By Caesar Cantone, PT, LAc




The principles of breathwork, or guided breathing, can be applied to any exercise or activity by consciously controlling the flow of air entering and exiting the body.  In addition to the transformative effects that breath control can impart upon any specific training routine, it can also be taught as an isolated exercise with both meditative and restorative benefits.  


I have outlined three specific types of breathing exercises, which I’ve learned and practiced over the past 10 years through my experience in the Russian Martial Arts.  The physical mechanics of these exercises can appear quite simple, but the mental and emotional depth found within them can be as sophisticated as the participant permits.  Remember, breathing is natural and fluid, and even when controlled it should not seem forced or irregular.  


If you seem to lose your focus within the exercise and your breath becomes unnatural, you should stop immediately.  Take a deep breath in through your nose and blow out quickly through pursed lips.  Restore yourself, as often as required, and then continue as you feel able.


Ex. #1 - WAVE BREATHING - Stress Reduction



1 - Lie in a relaxed, supported position, preferably on the ground, and close your eyes

2 - Breathe IN gently through your nose, and out through your mouth (equal volumes)

3 - Gently contract the muscles of your feet with no more than 50% tension as you inhale, guiding the air into the lower body and relaxing everything else above the ankles

4 - Slowly relax the muscles of your feet as breathe OUT, returning your body to its baseline state

5 - On the next inhale, contract your feet again and then bring your breath and muscle contractions higher up the body to the knees, still making sure not to tense even 1% above these areas (especially in the face)

6 - Exhale and release the knees, and then follow with relaxing the feet completely

7 - You can sequentially move the breath up and down the body, as if you were lying on the beach and the tide was rising and receding beneath you

8 - Bring the breath flow and muscle contractions to a level no higher than your neck, always making sure to keep your face soft, pleasant-looking, and free from anxiety or tension


This is a fantastic exercise to be done at night after a long, stressful day of work or training.  The key to your success with this lies in your ability to “specifically” isolate just the areas you are targeting with your breath, and completely relaxing everything else.  There is a serene, almost meditative quality to this exercise that makes it appropriate for any person and condition.


Ex. #2 - STRETCHING YOUR BREATH - Walking Endurance



1 - Walk, strut, or stroll at a comfortable and even pace (eg. around the park)

2 - Breathe IN over 2 steps (ie. halfway at each step), then

3 - Breathe OUT over the next 2 steps (ie. 4 steps equals one breath cycle)

4 - When you are ready, progress your breath in over 3 steps (ie. one-third at each step), “stretching” it across a full, and even inhalation

5 - Breathe out over the next 3 steps (ie. 6 steps equals one breath cycle

6 - Eventually progress your inhale/exhale repetitions in a sequential manner to a target number that feels challenging, but not distressing

7 - When finished, restore yourself with deep, pursed breathing until you feel relaxed


This is a very challenging variation of breath training, because the purpose of the exercise is to gradually bring yourself to a self-imposed limit, which is inherently uncomfortable.  The key to reaping benefit with this method of training is by making sure the volume of air breathed in and out is at even, smooth increments.  The movement of air flow is not staccato, or step-like as if on a graph, but fluid, and sinusoidal.  Do not make yourself distressed or panicked!  The goal is to improve your lung capacity and regulate your sympathetic nervous system.  Always restore yourself with recovery breathing until you feel relaxed and able to breathe in a normal manner again.  You should feel tired, but also refreshed, and not exhausted.


Following an type of rigorous activity, your breathing may be rapid, and seem difficult to control.  Use the next exercise to help yourself recover more calmly and efficiently.


Ex. #3 - PYRAMID BREATHING - Recovery



1 - Stretch your breath IN over a count of 2 seconds (ascending the pyramid)

2 - Stretch your breath OUT over a count of 2 seconds (descending the pyramid)

3 - Don’t breathe for a count of 2 seconds (base of the pyramid)

4 - Progress the count to 3 seconds as you see fit, until you feel restored


It is important to note that the concept of the “breath hold” is anathematized in Western Medicine, primarily because of potentially dangerous blood pressure fluctuations when practiced improperly.   There are Eastern disciplines that can take breath holding to extremes, such that they only be undertaken with careful guidance and medical supervision.  The restorative exercise of pyramidal breathing is not a “breath hold” exercise, and should by no means create tension, anxiety, or any blood pressure consequence.  If, however, you have any personal concerns because of your medical history, you should definitely discuss them with your doctor first.


Much of what has been outlined here is by no means my singular invention, or the copyright of one particular person or school of thought.  Rather it is a small, generalized, yet helpful introduction to the seemingly infinite world of breathing exercises found spotted across ancient cultures from around the globe.  If you would like a further exploration of breathwork, you can investigate the Indian discipline of yoga, the Chinese tai chi, and the Russian martial art of systema.  An excellent book titled, LET EVERY BREATH, by Vladimir Vasiliev, has been the foundation for my introduction to breath training, and may prove a good place for you to start too!


