Coronavirus (COVID-19) Recovery: Breathing Exercises
Jeanne R. Seliskar, MA, CCC/SLP
Corporate Director of Rehabilitation
Diaphragmatic Breathing (Belly Breathing)
Diaphragmatic vs. High Chest Breathing: High chest breathing is when the chest rises and falls with inhale/exhale, this does not allow for expansion of the lungs in their entirety and therefore shallow breathing. Diaphragmatic breathing is when the stomach rises and falls with inhale/exhale. The diaphragm contracts which then expands the rib cage and allows for more room for the lung to expand.
Phase I: Deep breathing while laying on your back.
Phase II: Deep breathing while laying on your stomach.
Phase III: Deep breathing while sitting in a chair.
Phase IV: Deep breathing while standing.
Pursed Lip Breathing: Inhale through nose and exhale through mouth with lips pursed as if trying to blow a kiss.
Alternate nostrils breathing:
- After exhale, use thumb to gently close right nostril.
- Inhale through left nostril.
- Switch position of hand and close left nostril in order to exhale through right nostril.
- Continue alternative breath pattern for up to 5 minutes.
- Inhale deeply through nose and open eyes wide.
- At the same time, open mouth wide and stick out your tongue, bringing the tip down toward your chin
- Contract muscles at front of throat as you exhale out through your mouth by making a long “ha” sound
Humming Bee Breath:
4-7-8 Breathing Technique: Inhale through nose for a count of 4 seconds. Hold breath for a count of 7 seconds. Exhale for a full 8 seconds through nose. Complete 5-8 cycles of this pattern.
Kapalbhati breathing exercise: Sit with your hands on your knees and palms facing the sky. Take a deep breath in and as you exhale, contract your belly and force the breath out in a short burst. Put on a hand on your stomach to feel abdominal muscle contract if needed. As you quickly release your abdomen, your breath should flow into your lungs automatically. Complete 20 breaths.
Despite COVID 19 being on the decline, vulnerable individuals are still contracting the disease and with many residual effects lingering or only partially resolving. One of the most common areas for impairment is breathing. As a critical and integral element of functioning and being mobile, it has become a foundational factor in Physical, Occupational and Speech Therapy. It has been a component consisting of several exercises to improve controlled inspiration and controlled expiration in addition to proper diaphragmatic pattern of breathing which targets increased respiratory volume. All of these targeted exercises (a few shown above) are aimed improving activity tolerance during functional activities/mobility. With the patient learning and independently practicing these breathing exercises, significant improvement in various facets of treatment are noted.
Posture also becomes an essential part of this process. Using the “Y”, “T” and “W” positions with the arms in lying, sitting or standing, allow the chest cavity to open up and increase the respiratory volume. It also helps the patient to move from shallow high chest breathing to expanding the lungs and moving the abdomen forward as in diaphragmatic breathing. Although, patients may not achieve perfect postures, approximations ultimately result in better breathing patterns and improved recovery.
According to Physical Therapist Peiting Lien at Johns Hopkins: “Deep breathing can help restore diaphragm function and increase lung capacity. The goal is to build up the ability to breathe deeply during any activity, not just when at rest.”