Breathing techniques

Breathing

The main muscle of breathing is the diaphragm. It is a large muscle that covers the base of the ribcage above the stomach. As you breathe in it flattens down helping to draw air into your lungs and your stomach will swell out, as you breathe out the diaphragm relaxes up and your stomach sinks back in. The diaphragm is the most efficient muscle to use for breathing. There are other muscles around your neck, shoulders and upper chest that can help with breathing when you are breathless. These muscles normally move the neck and arms – they can operate in reverse to move the ribs to help with the breath in, but they are not as efficient, demand more energy to work and will tire more easily. With prolonged use they can become tight, stiff and sore. These are the accessory muscles of breathing.

It is normal to use these muscles when short of breath but it is important to try and relax them at rest and concentrate on using the diaphragm as much as possible.

Breathing control

The aim is to slow down your breath when you are feeling short of breath and breathing fast. Get into a recovery position – arms supported and leaning forward if possible, use your fan or position yourself near a window if that helps. Try to breathe in through the nose and out either through your nose or through pursed lips, this helps to slow the breathing rate down. Try to focus on a longer out breath than in breath, counting may help. Try to relax, letting go of muscle tension on the out breath.

Things to try to help lengthen the out breath

Pursed lip breathing

1. Relax your neck and shoulder muscles.
2. Breathe in for two seconds through your nose, keeping your mouth closed.
3. Breathe out for four seconds through pursed lips. If this is too long for you, simply breathe out twice as long as you breathe in.

Pursed-lip breathing can be particularly useful in COPD

Count as you breathe – the aim is to make the out breath twice as long as the in breath, ie 2 : 4, 4: 8. Find what works for you.

Rectangle Breathin

Find a rectangle in your environment, a window, picture, door frame – follow the edges of the rectangle with you eyes as you breathe, in – along the short side and out – along the long side.

Sniff the flower, blow out the candles

Imagine gently sniffing the aroma of a flower through the nose and then gently blowing out the candle flames like on a birthday cake.

Relaxed or diaphragmatic breathing

This can be used to help recover after activity, or if you are anxious. You can use your fan at the same time.

Find a comfortable position

Head, neck, arms supported so your shoulders can drop andrelax. Put one hand on your tummy and feel the movement as you breathe in and out, your hand should rise with the in breath and fall on the out breath. Breathe gently, the movement is small. This may not feel comfortable or natural to begin with but practising when you are not short of breath will help you become more familiar with the technique.

The Calming Hand

Encourages a longer sighing out breath – see separate information sheet.

Helpful Tips

If you become short of breath during exercise or regular activities, try these 3 steps: Stop, Reset, Continue.

Stop your activity;

Reset; by sitting down or take up a recovery position if you are unable to sit, relax your shoulders, and do pursed-lips breathing until you catch your breath;

Continue activity; doing pursed-lips breathing as you go. Go at a slower pace if you need to.

Avoid holding your breath during activities.

Try ‘Blow as you go’, breathing out on an effort, ie standing up, lifting or reaching. Avoid rushing, pace your breathing with your steps.