Last time we talked about pursed lip breathing for COPD - what it is, and why it helps when you're short of breath (SOB). Today we're going to go a step further and learn about diaphragmatic - also called belly, or abdominal - breathing. Remember that some of these techniques can be used with other pulmonary disorders as well, but as always, check with your doctor or respiratory health care professional before starting to use any new technique or exercise.

Now, I'll tell you right up front - this is kind of technical, but just stick with me here because doing diaphragmatic breathing (and doing it correctly) can mean the difference between huffing and puffing and struggling your way through each day, or being in control of your breathing as you do the things you want to do.

First of all, let's review why we're even talking about learning how to breathe in the first place. You might be thinking, "I've been breathing since the moment I came into this world so why am I suddenly supposed to ‘learn' how to breathe?" The answer is simple. If you have COPD or another chronic lung disease that makes you short of breath, there have been changes in your body and you are no longer able to breathe as you once did.

So, what's going on in my lungs?

When lungs become damaged from cigarette smoking or other hazards in your environment, the elastic fibers within them start to deteriorate and the lungs begin to lose their elastic recoil - their ability to get air out efficiently. You can think of this by comparing a balloon to a paper bag. The air in the balloon comes out easily because the balloon is elastic. A paper bag is not. Over the years the loss of your lungs' elastic recoil gets worse and the lungs develop air trapping and over- inflation. This means that your lungs actually get bigger than they should be. And this leads to trouble because the extra, stale air compresses the good lung tissue so it can't do the job it should - kind of like when the air bag in your car inflates and is pressing on your chest. When your lungs are too big for the inside of your chest, it's crowded in there and your lungs have trouble expanding and recoiling. Also when this happens, your diaphragm, which is supposed to be in the shape of a dome, becomes flatter, putting you - and your lung movement - at a mechanical disadvantage.

No wonder it's so hard to breathe! You're spending more energy using the muscles around your collarbone, your neck, and between your ribs. Using these muscles to breathe not only takes a lot of energy but it can make you sore and tense in your shoulders and your back. More work for breathing plus less efficient lung expansion and movement adds up to a whole lot of effort and fatigue without a lot of results!

Shortness of Breath and Anxiety

Furthermore, when you become anxious (and who wouldn't be when they can't breathe!), your body releases adrenaline, which causes your heart to beat faster. The brain then tells your lungs that your heart is working harder and needs more oxygen. So you start to breathe faster and harder, and more and more shallow. Your brain then tells your heart that your lungs need more blood to process, and so the heart starts to beat even faster...and so on, and so on, until you are completely breathless.