Breathing is one of the most important aspects to consider when dealing with musculoskeletal dysfunction and pain, particularly of the upper extremity. The importance of breathing pattern cannot be overestimated as it is something that we do multiple times per minute for as long as we live. Correct breathing involves synchronized motion of the upper rib cage, lower rib cage, and abdomen and diaphragm muscles.
Abnormal breathing is seen when breathing occurs from the upper chest, and greater upper rib cage motion is seen compared to the lower rib cage. Breathing pattern disorders (BPD), defined as inappropriate breathing is present in a variety of individuals with musculoskeletal dysfunction.
Individuals with poor posture, scapular dyskinesis, low back pain, neck pain and temporomandibular joint pain exhibit signs of faulty breathing mechanics. Thoracic breathing is produced by the accessory muscles of respiration (including sternocleidomastoid, upper trapezius, and scalene muscles), dominating over lower rib cage and abdominal motion. Over‐activity of these accessory muscles have been linked to neck pain, scapular dyskinesis, and trigger point formation.
If you have ongoing low back pain, neck pain and temporomandibular joint pain without a known cause it could be your breathing is at fault. There are various signs and symptoms and testing to diagnose BPD.
Below are some breathing exercises which will help you learn to breathe correctly:
Exercise 1: Practice your breathing when sitting or lying in a comfortable position. Imagine your lungs are divided into three parts. Breathe in gently through your nose. Imagine the lowest part of your lungs filling with air. If you are using your diaphragm your stomach will come out a little. Imagine the middle part of your lungs filling with air and your lungs becoming completely full. Your shoulders may rise slightly and move backwards.
Gently and slowly exhale fully and completely. Repeat the exercise three or four times.
Exercise 2: Take a deep, full breath. Exhale slowly, fully and completely. Inhale again and count from 1 to 4 (or for as long as feels comfortable). Pause for a few seconds. Exhale slowly while counting from 1 to 4 (or for as long as feels comfortable). Repeat the exercise three or four times.
As you practice this breathing exercise, try to increase your breathing out. Counting will be helpful. For instance: in 1, 2, 3 out 1, 2, 3.