The Key to Increasing Quality of Life Through Respiration Part 1: Posture and Diaphragmatic Breathing

Jun 5, 2018 | Article

This past weekend I had the opportunity to present at the Cystic Fibrosis Family Con on posture and its implications on respiration. I had a great time talking with some very passionate people in the CF community. One thing we tend not to realize is how much breathing we actually do a day. Our respiration is an involuntary response that is developed and morphed by many different variables and then put away into our unconscious and subconscious patterns to allow us to move, and survive through our daily routine. Our respiration thrives on the ability to take in oxygen and expel carbon dioxide along with other waste at a frequency and duration fits our human system. Over the course of a day this can accumulate anywhere from 16,000 to 24,000 breaths a day.


If we conscious think about all the breaths we take, we wouldn’t have any time to think about anything else. Adults (18 +) average anywhere from 12 to 16 breaths per minute and infants to 18 average anywhere from 18 to 60 breaths per minute. Trying to stay on top of how many breaths you take per minute/per day would be impossible if you would like to have life outside of breath counting. The volume of breaths per minute is one reason why our respiration is involuntary and acts based on many intrinsic and extrinsic factors. One particular variable is our posture and how we move throughout the day to sustain multiple postures.

During my presentation I talked about how powerful the orientation and position of our bodies at rest are during respiration. Our skeletal structure is held up by connective tissue, that is intertwined through skeletal muscle that connects muscles to bone and that connects bone to bone.  Our body is one unit and when we move, sleep or sit for long periods of times “everything” from proximal to distal adapts.

When our tissue alters its properties, angle of position and pull to allow movement to be present, our neurological system will increase stimulation, amplitude, duration and frequency that is needed to complete the goal. This pertains to everything not just exercises. Sitting, standing and laying down all recruit sensory and motorneurons to establish a sense of a controlled state. We just have so much going on in our lives to think about body mechanics after a long day of getting pulled in many directions by family and friends.

CA LungsWhen there is a reoccurrence and you increase the duration at which you are in a particular posture like sitting, your musculoskeletal system will change its approach to allow you to maintain what you’re doing. In relation to respiration, a muscle that changes its properties and can alter its performance output is your diaphragm. Your diaphragm is dome shaped and looks very similar to an umbrella. On top of your diaphragm rest your lungs. When you inhale air, your diaphragm descends down towards your pelvic floor allowing your lungs to fill up with oxygen. When you exhale your diaphragm ascends back up pushing the air out that is filled with carbon dioxide. Now if you sit all day or even stand all day your posture is going to adapt and change the line of pull of your musculoskeletal system altering where your diaphragm starts its descent down. This will then how affectively air is inhaled in as well as exhaled, leaving you with potential loss in oxygen consumption intrinsically. This then changes your respiration rate, with indirect change of stiffness in and tightness in areas like your lower back, neck and the anterior part of your hips. From a conscious thought process, you could think you need to stretch your lower back or hip flexors but deep down your breathing muscle (diaphragm, pelvic floor, transverse abdominus, etc…) have altered their state of performance and just not working as efficiently as they could. This can also lead to anxiety, sleep apnea and decrease performance output.

90:90 Diaphragmatic Breathing.JPG

Now this all depends on who you are, what your goals are and the environment you live in however everyone at some point in their life has disruptions in their respiration and can benefit from working on diaphragmatic breathing exercises.  Over the course of this three-part series I am going to give insight into options on how you can improve your diaphragmatic breathing and your overall respiration mechanics. There is no guarantee that this will improve lung function but I do believe it will help you move better and improve your quality of life.

Just remember Understanding that all postures are good but living and moving within one all the time creates poor overall movement patterns. Breathing in through the nose and exhaling through the mouth is one of the best ways to down regulate your system and allow the proper respiratory muscles to work.


*Pictures from Complete Anatomy* 

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Intrinsic motivation is something that develops over time. Kids don’t yet have the cognitive abilities to grasp the concept that, “exercising is good for physical and mental health.” The understanding that by “doing something good for your body now, your future self will thank you,” is far too abstract. Kids don’t live for the future, they live for the here and now.

By the time children are in high school and/or go through puberty, those high order thinking cognitive processes begin to develop. However, social obligations and a sense of figuring out one’s own identify often trump the desire to be consistently active for one’s own physical and/or mental health purposes.

Sports certainly help, as they play a role in encouraging healthy competitiveness within oneself and others, as well as promotes team building and social opportunities that child and young adults actively seek out. However, not every kid plays a sport or has the health opportunities to actively participate in one. So, how do we encourage motivating?


There are two types of motivation: intrinsic motivation and extrinsic motivation. Some will say, intrinsic motivation is ideal because it creates long lasting effects on one’s drive and purpose to reach a goal. The definition of intrinsic motivation is, “behavior that is driven by internal rewards.” Extrinsic motivation is the opposite. Extrinsic motivation is defined as, “behavior that is motivated to perform an activity to receive an award or avoid punishment.”


When starting to increase your child’s motivation to exercise, extrinsic motivation is the “easiest” way to go. When young, a child/teen is beginning to develop his/her own sense of motivation and enjoyment from exercising, something that is not going to happen overnight. Fortunately, exercising regularly will naturally contribute to developing intrinsic motivation, as it increases the feel-good happy chemicals in your brain (serotonin, dopamine, endorphins). But, habits do take time, so here are three tips to increase your child’s motivation to exercise!

  1. Reward System

There are often mixed reactions to implementing a reward system. However, a reward system is not something to frown about when working on establishing a foundation for positive behaviors. Research has shown that children respond better to positive reinforcements than they do to negative reinforcements.

How to begin a behavior reinforcement plan:

  • For children ages 7-12: Make a personalized goal tracker with your child. For example, if want your kid to do something physically active 3x a week, create a page with three boxes per week to check off after each workout (e.g., can use stickers, a drawing, a penny, etc.)
  • For children 13 and older: they can often keep rack on their own, and independence is key for teenagers and young adults.
    • Each workout = 1 point.
      • It is up to you to decide how often a reward occurs and what the reward will be.
      • Reward types: with your child’s help, create a list of 5 items/things that might be motivating to earn. For example, 30 minutes of a favorite show, a new toy or “surprise box,” staying up later one night a week, choice of a favorite meal for dinner, a new book, etc. The possibilities are endless!
  1. Social Opportunity

As an adult, performing 15 reps, 4x on one exercise is manageable. Our attention is longer. We enjoy isolation more. We have intrinsic motivation or tangible goals set for ourselves, like losing weight. However, children and young adults are heavily socially dependent with shorter attention spans. Their worlds thrive around social opportunities, So, make physical exercise a social experience. Workout with your child, put on a YouTube video and together and complete 30 minutes. Put on your child’s favorite music on in the background and encourage your child to work out for 20 minutes (set a timer). One time a week (or more) invite a friend or sibling, make it an event that can be done inside or outside, and make it fun.

  1. Bring back Play

Which brings us to our third tip: Bring back play! Even if you have a teenager or young adult, play is important to developing a positive attitude towards physical exercise. Play can consist of hiking with friends or family, trying a new activity in your community, and generally, reducing the strict structure around exercise that children and young adults often try to escape as they build independence and autonomy. A majority of the time, exercising can consist of structured exercises catered around a specific goal, however, a few times a month it’s important to switch it up and encourage exploring of physical exercise through unstructured (play) opportunities.


















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