How Breathing Pattern Disorders Cause Injuries and Pain

Andrew O' Neill Chartered Physiotherapist @ TC Physiotherapy

What are breathing pattern disorders?

Before I answer that question we have to understand what good functional movement is. It can be described as the following - the ability to produce and maintain an adequate balance of mobility and stability while integrating fundamental movement patterns with accuracy and efficiency within the body.

Why is this important?

If we can’t move efficiently we will more than likely have pain somewhere in the body or the in-efficiency itself may eventually lead to an injury. To be efficient in movement, even in general walking or running you have to be able to shift the body from one side to the other effectively. Many, many people can’t do this. In essence, they are ‘stuck’ in one side, mostly on the right leg i.e. most people will place more weight and force on their right side. Many people think this is because most people are right legged or right handed. But, it actually comes down to the diaphragm which is stronger on the right side and in a poor position. Without going into too much detail we compensate for this by shifting to that side from pelvis down and rotate our rib cage and thoracic spine to the left. Unfortunately, we can shift too much into these compensatory patterns and reduce our movement efficiency which may lead to injury and pain. Also, it's important to remember we are not perfectly symmetrical like textbooks and anatomy pictures show us!

(more accurate representation of what the diaphragm looks like)

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So we are getting a picture here why the diaphragm is important. When it works efficiently and is in a good position these overcompensatory patterns are not an issue.

Let’s get back to breathing pattern disorders ! what are these? They are really just when a diaphragm does not work properly - remember it is a muscle, it has to be able to lengthen and contract like every other muscle. We see in our clinic that many people’s diaphragms are weak, hence they are not breathing properly. Most will breathe through their mouth and are what we call apex or upper chest breathing. This means the rib cage becomes elevated which in turn leads to an increase in the arch in the lumbar spine and an anterior pelvic tilt. (see below)


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This leads to a multitude of issues. Have, you ever had low back pain, tight calves, achilles pain, plantar fasciitis, knee pain, neck or shoulder pain? All these issues could be down to poor breathing patterns.


How do we fix it?

Well, there are few things we need to do, Firstly, we need to be able to lengthen and strengthen the diaphragm. Like I said it is a muscle. We can train it just like any other muscle. Specific breathing exercises in specific positions and even using a balloon can do this (see pic below). We a need to reduce our respiratory rate (the amount of breaths we take per minute) breathing should be long and slow, not short and shallow, this reduces neuromuscular tension and relaxes the nervous system while also reducing the need for upper neck and shoulder muscles from working too hard. Nose breathing will slow down respiratory rate while also using your diaphragm more effectively. Also just ‘strengthening’ your core will not ‘fix’ your back. The most effective trunk stabilizer you have is actually your diaphragm, strengthen this.


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Tommy ConwayComment