Backpacks & Back Pain

By Sara Mikulsky


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The fall season is here and that means the kids are heading back to school.  That also means it’s time to hit the store for new school supplies and backpacks!  To help prevent your child from experiencing back pain from his or her backpack, follow these simple steps (video below)


Purchase a backpack that fits your child

A backpack should fit in the space between the cervical (neck) and lumbar (lower back) spine.  Essentially, this is where the thoracic spine and ribcage are located.  The shoulder straps should be wide or narrow enough to fit in the middle of the shoulder (not on the tip).  Additionally, the backpack should be adjustable to allow your child to grow




Don't load a backpack with more than 10% of body weight

A backpack should never be filled with weight greater than 10 % of your child’s weight.  For example, if your child weighs 70 pounds, the backpack should not be heavier than 7 pounds!  Many times, kids can over fill backpacks with books, binders, and other school supplies.  Make sure the essentials are in the backpack, as to prevent back pain or poor posture routines.


Educate your child on how to wear a backpack properly

The backpack should sit just above the hips and buttock area and snug against the middle back.  Show your child how the backpack should sit, and teach them how to adjust the straps.  Some backpacks also have a waist strap.  This strap is designed to fit snuggly over the hips and NOT the waist.  This strap is meant to help decrease loads on the lumbar spine.  


Encourage good posture all the time!

If you notice your child is walking with bad posture or carrying too much, remind them not to!  Reinforcing good posture habits is the first step to preventing lower back pain.  If your child does start to report pain in his or her back, contact a physical therapist to assess your child.   They can help determine if further tests or healthcare professionals should be involved.  Often times, fixing posture and strengthening muscles is the key to reducing your child’s back pain.  



By Caesar Cantone, PT, LAc

There is an old Chinese adage that proclaims, “Where there is movement, there is life!”  But for most of the average American population, this invocation to move functions as more of a tease than it does an incentive.  Many office professions have tethered their employees to the confines of a narrow cubicle, while other more physically laborious occupations push their employees to a level of movement and activity that is bound by complete exhaustion.  Both of these extremes are injurious, both are marked by significant levels of stress, and both can truly benefit from the one constant, and omnipresent “exercise” of breath training.

As the conscious ambassador between the higher and lower levels of the nervous system, breathing, itself, is the quintessential exercise to remove stress, reduce pain, and restore health and healing.  If there is life in movement, then there is illness and ultimately death in stagnation.  Therefore, the extent and severity of all injury, be it from either external or internal sources, is dependent upon the mind’s ability to hold and retain tension, or “lack of movement,” within the confines of the physical body.  More specifically, this sequence of “tension-retention” is called pain.  Even more specifically, it is called “pain that you care about.”

Considering the gamut of life roles we participate in throughout our daily routine, how do we move without tension?  Or, for those of the more sedentary obligation, how do we move… without moving?

Obviously, the answer is in the way we breathe.  If there is no breath (aka internal movement), there is no animation to the body-- no life!  This is not just obvious, this is instinct.  So therefore, as you breathe guide your breath throughout your body.  Pay special attention to the areas where stress most readily harbors, where injury retains your pain.  Don’t confine the flow of “air” to the anatomical boundaries of the throat, chest and lungs, but instead breathe through these regions and restore them.  Whether your personal bias is to label the intangible movement here as air, energy, Qi, psycho-somatic awareness, or just plain “imagination,” your body will still reap the benefits of this transformative work with or without the appropriate choice of vocabulary word.

The physical mechanics of breathing with exercise should actually resemble the pendular sway of a clock or the ebb and flow of the tide, where there is perfectly uniform movement in both directions.  The inhale and the exhale should be of equal volumes of air, with only the tiniest of pauses during the transition state from one cycle to the next.  It is especially important not to get fixated on the idea of a “perfect” breathing pattern while exercising, since most functional activities will never mirror the ideal training circumstances of your gym or home living room.  Instead, breathe continuously and learn to manipulate the flow and speed of your breath to create strength or softness as you see fit.

I can tell you from personal experience, the most important consideration when beginning to undertake any breath-work routine is not to obsess over it.  Breath training at its most fundamental level is meant to be restorative and rejuvenating.  It is important to relax and be natural and fluid, leading the air in through your nose and out through your mouth.  If it looks like you’re trying to “do something” then you are doing something wrong, that is, with too much effort.  Many times a quick, full inhale followed by a hard, pursed exhale is enough to “reset the system” before beginning breath-work again.

The first, and ultimately only one, real, true rule about breathing is to NOT STOP breathing.  By adhering to the multiplicity of variations within this broad directive and the few aforementioned caveats, you will find a colorful way to reinvent your exercise program and invigorate your work life.


(Part 3 - Breathing Exercises - Next Month)


Almost nothing is ever counseled on the subject of breathing at either the beginning or advanced levels of training.  Occasionally one will receive the obligatory disclaimer, “Exhale while lifting,” or “Don’t hold your breath!”  Most clients typically show an understandable level of annoyance when instructed to “breathe,” with objections invariably following.  “If I wasn’t breathing I’d be dead,” they’d say, or, “My body knows how to breathe. I’ve been doing it since I was born.” Of course, the body itself knows how to breathe, when it’s left purely to its own devices; it’s the mind that always gets in the way!



In Chinese philosophy there is a principle of balance and mutual transformation, called Yin and Yang. It is very common, and most have heard of it, and all of Oriental Medicine believes one hundred percent, completely in it. This elegantly simplistic ideology states that cause and effect are self-perpetuating, and even reversible. That is, given enough time, an action or ‘effect’ can actually begin to mimic, and in some cases even ‘create,’ the type of environment most suited to fostering its own, natural development. In simple English, “Fake it till you make it,” seems to actually work!