There must be a link to the chronic conditions in today’s society. Examples of these conditions can include low back pain, posterior/lateral neck pain, postural dysfunction, and shoulder impingement. Clinicians tend to treat the area of pain, while strength and conditioning coaches tend to exercise the “core” and posterior musculature as a means of corrective exercise. However, the most overlooked problematic area is the one aspect we all have in common. The thing that, on average, we do 18,000-22,000 times per day.


*Improper breathing mechanics and positional disturbances will create whole body dysfunction.

The kinetic chain from the ground up is affected from poor breathing patterns. Critical respiratory muscles such as the diaphragm, scalenes, intercostals, and abdominals must be coordinated appropriately for functional breathing to occur. Without the proper mechanics, the body falls into a full-fledged compensation just to survive, let alone exercise and activities of daily living.

The diaphragm has vast attachment sites which include the lumber vertebrae, arcuate ligaments, costal cartilages of ribs 7-12, and the xiphoid process. With attachment sites spreading cephalic and caudally, it’s no wonder that diaphragm dysfunction can become so problematic. Furthermore, due to the larger surface area of the right diaphragm and a large liver on the right, the left diaphragm is biased to transition to a more postural/stabilizing role rather than its real job of respiration. As a result, airflow tends to strictly originate from the right diaphragm while the left diaphragm becomes more inhibited. The right diaphragm pushes air to the left chest wall, but due to the inactivity of the left, the right chest wall tends to close down. A secondary area of concern are the lungs becoming hyper-inflated (trapped air in lungs) creating altered diaphragmatic length-tension strength, which diminishes its power and effectiveness. As a consequence, the rib cage can actually change from a normal oblique axis to more of a horizontal position. In simple terms, the rib cages becomes stiff. Conversely, everything we do as athletes, exercisers, and daily living activities requires a mobile rib cage for normal gait mechanics and optimal performance.

Three muscles of the anterior, posterior, and lateral neck become primary respiratory muscles. The sternocleidomastoid, trapezius, and the scalenes begin to become overdeveloped and overused. All three of these muscles have some placement of attachment on either the clavicle, cervical spine, and or ribs which elevates the rib cage during inhalation. We, as humans, become pullers. Everything we do from breathing, walking, and exercising all begins and ends with a pull. We initiate the inhalation by “pulling” the air in by using our neck and low back musculature. In other words, these muscles are constantly contracting upwards of 22,000 times per day. The hypertrophied and overused muscles with simultaneous decreased diaphragm performance, leave us with no choice but to shift our primary means of ventilation through the neck and low back.

Lastly, dysfunctional breathing mechanics creates altered physiological parameters. The hyper-inflated lungs can create a system which is in a constant state of hyperventilation. Consequentially, the brain increases the activity of the sympathetic nervous system (flight or fight). Now, add up the stress and challenges during the course of a day and you have a person who cannot get into their parasympathetic nervous system. As a result, they lose the ability to simply breathe and relax. Their breathing patterns create an environment of lower CO2 levels which can lead to disrupted brain function, altered PH and metabolic functions.

In summary, breathing is a key function that should be assessed in the rehabilitation and fitness industries. Teaching proper breathing will give the client/athlete physical and physiological improvements. Also, it will allow them to employ their parasympathetic nervous system while decreasing the hyper-tonicity of the sympathetic nervous system. Most importantly, it can be useful to treat these chronic conditions that will help lead people to increased performance, improved activities of daily living, and better overall function.



  • Courtney, Rosalba. “The functions of breathing and its dysfunction and their relationship on breathing therapy.” International Journal of Osteopathic Medicine 12 (2009) 78-85.
  • Postural Restoration Institute