Why Breathwork Belongs in Physical Therapy

You go to physical therapy because your back hurts. Or your hip has been bothering you. Maybe you're trying to get stronger after an injury. And then your physical therapist asks you to breathe.

It can feel a little unexpected. After all, you've been breathing your entire life. What could that possibly have to do with the reason you're here? Quite a bit, actually.

Breathing is one of those things we rarely think about because our bodies do it automatically. But the way we breathe is connected to much more than getting oxygen in and out. It influences how we create support through the trunk, how different muscles coordinate during movement, how much tension we carry, and how our nervous system responds to what's happening around us.

At A Life in Balance, that's why breathwork may become part of physical therapy even when breathing isn't the reason you came through the door. In physical therapy, breathwork means paying attention to how breathing and movement work together—and using that connection to support better coordination, stability, and more efficient movement.

Breathing Is More Than Taking a Deep Breath

When people hear "breathwork," they often picture meditation, yoga, or someone telling them to take a few deep breaths when they're stressed. Those can all have value, but that's not really what we're talking about here.

Breathing is also part of movement. Your diaphragm, pelvic floor, abdominal muscles, and other muscles around your trunk work together to create support as you move. Diaphragmatic breathing is part of that coordinated system, helping your body find stability without requiring you to consciously tighten your core before every step, reach, or lift.

As Dr. Paula puts it, "Breath is the organizer."

And your body gets plenty of practice. According to the American Lung Association, we typically breathe about 12 to 15 times each minute. That's roughly 17,000 breaths a day and more than 6 million breaths a year. When something happens that often, the patterns surrounding it can have a meaningful effect on how your body moves.

What Your Breathing Can Tell Us

Your breathing isn't the same all day long. It changes naturally based on what you're doing and what your body is experiencing. Carry something heavy, and you may instinctively brace or hold your breath. Get startled and your breathing changes. Settle into a comfortable chair at the end of the day, and it changes again.

Similar changes can happen when your body is dealing with pain, stress, or a sense of instability. Breathing may become shallower or more restricted, and you may begin holding your breath during certain movements to create extra stability. It's one example of the mind-body connection at work: what your nervous system is experiencing can show up in the way your body breathes and moves.

At ALIB, we don't automatically see that as something you're doing wrong. Breath holding can be a protective strategy. Your body found a way to make a movement feel more secure, and at some point that strategy may have been useful.

But bodies are very good at holding onto strategies they've learned.

As we explored in Your Body Is Adapted, Not Broken, those adaptations can stick around. You may continue bracing during an exercise long after an injury has healed or hold your breath during a movement that no longer requires that much protection. A physical therapist can notice those movement patterns and start asking a different question—not How do we get you to breathe correctly? but Why does your body feel like it needs this much support?

That can tell us quite a bit about what's happening beyond the area that hurts.

How Is Breathwork Used in Physical Therapy?

Your core isn't one muscle that needs to be switched on or tightened harder. It's a coordinated system that includes the diaphragm, pelvic floor, abdominal muscles, and other muscles that help stabilize the trunk. When those pieces work together well, your body can adjust the amount of support it creates based on the movement you're doing.

Breathing is part of that process. Says Dr. Paula, “Breathwork in physical therapy can be used alongside movement to help improve trunk coordination, reduce unnecessary tension, and help the body access support without automatically relying on more bracing.” 

During physical therapy, we may incorporate breath into a movement to see what changes. An exhale, for example, changes pressure within the trunk and can help coordinate the deeper muscles involved in stability. For someone who has gotten used to creating stability by holding their breath and bracing hard, that can offer another way to find support.

That doesn't mean bracing is bad. Sometimes your body needs a lot of stability. The goal is for it to also recognize when it doesn't.

This is also where breath and the nervous system come together. As we explored in If Your Injury Has Healed, Why Doesn't Your Body Feel Better?, the nervous system can continue using protective movement patterns even after the original reason for them has changed. Working with breath gives us another way to help the body experience a movement without automatically reaching for the same old strategy.

Over time, we're trying to give your body more options so it can use the amount of effort and support that actually fits the task.

Try This: Just Notice Your Breath

You can get a sense of this without doing a single breathing exercise.

For the next day or two, pay attention to your breath during normal activities. Don't try to change anything or make yourself breathe differently. Instead, get curious about what your body is already doing. Notice:

• When does your breath feel restricted or shallow? Maybe it's while exercising, lifting something, concentrating, or trying particularly hard to do a movement "right."

• When do you catch yourself holding your breath? Pay attention to what you're doing at the time and how much effort the task actually requires.

• What movements feel easier or harder when your breathing stays free? See if you notice a difference in the amount of effort or tension you feel.

• What happens when you fully exhale? Notice how your trunk and the rest of your body respond without intentionally tightening or bracing anything.

 There isn't a correct answer. The exercise is simply about noticing something your body normally handles in the background.

That's much closer to how we think about breathwork at ALIB. We're not grading your breathing or trying to teach you a perfect technique. We're paying attention to what your breath can tell us about how your body is responding.

Breathing Doesn't Need to Be "Fixed"

Trying too hard to breathe correctly can become another source of tension, which misses the point entirely.

As Dr. Paula says, "Breathing doesn't need to be fixed. It needs to be restored."

We want breathing to be available to the body again so it can coordinate naturally with movement. That might mean finding stability without so much bracing, allowing the core to respond more reflexively, or simply helping a movement feel less guarded.

 Breathwork in physical therapy isn't about taking a few deep breaths and hoping your pain goes away. It's one piece of understanding how your body has adapted and helping it rediscover movement strategies it may have stopped using.

At A Life in Balance, our holistic physical therapy approach looks beyond the painful area to understand how your body is working as a whole. If breathing, bracing, tension, or old movement patterns are affecting the way you move, we can help you understand those patterns and find a better way forward. If you're looking for physical therapy in Flemington, NJ, or Stratton, VT, our team is here to help.