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This L.A. Doctor Wants to Re-Teach You How to Breathe

I played organized football from ages 8 to 18, and on every team, there was at least one meathead coach who refused to let us rest with our hands on our knees. We’d run wind sprints to the point of nausea, and I’d collapse at the waist. Then some coach would bark at me to stop doing that.

“Stand up,” he’d say.

“It’s easier for lungs to get air that way,” he’d say.

Well, it turns out he/they were all full of shit. (What a shock, I know.)

Standing up does not help you catch your breath faster. In fact, bending over the waist is a better way to replenish your oxygen stores when you’re winded.

The “don’t-bend-over-when-you’re-tired” advice is just one of the many poor habits humans have adopted when it comes to breathing, according to Dr. Ryan Greene, a 30-year-old osteopathic physician and co-founder of Monarch Athletic Club, a L.A. health center that combines exercise, nutrition and medical consulting. Dr. Greene also works as a brand ambassador for activewear brand Lululemon, for whom he recently conducted a seminar on the importance of proper breathing.

Of course, breathing would seem like the last thing you’d ever need to work on. It’s something we do automatically, thousands of times a day, with nary a thought. But the average human being has, for reasons that aren’t entirely clear, adopted breathing habits that are detrimental to their health and prevented them from achieving their potential. So much so that Greene believes the world is suffering from something of a breathing epidemic.

To ensure that I was at least doing my part to inhale and exhale correctly, I caught up with Greene earlier in the week to discuss why he thinks better breathing is a more sensible treatment for anxiety than Xanax, how the best kind of breathing involves a Buddha belly and what you can do to improve the way you suck in air.

How’d you get interested in studying breathing, of all things?
My focus is in integrated medicine, which is preventive medicine, with focus on exercise, nutrition, recovery and metabolic optimization (such as hormone therapy). Essentially, it’s everything you can do to prevent the onset of disease and optimize how your body functions.

One component of that is understanding the value of alternative medicine. Medicine is often divided between Western medicine — evidence-based scientific research — and Eastern medicine, which doesn’t have the research basis, but goes back further than our traditional Western medical framework.

One thing that has crossed over from Eastern to Western medicine, though, is the idea of mind-body medicine, how our psychological state affects our physical state. There’s more and more research coming every day validating this connection. And breathing (or breathwork, in medical parlance) is a major part of that mind-body interaction.

What do you mean by breathwork?
Anything that involves controlled breathing exercises. Meditation that involves breathwork is, without question, a medically validated way to treat issues that are associated with chronic stress, for example.

How does this process work?
You and I live in a world where we’re constantly activated. We’re constantly on high alert, so we can complete the activities of our day — whether it’s work, exercise, going out or just interacting with other people. That’s when your sympathetic nervous system, which controls “fight or flight” responses, is activated. And in a perfect world, our sympathetic nervous system would be in perfect balance with our parasympathetic system, which controls rest and digestion.

But it’s often not. And when you’re sympathetic nervous system is overactivated, it can have serious deleterious effects on your health. One of the easiest things you can do to bring down your level of alertness and achieve an appropriate balance is activating the vagus nerve. That stimulates your parasympathetic nervous system. And one of the easiest ways to start that process is with breathwork.

Breathing can be equally effective, if not more so, than a Xanax for anxiety.

You’re saying that this can be used in lieu of medication? That seems like it would have profound public health benefits, especially given the current opioid crisis.
Absolutely. For people with chronic pain, for instance, activating their sympathetic nervous system can make them hypersensitive to pain, whether it’s a new injury or something that occurred years ago. One thing that can dampen that response and allow your brain to say, “Hey, this isn’t as serious as we’ve initially anticipated,” is proper breathwork. That will calm them down and ease the pain. That’s why breathwork is popular among physical therapists.

At the risk of oversimplifying the medical science here, it seems like this is all a “mind over matter” practice.
One hundred percent.

So are the benefits of proper breathing more psychological or physical?
I’d say it’s both. If you can get to the point where your reflex isn’t to reach for a chemical, and instead implement breathwork, which is a natural treatment, you’ll likely find yourself feeling happier and healthier — physically and mentally. And without having to deal with addiction, or any other side effects of taking medication.

How do I know if I’m breathing correctly?
The appropriate way to breathe is from your diaphragm, which is located at the bottom of your ribcage. If you’re breathing from your diaphragm, your stomach will expand and distend, and you’ll have a little Buddha belly situation going on. When you breathe from your diaphragm, it pushes down on your internal organs — liver, kidneys, etc. — and that activates your vagus nerve, allowing you to relax.

If you watch a child or baby breathe, they do this naturally. But for some reason, we get to a point in our development when we start heaving our chests and lifting up our shoulders when we breathe, which is wrong. You’re flexing all your neck and shoulder muscles — your traps, your rhomboids, your scalene. When you do that, it pulls on the fascia on your scalp and constricts blood flow to the brain. You’re not getting the most oxygenated blood possible up to your brain, and that triggers your fight or flight response.

Wait, we forget how to breathe properly? How can that be?
There aren’t many working theories as to why our breathing changes over our lifetimes. It could be a behavior we learn in athletics, though. When I played soccer, we were told not to bend over when we were tired.

I heard that same thing playing football!
After a hard workout, what do you want to do? You want to lie down. And when you do, your belly is the body part that’s moving the most — it’s hard to lift your chest up when you’re lying on the ground. If you bend over, you’ll notice your chest isn’t heaving as much when you breathe. It’s more your belly that’s moving in and out.

We have these behaviors built in to our physiology that allow us to breathe appropriately in the times of greatest need. But socially, we think they’re incorrect.

What’s the best way to get my wind back when I’m exercising?
Instead of taking a bunch of quick, shallow breaths and heaving with your chest, concentrate, and take long, slow, deep breaths from your diaphragm. That’s where you have the greatest lung volume, not in your chest and shoulders.

That seems like it requires so much discipline.
It does require training. But the good news is humans are the only species on Earth that can manually control their breathing. So we can correct these bad habits. And remember to focus on exhaling, too. Inhaling and exhaling are both active processes.

Why is exhaling important?
It’ll make your breathing more efficient. You want to force air out of your lungs, so that new, oxygenated air can come into your lungs, and into the areas where the physiological process of breathing occurs.

What about if I’m not an athlete or the workout type? What are the benefits of proper breathing for ordinary people?
Proper breathing can have an enormous effect on on people’s personal and professional lives, as well. Breathwork can calm you down when you’re stressed and help you focus before a big presentation, for example.

How should I implement this in my everyday life?
When you’re not exercising, practice taking slow, deep, belly breaths. Two, recognize that inhalation and exhalation are both active processes. When you exhale, you actually want to squeeze your abs to help you push all that used air out of your lungs.

How can I make this a habit?
Do it everyday for at least eight to 12 weeks.

How many people breathe incorrectly? How pervasive is this problem?
I would say more than 95 percent of the population doesn’t breathe correctly. The hard part is that we live in a culture that says, “We need to fix this immediately.” And that quick fix usually a chemical. But now that people are more aware that for every medication you take, there’s an unwanted side effect, people are coming around to treatments that don’t involve swallowing a pill.