Breathe Easy to Ease Low Back Pain (Part 2): Consequences of Dysfunctional Breathing

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11 minutes read

Breathe Easy to Ease Low Back Pain (Part 2): Consequences of Dysfunctional Breathing

Published by Dr. Alden Clendenin

This is the second installment of 3 articles teaching you why they way we breathe is so important and how to breathe more effectively for decreased pain, lumbar stability, and even increased power/performance in sports.

Last week I talked about the mechanics of proper breathing patterns and a couple of exercises to get you started. Hopefully those have been helpful. I realize that the intricate anatomy and biomechanics of the breath is not exactly a blockbuster topic so kudos to you for sticking around for part 2! Today I’ll be talking about how the breath is important for low back stability, common faulty breathing patterns you may recognize in your own life, and a couple more tips and exercises to keep you progressing. Remember, the goal is not to make you really good at breathing just while you’re lying on your back, but to take this new skill to your everyday life where it matters.

The diaphragm is the primary stabilizer of the low back. It’s not having 6 pack abs, its not having “strong back muscles,” and its definitely not achieved by countless repetitions of sit ups. As we discussed in the previous article, the diaphragm creates an increase in pressure below it that stabilizes the spine when we breathe efficiently. All of the other core muscles work in concert to maintain this intra-abdominal pressure created by the diaphragm. This is the true definition of core strength. This all sounds fine and dandy, but the problem is that the majority of us do not breathe this way. Here are a couple of reasons why:

1: We become focused on aesthetics. When we properly breathe with our diaphragm, we should look something like this little stud.

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We should get expansion of the abdomen in 360 degrees before we start to get elevation of the chest. Many people cannot imagine the idea of purposefully increasing the diameter of their abdomen so we end up with something that looks more like this.

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Notice in the picture above how the ribcage has elevated? This is a common faulty breathing pattern that a lot of us fall into in an attempt to appear to have a slimmer figure.

2. Lack of proper development. As babies, we mostly develop the core and movement patterns correctly because they are hard wired. As we gain stability as babies, we earn our way to being able to sit upright, crawl, stand, and eventually walk. Problems in this progression occur when the baby is put into positions that it is not developmentally ready for. The most common of these is holding on to the baby’s hands as we attempt to help him/her walk before she can do so on their own. Since the baby is not physically developed enough to walk on its own, that baby will start to develop muscle imbalances and compensations that will follow him/her through their lifetime. These bad tendencies become their primary way of moving and have consequences along the way. With regard to the core, many babies are put in seats or swings that sit them upright before they are ready. The core musculature never really fully develops because it never has to (the seat holds the baby up), so then when its time to crawl and move on their own, they are already doing so on a core that’s not ready for it.

3. Lack of proper training/sitting too damn much! Most of us fall into this category. We grind away at the gym, putting in your 45 minutes on the elliptical followed by 100 repetitions of “core work” aka 3 or 4 different versions of crunches. We do all of this after sitting with poor posture for 8 or so hours. In essence what we are doing is grooving bad motor patterns. Unless we sit with perfect posture, we are setting the canister system that is our core up in a way that inhibits diaphragmatic motion.

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Notice how when we sit with poor posture how we inhibit the diaphragm from moving efficiently when we breathe.

Now, our bodies are tremendous at finding ways to compensate to get things done. So just because we aren’t breathing in a way that is going to stabilize our core doesn’t mean that we don’t breathe. What we end up doing is developing faulty breathing patterns, or alternate ways to breathe. These secondary ways of breathing are not as efficient and cause a myriad of issues. Think about the mechanics again: the diaphragm descends in the chest wall as we inhale, creating an increase in pressure below it. When this happens, it creates a negative pressure above the diaphragm and space for the lungs to expand and take in air.

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When we do not use the diaphragm to create space for the lungs, we have to find another way to do it so that we can actually take in some oxygen. Enter the secondary breathing muscles: muscles of the neck called Scalenes and Sternocleidomastoid. These muscles are all attached to the upper ribcage. So when we can’t create space below the lungs to take in air, these muscles will yank up on the upper ribcage in an attempt to create space above the lungs.

