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Breathing techniques for running

Breathing Strategies for Running

It is not uncommon for runners to gas out when running. Their lungs will fail them before their legs. While this is more common among beginners breathing strategies for running is often a key component of performance even among elite runners.

In 2022 I run my first two 5k races at 22 mins 22 secs each. During my preparation and the races I deployed a few breathing strategies based on my research which I believe contributed to hitting these times. In this article I will share the 5 most important ones I used on the racing day.

1 Use the max # of red blood cells possible

Preparation: 10mins before the race I performed some gentle breath holds. Ideally, they should have been a lot stronger to get the spleen and EPO effect but even the way I did them was still beneficial in my opinion.

2 Breathe Nasally as much as possible

Race: The easy part of the race – which was not a lot – was done with nose breathing, teeth touching & tongue at the top of the pallet. The reason for that was to stay as much as possible in a parasympathetic state (ie. keep my HR low).

3 Breathe at a steady rhythm

Race: During most of the race I tried to keep a rhythm in my breathing. The rhythm had to change during the race based on my stride. The slower the stride the “lighter” the breathing. Maintaining a rhythm in the breath is a common recommendation for runners. What I found necessary was to modify the rhythm in different sections of the race.

4 Recover half-way when possible

Race: The recovery parts of the race during which I had to “change gears” were by far the most critical “breath-wise”. During some of them, I had to slow down in order to reset my breath.

5 Recover faster by addressing the biomechanics

Post-race: I lay on the grass to recover but soon after I remembered that lying on my belly would help me recover faster (which it did). The reason has to do with the biomechanics of breathing.


Does Buteyko breathing really work?

Does Buteyko breathing really work?

Developed by Russian doctor Konstantin Buteyko in the 1950s the Buteyko Method is a system aiming to restore the levels of healthy CO2 in the body through breathing exercises. It has been found beneficial among individuals with cancer, high blood pressure, anxiety, asthma, allergies, snoring and sleep apnea.

I got certified as a Buteyko instructor in 2017 and in this article I answer some of the most frequently asked questions on the Buteyko Method (BM).


The Benefits

What are the benefits of practicing the BM?

By restoring optimal levels of CO2 in the body the BM promotes healthy function in our cells, tissue, organs and systems.

Our body’s organs depend on sufficient supply of oxygen to function. Due to the Bohr effect this can only be achieved through healthy levels of CO2 – as CO2 & O2 work synergistically. To that extent optimal organ function relies on healthy levels of CO2.

Knowing that, it may come as no surprise that K. Buteyko noticed early in his career as a doctor, a lot of chronically ill patients breathing poorly.


How does the BM improve breathing?

The way we breathe depends on our posture and our respiratory biochemistry. The Buteyko Method focuses on the later, through exercises that aim to restore optimal levels in the 3 blood gases: Nitric Oxide, Carbon Dioxide and Oxygen.

No matter how good your posture is if you breathe like an asthmatic armadillo you will suffer the consequences.

The benefits of the Buteyko training can be amplified however when combined with yoga.


Can the BM help with asthma or other respiratory issues?

The Buteyko Breathing has been found in research to benefit adults (ref1, ref2) and children (ref) with asthma as well as those with Obstructive Sleep Apnea (ref). These findings however, do not pay justice to the numerous cases of individuals that have benefited from the practice.

Once someone understands the logic behind the Buteyko Method he will not seek further proof to believe in its importance.


The Criticism

How long does it take to see results from practicing the BM?

Positive results from the Buteyko practice in most cases are evident within 2-3 weeks. In my experience there are 3 reasons this is not always the case:

1 Breathing is not compromised at first place.

There are instances when the symptoms of other imbalances overlap with those of dysfunctional breathing. If you implement a breathing protocol without any breathing issues chances are you will see little to no benefit in your symptoms. For that purpose an initial assessment is important.

2 The exercises practiced are not appropriate.

For any protocol to have an effect, it needs to provide the appropriate stimuli. If you follow a Buteyko exercise which is too easy for you, chances are you will not see much effect from it.

3 Compliance is poor.

Sometimes 90% (or even 99%) is not enough. While some individuals will see results by adopting 50% of the recommendations others will need to be 100% compliant.


Are there any risks or side effects associated?

NO. The reason is very simple. The cornerstone of BM is to incrementally increase the exposure of an individual to CO2 so he becomes more tolerant to it over time. Our body is very sensitive to CO2 and thus will resist its build up way before it reaches moderate levels (used in lab experiments), let alone dangerous levels. Anyone that argues otherwise has not done any breathwork and speaks theoretically.


Is it a complete breathwork system?

