Breathing for Pain Relief, Part 1
“The breath must be enticed or cajoled, like catching a horse in a field, not by chasing after it, but by standing still with an apple in one’s hand.” – B.K.S. Iyengar
Breath work is a foundation of the yoga practice. The Sanskrit word for breath work is pranayama, and it can be translated as working with our life energy. There are many different ways of working with the breath in yoga, and how a person chooses to work with the breath will depend on their intention.
Using breath to reduce pain
Generally, when we use breathing techniques to find relief from pain, we want to breathe in a way that helps to calm our nervous system. In other words, breathing practices that help us relax will help reduce our pain. Breath work is receiving a lot of attention as a tool to reduce pain, but unfortunately, there has been an over-emphasis on what the breath looks like and an under-emphasis on what the breath feels like.
Many pain patients are told that relaxed breathing can reduce their pain, and then, they are told to practice “abdominal breathing” – which describes a way of breathing where the abdomen appears to expand with the inhalation and soften with the exhalation. The problem with this advice is that many people have been breathing in their chest for decades, and trying to force their abdomen to move with the breath is not at all relaxing.
I have seen people trying so hard to make their abdomen move that they have visible muscular strain through their face and neck. I met a young woman who persisted in trying to make her abdomen move even though she felt like she was going to throw up every time she did.
Abdominal movement is a result of relaxation
Our lungs are in our chest, so what is happening when our abdomen moves in response to our breath? There is a large, umbrella-shaped sheet muscle – called the diaphragm – that attaches all around the lower edges of the rib cage. As our breath comes in, the volume in our chest increases, and the diaphragm contracts and presses down on the contents of the abdomen. If the abdomen is relaxed, the belly will appear to expand slightly (on its own) with the inhalation.
What if the abdomen is not relaxed? Dr. Jon Kabat-Zinn explains in his book Full Catastrophe Living:
Suppose the muscles that form the wall of your belly (the abdomen) are tight rather than relaxed when the diaphragm is contracting. As the diaphragm pushes down on the stomach and the liver and the other organs that are in your abdomen, it will meet resistance and will not be able to descend very far. Your breathing will tend to be shallow and rather high up in the chest.
The natural movement of the abdomen in response to our breath is the result of a relaxed belly. We can’t force our abdomen to relax any more than we can force the tension in our neck to release.
Entice your breath
As well-known yoga teacher B.K.S. Iyengar says, “The breath must be enticed.” We cannot take the physical form of a relaxed breath, impose it on a tense body, and then expect the body to relax. To arrive at a relaxed breath, we need to first take the tense body towards a more relaxed state. Breath work is a powerful tool to help a tense body become more relaxed, but the breath practices you want to use to calm the body will meet the breath where it is at and gently begin to free it – not immediately force it to be different.
In my experience, many pain patients (me included) tend to be active problem solvers. We want to figure out what we are supposed to do, get it done, and get out of pain – as soon as possible. While I genuinely appreciate this problem solving tendency in myself and others, I think it also plays a role in getting us stuck in pain. We can easily become much more focused on breathing the “right” way than we are on noticing how we feel from moment-to-moment and day-to-day in relationship to the way we are breathing.
The breath work that will reduce pain is soft and gently expansive. It feels easy, and it breeds a sense of calm, especially on the exhale. The practice of yoga isn’t about getting things right; it is about trying things and seeing how they make you feel. If you are interested in using the breath work to reduce pain, set aside 15-20 minutes, lay down somewhere comfortable, and explore using your breath in different ways. Notice how the different things you try make you feel. When you find ways of using your breath that make you feel more relaxed and reduce your pain, you have found your practice.
If you would like some ideas and guidance around exploring your breath, check out Part 2 of this post for some suggestions.