When people think about concussion recovery, they often picture specialized therapies, rehabilitation exercises, advanced imaging, or cutting-edge technology.
Rarely do they think about breathing.
After all, breathing is automatic. We do it more than 20,000 times every day without giving it a second thought.
But what if the way you're breathing is quietly influencing your brain fog, dizziness, anxiety, heart rate, sleep, and even your ability to heal?
In a recent episode of Life After Impact, I sat down with chiropractic neurologist Dr. Jonathan Chung to discuss why breathwork has become one of the very first interventions he teaches many of his concussion patients. His answer was surprisingly simple:
"If you can learn to control your breath, you can begin to influence your physiology."
For many people recovering from a concussion, that realization can be incredibly empowering.
Why Breathing Changes After a Concussion
Many people don't realize that breathing is regulated by the brain itself.
While we can consciously choose to take a deep breath, the vast majority of our breathing is controlled automatically by centers within the brainstem — particularly the pons and medulla. These regions constantly adjust our breathing based on our body's changing needs.
A concussion doesn't just affect thinking and memory. The rapid acceleration and deceleration forces that occur during a concussion can also place stress on deep brain structures — including the pathways involved in autonomic regulation and respiration. At the same time, many people develop dysfunction of the autonomic nervous system, shifting toward a state of heightened sympathetic ("fight-or-flight") activation.
The result?
Your breathing may become faster, shallower, and less efficient without you even realizing it.
Could Your Breathing Be Contributing to Your Symptoms?
Many concussion patients describe symptoms like:
- Brain fog when they wake up
- Feeling 'hungover' despite not drinking alcohol
- Air hunger or the sensation of never getting a satisfying breath
- Anxiety that seems to come out of nowhere
- Racing heart
- Poor sleep
- Fatigue
- Dizziness
While these symptoms can have many causes, dysfunctional breathing patterns can become part of the picture. Dr. Chung explained that one of the first things he evaluates is how someone breathes — not simply whether they breathe enough.
He's looking for clues such as:
- Rapid resting respiratory rate
- Chest-dominant breathing
- Shoulder elevation with every breath
- Tight neck muscles (particularly the scalenes and sternocleidomastoid muscles)
- Limited rib movement
- Restricted diaphragm motion
These mechanical changes often develop gradually and may become so habitual that people no longer recognize them.
Breathwork Isn't Just About Relaxation
Many people hear the word breathwork and immediately think of meditation.
But from a functional neurology perspective, breathwork is much more than a relaxation exercise. It is a way of directly influencing the autonomic nervous system.
Unlike many bodily functions, breathing is one of the few automatic processes we can consciously control. That makes it a unique doorway into our physiology.
Every slow, intentional breath sends information back to the brain. Every prolonged exhale tells the nervous system: "You're safe."
Why the Exhale Matters So Much
One of my favorite parts of our conversation was Dr. Chung's explanation that many people focus on taking a big inhale. But the real therapeutic power often lies in the exhale.
A longer, slower exhalation increases activity within the parasympathetic nervous system — the branch responsible for rest, recovery, digestion, and healing. It also stimulates the vagus nerve, helping reduce heart rate and shift the body away from chronic fight-or-flight physiology.
A simple shift in perspective
Instead of thinking:
"Take a deep breath."
Try thinking:
"Take a slow breath out."
Sometimes that simple shift can make all the difference.
Breathwork and Heart Rate Variability
One reason functional neurologists often recommend breathwork is its effect on heart rate variability (HRV) — the tiny changes in time between each heartbeat. Although it sounds subtle, it provides important insight into how adaptable your autonomic nervous system is.
Higher HRV
Suggests greater flexibility and resilience in the nervous system.
Lower HRV
Often reflects chronic physiological stress and reduced adaptability.
Dr. Chung frequently begins treatment by using HRV biofeedback while patients practice slow breathing, allowing them to watch their nervous system respond in real time. Instead of hoping something is happening — patients can actually see it.
A Simple Starting Point: Five Minutes Per Day
One thing I appreciated about Dr. Chung's approach is how practical it is. He doesn't ask patients to meditate for an hour. He simply asks for five minutes a day.
His preferred starting strategy is often called resonance frequency breathing, which generally involves breathing at approximately six breaths per minute.
For most people, this means:
Inhale
Exhale
This slightly longer exhalation supports vagal activity and improves HRV.
For individuals with severe dysautonomia or POTS, even this may be too much initially. Dr. Chung emphasizes meeting the nervous system where it is — sometimes beginning with a gentler 3-second inhale and 3-second exhale before gradually progressing.