The Buteyko Method has 2 primary weakness as a breathing system:

1 Not addressing sufficiently breathing biomechanics.

2 Not incorporating enough exercises at a high Heart Rate.

That is due to the fact that K. Buteyko worked primarily with sick individuals. Oxygen Advantage includes some breathing exercises relevant for athletes.


Are there any scientific studies or research supporting the effectiveness of the BM?

Research on asthma (ref) and Eustachian tube dysfunction (ref) has indicated that the Buteyko Method and the Control Pause are beneficial for patients with compromised breathing.


The Application

Can it be combined with other forms of exercises or training?

Absolutely. I will argue that, for best results the Buteyko Method HAS TO be combined with one or more physical exercises. Which one depends on one’s status of physical health and the goals. Good candidates are: yoga, pilates and cardiovascular training.


How can I get started?

The best way to get started with the Buteyko Method is understand the principles and adopt a 10-20 mins protocol appropriate for your level of respiratory capacity and goals. If the exercises you adopt don’t meet the above 2 critical you are unlikely to see any benefits.


My opinion in a nutshell


K Buteyko

Buteyko Breathing for sinus infection

Sinusitis is caused by swelling or inflammation of the tissue lining the sinuses, leading to nasal blockage and breathing discomfort. Those seeking natural relief can use Buteyko Breathing for sinus infection as it will help them restore their respiratory hygiene and function.


What helps breathing with sinus infection?

Those suffering from sinus infections can find relief through the following methods:

1. Use decongestant essential oils

• peppermint oil, which also has anti-bacterial (ref), and anti-inflammatory properties (ref).

• eucalyptus oil (ref).

• lavender oil, which also has pain-relieving properties (ref).

• tea tree oil, that has antiviral, antifungal, and antibacterial properties (ref).

• oregano oil, which can stop bacteria from growing (ref).

• rosemary oil (ref).

• clary sage oil, which acts as an antimicrobial agent (ref).

2. Massage the maxillary sinuses

to encourage fluid drainage.

3. Have a hot bath

Apply a warm compress (towel or water bottle) or breathe over a humidifier as the heat will loosen up the mucus in the nasal cavity.

4. Practice hypercapnic breathing exercises

CO2 training will help keep your airways open.



Can breathing exercises help sinusitis?

The way we breathe determines our nose’s hygiene. Hyperventilation, mouth-breathing, and erratic breathing are types of dysfunctional breathing that promote inflammation in the sinuses and lead to a blocked nose. The Buteyko Method through the application of basic biochemical principles can help reduce inflammation and restore good respiratory function.

In order to unblock your nose, you need to increase your levels of CO2 and NO in your nasal cavity.

A quick way this can be achieved is by performing short breath-holds:

Inhale – Exhale – Pinch your nose for 60% of your max capacity – Inhale from the nose – take 3 recovery breaths – repeat x7

The longer the breath holds, the higher the build-up of CO2 and NO, while the more physically active you are CO2 will further increase. You can increase CO2 levels by moving your body from side to side on the spot or walking during the breath-holds. What matters most is to keep the recovery breaths short and nasal.


Does chronic sinusitis ever go away?

In contrast with acute sinusitis, chronic sinusitis is more likely to be caused due to chronic dysfunctional breathing patterns (ref). Increasing one’s Control Pause [video] to 30 sec will be a step in the right direction.

Sinusitis is considered chronic if it persists for 12 weeks or more. The symptoms may include:

  • Nasal congestion
  • Pus in the nasal cavity
  • Runny nose
  • headaches, tooth pain, bad breath
  • Fever

While the exercise with the short breath-holds described above can still be used, a more structured approach will be needed.


Can deviated nasal septum cause sinusitis?

If the septum has deviated far enough it may block the nasal passage increasing the chances of sinusitis. The more one uses his nose 👃🏼 the less likely it will be for the nasal passage to get blocked and fluids to back up in the sinus cavity. For that reason, even following an operation, it can be beneficial for the individual to practice some breathwork in line with the Buteyko Method, such as CO2 Breathing Therapy.

Can sinusitis affect your lungs?

While sinusitis is considered an upper respiratory infection (URI) it is sometimes linked with poor diaphragmatic recruitment or lung function. As the respiratory tract operates as a system consisting of different organs, the function of breathing muscles needs to also be considered in respiratory infections.

In a paper published on the 23rd of March 2020 (ref) 12 patients (7 men and 5 women) with SARS-CoV-2 and symptoms of acute respiratory distress syndrome at the Jinyintan Hospital showed improved lung function when alternating between pronated and supine position vs supine only.

