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Physical Therapy

Take a Deep Breath!

Deep breathing exercises that focus on your diaphragm do more than help you de-stress. They strengthen your core and improve body function.

Kelly Brown Gross

Take a Deep Breath!

"Take a deep breath."

How many times have you heard that phrase? Especially in stressful situations or when there is pain, fear or anxiety?

The reason people say it is because it works! When you take a deep breath, more specifically, breathe with your diaphragm, it sets off a ton of useful things in your body and brain.

Deep breathing helps you deal with modern-day stress.

The diaphragm is linked to your autonomic nervous system (ANS). Your ANS is composed of two different parts: the sympathetic nervous system and the parasympathetic nervous system. The sympathetic system is the driver of the "fight or flight" system, which is your primal response to stress. The parasympathetic system is more of a calming system — where you should be most of the time.

Now, centuries ago, stress was a little different. It was life or death, like coming across a bear in the woods when you were out hunting. These days, you might still come across a bear in the woods if you are out hiking. But more commonly, your stressors come from deadlines, running late for a meeting, traffic and financial, health or relationship issues.

Your body's response is about the same, however. In response to stress, your body produces adrenaline, your heart rate and respiratory rate increase and blood flow is diverted from your gut to your muscles. In the case of that bear, you are prepared to fight it or run away.

Other stressors can be more persistent and chronic, and this is where your body can have some difficulty. When you're constantly in a state of "fight or flight," your body and brain are on high alert and not in a good place. When you take a deep breath and breathe with your diaphragm, you can calm down that "fight or flight" system and bring balance and calm back to your body and brain.

Diaphragmatic breathing is good for your core muscles.

Not only does diaphragmatic breathing help calm your body and help you deal with stress better, but it also helps strengthen a muscle essential to inner core function, stability and pressure management. The diaphragm is a dome-shaped muscle that sits inside your lower ribcage. Together with the deep abdominal muscle and the pelvic floor muscles, it works to add stability and support to your spine, abdomen and pelvis. For people who experience low back pain, research has shown that the diaphragm doesn't move as much and is in an elevated position compared to people without back pain.

The coordination of the inner core, including the diaphragm, abdominal muscle and pelvic floor muscles, is also essential for bowel and bladder control and pressure management. Many people who experience urinary incontinence could benefit from posture retraining to improve the position and function of the diaphragm as well as the coordination with the deep inner core to improve bladder control.

Practice this diaphragmatic breathing exercise to heal your body and brain.

So how do you breathe with your diaphragm? It's pretty easy, actually. After all, it's breathing! All it takes is a little time and focus. Find a place where you can focus and follow these steps to exercise your diaphragm and reduce your stress.

  1. Start by either sitting quietly, laying down on your back or on your side. If you are sitting, make sure you are sitting with pretty good posture and that your ribcage stacks nicely over your pelvis.
  2. Take a breath in. Really focus on your lower ribcage expanding — picture an umbrella opening inside your ribcage. This should gently expand your lower ribcage and abdomen You should feel a little deeper breath than normal.
  3. As you blow air out, the opposite should happen, your abdomen and ribcage should gently draw in.
  4. If you want to take it a step further and include your pelvic floor muscles (think Kegels or the muscles you would use to stop your urine stream, gas or a bowel movement), then as you inhale, let go of those muscles or let them gently expand as well. As you blow the air out, gently draw those muscle up and in, aka a Kegel.

Basically, as you breathe in, everything expands from your ribcage to your pelvis. As you breathe out, everything draws in gently. This is diaphragmatic breathing and the coordination of the inner core. Practice it for several minutes, several times a day to calm your nervous systems to help manage your daily stress and improve your inner core for strength and stability. Specifically, slowing down your breathing to six to 10 breaths per minute has been shown to improve your ability to manage physical and mental stress and balance your ANS.

Practicing diaphragmatic breathing also helps when it comes time to exercise, lift something heavy or control your bowel and bladder. The trick with lifting or exercising is to exhale through the exertion to activate your deep inner core muscles. In the case of bowel or bladder control, coordinating all those muscles is a little more difficult. A pelvic floor physical therapist can do an evaluation to make sure you are activating the correct muscles and achieving the desired coordination. When you can coordinate your inner core, you will be able to decrease the intra-abdominal pressure and activate the support muscles from the bottom up to stop the leaks.

So, take a deep breath and good things will happen!

Kelly Brown Gross

KellyBrown Gross , PT

Kelly Brown Gross, PT, has been practicing with The Iowa Clinic since 2006. Kelly loves The Iowa Clinic because she gets to decide what is best for her patients, as well as the excellent work environment.

Kelly stepped in as the physical therapist for men's and women's pelvic health and very quickly realized how many people she could help in an area that is not widely known. She is a board-certified specialist who truly enjoys helping her patients get their lives back and live to the fullest.

In her free time, Kelly likes to hang out with her husband, Dave, and two sons. She can often be found cheering her kids on at their sporting events, and enjoys many outdoor activities — including golf, tennis, and running.