Breathing exercises are more important than you might think

If you are familiar with physiotherapy, you would know that we use a variety of techniques for treating pain, preventing injuries, and managing disability. The one technique/exercise that is the most primitive yet undervalued is breathing. Respiration is a necessary function and vital to our being and existence; and when used correctly, provides us more with benefits than keeping us alive (and singing)!

Breathing technique: Deep/abdominal/diaphragmatic breathing is an efficient breathing technique and it involves the diaphragm muscle, located right under your lungs. As the diaphragm contracts, your abdomen expands and brings more air in the lower parts of the lungs. Breathing using mainly your upper chest and shrugging your shoulders (we call it apical breathing) is inefficient and could increase shoulder and neck tension by doing so.

            How to: diaphragmatic breathing

  • Sit upright in a chair or lie down on a comfortable bed.
  • Place your dominant hand on your abdomen and the other on your upper chest.
  • Breathe in through your nose and let your abdomen rise and expand.
  • Next, feel your rib cage expand and then at last your upper chest rise.
  • Exhale slowly through your mouth and repeat!

Core function training & exercise performance: Correct diaphragmatic breathing exercises are oftentimes included in core training with regards to posture stabilisation, functional movement, core motor control and core endurance. This is due to the fact that breathing and core/posture are interlinked. For instance, the way we breathe affect our posture because the respiratory muscles we use and how we use them, influence which muscles we use for moving and posture.1 Your diaphragm and breathing muscles are muscles in the end and so training them could improve exercise performance. Respiratory muscle fatigue could play part in limiting submaximal exercise as well as maximal exercise.

Chronic pain management: There are many facets to chronic pain management that includes pain neuroscience education that can be discussed with your physiotherapist. Stress, anxiety and depression along with many biopsychosocial factors have an impact on pain and pain perception. Deep breathing is one of the many self-management strategies for chronic musculoskeletal pain.2Unsurprisingly, it is a relaxation exercise and promotes mindfulness practice which has shown to be helpful to older adults coping with chronic low back pain.3

– Wing Ting Truong, Registered Physiotherapist


  1. Nelson, V. B. Ponte. Diaphragmatic Breathing: The Foundation of Core Stability. Strength and conditioning journal. 34. 34-40 (2012).
  2. S. Matthias, E. J. Miech, L. J. Myers, C. Sargent, M. J. Bair, An Expanded View of Self-Management: Patients’ Perceptions of Education and Support in an Intervention for Chronic Musculoskeletal Pain. Pain Medicine. 13, 1018–1028 (2012).
  3. G. Luiggi-Hernandez et al., Mindfulness for Chronic Low Back Pain: A Qualitative Analysis. Pain Medicine. 19, 2138–2145 (2017).
  4. Orfanos, E. Ellis, C. Johnston, Effects of deep breathing exercises and ambulation on pattern of Ventilation in post-operative patients. Australian Journal of Physiotherapy. 45, 173–182 (1999).