Breathing Exercises for Athletes

 Jennifer Morris, MD MBA

ABPN, ABOM, ABPM-add

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Breath control is an integral part of aerobic-geared sports: running, basketball, tennis, swimming. When breathing falls apart, it not only derails the athletic effort, but it may also lead to anxiety. By utilizing a few simple strategies, breathing control can be regained. Presented here are three strategies for managing breathing in warm-ups, practice, competition, and recovery.

Please note that these breathing strategies are not appropriate for all athletes or athletes with certain medical conditions. 

1. rapid breathing: this technique raises alertness, cognition, and movement control. This strategy is helpful to initiate the day (in the am, upon waking up) or before warm-ups for practice or competition. It also facilitates recovery during exercise sets or intervals. (Sakamoto)

A. sit/stand tall with air passageway relaxed-open

B. Inhale/exhale at one second intervals

C. repeat for 30 seconds-2 minutes (start with 30 seconds if this exercise is new)

A variation of this is utilized to reset overactivation or overthinking. 

A. Orally breath out to clear all air from lungs

B. let air passively flow in until lungs are filled

C. exhale clearing all air. The focus is on clearing the air out rather than breathing air in

D. repeat at one breath cycle every 2 seconds, for 20-40 seconds duration

E. Finish with a long, 12 slow-count clearing breath through pursed lips (McDuff)

BOX BREATHING

2. Box Breathing: this activates the parasympathetic nervous system to aid with recovery or to calm overtight nerves when the sympathetic (fight or flight) nervous system has derailed athletic performance. By virtue of activating the parasympathetic nervous system, concentration and therefore performance can be improved. 

A. Assume a relaxed position, ideally sitting straight in a comfortable chair with a back. 

B. slowly exhale to get all air out of lungs; focus on this with intent

C. inhale through the nose to a slow count of 4; feeling the air enter the lungs until they are completely full and the abdomen is activated

D. hold breath for slow count of 4

E. exhale for slow count of 4, expelling air completely from lungs

F. Repeat, for a duration of 2-5  minutes. 

A variation of this is patterned breathing:

A. Start this exercise with a strong, full exhalation so that all the air is pushed and then squeezed out (using the chest and core muscles) until a small tight knot is felt in the center two inches above the navel. 

B. Next let the air flow in through the nose to a four count using the diaphragm to smoothly fill from the navel up to the level of the clavicles (collarbones) while letting the belly move out. 

C. Once the lungs are filled, hold for a count of seven. 

D. Just as the hold is ending, prepare to breathe out smoothly and confidently for a count of eight.

E.  Repeat this pattern for a total of eight breath cycles (takes about two minutes). (McDuff)

Additional tips for breathing control while running:

1. Breath deeply from the diaphragm or belly, rather than from the chest. While it is easy and common for runners to slip into chest-only breathing, chest-only breathing is both inefficient and can increase anxiety, which derails runs and can lead to a sense of oxygen starvation. If diaphragmatic breathing is a new concept, try it first at rest or on slower runs, to practice the technique

2. Practice odd-count step-breathing, to reduce the risk of overexerting one side of the body...for example an inhale 3 exhale 2 count...as the first part of the exhalation phase delivers a higher stress to the side of the body receiving the weight load. By alternating sides, one side is not carrying all of this stress. 

3. Focus on the exhalation phase (pushing air out) rather than the inhalation phase (let the air flow in rather than be "sucked" in.) This reduces the sense of oxygen starvation and diminishes anxiety. 

(Fetters, Dack)

Sakamoto, Akihiro and Hisashi Naito, Chin-Moi Chow. Hyperventilation as a strategy for improved repeated sprint performance. J Strength and Conditioning 2014 Apr; 28(4):1119-26. doi:10.1519/JSC.0b013e3182a1fe5c. https://pubmed.ncbi.nlm.nih.gov/23838981/. Accessed 8/27/24. 

Reference: “Sports Psychiatry: Strategies for Life Balance & Peak Performance by D McDuff (2012) 

Fetters, Aleisha. 5 Breathing Fixes to Take Every Workout to the Next Level. https://www.runnersworld.com/training/a20866610/5-breathing-fixes-to-take-every-workout-to-the-next-level/. April 21, 2017; accessed 8/31/24. 

Dack, David. The Ultimate Guide to Deep Breathing Techniques for Runners. https://www.runnersblueprint.com/the-ultimate-guide-to-deep-breathing-techniques-for-runners/. Jan 24, 2024. Accessed 8/31/24.