Recovery is not about forcing the nervous system. It's about teaching it.
What Is Resonance Frequency Breathing?
Not all breathing exercises are created equal. Resonance frequency breathing was developed through decades of research on HRV and the autonomic nervous system. Rather than simply "taking deep breaths," the goal is to synchronize several natural rhythms within the body so they begin working together instead of competing.
Think of it like pushing a swing.
If you push at exactly the right moment, the swing travels higher and higher with very little effort. Push at the wrong time, and the motion becomes inefficient. Your cardiovascular system behaves in a surprisingly similar way. At a certain breathing rate — usually around 4 to 6 breaths per minute — the heart, lungs, blood vessels, and autonomic nervous system begin to oscillate together. Researchers call this your resonance frequency.
When these systems synchronize, the effects on physiology become much larger than breathing alone would suggest.
Why Does It Work?
Every time you inhale, your heart rate naturally speeds up slightly. Every time you exhale, your heart rate naturally slows. This completely normal phenomenon is called respiratory sinus arrhythmia (RSA).
Many people hear the word arrhythmia and think something is wrong. In this case, it's actually a sign of a healthy, adaptable nervous system. The greater this natural variation between inhalation and exhalation, the healthier the communication between your brain and heart tends to be.
Resonance frequency breathing amplifies this effect — instead of your heart rate making tiny adjustments with each breath, it begins producing larger, smoother oscillations associated with increased vagal activity, improved autonomic flexibility, and higher heart rate variability.
The Baroreflex: Your Body's Built-In Blood Pressure Regulator
One of the most fascinating effects of resonance breathing involves something called the baroreflex — a feedback loop most people have never heard of, yet it's working every second of every day.
Specialized pressure sensors called baroreceptors sit within the carotid arteries in your neck and in the aortic arch leaving your heart. Their job is to monitor blood pressure and signal the brainstem to adjust heart rate and blood vessel tone accordingly.
After a concussion
Many patients with dysautonomia or POTS have impaired baroreflex sensitivity, making it more difficult for the nervous system to rapidly stabilize circulation. Research suggests resonance frequency breathing may strengthen this reflex over time by repeatedly exercising the communication loop between the heart, lungs, blood vessels, and brainstem.
It's almost like physical therapy for your autonomic nervous system.
Why Nasal Breathing Matters
Another fascinating topic we explored was nasal breathing. Breathing through the nose does much more than filter and humidify the air.
Emerging research suggests that nasal breathing enhances communication across widespread areas of the cerebral cortex, potentially improving attention, learning, memory, and neuroplasticity. Some studies have even found that people perform better on certain cognitive tasks while breathing through their nose compared with mouth breathing.
Researchers believe this may be related to activity within the olfactory system, which has extensive connections to frontal brain regions involved in cognition and executive function.
Breathwork Gives You Something Many Patients Feel They've Lost
Control.
One of the most heartbreaking parts of concussion recovery is the feeling that your body no longer listens to you. Your heart races. Your dizziness appears without warning. Your brain feels overwhelmed by ordinary life.
Breathwork offers something different. It doesn't promise instant recovery.
It offers agency. Every slow exhale becomes a reminder that your nervous system is not completely beyond your influence.
My Perspective
One of the reasons I was so excited to record this episode is because breathwork embodies something I believe deeply about concussion recovery.
Healing doesn't always require another prescription. Sometimes it begins by improving the systems your body already possesses.
Breathing is free. It's portable. You can practice it anywhere. And while it may seem deceptively simple, its effects ripple through nearly every system involved in concussion recovery — from autonomic regulation and heart rate variability to sleep, anxiety, cognition, and resilience.
No, breathwork isn't a cure-all. But for many people, it becomes one of the foundational habits that helps the rest of recovery fall into place.
If you're recovering from a concussion or traumatic brain injury, don't underestimate the power of five intentional minutes a day. Sometimes the most profound therapies begin with something you've been doing your entire life — you just learn to do it differently.
Life After Impact Podcast
Episode 48 — Dr. Jonathan Chung
In my conversation with Dr. Jonathan Chung, we dive much deeper into the neuroscience of breathwork, dysautonomia, POTS, heart rate variability, nasal breathing, CO₂ tolerance, and practical breathing techniques you can begin using today.
If you're looking for a simple, evidence-informed tool to support your concussion recovery, this is an episode you won't want to miss.
Listen to Episode 48