Breathing is fundamentally important to feeling well – we simply can’t live without it. While breathing often comes naturally, there is usually room for improvement, particularly during moments of stress and crisis – such as a pandemic. Advanced Physiotherapy Practitioner Kate Bazin, who specialises in respiratory issues, shares the lessons we can take forward about breathing better.

The impact of COVID-19

As a specialist respiratory physiotherapist, I’ve worked with patients with all sorts of breathing issues, from those who are critically unwell in hospital, to those who find themselves breathless on a regular basis, even though they have no underlying heart or lung issues.

Suddenly, however, the pandemic has put breathing on the map – for all of us.

The COVID-19 virus itself has impacted many systems of the body. Broadly speaking, there have been three different groups of patients who have developed breathing issues related to the pandemic.

Firstly, there are those people who were hospitalised with COVID-19 for a relatively long period of time.

Once these patients recover from COVID-19, they tend to feel weaker and less fit than they were before, so we work to progressively regain their level of fitness over time.

Secondly, there are those who tested positive for COVID-19 but the symptoms they experienced were, fortunately, not threatening enough that they needed to visit hospital.

However, they might have been left with horrible symptoms linked to post-viral fatigue. They may feel breathless while getting dressed in the morning, or unable to take part in their usual form of exercise.

For these two groups, it is advisable to seek medical attention and continue to do so throughout the healing and rehabilitation journey. You can discover more on the support we provide at The London Clinic here.

But what about the third group? It might seem surprising, but we are seeing patients who have not had COVID-19 and yet are still experiencing breathing difficulties.

In this article, I will explore the signs and symptoms and offer guidance on what can be done to improve breathing.

Fight or flight

Fundamentally as humans, we don’t cope well in uncertain, anxiety-inducing conditions such as those we have all experienced during the pandemic. Instead, we depend on routine and structure.

As well as impacting our mental well-being, anxiety can cause disturbances to our breathing.

We’ve likely all felt the butterflies in our stomach, the tightening of our chest in certain stressful situations. This is called “fight or flight”; adrenaline-fueled panting, which is known as our sympathetic breathing system.

This is something to consider in relation to the pandemic, such as when we came out of lockdown. Many of us may have felt anxious at the thought of socialising in larger groups after extended periods of isolation.

While we can handle breathing in this fight or flight way for a short while – in fact it helps us manage stressful situations – it’s bad for us in the long term. If this type of breathing persists, people are left in a totally frazzled state. They become hyper aware and left in a vicious cycle of anxiety.

Retraining our breathing

Breathing pattern retraining can be incredibly helpful for those people who have been left with feelings of breathlessness during the pandemic.

If you’ve noticed changes to your breathing recently, you might want to consider practising these short tips on how to breathe well:

• Close your mouth and breathe through your nose, which helps to filter, warm and moisten the air
• Relax your tummy and try to become aware of your diaphragm, with is attached to the lower edges of the ribs. This strong, flat muscle moves upwards and downwards to draw and expel air from our lungs
• Think about your posture and allow your shoulders to drop down and relax
• If you find yourself struggling to catch your breath while speaking, slow down by consciously adding pauses in between your sentences

The goal of breathing pattern retraining is to help our muscles work more efficiently for less effort, and you are doing just that by using the diaphragm rather than other muscles in your chest or shoulders.

When breathlessness becomes something more serious

If you find that the problems you are experiencing are persisting, despite the above self-help tips, I’d highly recommend consulting a healthcare professional for advice.

Not breathing correctly due to something stressful in life – either physical or mental – can lead to many physiological symptoms over time, which can in turn lead to worse health conditions or a disorder if not addressed.

A breathing pattern disorder occurs when someone consistently uses less efficient muscles to breathe, such as their upper chest rather than the diaphragm, and mouth rather than their nose. People with a breathing pattern disorder could feel:

• Like they can’t take a satisfying breath
• That their breathing feels “stuck”
• Breathless after gentle exercise
• Muscle aches and tension around the neck, shoulders and jaw
• Chest pains or palpitations
• Numbness or pins and needles
• A bloated feeling in the stomach
• The inability to think clearly or concentrate

Prevention is key 

As mentioned, it’s helpful to think about how you can introduce “pauses” to your day-to-day life. Look for the moments of relaxation and reflection.

Although we all relax in different ways, that doesn’t mean going to the pub or looking at your phone! Instead, switch off and take a few moments in your day to focus on “good breathing” by using techniques such as meditation.

Breathing can be so simple, but it can also be complex to restore it if it goes off track.

Above all, being mindful of how we breathe during particularly stressful moments can be highly beneficial in the long term.

Further information

Kate is a member of The Physiotherapy for Breathing Pattern Disorders Group, which provides a variety of free online resources, videos and self-help guides for people who want to access and improve their breathing. 

If you would like to make an appointment with Kate, our breathing pattern disorder physiotherapist, please contact the physiotherapy department on 0207 616 7651, or email physio@thelondonclinic.co.uk.

Find out more about The London Clinic’s wide range of physiotherapy services.