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These secondary breathing muscles are necessary when we have an increased need for breathing. For instance while we are exercising or in times of stress. The problem arises when we rely on these muscles all day long as our primary breathing muscles. These muscles become very tight and laden with trigger points. We can work on these muscles all day long to try to relieve some tension in them but the actual problem goes unaddressed. These muscles will continue to be tight and overworked unless the breathing pattern is changed.

Ok, I like to speak in metaphors because they make things easier for me to understand. So consider this metaphor with regard to fixing this underlying problem: It’s like an open window in a room with a coffee table that has a stack of papers on it. The wind blows in through the open window and the papers are scattered all across the room. We could fix this problem 2 different ways. We could either pick up all the papers and stack them neatly again on the table, only to be blown away by the next gust of wind. Or we could shut just shut that damn window. So, we yes we can keep working away on those tight neck muscles and temporarily make them feel better, OR we could fix the breathing pattern to make sure they don’t become chronically tight in the first place. Shut the window on your faulty breathing patterns.

Cause & Symptoms of Pain

Consequences of this common faulty breathing pattern are things you may already deal with on a daily basis. Everything from the tight neck muscles I previously mentioned, to degenerative disc disease, chronic stress, and tightness of muscles all over the body that don’t respond to stretching. Here’s a classic example: Hyperactivity of the neck muscles (caused by faulty breathing patterns) causes these muscles to become tight and imbalanced. This chronic imbalance places uneven compressive stress on the bones of the neck. Over time, this uneven displacement of stress causes the bones to degenerate. What I am describing is Degenerative Disc Disease. Most people view this as a chronic pain type of diagnosis but in many people, range of motion and pain can be drastically improved simply by fixing the breathing pattern and taking some of the stress off of the neck musculature.

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This x-ray of degenerative disc disease is common in those with dysfunctional breathing patterns. Even though this xray looks a little gnarly, pain and function can be restored with changes in the way you breathe.

This pattern of tight muscles and degenerative processes happens all over the body as a result of compensations that occur when our biomechanical system isn’t working efficiently. Tight hip flexors and back muscles, thoracic outlet syndrome, TMD, and core instability almost always have a dysfunctional breathing component. There are countless other dysfunctional movement patterns we exhibit that can lead to degeneration and injury, but breathing patterns are by far the most common AND commonly yield fantastic results if addressed.

As promised, here are two more breathing exercises that you can progress to on your way to core stability, decreased stress and better performance in sports. And remember, the idea is to take this new found way of breathing with you everywhere you go. So while you’re sitting at your desk, think about if your shoulders are elevated or your gut is sucked in. Relax through the shoulders and work on your breathing all day long.

Triple Flexion breathing

–          This is a progression of the first exercise given last time. This time you will be responsible for holding your own legs up as you breathe. Remember, the goal is 360 degrees of abdominal expansion with very little chest elevation as you breathe. A good way to promote this is to wrap an exercise band around your waist at about bellybutton height. This will give you feedback you can feel as you breathe.

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Once you are in this position and can comfortably control the breath, you are ready for the Dead bug exercise. It looks like this:

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Here are some things to remember with the dead bug:

  1. The back of your head and the small of your back should remain in contact with the floor.
  2. The movement is “opposite arm, opposite leg.” So when the left leg goes down, so does the right arm. This motion is slow and controlled. It is particularly important to keep the low back in contact with the ground throughout the whole movement.
  3. Always return to the starting position before moving the other arm and leg. Only 2 limbs moving at a time.

This exercise really sets the stage for what’s to come. Almost every sport requires this contralateral or cross pattern exhibited in the deadbug exercise. Throwing, running, kicking; all of these motions require opposite limb movement and a stable core to transfer energy. This will be discussed in depth next week along with more exercises to keep you moving and progressing!



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

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