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6 minutes read

Breathe Easy to Ease Low Back Pain (Part 1)

Published by Dr. Alden Clendenin

This is the first installment of a 3 part series on the importance of proper breathing patterns. I get it, it’s not the most exciting thing to talk about. We all know how to breathe, hell I’ve been doin’ it for as long as I can remember! Trust me, stick with me through three to-the-point articles and I promise you’ll have learned how to effectively breathe to ease low back pain, relax during your hectic work day, and even develop more strength and power in your athletic endeavors. Even though we obviously all must breathe sufficiently enough to sustain life, there IS a superior way to breathe that goes beyond getting oxygen in and carbon dioxide out. I’m going to touch on breathing not only for respiration but for low back stability as well.

Although there are many muscles at play here, lets just consider the main muscles we use to breathe as the following: Diaphragm, transverse abdominis, and pelvic floor. You can see the anatomy in the picture below. The diaphragm lives just below the lungs and creates a “tent” over the stomach and guts. Think of the transverse abdominis as your internal weight belt. It wraps all the way around your body much like strapping on a lifting belt would. The pelvic floor creates the bottom of this canister.

respiratory system

When we breathe, these muscles work in concert with one another, or at least they should. It goes like this: When we inhale, the diaphragm descends to make space for the lungs above to take in oxygen. The cool part about this is what happens below the diaphragm. As it pushes down, or flattens out, it creates pressure below it that pushes against the transverse abdominis and pelvic floor. This pressure that is built up as we inhale is the primary stabilizer of the low back. Think of this process the same way you would think about how a piston works. Take a look.


As the plunger pushes down inside the piston, pressure builds up below it. The plunger acts like the diaphragm, the bottom of the piston is the pelvic floor, and the walls of the piston are like the transverse abdominis. This canister system only works if these muscles work together and the timing is right. If done correctly, our spine is fully supported by this increase in pressure in the abdominal cavity. Think about this, the spine is supported from the back and sides by muscles right? So what supports it from the front? Intra-abdominal pressure!

When we are able to achieve this intra-abdominal pressure, our spine and core are at its strongest. This is truly what core strength means. We can lift more weight, develop more power, and move in a way that spares the spine. The problem is that the majority of us do not breathe this way on a regular basis. Due to the fact that we sit entirely too much, assume bad postures, and develop muscle imbalances, this canister system becomes compromised and we leave ourselves prone to low back injury and a myriad of other musculoskeletal issues. These occur because we rely on ways of breathing that call on other muscles to do the job when they are not supposed to. Muscles of the neck become tight and laden with trigger points that just won’t go away. Low back muscles get sore and overworked. Take a look at these two studies that prove breathing rehabilitation must be part of creating a healthy spine:

back pain and breathing

So now that we know the importance diaphragmatic breathing, here are a few keys to learning how to do it correctly. Keep in mind that this takes practice and consistency but once you’ve got it down, you can use this way of breathing in all of your activities. Practice makes perfect. Try these two exercises to start:

1. Lie on your back with your feet up on a ball or chair, knees and hips bent at 90 degrees. Everything should be relaxed. Put one hand on your bellybutton and one hand on your chest. The goal is to breath in and out with minimal movement of the chest hand while the belly hand moves up and down.

ball exercise

2. Crocodile breathing: Lie on your stomach like the picture below shows. The goal is to raise your low back with each inhale using only the breath.

crocodile breathing

Here are a few cues to make it easier:

– push air as deeply into your pelvis as you can
– if you were wearing a weight belt push air into every part of that belt with each inhale
– exhale until you can’t exhale anymore, then inhale while leaving the ribs where they start.
– your rib cage should not come up towards your head until the very end of the inhale.


In the next article we’ll talk about how to progress the breathing training and how to use this technique in exercise and daily activities.


Dr. Jeffrey Jones, D.C., C.S.C.S.
Loop Chiropractic & Sports Injury Centers

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