Breathing is something we rarely think about, yet we take around 22,000 breaths each day (Canadian Lung Association). Although, for the most part, this is automatic, how we breathe influences far more than just oxygen levels. It affects our movement, posture, pain and mental health. When breathing patterns change, they can lead to common breathing problems such as tension, fatigue or feeling short of breath. Additionally, these changes can result in significant breathing difficulties.
As Osteopaths we’re ultimately interested in empowering our patients. By using targeted breathing exercises, including diaphragmatic breathing, and working directly with the respiratory mechanics, we can help improve movement, reduce unnecessary tension, and support your body’s natural ability to regulate stress and pain. Many modern breathing techniques, often referred to as ‘breathwork’ or ‘breath yoga’, focus on slowing and consciously controlling the breath to improve breathing patterns and support nervous system regulation.
This blog aims to cut through the noise, outlining the basics of respiratory health and providing you with 3 simple breathing exercises to get started with.
Breathing problems in New Zealand
Respiratory conditions are common in New Zealand and continue to place a strain on healthcare. As the graphic below shows, respiratory disease affects approximately 1 million of the population and accounts for around 1 in 11 hospital stays nationwide (Teflar-Barnard and Zhang, 2024).
Addressing breathing difficulties is essential for improving overall health and well-being, and it is important to seek help if you experience persistent issues. We see patients weekly with simular complains and struggles at our North shore clinic in Auckland.
Respiratory disease in New Zealand
Importantly, breathing issues don’t only affect people with diagnosed lung conditions. Stress, persistent pain, and modern lifestyle factors can all change the way we breathe. Because of this, simple breathing exercises and breathing techniques can help improve breathing patterns and reduce everyday breathing problems, even without a formal respiratory diagnosis.
Breathing anatomy
The diaphragm plays a key role in breathing. Described as the ‘primary driver of respiration’ (González-Álvarez, 2015), it is a dome-shaped muscle that sits below the lungs.
As we breathe in, the diaphragm contracts and moves downward. This creates space in the chest, allowing air to flow into the lungs, while the abdomen gently expands. As you breathe out, the diaphragm relaxes and returns to its dome shape, helping air leave the lungs.
When the diaphragm is working well, breathing is quiet, efficient, and requires very little effort. Oxygen delivery is effective, and the muscles involved in breathing use minimal energy during relaxed, everyday breathing.
Alongside the diaphragm, we also have accessory breathing muscles in the neck and shoulders. These muscles are designed to help when we need extra air, such as during exercise or physical exertion. However, chronic stress, pain or habits can cause these muscles to take over most of the time and breathing can become fast, shallow and upper-chest dominated. Over time, this can contribute to ongoing breathing problems, muscular tension and fatigue.
Benefits of breathing exercises
Back pain and posture
The diaphragm works alongside our deep core muscles to help support the spine. Research suggests that breathing exercises exercises, particularly those that encourage diaphragmatic breathing, can help activate these deep muscles, reducing unnecessary strain on the spine, and improving postural control (Shi et al., 2023).
Shoulder pain
Early research suggests breathing exercises may help support recovery in some shoulder conditions, including frozen shoulder. Studies have shown diaphragmatic breathing may help reduce pain and improve shoulder movement (Lee, 2015; Elrahim et al., 2023). Breathing influences rib movement, muscle tension around the neck and shoulders, and the nervous system, all of which can affect shoulder function.
Calming the nervous system
Breathing has a direct influence on the nervous system. Faster, shallow breathing is
associated with the body’s stress response and higher cortisol levels. Slower breathing techniques, including box breathing, can help regulate breathing patterns and support relaxation and focus. Growing research also shows that controlled breathing techniques can increase parasympathetic activity (the body’s ‘rest and digest’ response), helping counterbalance the stress response and reduce feelings of anxiety (Bentley et al., 2023).
Cardiovascular health
Diaphragmatic breathing can help improve lung efficiency by slowing breathing rate and increasing the amount of air moved with each breath. This supports oxygen exchange, circulation, and can contribute to lower blood pressure and improved venous return. Regular breathing exercises may also help people experiencing mild breathing problems improve overall breathing control.
Digestion
Each breath gently changes pressure between the chest and abdomen. This natural rhythm helps support digestion and circulation within the abdominal organs. Relaxed diaphragmatic breathing can be particularly helpful for people who hold tension in their abdomen or tend to breathe shallowly.
