of two-hour gap between your meal and the exercise. And, that's assuming you had a light vegetarian meal because a light vegetarian meal completely digests in two hours. If you had a heavier meal, you may want to increase the gap to three hours or more. Start all breathing exercises with an exhalation first. This is a subtle but extremely significant point. Exhalation allows you to expel toxic air in your system. If you start with an inhalation, you simply pressurize the foul air to circulate through your system. A general rule of thumb is to be followed for all yogic exercises: if they make you uncomfortable, stop right away and seek expert guidance.

Simple Deep Breathing Simple deep breathing is a hassle-free, potent and easy exercise. Assuming you have followed the prerequisites, just sit comfortably, rest your hands in your lap if you are sitting cross legged or on your knees if you are sitting in a chair. Start with exhale as per prerequisit. Inhale deeply and gently with both nostrils. Fill your belly and lungs with fresh air. Do not hold it and instead start exhaling gently. Pull your stomach in as you exhale and gently push your stomach out as you inhale. Simple deep breathing can be done for fifteen minutes in the morning. Do it for five minutes and take a break of two minutes and then do it for another five minutes.

Alternate Breathing Alternate breathing is a type of pranayama that is excellent for neurological and respiratory cleansing and detoxification. It forms part of the nervous-system-purification (nadi-shodhana) regime. It is called anuloma-viloma in yogic texts. To do alternate breathing, follow the prerequisites. As always, start with complete exhalation with both nostrils. Put the thumb of your right hand on your right nostril to close it. Now breathe deeply, steadily and gently through your left. DO not hold the breath. Put the middle finger of your right hand on the left nostril and lift your thumb to open the right nostril. Exhale completely, steadily and gently. Ideally, your exhalation should be so soft that you should not even hear yourself breathing out. Yogic scriptures state the standard one-four-two rule for pranayama. It means if it takes you one second to breath in, for example, you should hold the breath for four seconds (four times the length of inhalation) and exhale over two seconds (double the length of inhalation). However, as I stated earlier, retention of breath should be done only if you have been guided by an expert and if you are observing all the rules. At one stretch you can do twenty repetitions. One complete repetition is inhale from the left, hold, exhale from the right, inhale from the right, hold, and then exhale from the left. This is one repetition. If you have the time, you are free to do it twice or even thrice a day. There is no better purifier of your entire nervous system than pranayama. It is nothing short of a miracle exercise handed down to us by the ancient yogis.

Is it possible to separate the spiritualism and pseudo-science from the actual facts? Lines like saying belly breathing "pacifies the three doshas and strengthens the seven dhatus" serves to discredit any possible real benefits.

I think we always have the option to ignore what doesn't fit in our world-view. I mostly just copied text on breathing from the book on Ayurveda in which these things are fundamental building blocks of the human physiology.

I was intrigued by this report last year (http://www.sci-news.com/medicine/inspiratory-muscle-strength...) and did some research around the idea of Inspiratory Muscle Strength Training (IMST). Turns out there has been a bit of peer-reviewed work done recently around IMST and statistically significant reductions in blood pressure, especially in regard to obstructive sleep apnea treated with CPAP (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863204/). I went out and purchased the K3 that was used in the recent work showing 5 minutes of IMST training at 75% capacity reduced blood pressure by 10 points (https://www.powerbreathe.com/product-category/breathing-trai...). I've been doing it off and on for 6 months now, and I can attest that after 3 weeks of twice daily use, my blood pressure was reduced by at least 10 points. I've also noticed sleeping better with my CPAP. YMWV, but the peer reviewed science seems legit and I've personally benefited from it!

Thank you very much for mentioning this. I have high blood pressure and wasn't going to read the article until I saw this.

I don't have a high blood pressure but I do use a CPAP device for handling my spnea. Currently using a Philips Dreamstation. After it was diagnosed I immediately got the device and ever since my AHI dropped from about 50 to 2 or 3 an. I wonder if it is possible to ever get off this device. Would this breath exercises help in reducing the AHI?

Some actions which I have experienced in a positive way of reducing AHI: - Hiking / workout before going to bed - Quit consuming drinks containing alcohol.

Any other suggestions would be great and very welcome!

