How does Breathing Technique Influence Muscle and Joint Pain?
What is diaphragm breathing? How do we change our breathing pattern? How does it influence fatigue?
(Approx 1-2 minute read)
By Jennifer Ellis DC Mchiro
DIAPHRAGM BREATHING AND THE MUSCULOSKELETAL SYSTEM
There’s a lot of talk about breathing patterns in the wellness worlds and there’s lots of variations of breathing patterns. Here, we focus on the basic breathing patterns, the effects that breathing can have on your musculoskeletal system and why that ties in to your fight or flight response.
There’s a ‘how to’ guide at the bottom of this article.
Diaphragm Breathing in a Nutshell:
Diaphragm breathing is the deeper and more optimal way of breathing. It distributes effort evenly through the torso, has better quality air and less strain on neck and shoulders. Shallow breathing is the opposite and primarily uses chest, neck, and shoulder muscles which can create unnecessary tension, especially if it becomes our default.
If checking your breathing in a seated position:
Shallow breathers: On the inhale, your shoulders will rise up to your ears and lower ribs don’t expand out much.
Diaphragm (deep) breathers: On the inhale, your lower ribs will expand out and only a little movement upwards in the shoulders.
Babies naturally breathe through the diaphragm, but as we grow up many of us shift to a shallower breathing pattern without even realizing it. Modern Western lifestyles often have us sitting for long periods from a young age, which naturally limits rib and diaphragm mobility. Over time, this can lead to shallow breathing, which is also commonly associated with the body’s stress response.
The Secret Link Between Breathing and Your Body’s Biomechanics.
How you breathe affects more than just your lungs. A non exhaustive list includes:
Neck and shoulder muscles (and associated headaches).
Shoulder-blade and shoulder joint position.
Rib joints (costovertebral and costochondral joints).
Abdominal pressure and gut motility .
Oxygen, carbon dioxide, nitric oxide levels in the body.
Stress state.
Pelvic floor and associated concerns.
Have you ever noticed how your breathing changes when you’re feeling anxious or excited? Or how a slow, deep breath can instantly calm your mind and body? There’s a deeper reason for this; it is not just about mood. Your breath is a powerful reflection of your nervous system and directly influences how your body moves and functions. Breathe quality sends stress signals, and stress signals change our breathing. It’s a cycle.
Here’s something to consider:
We take over 20,000 breaths every single day. That’s 20,000 opportunities for our breath to either support or strain our body, especially our posture, muscle tension, and even stress levels.
Quick anatomy understanding:
Your ribcage and pelvis play a key role in how well you breathe—and move.
· The upper ribs (2–7) move like a pump handle, lifting up and forward as you inhale.
· The lower ribs (8–12) move more like a bucket handle, swinging outward and upward during inhalation.
The main muscle for breathing is the diaphragm, a dome-shaped muscle that sits inside your ribcage. When you inhale, the diaphragm contracts and moves downward, helping draw air deep into your lungs while gently influencing your abdominal and pelvic areas.
Your torso is constantly balancing out the pressure in your abdominal and pelvic cavity against the pressure in your thoracic (lung) cavity.
When the diaphragm is not doing its job well, often due to poor posture or stress, your body starts relying more on accessory muscles in your neck, shoulders, and upper chest to help pull in air. These muscles are meant to assist only during intense effort (like during exercise), not all day long. Overusing them can lead to tension and fatigue.
Overall: efficient breathing is more than just the lungs, it is a whole-body movement that starts with your diaphragm, ribcage, shoulders and pelvis working in sync.
What could change this function of breathing?
Lifestyle factors, but most notably stress and sedentary positions and lifestyle. In Western culture, we are sat down a lot, so we often see it starting to change in childhood.
With regards to stress, our nervous system has two modes: Fight or flight vs Rest and restore!
Sympathetic (fight-or-flight): This mode kicks in when you're stressed, anxious, or physically active. In this state, your breathing often shifts to the upper chest and shoulders. This activates your accessory breathing muscles—like those in your neck and upper back—which are meant to assist breathing during short bursts of effort, not all day long. Over time, relying on these muscles can lead to tension, fatigue, and poor posture.
Parasympathetic (rest-and-restore): This is your body’s recovery mode—active when you're calm, relaxed, or sleeping. In this state, you breathe more efficiently, using your diaphragm and lower ribcage, allowing for fuller, deeper breaths. This not only helps calm the nervous system but also supports better core stability and overall movement.