Most importantly…

The way you breathe on a daily basis is going to play a significant role in the occurrence and severity of sinusitis. You can improve the way you breathe when you are not conscious of it with the 5 day online Breathe Right course.


Breathwork for Pregnancy

Breathwork for Pregnancy

Breathing exercises during pregnancy will allow you to stay relaxed, focused and support adequate oxygen delivery to the fetus and your body. The safest and easiest way to achieve that is by breathing slow, softly, and nasally in a seated position.

The purpose of the article is for educational purposes only. Prior to practicing, consult your primary physician.


Your breath is going to change throughout pregnancy. If you want to learn:

• How will your breath change during these 9 months?

• Which breathing exercises are safe in the 1st trimester?

• How to breathe in order to support oxygen delivery to the fetus?

Read on…


Benefits of breathing exercises during pregnancy

Different breathing exercises during pregnancy can help:

  • You improve blood circulation and thus oxygen and nutrient delivery to the fetus and your body organs.
  • Keep your muscles relaxed, alleviating some of the tension some times builds up due to stress
  • Keep your nervous system calm
  • Breathe comfortably, while the natural increase of progesterone and the growth of the baby will make breathing harder.

A 2010 study showed that fetuses respond to maternal stress with changes in their fetal heart rate (FHR). Stress hormones appear to impact blood flow to the fetus through their vasoconstrictive effect on the placenta (ref). So…

By breathing better you are looking after your baby.

Women at risk of premature labor benefited from massage therapy, breathwork, and hypnotic relaxation while the type of delivery and duration of labor was shown to positively correlate with having practiced yoga (ref). So…

Breathwork increases your chances of an easy pregnancy.


Is breathwork safe for pregnancy?

Breathwork is safe in pregnancy provided the new mother has developed awareness of her breathing first. In the absence of prior experience, breath holds and breathing techniques involving hyperventilation should be avoided as they can cause oxygen deprivation to the fetus.

A few red flags 🚩 are:

🚩 You have pre-existing health conditions. If you previously experienced any neurological, cardiovascular or blood sugar regulation conditions you should be extra cautious and work with an instructor.

🚩 Gestational diabetes. Lowering of O2 saturation can cause a sudden drop of 🩸 blood sugar. While some breathing exercises will be appropriate using an oximeter during practice is highly advisable.

🚩 The use of medication. This, of course, is a case-by-case scenario and actually, there are very few counterindications. It is worth checking with your physician first though.

Having said that, during the 9 months of pregnancy life doesn’t stop. Pregnant women perform cardio workouts, swim, and practice yoga all of which directly challenge the respiratory system. As the focus of all breathing sessions during these 9 months will be to make breathing comfortable at no point there should be a loss of consciousness or strong air hunger.

To be extra cautious with breathwork you can invest in an oximeter which will allow you to monitor continuously both your HR and SPO2.

When to start breathing exercises during pregnancy?

Breathing exercises that involve either monitoring the breath or slow manipulation of the inhalation and exhalation can be performed from the very start and can help deal with nausea, cramps, and lower back pain.

At what point in pregnancy does it become hard to breathe?

Shortness of breath is common both at the start of the pregnancy due to an increase in the progesterone hormone and around weeks 31-34 when the uterus is likely to press against the diaphragm.

During the 3rd trimester and as the fetus grows the pressure in the lungs increases limiting lung capacity. The additional weight of the fetus will also tax the cardiovascular system and thus the respiratory. It is often at that stage that breathing becomes labored even during simple tasks such as walking and laying down.

How can I increase my oxygen levels during pregnancy?

To maintain oxygen delivery to the fetus and your organs you need to maintain adequate levels of CO2 (due to the Bohr effect). Did you know that CO2 has therapeutic properties? This can be achieved by breathing as softly as possible through the nose 👃🏼, making the exhalations x1-2 longer than the inhalations.

Start by breathing in for 4 seconds out for 4 seconds. If that feels comfortable gradually increase the exhalations to 6 seconds and then 8 seconds.

Within 10 mins you will feel a lot better.


3 best breathing exercises during pregnancy

Synchronize heart and belly breathing

Place one hand ✋🏼 on the chest and one 🤚🏼 on the belly, in a seated position and with your back supported 🪑. As you inhale feel your hands moving. You may notice 1 of the 2 hands moving more than the other. Try to expand both parts of your body (chest and belly) evenly. Perform that for 5 mins and then place your hands on your knees. Recover your regular breathing but keep your attention on your chest and belly.

Ujjayi breathing

Ujjayi breath is achieved by constricting the back of the throat during exhalation creating a deep sibilant breath 🌊. As Timothy McCall mentions in his book: Yoga as Medicine, the constriction can be generated by imitating that you are trying to fog your glasses. The breath should be performed through the nose at all times. When practitioners are starting out they may find it easier to produce an audible sound 🔊, but over time the sound becomes so gentle that is hard to notice 🤫.

