Breath workshops, courses, and retreats can be awesome. Learning to breathe properly again can be an amazing experience. It can make us feel healthier, happier, and more energetically vibrant. Yet, not all of us achieve such outcomes. Some of us will feel ‘injured’, ‘hurt’, or otherwise more dysfunctional than before we participated. Rare?

It’s more common than you think, and here’s why…

Breathing is simple, right? If you are reading this you must be doing it. Chances are that you were not really aware of that either, until you read this sentence. Yes, you are breathing, right now. But what does breathing actually consist of and, more to the point, are there ‘wrong’ and ‘right’ ways to breathe?

The answer to that last question is yes, there absolutely are. But it’s not so much about right or wrong ways as it is about efficiency and effectiveness. When we breathe properly we breathe efficiently and effectively. When we’re not, we are using too much of our energies for too little gain. Almost literally, we run out of steam while, all the same, our fires are burning at full throttle and our water tanks are filled to their brim.

Of course, the very point of breathing workshops is to help us correct this. Yet, while I don’t doubt that the facilitators of such workshops have the very best of intentions to share their knowledge and wisdom constructively with you, relearning how to breathe properly is seldom something that can be achieved in a three-hour workshop. It takes longer, and sometimes much longer.

Why? Because breathing isn’t so much about learning how to do it properly. It is just as much about unlearning how not to do it. This requires more than cognitive focus, mediation, or mindfulness. It also requires a body that is receptive to the movements it needs to make to facilitate that ongoing process of proper breathing. If it isn’t, breath work may certainly improve your breathing – but it may never become as optimal as you would like it to be.

To understand what this means, let’s delve deeper into our anatomy.

The anatomy of breathing

Breathing is the movement of air into and out of the lungs, which is made possible by changes in three pressures, atmospheric, alveolar, and intra-pleural.

Here they come –

Atmospheric Pressure

First, there is atmospheric pressure. This basically is the pressure exerted by the weight of air above us. Breathing is easiest of us at sea level because the column of air above us is taller than at higher levels, therefore heavier. That column is less tall on top of Mount Everest, for example, which is why it is much harder for us to breathe there. The air pressure at sea level is considered ‘normal’. It reduces when we move higher up into the atmosphere.

Alveolar Pressure

The second is called alveolar pressure. Alveoli are tiny, balloon-shaped air sacs located at the end of the bronchioles, the branch-like tubes in our lungs. The alveoli move oxygen and carbon dioxide (CO2) molecules into and out of your bloodstream.

Intrapleural Pressure

The third pressure is that within the pleural cavity, called intrapleural pressure. The pleural cavity is a fluid-filled space that surrounds the lungs and is found in the thorax, the region of the body located between the neck and the abdomen. This is where we find our heart and lungs.

The pleural cavity is bounded by a double-layered membrane called pleura that is filled with a small amount of fluid, which allows the lungs to move freely during breathing. It separates our lungs from their surrounding structures such as the thoracic cage (rib cage), intercostal spaces (the spaces between your ribs), and the diaphragm (the dome-shaped skeletal muscle that separates the thoracic and abdominal cavities from each other). This cavity has its own pressure.

To sum this up quickly, our ability to breathe is determined by pressures in three spaces – the atmosphere, our alveoli, and our pleural cavity. If none of these spaces would be pressurized, we wouldn’t be able to breathe. In fact, we couldn’t breathe if any of these spaces become unpressurised.

The act of breathing

Now that we’ve introduced the importance of pressure let’s take a look at what we do with it. How does breathing actually work?

Your lungs and chest movement

Before we move on to showing how breathing actually works let’s deal with a common misconception first. Your lungs aren’t actually responsible for making your chest move during breathing. Some people believe they do – but they don’t. They are not involved in creating the movement that helps inspiration (inhale) and expiration (exhale). By themselves, your lungs are more or less just flaccid sacks. Those movements are mostly created by two other players – your diaphragm and your external intercostal muscles. Mostly because breathing is to some degree a whole-body process, especially when we breathe deeper than usual.

We will come back to that in a minute.

Enter Pressure Gradient…

Breathing is made possible by variations in the three pressures we discussed above. Like any other gas, air flows down a so-called pressure gradient. It flows from an area of higher pressure to an area of lower pressure.

Atmospheric pressure is greater than alveolar pressure, and alveolar pressure is greater than intrapleural pressure. Air flows out of the lungs during exhale based on the same principle; pressure within the lungs becomes greater than the atmospheric pressure. This creates a two-phase process; that of inspiration (inhale) and expiration (exhale). Air enters our lungs during inspiration. Air leaves the lungs during expiration.

A respiratory cycle is one sequence of inspiration and expiration.

Inhale, exhale…

Let’s look at what actually happens when you breathe in. When the diaphragm contracts it moves down into your abdomen. This creates a larger thoracic cavity and more space for the lungs. When your intercostal muscles move your ribs upward and outward at the same time, your ribcage expands, which increases the volume of your thoracic cavity even further. Because pleural fluid has adhesive qualities this expansion forces the lungs to stretch and expand as well.