The way you breathe doesn’t just reflect your stress level—it shapes how your body functions. Learning to breathe from your diaphragm and ribcage, rather than your shoulders, can help shift you into a more relaxed, balanced state—and support better posture, movement, and energy.
How Can We, as Chiropractors, Help?
As chiropractors, we often assess breathing as part of a full-body evaluation. Why? Inefficient breathing patterns can show up in ways that are not always obvious, but they can have a real impact on posture, pain, and movement. Here are some common signs that your breathing mechanics may need attention:
Your pelvis tilts forward when you stand or walk
Your lower ribs flare out noticeably
Your upper back appears flat, limiting ribcage expansion
You mainly breathe into your belly, rather than your chest and sides
Your neck and shoulders feel tight or sore regularly
You often feel anxious or unsettled, even without a clear cause
With a thorough history and physical exam, we can often identify breathing dysfunction as a contributing factor to issues like recurring shoulder pain, back discomfort, or postural imbalances. Breathing assessments are not just about the lungs—they're another valuable tool to uncover the why behind what you're feeling.
How To Guide for Diaphragm Breathing (At home practice):
There are many ways to retrain our breathing; one to start with is simply retraining our main muscle of breathing, the diaphragm.
How to Practice Diaphragmatic Breathing:
1. Get in position:
Find a comfortable position, either lying on your back with knees bent or sitting upright with your feet flat on the floor.
Place one hand on your chest and the other on your abdomen, just below your ribcage
2. Monitor your natural breath with a couple of deep breaths:
Monitor your breath rate - an average of 2 sec inhale and 3 sec exhale is normal. Quicker suggests either your brain or body is stressed. Slower means it’s more relaxed.
Shallow breathers: On the inhale - your top hand is going to lift up, and your belly hand is going to drop down.
Deep breathers: On the inhale - your top hand is relatively still and the belly hand lifts up as your torso fills with air.
3. Optimise your breath style:
Inhale slowly through your nose. As you breath in, aim to feel the bottom hand rise and the top hand should stay relatively still. Remember the lungs are a 3 dimensional balloon so we should have movement at the front, sides and a bit at the back of the rib cage.
A good slow inhale is 4-8 seconds, more with practice.
Exhale slowly through pursed lips, allowing your abdomen to fall and your ribcage to return to its starting position.
Repeat for several cycles, paying attention to a smooth, relaxed rhythm.
Practice for up to a few minutes each day, gradually extending the duration as it becomes more natural.
4. Next steps:
We tend to start breathe practice in this position as your muscles are most relaxed. If you do not relax in this position, or if you want to add more to your breathing practice then can go seated or standing but this is usually harder.
Keep an eye:
All the extra oxygen can make you go light headed, so start with 5-10 breaths but you can do more or less depending on how you feel and build up over a few weeks.
Nose inhale and mouth exhale is great for better nitric oxide levels in the body. But if you struggle with nose inhales, then mouth inhales are just fine.
Old school diaphragm breathing practice was to focus on pushing the belly out but this can put too much strain in one dimension. Don’t strain, just let the breath gently fill the whole abdominal cavity.
Sometimes too much focus can put us into a shallow breathing style, relax and try not to get frustrated if it doesn’t work straight away!
Everyone’s breath rate is different, so if you start with a 2sec in and 2 sec out then fine, if you can do a 4 or 5 or 6 or 15 second then great but no stress.
The most common issues include going too speedy on the first 1-2 seconds of the inhale and then struggling with the rest of the breath.
Certain famous types of breathing such as ‘box breathing’ include a breath hold. I do not use this as I personally find that holding breath can cause more stress in the body as carbon dioxide chemoreceptors send panic sensors to your brain when you cant breathe. If it works for you then great, but we don’t include breath holds as standard in clinic.
To conclude the breathing wonders:
Breathing well is not just about oxygen; it is about moving well, feeling grounded, and staying out of chronic stress mode. When your diaphragm, ribcage, and pelvis work together the way they should, your entire body benefits. And sometimes, a small shift in how you breathe can make a big difference in how you move and feel.
Please be aware that any signs of significant spinal pain or nerve complaints should be assessed by one of our Dr’s of Chiropractic to diagnose first.
Our clinic is based in central South Woodham Ferrers, with free parking and is easily accessible from Maldon, Chelmsford, Wickford, Danbury, Rayleigh, Wickford, Latchingdon and Southminster.