Alternative Nostril Breathing

In Alternative Nostril Breathing, the inhalation and the exhalation of each cycle take place from a different nostril and the direction reverses at the end of each cycle. Start by breathing in from the right nostril, exhale from the left, breathe in from the left, exhale from the right…



Is belly breathing, good for pregnancy?

The reason I don’t recommend belly breathing during pregnancy is due to the tension it can bring to the abdominal muscles, increasing this way the risk of abdominal diastasis❗️ A safer recruitment of the diaphragm, is through the slow inflation of the lungs 🫁, and outward expansion of the ribcage.

Pelvic floor contractions have also been shown to improve respiration (ref), while experienced practitioners will have no problem performing belly breathing without tensing their abdominals (and thus staying safe).



Breathwork for pregnancy 🤰🏻 is very powerful yet it is much easier to practice if you have prior experience. Knowing that if you planning on getting pregnant in the next 6 months start soon❗️


Wim Hof Breathing Explained

Wim Hof Breathing Explained

Wim Hof Breathing consists of 30 deep – rhythmic breaths, followed by 2 breath-holds (x1 max + x1 10sec long). Practitioners usually perform x3-5 rounds. It is part of the Wim Hof Method, which combines this breathing technique with cold exposure.

If you want to understand:

a. What happens during the Wim Hof Breathing and why?

b. If the hype about Wim’s Breathing has some merit?

c. How Wim’s Breathing compares with Patrick McKowen’s breathing advice?

Read on…

What is the Wim Hof Breathing?

Each round of Wim Hof Breathing has 3 stages:

  1. 30 rounds of hyperventilation.
  2. A maximum breath-hold (on an exhalation)
  3. A 10-sec breath-hold (on an exhalation. You can also tense the upper back muscles for DMT activation!? 💥)

Should you breathe from the nose 👃🏼 or the mouth 👄?

Wim’s instructions are clear: “Get the air in your body whichever the hole.”


He encourages people to breathe deeply as he believes this way they will feel up their lungs 🫁 with air and every cell of their body with Oxygen. He will often instruct:

“Fully In, Fully Out.” or “Breathe In and Let Go.”

He may occasionally mention using the nose or the mouth but that’s not consistent. What he will say though is that:

“When you don’t feel well you should take it easy.”

By taking it easy, he means you should not breathe as deep. That is a very valid point and very much linked to the use of the nose vs mouth. As we will discuss in the next section, the effect of Wim’s Breathing is primarily due to the drop of CO2. When you breathe from the mouth the drop will be bigger and quicker. So whether you use your nose or mouth matters❗️

While the Breath Holds are a trademark of Wim Hof Breathing they are not any type of Breath Holds, as they are preceded by Hyperventilation. Hyperventilation gets people on a high and Breath Holds sends their adrenaline through the roof.

In a nutshell: “Wim’s breathing is a series of breath holds, on steroids.”.


What does Wim Hof breathing do to your blood?

The Wim Hof Breathing is a Hypocapnic Hypoxic technique.

Meaning both the levels of Carbon Dioxide and Oxygen fall below normal: ↓CO2 ↓O2. Here’s why:

One round of Wim Hof Breathing

Hyperventilation phase (30 breaths) 😤

  • O2 increases marginally in the blood as saturation of hemoglobin is always 95-97%
  • Carbon Dioxide (CO2) drops
  • pH increases (ie. blood becomes more alkaline) due to CO2 drop

Breath Hold phases 🤐

  • O2 levels in the blood reduce
  • CO2 in the blood increases until CO2 tolerance is reached and the brain 🧠 signals it’s time for the next breath
  • pH drops, due to the increase of CO2

This however is a theoretical model, let’s see what happens in reality❗️

A few rounds later…

Based on the Nijmegen study the CO2 levels of the participants at the end of each round were lower than at the start. As a result, the participants’ blood 🩸 was hypocapnic for the entire time. At one point oxygen levels drop as low as 50%, bringing the blood 🩸 into deep hypoxia.

Nijmegen Wim Hof Study


Its effect on Nitric Oxide (that no-one speaks about)

The Wim Hof breathing is likely to have a massive effect on Nitric Oxide.

The reason for this is due to the prolonged breath holds.Wim Hof Breath and Nitric Oxide

source: ref

The length of a breath hold increases the production of Nitric Oxide exponentially. With most practitioners’ breath holds reaching 2+ mins it is estimated that the NO levels reach 3-5000 ppb per round. This is much higher than any dosage of Nitric Oxide been used in clinical research.