Obstructive sleep apnea is terrible. I am thin but have a malformed throat/jaw so I have OSA. Fortunately, mandibular advancement devices worked well for me but you can only use them for 8-10 years before they permanently adjust your bite. I used one religiously in my late 20's early 30's and it was great, but I have since moved to CPAP full time using nasal pillows and a chin strap off Amazon to keep my mouth closed. I also sleep on a 7deg straight incline (whole bed, not wedge). Putting all these things together works wonders for me. I am also APOE3 heterozygote so I am super fastidious about proper sleep hygiene to ensure lymphatic clearance of beta-amyloid plaque. The no alcohol before bed is super important, but I have a hard time holding to it--I'll get there eventually. Overall, there is nothing to do about it. The only surgical options are terrible and the new electrostimulatory devices are promising but new and therefore long-term effects are unknown. I hope we reach a point where there is a "cure", but for me it's doubtful.

Hello there I actually have a Phillips DreamStation Auto BiPAP Hum Dom (DSX700H11), thats connected to the DreamStation Hum Core Pack DOM (DSXHCP), that I’m currently trying to find a new home for. It was my fathers, he recently past an the machine cost us a small fortune because at the time he had no INS. Anyways if anyone is interested please contact my via Email. My Gmail is the exact same as my user name on this site. I appreciate any feedback as far as where else I might been able to recoup some of my money spent as well as help someone that may not have the right resources to set one through there INS or what not. Again that’s, and sorry to interrupt your conversation! Benenati2323

This is a VERY active community around sleep apnea. Someone there could certainly help you: http://apneaboard.com/

Very interesting. I was already practising similar kind of respiratory exercises: you inhale-exhale deeply 20 times, then you empty your lungs and hold this state as long as you can (depending on your health condition, can be 20s or 2mins). It helps against nasal congestion along with the rest of body stretching of course

I almost hyperventilated myself before I got to the "hold your lungs empty" part; I should have known better than just to try it on a whim.

I have done this breathing exercise for a long time.... though addmitedly, much less recently. T.Hanx for the reminder...

I used to meditate an hour a day when I was in my 20s, and now, being in my 40s, I can measurably feel the difference of not meditating regularly. Its time to really get dedicated to it.

Is it worth getting the electronic versions vs. the manual ones?

I prefer the K3 (electronic version) because it automatically adjusts, even mid-training, to keep the max effort around 75-80%. Your diaphragm gets strong, fast so if you don't adjust continuously soon there is not enough resistance. It's like lifting weights where a machine constantly increases the weight and manages it so you're always pushing yourself. You can do this with the manual ones, but I'm lazy and would rather pick up the device in the AM and PM, do it for 5-10 min, and be done not having to think about it. Keep in mind, though, the K3 is like $400...

I wanted to improve my presentation skills. I felt my voice was too nasal and thin, I spoke too fast, and emphasised too many words.

So I approached a voice training coach. It seems everything -- from delivery, pauses, speed of delivery to sore throats -- could be improved if one could pay attention to proper breath control, and diaphragmatic breathing. I can certainly attest to that.

Can confirm that breathing is super important in speaking; my sister has the weird habit of continuing to talk until her lungs are nearly empty, to the point where you can hear the 'distress' in her voice. It's a bit annoying tbh.

I went looking for a voice coach. All I could find were singing coaches and autistic speech therapy ones. Nobody who could coach me at giving presentations. How did you find yours?

You could look for coaches who train actors AND singers. But my coach trains singers primarily, and it seems to me that the techniques are the same.

I wanted to work on my enunciation as well, in addition to loudness, cadence, nasality etc. My speaking style is staccato, and I emphasise too many words. That she corrected by telling me to read from a fully prepared script if I could help it, which is useful for recordings in these times! That got rid of the staccato, because my low-bitrate brain was freed from having to figure out what clever thing to say next :)

Then to work on the cadence, I had to underline at most two words per line, which would most effectively deliver the import of that line.

Finally, breath control. "Speaking from the diaphragm" is a real thing. There's a daily regimen of vocalization and breathing exercises that I do. My neighbors look at me oddly. But these exercises do help. Good breath control allows you to deliver a long line, with appropriate pauses and cadence, without feeling your tank is going to empty soon.

Did one session with an acting coach once which was very useful.

Most useful tip he gave me: in between sentences focus on breathing out, instead of breathing in. If you clear your lungs they will take care of filling up automatically.

Here's the thing. I often listen to recorded voices at 1.25x or 1.50x speedup. Some people can be easily understood faster, others not. A commonality in those that can be understood are they are professionals, and ones that can't are lay people. Clearly (!), the professionals enunciate in a way that's much more understandable.

I've also noticed when listening to a presentation that some presenters are a lot easier to listen to. I'd like to improve my presentations in that way - that means tone, pacing, enunciation, etc.

