Recovering from a concussion is not just about rest and physical healing. Many patients experience lingering symptoms such as anxiety, brain fog, dizziness, and emotional ups and downs. These challenges are often linked to an overstimulated autonomic nervous system, which can keep the body in a “fight-or-flight” state long after the initial injury.
One simple and effective tool for helping regulate your nervous system is box breathing, a structured breathing technique that promotes calm, focus, and overall recovery.
Learn more about box breathing from our companion blog: Box Breathing Exercise
David Buechner, MD, is a highly skilled radiologist and neurointerventional specialist who leads the medical team at Keystone Medical Group. He provides expert interpretation of advanced imaging, including MRI Diffusion Tensor Imaging (DTI), to identify subtle brain changes in patients with traumatic brain injuries, concussions, and other complex injuries.
In addition to his imaging expertise, Dr. Buechner leads a research program using a novel regenerative medicine therapy for TBI, developing targeted treatments to improve recovery and enhance patient outcomes. He oversees all aspects of patient care, ensuring that diagnostic precision, innovative therapies, and coordinated rehabilitation work together to support both cognitive and physical healing.
Dr. Buechner’s guidance allows clinicians to create individualized treatment plans while providing patients and their families with clear insights into recovery progress. Patients throughout Kansas City and surrounding areas trust his expertise to guide their care, achieve optimal outcomes, and regain confidence in their daily lives.
Box breathing, also called square breathing, is a controlled breathing exercise that helps reset the nervous system. By slowing your breath and creating a consistent rhythm, it stimulates the parasympathetic nervous system, encouraging your body to shift out of stress mode and into a state of relaxation.
For concussion patients, this can mean improved focus, reduced anxiety, and better regulation of daily symptoms.
Box breathing is simple, portable, and can be done anywhere. Follow these steps:
Inhale slowly through your nose for a count of four.
Hold your breath for four seconds.
Exhale gently through your mouth for four seconds.
Hold again for four seconds.
Repeat for four to six cycles or for two to five minutes.
You can adjust the timing to three, five, or six seconds per phase depending on comfort. Consistent practice enhances its calming effect and supports better daily symptom management.
Box breathing offers several advantages for patients recovering from brain injuries:
Reduces stress and anxiety by activating the parasympathetic nervous system
Improves focus and mental clarity through mindful, rhythmic breathing
Enhances nervous system balance which can positively influence heart rate variability (HRV)
Supports symptom management including dizziness, headaches, and irritability
Patients often find it helpful to use box breathing:
First thing in the morning to start the day calmly
Before or during therapy sessions to prepare the mind and body
During stressful moments or symptom flare-ups
Before bed to promote restful sleep
Even a few minutes a day can make a noticeable difference in managing post-concussion symptoms.
While box breathing is a powerful tool, it works best as part of a complete concussion care program. At Keystone Medical Group, we combine breathing techniques with neurocognitive testing, balance assessments, vestibular therapy, and personalized medical care to optimize recovery. Deep breathing exercises like box breathing enhance these therapies by calming the nervous system and improving focus during rehabilitation.
If you or a loved one are recovering from a concussion, incorporating box breathing can help manage symptoms and support your overall recovery.
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