Because it’s so important to keep our lungs healthy, especially when faced with a virus that seems to target them specifically, I’m sharing some breathing exercises I learned last year when I was diagnosed with vocal cord nodules (I’m good now, thank you!). If you have any concerns, check with your doctor first, but I found these exercises to be relaxing and enjoyable. Best of all, you can do them in 5 minutes anywhere, as a treat to both your lungs and your mind. Give it a try and read on below for some of the science behind it.
I hope you’re feeling relaxed and clear in your lungs and your mind! So, why are we focusing on the diaphragm? Simply put, because it’s a muscle, and the main muscle we use for breathing, it’s something we can work out and strengthen, just like biceps or abs. Having a strong diaphragm is essential, especially when we’re faced with difficulty breathing. If you’re having trouble picturing what your diaphragm is, you’re not alone; when my ENT first told me I needed to learn to “speak from my diaphragm,” I really couldn’t quite grasp what she meant. Take a look at these visuals:
Photo credit: Qasim Zafar
It helps me to think of it as a curved platform on which your lungs sit, which keeps them from bumping into your stomach. When your diaphragm flexes (or contracts), it’s flattening out and pulling downward, which makes your lungs pull downward, creating a vacuum into which air flows. Voila, you’re breathing in. Then, the diaphragm relaxes (or expands), going back into its resting upside-down-bowl shape, which pushes up on your lungs and the air in them. That’s breathing out.
We want to keep our diaphragms in great shape. There has been really interesting guidance coming out of Zhejiang University Hospital, near where the first cases of covid were reported. Doctors and nurses there issued a guide based on their observations to help doctors and nurses around the world to better assist sick patients. They found that the worst thing a sick patient could do was lie flat on their back for long periods of time. Instead, they recommended standing if at all possible, or at the least being propped up in bed, and they strongly recommended breathing exercises like the ones we just did. You can see the full report (which is heavily medically-oriented) here, but the relevant recommendations read:
(1) Position management… Patients must learn to tip themselves into a position which allows gravity to assist in draining excretion from lung lobes or lung segments…. Standing is the best body position for breathing in a resting state, which can effectively increase the patient’s respiratory efficiency and maintain lung volume. As long as the patient feels good, let the patient take a standing position and gradually increase the time standing.
(2) Respiratory exercise. Exercise can fully expand the lungs, help the excretions from pulmonary alveoli and airway expel into the large airway so that sputum would not accumulate at the bottom of the lungs. It increases the vital capacity and enhances lung function. Deep-slow breathing and chest expansion breathing combined with shoulder expansion are the two major techniques of respiratory exercises.
① Deep-slow breathing: while inhaling, the patient should try his/her best to move the diaphragm actively. The breathing should be as deep and slow as possible to avoid the reduction of respiratory efficiency caused by fast-shallow breathing. Compared with thoracic breathing, this kind of breathing needs less muscle strength but has better tidal volume and V/Q value, which can be used to adjust breathing when experiencing short of breath.
② Chest expansion breathing combined with shoulder expansion: Increase pulmonary ventilation. When taking a deep-slow breath, one expands his/her chest and shoulders while inhaling; and moves back his/her chest and shoulders while exhaling. Due to the special pathological factors of viral pneumonia, suspending breathing for a long time should be avoided in order not to increase the burden of respiratory function, and the heart, as well as oxygen consumption. Meanwhile, avoid moving too fast. Adjust the respiratory rate at 12-15 times/min.
Furthermore, the Intensive Care Society in the United Kingdom recommends prone positioning (lying on your stomach) to increase airflow for covid patients with ARDS (acute respiratory distress syndrome), further demonstrating that if something as simple as body position can help, then having a strong breathing system going into an illness might also give a person the edge they need to recover.
And, since thinking about all of this can get rather stressful, it’s important to remember that our mental health and state of mind play a crucial role in our physical health. These breathing exercises can be practiced as mindful breathing to take a load off your mind and refocus yourself on your health and well-being. And that’s something all of us could use, before, during, and after these historical times.
I hope that you’ll enjoy these exercises as much as I have, and that they will serve you as well as they served me. I found that taking a pause to do them 2-3 times a day, over the course of the six months it took my voice to heal, had a great effect on my voice and my state of mind. Take care of yourselves and my best wishes for your health and happiness.