Yoga Breathing for Reduced Stress, Pain and Improved Performance

 In Exercise and Health

Reduced Stress

Human respiration (breathing) is the only physiological system in our bodies that is under both autonomic and voluntary nervous control and thus it is a key tool/limb in the wider practices of Yoga (1).

The Autonomic Nervous System is the automatic part of our nervous system that controls and modulates things out of our conscious control; such as heart rate, blood pressure, digestive system function and more. For the sake of simplicity – the Autonomic Nervous System has two main settings – Sympathetic (fight/flight) and Parasympathetic (rest/digest) that exist on a spectrum between each other.

Things like pain, lifestyle and training stressors bring us into a more sympathetic nervous system state – where our heart rate, blood pressure, and experience of anxiety increase (3). This can often lead to a negative feedback loop of sorts – where more physical and mental stressors beget further sympathetic nervous system ‘activation’.

Something more specific such as acute pain can trigger a stress response in the sympathetic nervous system, which results in increases in muscle tension, heart and respiratory rates, blood pressure, blood glucose levels, and blood coagulation. The adrenal cortex supports this stress response with glucocorticoids that enhance the “fight or flight” response but also suppress the immune system and heighten susceptibility to illness, (3) infection, and other complications. Unrelieved pain heightens the response to subsequent pain episodes; anticipation of it causes the same stress response that actual pain stimulus does. (3)

A key way Pranayama exercises work is through altering autonomic nervous system function – bringing our breath under conscious control, we can learn to voluntarily control and modulate our nervous system (1,2). Breath regulation in Yoga can include modulation of slowing down or pacing the breath, manipulation of nostrils, chanting of humming sounds, retention of breath and more (1). Slow breathing is the first and most important step in Pranayama as it has profound effects on the body;

  • reduced perception of stress (1)
  • decreased oxygen consumption (2)
  • decreased heart rate (2)
  • decreased blood pressure (2)
  • increased parasympathetic activity (2)
  • experience of alertness and reinvigoration (2)

Prolonged pranayama practice has been shown to cause a long-term shift in autonomic nervous system functioning, specifically, with slow breathing pranayama there is a noted increase in parasympathetic activity and a decrease in sympathetic dominance. To start experience the effects listed above, sit down in a comfortable position, preferably with crossed legs and a pillow underneath the buttocks as required. Sitting comfortably tall, hand over your knee and hold your right hand in the position pictured below:

Complete the following steps:

  1. Breathe in through both nostrils completely – at a slow and comfortable pace, and fully exhale
  2. Using a metronome or internal count – breathe in through your left nostril for 3-5 seconds (more if comfortable). Keeping your thumb over your right nostril
  3. At the end of the inhalation – comfortably hold your breath for 3-5 seconds (more if comfortable. Be sure not to push into any strain or tension – as this is counterproductive to the exercise
  4. Release your thumb and press the 4th and 5th fingers onto your left nostril – exhaling through your right for 5-10 seconds (ideally TWICE AS long as the length of your inhale)
  5. Repeat this cycle from steps 1-4, five to ten times

REMEMBER: don’t strain whilst practising the above pranayama technique – keep a relaxed and gentle attitude throughout. Get Started with this technique after your training session – or at the end of your day.

For more information of individualised yoga practice/therapy for your concerns – contact us at POGO for a booking.  


Oliver Crossley (APAM) POGO Physiotherapist

Featured in the Top 50 Physical Therapy Blog


  1. Saoji, Apar Avinash, B. R. Raghavendra, and N. K. Manjunath. “Effects of yogic breath regulation: a narrative review of scientific evidence.” Journal of Ayurveda and integrative medicine(2018).
  2. Jerath, Ravinder, John W. Edry, Vernon A. Barnes, and Vandna Jerath. “Physiology of long pranayamic breathing: neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system.” Medical hypotheses67, no. 3 (2006): 566-571.
  3. Schaffer, Susan D., and Carolyn B. Yucha. “Relaxation & Pain Management: The relaxation response can play a role in managing chronic and acute pain.” AJN The American Journal of Nursing104, no. 8 (2004): 75-82.


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