Unless we have asthma or a lung infection, breathing is something we take for granted. But according to Dr Sundeep Salvi, a pulmonologist in Pune, “breathing nourishes our body with oxygen that generates 90% of the body’s energy; only 10% comes from the food we eat and the water we drink.” The main problem, he says, is that we forget our natural way of breathing as we age, and breathe shallowly.
The right way to breathe
The main muscle involved in inspiration (air intake) is the diaphragm that sits between the chest and abdomen. “We must breathe with the diaphragm, not the chest,” says Dr. Salvi, who as the founder-director of the Pulmocare Research and Education Foundation (PURE), often sees patients who say they’re breathing deeply as they push out their chest. Instead, he says, as we take in a breath, the diaphragm contracts, pushing the abdomen outwards. Ideally, the tummy should protrude a little when we take in a breath, and go down when we exhale – much like a balloon.
The Cleveland Clinic, on its website, suggests a way of being more conscious diaphragmatic breathing. The idea is to strengthen the diaphragm (it’s a muscle remember). Lie on your back, knees bent, a pillow under the head and knees. Place one hand on the upper part of the chest and another just below the rib cage. Breathe in through your nose, and feel your stomach rise. Drop the muscles of your stomach inward, and feel the breath move out of the body. The chest shouldn’t rise or fall. Practice for 5-10 minutes, three or four times a day. In time, you can also do this sitting up.
Air pollution – both indoor and outdoor — is a genuine problem in our cities today, killing more than 7 million per year worldwide according to the World Health Organization. So we need to reduce exposure through wearing masks; enhance the body’s defence mechanism with hydration (dry airways are more susceptible to infections) and intake of antioxidants through fruit and veg; and exercise to keep the lungs fit, says Dr Salvi. Walking — or any kind of activity that raises the heart rate — helps improve lung power. There’s also a deep relationship between people and trees, so surrounding yourself with healthy trees also helps.
If you have a respiratory condition
Breathing techniques fall into inspiratory or those that focus on increasing lung volume, and expiratory, or those that focus on expiration to clear secretions, according to a review of 25 types of breathing techniques. Inspiratory exercises are useful in restrictive lung disorders such as obesity hyperventilation syndrome. Expiratory exercises are useful in obstructive lung disorders (COPD, asthma, bronchiolitis).
Subin Solomen, a scientific assistant in the Department of Physical Medicine and Rehabilitation, Government Medical College, Kottayam, who led the narrative review, says for those susceptible to COVID-19, inspiratory exercises, such as diaphragmatic and deep breathing (taking in air through the nose and blowing out of the mouth), as well as alternate nostril (anulom-vilom) are important. If you have asthma or COPD and are experiencing difficulty climbing up stairs, he suggests pursed lip breathing, where you purse your lips (imagine you’ve got a pencil in your mouth) and focus on breathing out.