Johns Hopkins All Children's Hospital 

Diaphragmatic Breathing

Practicing deep breathing can help when feeling tense or in pain.

Deep breathing, or breathing with your diaphragm, can help you to relax and manage stress when you are experiencing pain or tension.

What is the diaphragm?

Your diaphragm is a muscle located across the bottom of your lungs and above your stomach. This muscle flattens when you inhale and relaxes when you exhale to pull air in and out of your lungs. 

If you are unsure where it is, put three fingers right above your belly button and sniff! You should feel your diaphragm move when you sniff. If not, sniff harder.

We are all born using our diaphragm to take deep breaths, but as we age, we often get in the habit of using our chest for breathing and shift to shallower breaths.

Why is the diaphragm important?

Diaphragmatic breathing (or deep breathing) allows the body to trade more incoming oxygen for outgoing carbon dioxide. This causes the heartrate to slow and can lower or stabilize blood pressure. Using your diaphragm also activates your vagus nerve, which is the nerve in your body that triggers your body’s relaxation response (or parasympathetic nervous system) and lowers the body’s stress response (or sympathetic nervous system). 

Diaphragmatic breathing can help in managing symptoms of chronic pain, irritable bowel syndrome, depression, anxiety and sleep disorders.

Diaphragmatic breathing assists in:

  • Lowering blood pressure 
  • Lowering heart rate
  • Decreasing levels of cortisol (stress hormone) in body
  • Improving core muscle stability
  • Decreasing chances of injuring muscles
  • Improving ability to tolerate exercise

How to learn diaphragmatic breathing

  • Find a comfortable place and lay on your back.
  • Place a hand on your stomach, above your belly button. Place your other hand on your chest.
  • Breathe in slowly through your nose and imagine filling a balloon in your stomach. You will feel your hand moving as your stomach gets bigger and pushes out. The hand on your chest should stay still.
  • Breathe out slowly through your mouth and imagine the balloon shrinking as your stomach becomes flat.
  • As you breathe in you can imagine sniffing a flower or your favorite food. Breathe in as smoothly and gently as possible.
  • As you breathe out, purse your lips and image you are gently blowing out 100 birthday candles or slowly blowing bubbles with a bubble wand (using an actual bubble wand can be helpful). 

Practice, practice, practice!

Some people have difficulty with diaphragmatic or deep breathing because they typically use their chest to breathe. 

Breathing with your diaphragm may be difficult at first. Because the diaphragm is a muscle, practicing using your diaphragm to breathe helps to strengthen this muscle and your ability to pull oxygen in and out of your body. 

If you are having problems feeling your stomach move, try these tips:

  • Stand up.
  • Put your hands behind your head and lock your fingers together. This position locks your chest and forces breathing from your diaphragm.
  • Try breathing normally and watching your stomach move.
  • Remember to breathe in through your nose and blow out of your mouth. Many people find pursing their lips (similar mouth shape to whistling) to be helpful.
  • Practice deep breathing at times when you’re not in pain, stressed or feeling less pain.

Remember, relaxation strategies are like any other skill you learn (riding a bike, applying make-up, playing an instrument, learning a new game) — you get better and better with regular practice! 

Sometimes when practicing diaphragmatic breathing, we feel more pain because we have taken away our distractions. This is normal but will not last long because you can distract your attention again by focusing on breathing. Allow your focus on breathing to help you manage or get through pain, rather than becoming stressed or anxious if breathing does not immediately end your pain. 

When to use diaphragmatic breathing

Diaphragmatic breathing can help you deal with pain flares, manage discomfort at school or in public, or reduce stress that may come from schoolwork or other situations. As diaphragmatic breathing calms and relaxes the body, many people are able to think more clearly about how to manage their situation. While relaxing the body can be helpful when in pain or distress, it is most effective if we use it before our bodies respond to stressors. 

Picking a consistent time to practice diaphragmatic breathing each day can help you remember to practice or relax the body before stressful situations. Some experts recommend 10-30 minutes of slow diaphragmatic breathing each day, though multiple short practices can also be beneficial.

Mini-relaxation practices can be done anytime during the day. Whether you are in your bed, waiting to eat, opening a workbook, or using the bathroom, take a moment to take two to three diaphragmatic breaths. Even frequent short practices can make a difference!


Contact Us

 

We offer a number of non-medicine pain therapies that can be used as part of our patients’ treatment plans.

For more information about the Pain Management program, please call 727-767-7246.