Can Altered Breathing Patterns Cause Pain?

Can Altered Breathing Patterns Cause Pain?

Did you know that poor breathing mechanics can lead to neck pain, core stability issues, low back pain, and other issues?  Yes, something that is so second nature to us is actually very complex!

Normal breathing is an automatic and effortless action; however, breathing is a coordinated effort. The act of breathing requires our lungs to expand as well as a series of coordinated muscle efforts from the chest wall, the rib cage, movement of large and small muscles, nerve signaling, ligament stretch, and even the spine. Although we often think of our lungs as being within our chest, the tops of our lungs extend quite high, almost to the very base of our neck and shoulders. This is crazy, considering the entire body is involved!

Dysfunctional breathing refers to a group of disorders: paradoxical breathing (upper chest breathing), erratic breathing, breath holding, and breathing too deeply or erratically (hyperventilation syndrome). For this article, we will focus on the first: paradoxical breathing and the biomechanical effects of poor breathing mechanics. 

Why Altered Breathing is Important

It is important to assess breathing mechanics to determine if someone is using the appropriate muscles to engage in this vital task. Breathing is a complex activity involving the rib cage, joints of the spine and ribs, ligaments, connective tissues, muscles, and the lungs. Breathing performance is drastically affected if one or more of these structures are injured, damaged, or otherwise unable to work properly. One such common condition is upper chest breathing.

What is Chest Breathing?

Paradoxical breathing, or chest breathing, is a sign that you are not breathing properly.

Normal breathing involves expansion and contraction of the rib cage with our breath. The primary breathing muscle is the diaphragm, a dome-shaped muscle located at the base of our rib cage. The diaphragm is a major muscle mover that works with the lungs to inhale and exhale. When we breathe in, the lungs expand, and the diaphragm pushes down to make room for the lungs to expand with air. This presses the rib cage outward. When we breathe out, the diaphragm moves up, which helps move air out of your lungs and brings the ribs inward.

During paradoxical breathing, this action is reversed. During inhalation, the lungs still expand, but the diaphragm contracts. During exhalation, the lungs relax, but the diaphragm expands. As a result, the chest and lower neck muscles become overactivated. This targeted group of muscles works together to compensate for the diaphragm. They help inflate the lungs by pulling on the rib cage to expand the upper portion. 

These extra, or accessory, breathing muscles in the chest and lower neck still have their own responsibilities to perform as they help with our breathing activity. The result is tight, achy muscles that are not effective at either job. The upper back and thoracic spine may also become stiff due to poor muscle engagement from the diaphragm, resulting in muscle tightness. Sometimes, this can even extend into the lower back!

By itself, chest breathing is not necessarily a bad or pathological condition. Certain scenarios are noted for chest breathing. Some examples include a sudden sprint across a lawn or a pang of anxiety while taking a test. However, when chest breathing becomes our normal method of breathing, the upper chest expands and contracts with each breath, while the abdominal area does not function properly. The diaphragm is not used well during chest breathing. Chest-focused breaths tend to be short and quick. Chest breathing uses only a small portion of the lungs and delivers a relatively minimal amount of oxygen to the bloodstream. The result is poor oxygenation to the body’s soft tissues. 

In addition, excessive chest breathing causes the muscles of the chest, neck, upper back, and lower back to overwork. This can lead to tightness and strain in these areas due to overuse. The muscles become tight and ropy to the bare eye. Chest breathing is a form of diaphragmatic dysfunction that can have many causes including trauma to the chest wall, mineral deficiencies, weak respiration muscles, sleep apnea, and nerve injury.

Symptoms of chest breathing can include:

  • Frequently waking up at night
  • Shortness of breath
  • Excessive sleepiness that doesn’t respond to additional sleep
  • Diminished or poor exercise performance
  • Muscle soreness in the neck and chest
  • Abnormally fast breathing
  • Poor posture in the upper back
  • Rounded shoulder posture
  • Tight musculature along the front of the neck

Do I Chest Breathe?

Maybe. Here is a simple test and exercise you can do at home to improve your breathing.

Description: Breathing test to assess if a patient is a stomach breather or chest breather.
How to perform:

  • Lay on a comfortable surface on your back with your knees bent.
  • Place one hand on your chest and the other hand on your stomach.
  • Take five normal deep breaths and take notice of your breathing.

Up to 80% of breathing should come from the belly rising and falling; 20% should come from the chest rising and falling.

Chest breathing is more dominant than belly breathing when the belly barely moves. Here, the upper chest expands more than the abdomen, and the shoulders elevate towards the ears during inspiration. Excessive chest breathing causes overuse of the neck musculature and can lead to pain syndromes in the neck, shoulders, and upper back.

What Can I Do for Chest Breathing?

Our goal is to provide you with the correct diagnosis of your breathing pattern, determine the underlying root cause, and create an individualized treatment plan specifically for you. We have many tools in our toolbox to conduct an effective evaluation and create an appropriate treatment.  

We have many options for you! A few include specific stretches for muscles and tendons of the affected muscle, joint mobilization of the thoracic spine near the ribs, tendon loading and specific exercises to strengthen the surrounding muscles, hands-on soft tissue work into muscles, changes in exercise routine or modifications at work or at home, home exercise and stretching programs, and more. 

If there has been trauma to the chest wall, such as a motor vehicle accident, a full examination is imperative and may require imaging. The best way to determine your treatment approach is to make an appointment in our office for a full evaluation.

If you are dealing with poor exercise performance due to chest breathing, muscle tightness of the chest wall, upper back, or neck, excessive daytime sleepiness, or other symptoms of chest breathing, give us a call to get you moving better, feeling better and living better! Give us a call or send a message to get started.