Breathing for Pain Relief, Part 2

“Learn how to exhale, the inhale will take care of itself.” – Carla Melucci Ardito

In Breathing for Pain Relief, Part 1, I shared my opinion that there has been an over-emphasis on what the breath looks like and an under-emphasis on what the breath feels like in the prescription of breath work as a tool to reduce pain. This post offers guidelines for working with the breath in a more experiential way.

Meet your breath

Before you explore shifting your breath, learn more about your breath. Understand where you are starting from. Many people have developed chest breathing patterns (hence, the emphasis on abdominal breathing in treating pain, stress, and illness), but after years of chronic pain in my upper torso, I had the opposite. It took me years of practicing breath work to find an easy breath in my chest. Try to let go of preconceived ideas about how you should or shouldn’t breathe. If I had considered abdominal movement to be the gold star of breathing, I would have unwittingly continued to breathe in a very restricted way.

When you begin to meet and observe your breath, here are some things you might pay attention to:

Where is the movement in your torso when you inhale and when you exhale? Is it consistent from breath to breath?
How long is your inhalation and how long is your exhalation? Are they equal, or is one longer than the other? Is the length of your breath consistent from breath to breath?
What words would you use to describe your breath? Some sample words are short, long, shallow, deep, free, or constricted, but the words don’t need to make sense. There may be a colour or an emotion that describes your breath.

Notice your breath in different contexts. How do you breathe laying down versus standing up? How do you tend to breathe when you are in a lot of pain versus when you are feeling better? How do you breathe when you are with other people or when you are watching TV?

The more you understand about how your breath is naturally responding to things, the more empowered you will be to intentionally use your breath to influence how you respond to things.

Dance with your breath

Picture two eloquent ballroom dancers circling around the dance floor. One partner is leading, but to the untrained eye, it is virtually impossible to see anything but unison. I want you to cultivate the quality of this dancing when you work with your breath. You are leading your breath, but there is no force, there is no strain. You can feel your breath willingly follow your lead.

Here are some ways you may explore leading your breath:

Bring the length of the inhalation and the exhalation into balance. Find a length that feels accessible and sustainable, and maintain this balance for ten or more breaths.
Breathe with a longer exhalation. Again, find a sustainable count, and maintain the extended exhalation pattern for ten or more breaths.
Visualize different areas of your torso moving in response to your breath. Don’t worry about whether or not they actually move – just stick with the visualization of a particular area for ten or more breaths.

After you lead your breath in a particular way, pause and notice the effect. If you are wanting to use breath work to reduce pain, pay particular attention to how relaxed you feel. When you find ways of breathing that help you feel more relaxed, actively start to weave those breath practices into your day. Less is often more, but in the face of persistent chronic pain, when it comes to breathing in ways that calm your nervous system and help you feel more relaxed, more is most often more.

Happy Breathing.

Namaste,
Sarah

Breathing for Pain Relief, Part 1

by Sarah Pain Relief Pranayama

“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.

Namaste,
Sarah

5 Ways to Sleep Better

by Sarah Awareness Living Yoga Restorative Yoga

When I hear stories of friends having trouble sleeping, I often think to myself, “Wow. I am so lucky that I sleep so well.” But, the truth is that there is a lot more to it than luck. There are reasons why I sleep well, and there are changes you can make to sleep better too.

1. Value sleep

Sleep deprivation is linked to depression, anxiety, cardiovascular problems, weight gain, an inability to concentrate, moodiness, poor immune system function, and car accidents. Getting enough sleep is one of the most important things you can do for your health, and one of the easiest ways to sleep more and sleep better is to make sleeping a priority in your life.

2. Learn to relax

When a human body is under stress, hormones are released into the body that cue the body to prepare for action. This release of hormones is commonly known as the stress response. When you are lying in bed wanting to sleep and, at the same time, have stress hormones communicating to your body that it needs to be alert, your system gets confused.

So, when I say “Learn to relax,” I don’t mean sit on the couch and watch TV. I mean learn to attend to the physiological changes in the body that occur with relaxation, such as a slower heart rate and breathing rate, lower blood pressure, and a decrease in muscle tension. As you improve your ability to intentionally relax, falling asleep will become much easier.

If you’re not sure how to begin learning how to relax, try practicing Restorative Yoga. It is one of the best ways to begin retraining your body to relax.

3. Create a sleeping environment that supports sleep

If you live in the city, it can be harder to control all aspects of your sleep environment, but do your best to create a dark and quiet sleeping space.

Why dark? – Even when your eyes are closed, your body can sense the light from down the hall or the street lights outside your window. This light can cue your body to be alert, which makes it hard to sleep. Some ways to address the light include:

• Wear an eye mask

• Turn off ALL the lights in your home

• Make sure your blinds can be completely shut

• Use dark curtains

Why quiet? – Just like light, noise cues your body to attend to what is happening in your surroundings. Possible ways to address noise include:

• Wear ear plugs

• Keep a fan on as soft white noise

• Shut the door and the windows

4. Set a Sleep Intention

When I am going to bed, I look at the clock and set a sleep intention. For example, I might say to myself: “It is now 10:30pm and the alarm is set for 6:30am, so I am going to sleep for the next 8 hours and I am going to wake up at 6:30am.”

This informs my subconscious that I am not interested in staying up for a couple hours to think about the day and that there is no point in walking me up at 3am to remind me of something I forgot to do because I am not going to get up and do it. I am committed to sleeping 6:30am.

5. Stay present and let your body rest

We’ve all experienced the frustration of a restless night. You have already been trying to sleep for 45 minutes, so you start to get restless and you start watching the clock more intently. 60 minutes pass, then 90 minutes, and then your focus shifts to how little sleep you are going to get if you don’t fall asleep as soon as possible. At the most, 6 hours, 5 hours, 4 hours…

The irony here is that the more we get stressed about not sleeping, the less likely we are to fall sleep because our stressful experience of not sleeping is flooding our body with hormones that cue us to be alert. It is a vicious cycle!

The trick to sleeping is avoiding the fixation on sleeping. Commit to a meditative practice of bringing your awareness back to your body, to your breath and to an appreciation of rest and relaxation. Set yourself up in a comfortable position. Make sure you are warm enough. Gently deepen your breath and consciously guide your muscles to relax. When your mind starts to focus on a lack of sleep, remind yourself that time spent actively relaxing is much better for you than time spent being restless and agitated.

Simply, soften into the present moment – whether it holds rest or sleep – and trust that both deeply support the healing and restorative needs of your body.

Namaste,
Sarah Jamieson