As their volume increase, the pressure in the alveoli decreases, creating a pressure lower than atmospheric pressure. As a result, a pressure gradient is created that drives air into the lungs. At that point, inspiration occurs.

Or, in other words, we inhale.

The process of normal expiration, or exhale, is passive. No energy is required to push air out of the lungs. The elasticity of the lung tissues and the relaxation of the diaphragm and intercostal muscles do all the work. When this happens the thoracic cavity and lungs decrease in volume. This increases the interpulmonary pressure, which then rises above the atmospheric pressure. What happens then? You guessed it. This creates a pressure gradient that causes air to leave the lungs.

We exhale.

Different types of breathing

There are different types, or modes, of breathing that require a different process to allow for inspiration and expiration – quiet, deep, and forced breathing.

Here we go –

Quiet breathing

Quiet breathing, also known as eupnea, is a mode of breathing that occurs at rest. This type of breathing doesn’t require our awareness. We don’t have to think about our breathing to breathe this way. During quiet breathing the contracting work all gently done by our diaphragm and external intercostals.

Deep breathing

Then there is deep breathing, which is also known as diaphragmatic breathing. This type of breathing requires our diaphragm to contract. As it relaxes, air leaves the lungs passively. Conversely, when we breathe shallow – also known as costal breathing – the contracting work is done by our intercostal muscles. Similarly, air leaves our lungs when these relax.

Forced breathing

The third type of breathing we will be discussing here is forced breathing, also known as hyperpnea.

Forced breathing usually occurs when we exercise or take actions that require the active manipulation of breathing. This is what singers and players of wind instruments do, for example. During forced breathing we engage muscles actively to inhale and exhale, and not just those that are associated with the diaphragm and our intercostal muscles. Other muscles must also contract.

To increase our lung volume the muscles of our neck must contract to lift the thoracic wall. Muscles of the abdomen must also contract to force the organs that are located there upward against the diaphragm, which pushes the diaphragm even further into the thorax to clear more air out of our lungs. Other muscles, and specifically our internal intercostals must also help to compress the rib cage to further reduce the volume of the thoracic cavity.

Respiratory rate?

Most of us will be breathing without giving it a second through. We just don’t pay attention to it. We do know that we can consciously control it, such as when we swim under water, sing a song on the top of our voice, or inflate a party balloon or inflatable mattress with our lungs. But if I asked you how many breaths you are taking now per minute you probably wouldn’t know. That, then, is one objective of breathwork – to make you more aware of what you are doing when you breathe. Which is, of course, what you’re doing all the time.

As baby, your respiratory rate would probably have been higher than it is now. Even in healthy people it is known to decrease further as we age. Children younger than one year of age have a respiratory rate of between 30 and 60 breaths per minute. By the time is ten that rate can have dropped to anywhere between 18 to 30. Most healthy adults will take 12 to 18 breaths per minute.

Dealing with anatomical dead space

Another common objective of breathwork focuses on reducing something that’s called anatomical dead space. Your respiratory system contains spaces where air is present that never reach the alveoli and therefore never participates in gas exchange.

Alveoli that are affected by disease or abnormal blood flow are unable to function properly and do therefore not contribute to our respiration. While no amount of breathwork can reinstate diseased alveoli it can help optimise the function of those that simply aren’t pulling their weight as they should.

Essentially, breathwork aims to reduce the total dead space, which is the anatomical dead space and alveolar dead space together. By doing so we learn to use more of the air that cycles in our respiratory system so that more air participates in exchange process.

When breathwork doesn’t work

Breathwork advocates may not be telling us that our breathing is right or wrong. What they do seem to suggest is that there are better ways of breathing available to us. By optimising the gas exchange processes that happen within our lungs constantly we can feel happier, healthier, and more of our self. Unquestionably, this has merit. Yet, whether their breath teaching methods and techniques are all that beneficial to us remains to be seen. The crux of this matter lies in our body’s ability to physically adjust to these new ways of breathing. Time is one critical factor here.

Let’s look into that.

Thoracic wall compliance

As the bony framework for our breathing, the dome-shaped thoracic cage encloses most of the structures of our respiratory system. Its rigidity protects our organ protection, supports our upper limbs, and anchors muscles. Although it is resistant it must also be dynamic to allow for the necessary breathing movements to take place. Its potential for such movement is determined by the flexibility of the sternum, 12 pairs of ribs and 12 thoracic vertebrae, all connected with costal cartilages and intervertebral discs, respectively.

