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Belly breathing: The pitfalls of a name

I hear the term ‘belly breathing’ a lot. As a breathing instructor, I see both the beautiful simplicity of the message and the potential problems it can cause. Don’t get me wrong, used in the right way, simple language can help explain complex ideas and show that you understand them well. However, belly breathing can be misleading, and for that reason, it’s a term I don’t use.

When people say ‘belly breathing’, what they are usually referring to is diaphragmatic breathing. If you aren’t familiar with anatomy, that term can be confusing, so let’s break it down.

Diaphragmatic breathing involves the expansion and contraction of our diaphragm and intercostal muscles. The diaphragm is the dome-shaped muscle that sits underneath our lungs and heart and is attached to our lower ribs and spine.¹ It separates the chest cavity from the abdominal cavity and is our primary breathing muscle. When we contract this muscle, it flattens downward, increasing the volume of our chest.² At the same time, the intercostal muscles (small muscles between the ribs; our secondary breathing muscles) contract, helping to expand the ribcage.³ These two actions create an inhalation. When we relax these muscles, the air is expelled. Breathe in; Breathe out.

When we inhale, the pressure in our abdomen increases. This happens because the diaphragm pushes down on our organs. This is helpful because it stabilises the spine⁴ and is thought to encourage gut motility.⁵ A by-product of this may be that your belly expands, hence the name, belly breathing.

And this is where the problem arises. People can interpret the term “belly breathing” as meaning they should use their abdominal muscles (aka the ‘six-pack’, although there are many others as well) to breathe. Pushing your belly out doesn’t help you breathe because it doesn’t make the diaphragm contract.⁶ So, belly breathing can create an artificial mechanical response that reduces our ability to relax our breath and breathe correctly. The focus on belly-only movement can also limit ribcage expansion. The ribs should move when we breathe.⁷ If our breathing is predominantly into the upper chest, shallow, and rapid (above what we need at a metabolic level), this can overstimulate our stress response.⁸ Unfortunately, belly breathing may not solve this problem or can create other issues.

As already noted, when we breathe correctly, the belly may expand. However, the ribcage should also expand on the front, sides, and even the back. The pelvic floor will also respond to our breathing, moving down as we inhale and up as we exhale.⁹ This helps to maintain stability through our core. If we focus on pushing the belly in and out, we lose this 360-degree expansion and core support. As well as being bad for breathing, this may cause issues for those with hernias, reflux, and dysfunctional pelvic floors.¹⁰

Our anatomy can also affect how the belly moves when we breathe well. Factors such as ribcage angle, pelvic shape, and fat distribution all have an impact. Therefore, it is a flawed approach to rely on belly movement alone to determine whether a person is breathing well.¹¹ For those whose bellies only move slightly when they are engaging in functional breathing, asking them to belly breathe may negatively impact their breathing.

There are also possible psychological issues when asking people to belly breathe. In a world where we are flooded by images of six packs and flat stomachs (be clear, these are not indicators that a person is healthy, they are marketing spiel!) and eating disorders are prevalent, asking a person to expand their belly may be harmful.¹² It could even have the unintended consequence of a person holding the belly in so as not to draw attention to it. This could restrict the movement of the diaphragm.¹³

The truth is that you cannot breathe into your belly as it isn’t where the air goes. The instruction to belly breathe can be a well-intended attempt to simplify breathing terminology. Unfortunately, it may cause more harm than good. The best approach to breathing is to close your mouth and breathe lightly through the nose.¹⁴ This will encourage activation of the diaphragm and intercostals. Or reach out to a qualified instructor who can assess your breathing and teach you functional breathing.

References

1. Anatomy of the diaphragm – Standring, Gray’s Anatomy (42nd edition).

2. Diaphragm contraction mechanics – American Physiological Society.

3. Role of intercostals in breathing – De Troyer et al., Journal of Applied Physiology (2005).

4. Hodges PW & Gandevia SC (2000). Activation of the human diaphragm during postural tasks. Journal of Physiology.

5. Diaphragmatic influence on gut motility – Kolar et al., Clinical Anatomy (2012).

6. Clarification that abdominal wall expansion ≠ diaphragmatic contraction – Courtney, Breathe (2016).

7. Ribcage biomechanics – De Troyer A (2019). Comprehensive Physiology.

8. Chronic upper-chest breathing and stress activation – Jerath et al., Medical Hypotheses (2006).

9. Petroll WM, Knight H, Kolar P. The diaphragm and pelvic floor relationship in breathing. Physical Therapy (2015).

10. Impact of dysfunctional breathing on reflux, hernia, pelvic floor – Chaitow L. Breathing Pattern Disorders (2014).

11. Anatomical variation in ribcage/pelvis and breathing appearance – Courtney R. (2016).

12. Body image issues & breathing instruction – research on exercise and disordered eating (e.g., Piran & Cormier, 2019).

13. Diaphragm inhibition by abdominal bracing – Bordoni & Zanier, Cureus (2013).

14. Nose breathing benefits – Physiological Reviews, 2017; Naclerio et al., 2021.

Disclaimer

This blog is for informational purposes only. It is not medical advice. Always consult a healthcare professional for personalized guidance and treatment.