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Breathing is important in the Pilates method. In Return to Life, Pilates devotes a section of his introduction specifically to breathing

"bodily house-cleaning with blood circulation". He saw considerable value in increasing the intake of oxygen and the circulation of this oxygenated blood to every part of the body. This he saw as cleansing and invigorating. Proper full inhalation and complete exhalation were key to this. "Pilates saw forced exhalation as the key to full inhalation." He advised people to squeeze out the lungs as they would wring a wet towel dry. In Pilates exercises, the practitioner breathes out with the effort and in on the return. In order to keep the lower abdominals close to the spine; the breathing needs to be directed laterally, into the lower rib cage. Pilates breathing is described as a posterior lateral breathing, meaning that the practitioner is instructed to breathe deep into the back and sides of his or her rib cage. When practitioners exhale, they are instructed to note the engagement of their deep abdominal and pelvic floor muscles and maintain this engagement as they inhale. Pilates attempts to properly coordinate this breathing practice with movement, including breathing instructions with every exercise. “Above all, learn to breathe correctly.” Humans breathe on average around 18,000 breaths per day. Posterior lateral breathing is a way of breathing that facilitates bibasal expansion of the rib cage, this encourages the breath to travel down into the lower lungs and cleanse the blood by the exchange of oxygen with carbon dioxide. To understand this concept properly the practitioner has to first learn to expand and release the rib cage without deliberately breathing in or out. The in-breath (inhalation) and out-breath (exhalation) should occur instinctively as a result of the conscious expansion and release of the rib cage. This is how it is done: The practitioner places their hands on their lower ribs with their thumbs facing the back of their rib cage, trying not to think of breathing, relaxing their upper abdominals, and expanding their rib cage to the side against the soft resistance of their hands. Release the expansion of the rib cage by first melting away the area of the clavicles. This can also be tried with a scarf around the lower rib cage. The practitioner will not be able to expand and release the rib cage effectively if they try to contract their abdominal muscles to expand the rib cage and if they try to contract the rib cage instead of first releasing it.