Episode 33 | Ask the Expert | Guest: Julie Moore – Respiratory Physiotherapist, Institute of Sport, Exercise and Health
In a previous episode, Julie Moore – respiratory physiotherapist at the Institute of Sport, Exercise and Health – explored why fit people still get breathless and what breathing pattern disorders actually are. This time, Lucie invites her back for a more focused conversation: what happens to breathing when an athlete is under pressure, and what can be done about it before, during, and after competition.
The answer, as Julie makes clear, is nuanced. A degree of faster breathing before competition is not a problem – it is the body doing exactly what it should. The question is whether that response stays within useful bounds or tips into something that actively works against performance.
What actually happens to your breathing under pressure
The sympathetic nervous system – the body’s active and alert state – is heavily activated in the lead-up to competition. Breathing gets faster, heart rate rises, everything ramps up in preparation. This is not a malfunction. “That can really mean an amazing performance,” says Julie.
The problem comes when it overflows. Worrying thoughts, excessive sighing, breathing that gets too fast too soon – these can tip the physiological response from helpful to harmful. And once that happens, a cascade follows:
- Respiratory muscle fatigue: when breathing muscles work too hard too soon, blood is diverted away from the working limb muscles towards the respiratory muscles. The legs get less, the performance suffers.
- Falling CO2 levels: breathing too fast drives CO2 down, causing peripheral vasoconstriction – less blood to the muscles and the brain. Dizziness, chest tightness, and difficulty with quick decisions follow.
- Reinforcing anxiety: the physical sensations of over-breathing create doubting thoughts, which drive faster breathing, which worsen the sensations. A vicious cycle that is very hard to break mid-performance.
The concept of breathing flexibility
Julie’s central concept in this episode is what she calls “breathing flexibility” – the ability of the breath to rise to meet the demands of a situation and then come back down again afterwards. A flexible breathing pattern is one that can move from quiet, nasal, diaphragmatic breathing at rest, through higher, faster breathing during intense effort, and back down to slow recovery breathing afterwards.
This matters particularly for athletes competing in multiple heats in a day. The breathing that ramps up for a morning heat needs to come back down in the hours between sessions to allow proper recovery before the final. “Can you bring it back down again to get a couple of hours of recovery?” is Julie’s practical question for any athlete in that position.
Importantly, she does not want athletes to interpret this as “faster breathing is bad.” It is entirely normal for breathing to increase in a high-pressure situation, and suppressing that response would be counterproductive. The goal is flexibility and recovery, not control for its own sake.
Before competition: strategies that help
Know your optimal breathing pattern
The starting point is awareness. Understanding what efficient breathing feels like at rest – nasal, quiet, diaphragmatic, 8–12 breaths per minute – gives you a reference point to return to when things start to escalate. Julie recommends the Physiotherapy for Breathing Pattern Disorders website (physiotherapyforbpd.org.uk) as a useful self-assessment resource, including videos of what optimal resting breathing looks like.
Understand your triggers
Environmental factors – heat, humidity, pollution, allergens – can drive faster breathing before any nerves kick in. Being aware of what specifically makes your breathing escalate allows you to anticipate and mitigate it.
Keep the mouth closed
Simple but effective. When stressed, the mouth tends to drop open and breathing becomes bigger. Consciously keeping the mouth closed and breathing nasally in the hours before competition is a practical anchor. Alongside this: allow the shoulders to drop, think about the lower ribcage expanding outwards rather than the chest rising upwards.
Don’t force it
One of Julie’s more counterintuitive points: trying too hard to control breathing can backfire. The respiratory centre is sensitive to over-intervention and may respond by triggering a big, upper-chest breath. Sometimes listening to music, taking in the colours and shapes around you, or practising a relaxation technique that does not explicitly involve breathing is more effective than focusing on the breath directly.
During competition: what to do when it starts to unravel
Focus on the out-breath
Julie’s single biggest cue under pressure: breathe out. The anxious brain will fixate on breathing in, convinced there is not enough air. In most cases there is more air to come out first. Lengthening the out-breath creates space for a more natural in-breath and helps slow the overall rate.
Try cadence breathing
For runners, matching breath to stride – entrainment – can provide the rhythm the respiratory centre needs to settle. The specific ratio (in for three, out for four, for example) matters less than finding something that feels comfortable and consistent. A rhythmic breathing pattern is far more reassuring to the body than an erratic one.
If it goes badly wrong: tune out or use box breathing
When breathing becomes genuinely erratic and distressing mid-event, Julie offers two options:
- Tune out: lift the head, widen the gaze to take in the peripheral environment, drop the shoulders, and smile. There is evidence that widening the visual field helps downregulate the sympathetic nervous system. Smiling changes the emotional and physical state. These sound trivial; they are not.
- Box breathing: breathe in for a count, hold, out for a count, hold – following the shape of a box. Julie is candid that she generally dislikes box breathing as a routine practice (nobody breathes in squares normally), but as an emergency reset for a respiratory centre in chaos, the structure and rhythm it imposes can be genuinely useful. Even short counts – in for two, hold for two, out for two, hold for two – can provide enough rhythm to interrupt the spiral.
After competition: recovering efficiently
Recovery breathing is often neglected, but it directly affects how quickly the body restores itself for the next effort. The goal is to shift from sympathetic (active, alert) to parasympathetic (rest and recovery) as efficiently as possible.
The transition involves moving from faster mouth breathing back to slower nasal, diaphragmatic breathing – matching the breath to what the body is actually doing as it winds down. Julie notes that research points to six breaths per minute as the rate at which the parasympathetic nervous system is most strongly activated, which improves heart rate variability and accelerates recovery.
She is careful to note that jumping straight to six breaths per minute is not realistic if your resting rate is 16 to 18. The practical approach is to work towards 10 to 12 first, and to make any slower breathing feel genuinely comfortable rather than forced. A tense, uncomfortable attempt at slow breathing will not activate the parasympathetic state.
Two things to practise every day
Julie ends with two simple daily habits:
- While watching TV: close the mouth, allow the belly to rise and fall, and notice a natural pause after the out-breath. The breathing should be small and minimal.
- While cleaning your teeth: watch yourself in the mirror. Take a deep breath in and check whether the shoulders rise. If they do, drop them. Place hands on the lower ribcage and feel it expand outward – to the sides – on the in-breath. That outward expansion, rather than upward chest lift, is what normal diaphragmatic breathing looks like.
The bottom line
Pre-competition breathing changes are normal, necessary, and not something to eliminate. The goal is a breathing pattern that is flexible enough to rise for performance and return for recovery – and an athlete who has enough awareness and enough tools to nudge it in the right direction when it starts to tip too far.
Julie’s single most important cue: focus on the breath out. Everything else follows from there.
For more on breathing pattern disorders, breathlessness in exercise, and what good breathing looks like at rest, see Julie’s previous episode on the LBSM podcast. For self-assessment resources, visit physiotherapyforbpd.org.uk.
Julie Moore is a Respiratory Physiotherapist at the Institute of Sport, Exercise and Health, Tottenham Court Road, London, where she runs a specialist respiratory clinic alongside Professor Hull. The clinic accepts self-referrals.
To book an appointment with the LBSM team, visit lbsm.co.uk/booking
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