How Proper Posture and Breathing Can Minimize Doctors' Stress

Nadine Kelly, MD


January 20, 2022

This is the first in a series of instructional videos and guidance from Nadine Kelly, MD (Yogi MD) helping healthcare professionals to use yoga techniques to reduce daily stress and focus on their personal well-being. To view the accompanying video, click here.

The fast-paced and demanding lifestyle of healthcare professionals fosters a state of chronic stress that may have numerous insidious physical and mental consequences.

Nadine Kelly, MD and yoga instructor.

For example, chronic stress and burnout, especially during the COVID-19 pandemic, have been associated with increased cortisol levels. The fight-or-flight response resulting in the sustained elevation of cortisol and other stress hormones may lead to hypertension, cardiovascular disease, a weakened immune response, increased appetite, weight gain, poor memory and sleep, and symptoms of anxiety or depression. Deep breathing has been shown to mitigate the effects of chronic stress by stimulating the calming parasympathetic nervous system.

Fundamental yoga practices include proper breathing, supported by proper posture. Shallow breathing not only taxes accessory muscles of respiration, but it also may affect posture and vice versa, leading to the physical and mental consequences of chronic stress.

Diaphragmatic breathing, also called "belly breathing," is the practice of breathing slowly, smoothly, continuously, soundlessly, and deeply in and out of the nostrils, allowing the abdomen to move naturally. Diaphragmatic breathing accommodates lung expansion from apex to base, allowing for literal breathing room, making it easier to get a deep breath. Proper posture — sitting and standing tall, rather than slouching with the head and shoulders slumped forward — allows for easier diaphragmatic breathing, too.

Practicing deep breathing and proper posture is an easy, quick way to take account of your body and mind and perhaps may even lead to a calmer, less painful, and more focused day.

In yoga, a tall posture, whether sitting or standing, is called "mountain pose." Here's how to do seated mountain pose:

  1. Place your feet flat on the floor, making sure that they are parallel to one another, toes pointing straight ahead.

  2. Next, stack your knees over your ankles. Sit with a neutral pelvis, with the anterior iliac crests facing forward, while balancing on the ischial tuberosities.

  3. Then stack your shoulders over your hips. Your shoulders should be aligned with your hips and down away from your ears.

  4. Imagine that the crown of your head touches the ceiling so that you can create length and space in your neck.

  5. Finally, make sure that the back of your head lines up with the back of the sacrum. Relax your hands in your lap, either palms down or palms up. Lengthen your spine, relax your face. You are now as tall as a mountain.

Once settled in seated mountain pose, breathe slowly, deeply, soundlessly, and continuously through the nostrils. Inhale and exhale through the nostrils, expanding and deflating the abdomen like a balloon. Experiment with how many seconds you spend breathing in and out and with the length of each inhalation or exhalation (see how you feel with a longer exhale than inhale, for example), and keep note of how you feel before, during, and after your practice.

Nadine Kelly, MD is a retired pathologist, experienced yoga instructor, health integration coach, American Council on Exercise–certified Health Coach, and host of the YOGI M.D. podcast. 

Kelly practiced in a thriving community setting for several years. Despite numerous warning signs, she had a health crisis. It was more than burnout, and it was more than a weekend getaway could solve. Seeking help from her internist, she was diagnosed with major clinical depression. She took a leap and became a yoga instructor, empowering people to maintain the healthy bodies and minds they need to live life on their own terms, at every stage.


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