3 simple breathing exercises exercises
With the renewed interest in breathwork and breath yogahing exercises, there is a huge amount of information online. The three exercises techniques below are simple and easy to start and require no equipment. , with no equipment needed.
Diaphragmatic (belly) breathing
Why?
Engage diaphragm, reduce overload on accessory muscles, reduce stress, improve sleep.
How?
- Lie on your back with knees bent (or sit comfortably)
- Place one hand on your chest and one on your stomach
- Breathe in slowly through your nose
- Aim for your stomach hand to rise more than your chest hand
- Breathe out slowly and fully
- Start with 1–2 minutes and build up gradually.
Box breathing
Why? Calm nervous system, lower cortisol, improve focus
How?
- Breathe in through your nose, counting to four slowly. Feel the air enter your lungs.
- Hold your breath for 4 seconds. Try to avoid inhaling or exhaling for 4 seconds.
- Slowly exhale through your mouth for 4 seconds.
- Wait for another 4 seconds before you breathe in again.
- Repeat for 1–3 minutes. You can shorten or lengthen the counts depending on comfort.
Pursed lips breathing
Why? Breathing efficiency, anxiety, sleep
How?
- Lie on your back or sit comfortably
- Inhale through your nose for 2 seconds, focusing on drawing the air down into your abdomen
- Purse your lips and breathe out slowly, for 4 seconds. You should take twice as long to breathe out as you breathe in.
- Over time, increase the inhale and exhale counts (for example, to 4 and 8 seconds)
- Repeat for 1-10 minutes
If you are experiencing ongoing breathing problems, persistent tension, or pain that seems to worsen with stress, breathing exercises and diaphragmatic breathing techniques may be a helpful starting point. Our experienced Osteopaths on the North Shore Auckland can assess how you breathe and guide you through breathing techniques tailored to your individual needs.
Useful resources
https://healthify.nz/health-a-z/b/breathing-pattern-disorders
https://healthify.nz/apps/b/breathing-apps
Courses
If you’re interested in exploring structured breathing practices further, introductory breathwork or breath yoga courses are offered by organisations such as the Art of Living Foundation: https://www.artofliving.org/nz-en/intro-talk
References
Bentley, T.G.K., D’Andrea-Penna, G., Rakic, M., Arce, N., LaFaille, M., Berman, R., Cooley, K. and Sprimont, P. (2023). Breathing practices for stress and anxiety reduction: Conceptual framework of implementation guidelines based on a systematic review of the published literature. Brain Sciences, [online] 13(12), p.1612. doi:https://doi.org/10.3390/brainsci13121612.
Canadian Lung Association (2014). Breathing. [online] the lung association. Available at: https://www.lung.ca/lung-health/lung-info/breathing.
Elrahim, R.M.A., Salama, A.M., El-Hamid, E.A.A., Mouhamed, H.A., Zedan, A.M.E. and el-Khalek, W.O.A.A. (2023). Immediate Effects of Diaphragmatic Breathing Exercise on Shoulder Pain and Range of Motion in Patients with Adhesive Capsulitis. HIV Nursing, [online] 23(3), pp.401–406. Available at:
https://www.hivnursing.net/index.php/hiv/article/view/1734#:~:text=Diaphragmatic%2 0breathing%20exercises%20had%20an.
Lee, B.-K. (2015). Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: Single case study. Journal of Exercise Rehabilitation, [online] 11(5), pp.276–281. doi: https://doi.org/10.12965/jer.150229.
González-Álvarez, F.J., Valenza, M.C., Cabrera-Martos, I., Torres-Sánchez, I. and Valenza-Demet, G. (2015). Effects of a diaphragm stretching technique on pulmonary function in healthy participants: A randomized-controlled trial. International Journal of Osteopathic Medicine, 18(1), pp.5–12. doi:https://doi.org/10.1016/j.ijosm.2014.08.001.
Shi, J., Liu, Z., Jin, F., Wang, X. and Lv, L. (2023). Effects of Breathing Exercises on Low Back Pain in clinical: A Systematic Review and Meta-Analysis. Complementary Therapies in Medicine, [online] 79, p.102993. doi:https://doi.org/10.1016/j.ctim.2023.102993.
Telfar-Barnard, L. and Zhang, J. (2024). The impact of respiratory disease in New Zealand: 2023 update Prepared for Asthma and Respiratory Foundation NZ. [online] Available at: https://www.asthmafoundation.org.nz/assets/documents/Respiratory-Impact-Report-2023.pdf.
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