Facts & Fads about the Wim Hof Method

1. Does Wim Hof Method increase breath hold?

No. Your breath-holding time during the Wim Hof Breathing is long only because you have hyperventilated. With each round of Wim Hof Breathing, the Breath Holds get longer because (a) you start from a lower level of CO2 and (b) your spleen has released more red blood cells (due to hypoxia: ↓O2).

Wim Hof Breathing Biochemistry

Your breath-hold time depends on your tolerance to CO2 which is not trained in this breathing technique.


2. Does Wim Hof breathing make you alkaline?

Yes, your blood will temporarily be more alkaline. As CO2 levels drop (and CO2 is acidic) your blood will be less acidic. For that reason when Wim tests his urine after the breathing exercise, he finds it alkaline. Soon after though, the body will excrete alkaline buffers through the kidneys to return the blood’s pH to the original levels.


3. Does Wim Hof increase oxygen levels?

Depends where. As a hypocapnic (↓CO2) breathing technique, the Wim Hof Breathing gets the oxygen trapped in the blood 🩸, due to the Bohr effect. So O2 in the blood will increase, but in the peripheral tissue, including the heart 🫀 and the muscles 💪🏼, will decrease❗️

The effects of hypercapnia

Litchfield, P. M. (2003). A brief overview of the chemistry of respiration and the breathing heart wave. California Biofeedback, 19(1), 1-11.


4. Does Wim Hof breathing improve CO2 tolerance?

No. In order for your tolerance to CO2 to increase, you need to practice hypercapnic breathing exercises.


5. Does your tolerance to cold improve with Wim’s breathing?

Possibly but not directly. You will improve your tolerance to cold by practicing cold exposure. The way that Wim’s breathing will help you tolerate cold is by increasing your noradrenaline levels, which was shown to last for 2 hours. As the Wim Hof Breathing makes use of the mouth a lot of the time it has a cooling effect, not heating.


FAQ about the Wim Hof Breathing

1. What are the benefits?

Most of the benefits are derived from the increase in adrenaline. For people that:

  • feel depressed
  • have a hard time starting their day
  • have a slow metabolism
  • have a weak immune system

the increase in adrenaline is likely to help them initially. Also for those that have a hard time switching off their mind, the shutting down of the oxygen supply during the technique will help them stop thinking.


2. How often should you do the Wim Hof breathing?

Start slow. Once every 2nd or 3rd day is a good place to start. In the absence of any side effects, you can increase the frequency. Be aware that some people have adverse effects in which case you should stop and seek the advice of a professional breathing instructor.


3. When to do Wim Hof breathing?

First thing in the morning 🌞, if they want to get a boost from adrenaline, or last thing at night, they want your mind to switch off 🌙. To avoid adrenaline disrupting your sleep you may want to practice nasal breathing only in the evening.

Similar to all breathing exercises it is best to practice with an empty stomach and after you have urinated.  As your cognitive functions may be compromised soon after, it is best to leave at least 30 mins gap prior to driving, swimming, or doing any activity during which cognition is critical.

I also know people that practice prior to having sex.


4. Compare Wim Hof & Oxygen Advantage

While Wim Hof Breathing is a single technique, Oxygen Advantage is a system of breathwork. Oxygen Advantage (OA) is based on the Buteyko Method and is geared to help athletes improve their performance through breathwork.

While Wim’s breathing is a hypocapnic & hypoxic technique, Patrick’s system brings the body into hypercapnia & hypoxia.


5. Combining the Wim Hof & Oxygen Advantage

While there are no clear to me, synergies between the 2 systems nothing prevents you from combining them. What I have noticed in consultations is that hypercapnic training allows practitioners to enjoy Wim’s breathing by hold their breath longer.



6. My take on the Wim Hof Breathing

Since 2017 (when I got certified in the method), my understanding of breathing has evolved and for purposes of efficiency and safety, I teach a modified version of the Wim Hof Breathing.

In an effort to stay politically correct I will not express further my views in this article but will encourage the reader to truly understand the implications prior to practicing.


This article covers what effects Wim Hof Breathing has in the way most people practice it. It is meant to serve for educational purposes only and it is not an endorsement of the technique. Based on Harvard’s Copyright and Fair Use guidelines here I am expressing my opinion.



If you read the entire article you know more about Wim Hof Breathing than I knew when I finished the Wim Hof Method training in 2017, as non of the above was covered there.

If you are experiencing anxiety, headaches, or sore throat after the Wim Hof Breathing, you may benefit by modifying the practice. Ignoring any side effects is unwise.