Learn How to Breathe: Why Yoga Complements Physical Therapy

As a physical therapist and movement specialist, I treat from a holistic approach focusing beyond physical injury. This means that I consider other variables contributing to pain and healing potential including sleep patterns, nutrition, occupational hazards, and possible stressors. This recognition of the complexity of pain and injury led me to seek additional education by becoming a yoga teacher to serve as a way to teach the connection of the mind and the body. This connection is made stronger by having a strong practice in learning how to breathe.

“Pain doesn’t exist in your body, until it exists in your brain,” explained Lorimer Moseley who conducts research on pain and what affects our interpretation of it. Most often, my patients are in active physical pain by the time they see me. But pain can be hard to describe and is not always indicative of tissue injury. Enter yoga, a space which invites you to learn how to breathe and connect that mindfulness with your body, whether it’s still or in motion. I have learned that we are in control of tapping into a myriad of benefits that simple, conscious breathing techniques can offer us on the path to relieving our physical pain.


Yoga encompasses 8 limbs and 3rd on the list is “asana” which is Sanskrit for posture. This is the physical yoga practice and poses that we are familiar with. The 4th limb of Yoga is “pranayama,” which is Sanskrit for breath control. Technically if you are practicing conscious breathing, you are doing yoga. Yoga traditionally teaches breathing practices in a seated position to align your spine and your energy body from your seat through the top of your head. However, I find the easiest way to begin teaching a breathing practice, such as diaphragmatic breathing, is by lying on your back where gravity isn’t acting against your respiratory muscles. Lying in bed first thing in the morning is an accessible place to begin, or if on a flat surface with pillows or a bolster under the knees. Sitting in a comfortable chair with upright posture is the next optimal position.

Start by breathing in through your nose; think slow and low. By ‘low’ I mean breathing into your belly, allowing it to expand like a balloon to a count of 3 seconds. Slowly exhale through the nose to a count of 3 seconds. Perform 10 breaths, gradually increasing your count to 5-7 second rounds.

This type of diaphragmatic breathing has these effects on your body:

Filters Air – Specifically breathing through our nose is a natural filtration system. When air enters through our nasal passages it is warmed, circulated and moisturized to filter out particles and possible invaders.

Improves Immunity – Nitric oxide release increases approximately by 200% with nasal breathing, and occurs in the upper airways. This helps us receive oxygen into our blood efficiently and effectively compared to mouth breathing. Nitric oxide is also believed to help us defend against bacteria and threat of infections.

Improves Respiratory Function – Respiratory muscles such as the diaphragm, intercostals (muscles between ribs), and abdominal wall (external/internal obliques, transverse abdominis) are strengthened. Pulmonary function increases by circulating oxygenated blood through greater surface area within lung tissue and then onto our arterial system to the rest of the body.

Stress and Anxiety Reductionslow and low breathing promotes parasympathetic nervous system activation which helps us “rest and digest”. Patients with chronic pain are found to have higher sympathetic nervous system activation, “fight or flight,” making it difficult for their body to recover due to higher levels of cortisol (stress hormone) and inflammation. Frequently breathing through the mouth can actually stimulate this stress response and can produce anxiety.

With the relevance of mask wearing during the COVID-19 pandemic, we have all become acutely aware of our breath which perhaps is an unintended gift. This practice can help us improve our relationship with pain, increase our mindful presence defending against anxious thoughts, helps us tune into our bodies and elevate our respiratory health. This is an exercise I love to prescribe because everyone has the capability to do it, and you can do it anywhere when you think of it. Consider adding this to your wellness routine classified as your yoga practice and home exercise prescription!

You can learn more about this topic by visiting our Yoga PT page.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

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Dr. Krystal Sterling

Physical Therapist | Doctor of Physical Therapy
Krystal Sterling is a Doctor of Physical Therapy (DPT) specializing in orthopedic conditions with an integrative sports medicine approach. She works at Activcore in Atlanta, Georgia, located just 2 miles from Emory University.
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