Also curious. I tend to strain my vocal chords when I talk and can’t talk very loud. Normal conversations are fine but even reading to my son I feel like I’m straining my voice.

Would definitely be interested in some coaching and zero interest in singing. I wonder if it’s something you can do via zoom? Especially these days ...

I didn't take courses, but as far as I know proper breathing techniques are also taught by singing coaches, if that's what you are looking for.

I was looking for coaching to enunciate clearly.

I'm interested in this also. Would love to hear if you find something/someone good.

If you haven't already, start jogging/running. Unless you are in a super-dense city it's easy to meet isolation requirements. Start jogging at the start of each 5 (or 2) minute boundary, jog until you're too puffed, then walk until next boundary. Repeat until 20, 30 or 45 minutes is up. Done. Then repeat every day or other day until you are jogging non-stop. Congratulations, you're now a runner and your lungs are now unavoidably stronger.

Don't bother with stretching rituals unless you have extra time to burn -- they don't really make a difference versus simply running within your current comfort zone. Half of the running biz is a meditation on the state of your body during and between runs (the other half is scheduling, and that's aaaaall different now.)

Also, if you have 'gunky lungs' (either standard cold/flu or COVID-19) wait until you are mostly gunk-free before running!

I'm a daily runner now for 26 years ( five miles a day currently) and an asthmatic who always has gunky lungs, but, as per my lung test last year, I have the lung health of someone 20 years younger instead of 20 years older, which is what my doctor expected given the severity of my allergies and asthma. I grew up in the 80s when I was forbidden from all activity because of my asthma, but running is my bulwark of breath, my mental/physical/meditation on how to breath healthy instead of in a diseased asthmatic way.

> your lungs are now unavoidably stronger.

Are there any long term studies about the health effects of running in polluted cities ?

I remember a paper that found that its worse to run near roads than to run at all, with huge amounts of absorption of contaminants into the body. Contaminants being "recorded" in the runner's hair.

Out of the blue I found this paper finding a relationship between worse performance and pollution in marathons.[1]

[1] https://mpra.ub.uni-muenchen.de/79473/1/MPRA_paper_79473.pdf

That study was done in China which is pretty notorious for its air quality. Probably best not to run outside when the AQI is high though. https://airnow.gov/

Anecdotally I noticed a difference when running next to big, busy roads in Northern VA vs. running next to lakes (or even the same busy roads later at night when traffic was negligible). Couldn't go as hard, didn't feel like I was making as many improvements to speed/time/health, etc.

I wonder if this is trending because people figure you might be able to strengthen your diaphragm as a precautionary measure in case of contracting COVID-19.

Anyway, if anyone is interested in a practical application from a scholarly source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2971640/

Probably is; mind you, being in good health (respiratory and overall) will make it easier on both you and the medical system if you do contract it.

I started jogging recently for exactly this reason. (Usually, I just walk.)

>From an early age, you were likely taught to breathe with your upper chest.

Wait, what? People are taught how to breathe? Is this really a thing?

Haven't heard about it. I breathe with the "proper method" instinctively and never knew this was even a thing.

Perhaps it's something specific to American culture.

There's really nothing in American culture about breathing one way or another.

Cartoons always show chest breathing.

No it isn’t true most kids in India are taught to breathe through stomach not chest.

Watch any lessons in pranayama you will know it’s part of daily routine taught to many Indians and now most yoga practitioners learn it.

Gym class as a kid? Sports teams during high school (Running, Wrestling, Soccer, Football, Baseball, Lacrosse, etc)? Meditation practice?

I was taught that we learned bad breathing technique through learning how to speak. I don't really know how accurate that is, but non-speaking babies do proper breathing, and speaking age children no longer do for the most part, so there is correlation at the very least. It's anecdotal at best, but I didn't see anyone mentioning the speech aspect.

I've heard this in a variety of meditation & martial arts communities. I think it's is more of a straw man that various groups use to build up the importance of their own methods.

Definitely new to me.

I don't see any guide or any real description of the benefit of training your diaphragm (other than taking deep breaths by pushing your stomach out. But how much? How often?)

I train my diaphragm for singing, not really for any other benefits. But I think taking long, deep breaths is great for calming down and finding focus if you're stressed out.

Don't push your stomach out. Let the stomach be pushed out when you breathe in. There's a difference.

The simplest way (I think) to find a 'deep'/connected breath, is to breathe slowly all the way out, making a 's' sound, until there is no more air left. Then, hold for about 4 seconds. Now just relax and let the body breathe in on its own.