Thoracic wall compliance is a term that describes the ability of those elements to stretch while under pressure, which is what happens when we breathe. Inhale can only happen when the thoracic cavity expands and then recoils so that the process can be repeated. If the tissues of the thoracic wall are not compliant, it will be difficult for us to expand the thorax to increase the size of the lungs. What’s known to happen most commonly is that the thorax – your rib cage – will make only one movement, up and down, instead of three, together with sideways and forward expansion. Effectively, your thorax shows a vat-like behaviour where the entire thing moves only up and down because the walls have become too tight, fixed, and contracted to also move horizontally. What causes the fixation? Well, among other things, tight and fixated muscles and connective tissues for one, most notably the intercostal muscles.

Telling someone with tight intercostal muscles to do a deep breathing exercise (remember what we discussed above?) may actually do harm than good. After what may have been years of sub-optimal activity, we now ask them to suddenly stretch and flex at short notice. All of them. When they don’t – and chances are they won’t – we start to overexert our diaphragm as it now needs to compensate the inflexibility of all else. Yet, this is exactly what seems to happen at so many breathing retreats and workshops where an instructor with years of breath training now expects untrained participants to use their body as they do.

Problem is that it all can feel pretty awesome at first. Some of us like the rush hyperventilating can give – the light-headedness, the dizziness, and the rushes of biochemicals that come with it all. However, irrespective the short-term elation that can be experienced shortly after, all this doesn’t make this type of breathwork beneficial to the practitioner.

Frequently, this also leads to a delayed challenge for those who struggle to keep up with these deep breath exercises, which is similar to what happens when we ‘overdo’ it in the gym. The now overworked and overstretched breathing muscles will seek to repair themselves over the hours and sometimes days that follow the exercise. That can manifest as an even tighter chest, which can cause panic in those who experience it.

Bodywork to prepare for breathwork

Let’s just reset for a moment. It is more than likely that most of us who do not suffer from respiratory diseases or other clinical breath-impairing conditions may not be breathing as efficient and effective as we could. Breathwork can certainly help us with that but only if it is taught by an experienced instructor who possesses a solid and ideally certified understanding of our human anatomy. What can certainly help you prepare for any type of breathwork is bodywork.

For more than three years we have offered Thoracic Release sessions to hundreds of clients, including athletes, performing artists, and musicians. Many of these clients book these sessions regularly to optimise their breathing, specifically before their performances. We have worked in exactly the same way with clients who suffer from anxiety, depression, and chronic backpains.

More recently we also begun to work with active breathwork practitioners, with – may we say – extraordinary results. By gently and stepwise releasing the muscle and connective tissue structures that are primarily involved in our breathing our clients were able to gain much better benefits from their breath courses and workshops. Already after three treatments their respiratory rate declined to healthier cycles. The amplitude of their thoracic cage – which is the volumetric difference between a fully inhaled and exhaled chest measured by its circumference – increased noticeably. As added bonuses, chronic neck, shoulder, and low back pains were alleviated, or vanished altogether. Postures improved, and sometimes dramatically so. Usually, their participation in breath retreats and workshops became much more enjoyable.

Instead of spending time to retrain their body, these clients could focus more on mastering the breathing techniques they were taught. Isn’t that exactly the point of going?

Breathwork – final words

Just to make clear – I absolutely believe that breathwork has merits. I also believe that it should be coached, taught, and guided by experienced and informed instructors. What I am seeing and hearing from too many of my festival-going clients is that perhaps too few facilitators fall in that category.

As with any type of pedagogy and coaching, breathwork instructors must have a comprehensive understanding of the theories they teach. I would assume that this includes a well-developed understanding of our human anatomy in context of our breathing. Instructors who just teach from own experience or just convert theories into practices are likely to miss the mark here.

I am seeing too many clients who report with thoracic and diaphragm pains and discomforts after attending breath workshops at retreats and festivals. On examination and further treatment it becomes clear that muscles and connective tissues in their backs, shoulders, and necks are excessively tight. Of course, many other causes can contribute to those dysfunctions and it’s reasonable to assume that other factors may also have been at play. However, breathwork usually emerges as the primary common denominator.

What may also be noteworthy is that shame plays a role here. Participants who experience physical pains and discomforts during breath workshops may not always want to report them for fear of shame. Breathing should be simple, right? It is too often assumed that those pains and discomforts will just be temporary – something to endure until they go away. What I see in my practice is that this isn’t always the case. Pains and discomforts can last for weeks, sometimes even months.

Even when you consider yourself fit, healthy, and supple I still recommend you see a qualified and experienced bodyworker before you try or commit to breathwork. Especially if you are new to it, they can help you prepare physically and mentally for this type of work so that you will gain the most from the techniques and methods you are taught by breathwork instructors.

The Thoracic Release sessions we offer are comfortable and very relaxing. Initial sessions are 60 minutes long and can be provided as one-offs or as a programme. They often lead immediately to improvements, and it’s not uncommon for these improvements to ‘hold’ after two or three sessions.

A professional bodyworker can eventually work with you as a coach to help you elevate your breath practices to a fine art and ongoing discipline.

I assume that this is what you will be aiming for?