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Ever heard anyone say breathing is a passive process? Well it’s true. Breathing is a passive thing that just happens as we move about doing our daily activities whether while we are awake (like now) or while we are asleep. It all starts normally with the nasal cavities i.e., the nose or sometimes the mouth (if you unfortunately have a flu). It involves a complex process where the air we breathe in is broken down and changed into forms that our bodies can adequately use for efficient function. You could say it’s as important as life itself.

Breathing also known as, respiration is a passive process but it is divided into two phases; inspiration (which is more of an active in passive process) and expiration (which is a purely passive process; can’t hold your breath forever!). Although, as from basic science, we know that the organs for respiration make up the respiratory system; the nose,trachea,  a lung on each side of our chest cavity which contain medium to small tubes, and of course the alveoli sacs. But then, there are other “organs” that are similarly important in this active-passive process, which we will get to know of as we proceed.


Now, during the phase of inspiration i.e., breathing-in (with your nose of course which is very important because the nose warms, filters and humidifies the air we take in), gases move from the outside and into the lungs causing the chest cavity to expand much like an air filled balloon. During this phase, amongst muscles such as the intercoastals, levatores costorum, serratus posterior superior, the most important organ-muscle utilized is called the diaphragm.

The diaphragm is a dome shaped musclotendinous sheet that is attached to the inner part of the lower 6 ribs, the xiphiod process of the sternum and a few lumbar vertebra.

“Place your hand on your belly (right above your navel or belly button), relax your head, shoulders and chest muscles and breathe into that part underneath your hand. You should feel your diaphragm move down and outwards as you breathe in and then in and upwards as you breathe out. This will not be difficult if you are a natural belly breather.”- Diaphragmatic breathing

The downward movement of the diaphragm, elevation of the ribs and forward movement of the sternum all increase the dimensions; length and width of the chest cavity causing air to be drawn into the lungs. Apart from movement of the diaphragm, the ribs and sternum also contribute to the expansion of the chest cavity using mechanisms referred to as the “bucket handle” and “pump handle” mechanisms. Also, muscles such as the levatores costorum and serratus posterior superior help lift up the ribs from behind.

Source: istockphoto


Breathing-out is not as busy as inspiration and that is because of its passivity.  Simply by relaxing, the chest cavity springs back into its former shape and expiration can occur without much help from surrounding muscles. But this doesn’t mean that it is not assisted at all say for example during coughing.

“Place your hands on both sides of your abdomen right where your 6-packs or 1-pack should be and cough. You will notice a movement or contraction of the muscles right underneath your palms”- forced expiration.

The most important muscles for expiration are the abdominals; the external oblique, internal oblique and transversus abdominis. These muscles help expiration and or forced expiration and they are also very important for core strength. There are also small muscles that connect rib to rib; external intercoastal, internal intercoastal, innermost intercoastal and tranversus thoracis and they are expected to keep the ribs together and draw them in when you breathe out.

Respiration should occur spontaneously but there are diseases (restrictive or obstructive) such as; asthma, bronchitis, pneumonia, pneumothorax, emphysema, and so on which could resists air flow into the lungs or reduce lung compliance to air flow.

Do see a physiotherapist if you have been diagnosed with any form of respiratory disease or disorder for adequate management.

Now, we know the important muscles used for breathing. But how then do we efficiently make use of these muscles? And how do we breathe properly with these muscles? The key is to practice! Luckily this doesn’t mean you would have to take a day off of work or go to the gym (which is good by the way) or be inconvenienced. All you have to do is sit in a chair (like now), lay down or stand, relax and follow the instructions and illustrations below.

This exercise is to establish an easy normal and efficient breathing pattern:

  1. Sit in a chair and ensure you are well supported. Place your hands on your belly.
  2. Breathe in through your nose, feeling your belly expand slightly as you do so. Relax your upper chest, shoulders and arms, then breathe out as calmly as possible.
  3. Repeat to establish a calm, gentle breathing pattern.

This simple form of exercise can be done at any time of the day, especially if your breathing feels rapid maybe when walking or during your routine exercise.

Source: (breathing exercises with COPD)

Naturally, “belly breathers” would find it easy to perform a certain technique called the diaphragmatic breathing. This is because breathing for them already spontaneously involves proper use of the diaphragm. When belly breathers breathe, the diaphragm is allowed to move downward towards the base of the rib and into the abdominal cavity, thus making more room for the chest cavities and lungs to expand.

Apart from belly breathers, there are also the “chest breathers”. Chest breathers use the upper part of their chest for respiration using only certain muscles of the chest and not all muscles intended for respiration itself. When chest breathers breathe, the diaphragm is held in place while the ribs are free to move high and upwards,this causes the ribs and chest cavity to expand at the sides, front and back.

It is important to activate all muscles intended for respiration in your body as proper breathing has tonnes of benefits. Proper breathing lowers your heart rate, blood pressure, relieves stress, increases blood oxygen levels, improves metabolism and blood circulation, just to mention a few.

Physiotherapists understand the importance of proper breathing and its benefits thus, have a role in making sure you breathe properly and efficiently using all intended muscles of respiration, with or without the presence of disease.

To also improve respiratory muscle efficiency, there are some stretches and poses (yoga) that have been proven to really lengthen out those stiff muscles (picture a cat stretching).


Breathing exercises with COPD at,written by Rachael Nall(RN, BSN, CCRN) medically reviewed by Alana Biggers MD on April 7,2017.

Proper breathing technique improves your overall health by Dr David Williams at

“Chest breath” vs “belly breath” at posted on March 11,2015.

Clinical anatomy made ridiculously easy. Chapter 4: the muscular system. Stephen Goldberg, M.D.Associate Professor Department of Cell Biology and Anatomy University of Miami School of Medicine Miami, Florida 33101.

Nigel Palastanga and Roger Soames2012. Anatomy and human movement; structure and function. Published by Elsevier churchhill livingstone.