For some reason I find that my body doesn't seem to want to breathe in on its own. Like, I can't determine a comfortable point (and I've paid a lot of attention to this over my years in meditation) where my body seems to "take over" from my conscious control and decide to breathe in comfortably on its own. I've found that I hold my lungs empty for longer than is comfortable, to the point where breathing in causes a noticeable rise in heart rate. I'm mildly asthmatic, I'm sure that has something to do with it.

The only way to hand off control of your breathing to your subconscious is to do something that distracts your conscious mind. You can't focus on breathing and then say, "here you go, brain, handle it."

I don't think that's true. When I started breathing meditation, it felt like that for me: whenever I was aware of my breathing, I automatically switched to directly controlling the breath. As a result, my rhythm was off and I often became lightheaded and stopped.

At some point you learn to separate action and observation: you can focus your attention on the breath, meaning the sensations associated with breathing (air flowing through your nostrils and over your upper lip, belly slowly moving), and still let your body control the breathing action automatically.

In The Mind Illuminated, there is a comparison of this to catching a ball: instead of seeing the ball and trying to directly control your arm to catch it, you focus on your intention ("Catch the ball") and let your body simply act on (implement) this intention.

The great thing is that while you practice this separation of action and observation using the breath, it will apply generally to your life. Very powerful for managing your emotions: instead of being your emotion when you become aware of it, and identifying with the urge to act on it, you learn to observe the emotion without that observation having direct effects on your actions. You can choose to act on it, or choose not to.

I’ve been training diaphagm breathing as part of martial arts training for over a decade. Breathing is deeper and calmer and more powerful.

> Breathing is deeper and calmer and more powerful.

Diaphragm breathing is also part of the training for classical flute players to breathe. It is how babies breathe naturally.

and then?

I did some quick googling and it seems like there's some preliminary research that indicates it might help you reduce stress[0]. But I wonder how this stacks up against going for a jog or riding a bike, which have a well established record of reducing stress, and have other benefits.

[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/

Complementary and synergistic. Why pick breath training or vigorous exercise when you can just do both?

I think it leaves you physically stronger and mentally calmer. YMMV but it works for me.

It is like breathing more in sync with your center of gravity, it stabilizes you, which makes you calmer, may stimulate your digestive functions as well.

Big belly breaths (when you fill up with air, then top it off, then top it off again) stimulate the vagus nerve, which for me is crucial in combatting my anxiety.

I remember reading that diaphragm breathing helped inhaling more without changing pressure around the heart, unlike opening your chest fullÿ.

Singers also do extensive breath/diaphragm exercises: https://www.musikalessons.com/blog/2016/10/vocal-exercises-f...

I played the flute for a few years as a kid, and breathing was a big deal during my lessons.

OK, so what's the exercise?

"To do this, you’ll need to control your diaphragm by using your abdominal muscles to press your abdomen forward, allowing your diaphragm to flex downward."

Then the article goes into stretching ...

I'm surprised no one has brought up box breathing (aka four square breathing) yet. https://www.livestrong.com/article/74944-box-breathing-techn...

Short version: breathe in deep belly breaths for four seconds, hold for four seconds, breathe out for four seconds, hold for four seconds. Do this is a quiet and dark room and it helps with stress, anxiety, etc.

I got into it when Joe Defranco mentioned a progressive version of this on his podcast: breathe in for one second, hold for one, breathe out for one, hold for one. Then breathe in for two seconds, hold for two, breathe out for two, hold for two. Then breathe in for three seconds, hold for three, breathe out for three, hold for three. So on and so forth. Most people can get to six seconds, but not much more past that. This progression technique has helped with my diaphragm strength and breath-bracing (I do a lot of heavy weight training).

The best way to increase your cardiovascular capacity, and boost your immune system at the same time, is aerobic exercise "cardio".

I'm an anesthesiologist/intensivist and this is how I'm preparing.

I am guessing this is being posted in relation to the virus. Is this likely to be at all helpful? Is having a strong diaphragm useful when your lungs are filled with fluid?

In respiratory therapy school we were taught some breathing exercises to teach patients who were graduating after being on a vent, had lung surgery following cancer, COPD and/or other pulmonary issues. Some of the trainers like the inspiratory and expiatory trainers have benefits to non-compromised patients - some athletes use them for training in sports like swimming and basketball.

Maybe an MD will chime in, however in case not imo the diaphragmatic training is only beneficial for singers and yogis and others who need to do large diaphram style breaths. Most people will go back to their normal style of breathing even if they're trained and practice diaphragmatic breathing after they're done concentrating.

