How Box Breathing Helps Reduce Tension, Stress, and Pain
- Elena Biagioni PT, DPT, OCS
- Feb 10
- 3 min read
Good morning patrons of Padme PT!
New this week: the clinic has a new ’Breathing Technique of the Week’ chart on display.
What are some benefits of breath work?
+ Enhanced tissue repair through stress relief and improved sleep
+ Pain management
+ Improved focus and relaxation
+ Regulated nervous system, which can also lower blood pressure
+ Stronger breathing muscles
This week's technique is the Box Breath.
What Is Box Breathing?
Box breathing is a simple breathing technique that helps calm your nervous system and reset your body when you’re feeling stressed, tense, or overwhelmed. We often use breathing techniques in physical therapy because your breath has a powerful effect on muscle tension, pain, and how your body heals.
The name “box breathing” comes from the four equal parts of the breath, like the four sides of a box.
How Box Breathing Works
You’ll move through four slow steps, each lasting the same amount of time:
Breathe in through your nose for 4 seconds
Hold your breath for 4 seconds
Breathe out slowly through your mouth for 4 seconds
Pause with empty lungs for 4 seconds
Repeat for 5-10 cycles, or up to 5 minutes for maximum benefits.
Modification options:
If 4 seconds feels like too much, you can shorten it to 3 or 2 seconds. The goal is slow, steady breathing, not forcing it.
If you become lightheaded, take a break and then try it again with 2 second intervals
Interesting background on box breathing: it's used by Navy SEALS “The nervous system is not fixed; it’s plastic,” Dr. Young says. “We can change it by learning how to be less responsive to stress and how to calm that response.”
Why We Use Box Breathing in Physical Therapy
When you’re stressed or in pain, your body stays in a “fight or flight” mode. This can increase muscle tension, make pain feel worse, and slow down healing. Box breathing helps switch your body into a calmer, more restorative state.
When to Use Box Breathing
Box breathing is especially helpful:
Before or after exercise
During flare-ups of pain
Before sleep
Anytime you feel anxious, tight, or overwhelmed
It’s a simple tool you can use anywhere, no equipment needed.
Interested in learning more? Here are some additional articles on the topic:
A Small Practice With Big Impact
Breathing may seem basic, but when done intentionally, it can make a meaningful difference in how your body feels and heals. Box breathing is one way to support your nervous system and complement your physical therapy care.
Reach out to us to learn more and look out for more breathing techniques in the coming weeks!
About the Author
Elena Biagioni PT, DPT, OCS is a licensed physical therapist at Padme Physical Therapy with a whole-body approach to care. She enjoys helping people experiencing shoulder pain (rotator cuff injury or repair, reverse/total shoulder replacement), knee pain (meniscus injury or repair, ACL repair, patellofemoral pain, total knee replacement), plantar fasciitis, low back injury (sciatica, muscle strain), hip pain (muscle strain, total hip replacement). Elena was first introduced to the healing power of physical therapy through sustaining a knee injury while training for a half marathon, and she enjoys helping people looking to return to running after injury or surgery. Elena believes that movement is medicine and she’s so happy to have made it her life’s work.
Interested in working with Elena Biagioni? Schedule an appointment