If I had to recommend one thing to buy for a regular person to use, it would probably be a really simple inspiratory/expiratory trainer. Basically you inhale and blow through a hole and it strengthens your lungs.

This one is low tech and bombproof, cheap, easy to disinfect and used a lot in the field: http://www.medi-careequipment.com/Catalog/Product/26832/Pfle...


Thanks for posting. I’ve done diaphragm breathing exercises for sports training and meditation. How does using these inspiratory/expiratory devices strengthen the lungs? Isn’t the action just strengthening primarily the diaphragm and some chest muscles used in breathing? How many minutes training per day would you recommend for healthy people? And how much does the Pflex sell for? Site makes you request to order and collects a lot of info.

Aww geeze, I knew someone was going to ask some followup questions and I'd be out of my depth!

To be honest, I didn't practice in the field very long as an RT because I fell into hospital IT after my rotations and took to it like a duck to water and ended up really enjoying that as a career.

I'm gonna refer you to this study which - you are right- does show the insp/exp trainers help to strengthen breathing muscles. So perhaps it's the equivalent of using weights at the gym vs just doing diaphragm breathing exercises.


Breathing exercises are medically recommended for some very deadly lung conditions. For example:


It helps to oxygenate your body, which is (I'm guessing) pretty helpful if you're infected and are ever short of breath.

Also these are generally exercises one can do at home.

Art of Manliness did a nice piece on this with an interview with Dr. Vranich: https://www.artofmanliness.com/articles/how-to-breathe/

This link contains some actual guidance.

Helpful, direct and to-the-point article/guidance using simple language.

Thanks for the link.

so where's the guide?

Exactly. There's no how-to guide there. It's mostly an ad. Good idea, though. Search for "How to Breathe"; there are some good sources. Especially important if you're on lockdown and moving less than usual.

Right, this seems like an interesting subject, but not a lot of information there. Can anyone suggest better sources?

Any comments on the following: https://news.ycombinator.com/item?id=22662071

It took a bizzare turn with the sentence beginning "Focus on the foot and ankle muscles..."

I couldn't find anything either. Didn't expect click bait from Penn State.

Can someone summarize what's the best technique for breathing well? Something everyone can do daily and improve? I read the article (I think) seen no guide there.

I just mentioned the same here https://news.ycombinator.com/item?id=22661875

I had pneumonia when I was 14 (weakened immune system after growing 6 inches in 8 months...) and the doctor prescribed breathing exercises which were very helpful. There was of course a ton of ABX as well as inhaled steroids, but after all of that, the breathing exercises were what helped to restore me to normal. (The Prednisone actually did a lot of harm, don't go off it without a taper!)

Is there any evidence that fast growth rates cause weakened immune systems? That seems highly improbable. Lots of people get pneumonia.

This reminds me of some of the exercises I did during marching band and Drum Corps. We were taught, like the article says, to breathe by expanding the abs and then use the abs and diaphragm to push the air out through the instrument. In both, we used breathing gym techniques developed by Sam Pilafian and Patrick Sheridan. Here's a video of them demonstrating some of the exercises we did. https://www.youtube.com/watch?v=qEz0ku-oXM4

These exercises definitely helped me prepare my lungs for the stress of what is essentially running and playing a brass instrument at the same time for ten minutes. Even though they are meant for Marching Band and Drum Corps, I would still recommend breathing gym for anyone who wants to be a stronger breather.

Anybody interested in this might look into trying out the didgeridoo. I got one to help reduce snoring, and can attest that regular practice definitely strengthens the diaphragm and pharyngeal muscles. Plus it's pretty fun.

Having a strong diaphragm and good lung capacity is important for being healthy. Proper intake of oxygen can work wonders for your mind and improve efficiency by a lot. Stay safe everyone!

Pranayanama, the ancient breathing technique practiced by yogis, focuses on various types breathing exercises including Diaphragmatic Breathing.. it is explained in Adham Pranayanama.

Another modern (but still technical) treatment is Light on Pranayama by B.K.S. Iyengar.

I wonder if learning to play a woodwind instrument like the recorder or melodica is good exercise for lungs and diaphragm.

Go play a wind instrument. Saxophone, Trumpet, Flute. Breath control is very important. As it is for singers.

I played brass instruments for about 8 years in school; even playing the tuba didn't really help me with breath control.

I was lazy and apathetic, so the fault was mine, but it's just worth noting that while it may be helpful it's not sufficient.

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