Pain and Injury from Improper Breathing

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By John Vicchio, PT, CCTTBreathing is unquestionably a key function of the human body. It sustains life by providing oxygen needed for metabolism and removing the by-product of these reactions, carbon dioxide. Breathing has other functions that affect motor control, postural stability and roles in maintaining homeostasis function (maintain internal stability such as balance and equilibrium) in the autonomic nervous system and circulatory system. When breathing becomes dysfunctional it affects people’s lives, challenging homeostasis, creating symptoms that most patients do not associate with their pain and compromising health.The primary muscles of breathing are the diaphragm, intercostals (muscles running between the ribs) and abdominals, which allow the average person to take over 21,000 breaths per day. These muscles are located in the chest wall compromised of the rib cage/thorax and the abdomen, creating an effective respiratory pump. The respiratory pump can become dysfunctional due to many factors, which are altered and paradoxical motion between rib cage and abdomen called paradoxical breathing, thus increasing use of upper body muscles such as the scalenes, upper trapezius and sternocleidomastoids. Abdominal weakness and rib cage stiffness are common dysfunctions that we see at North Jersey Physical Therapy Associates (NJPTA).At our clinic we evaluate and treat on how breathing affects postural stability and motor control. Muscles such as the diaphragm, transverse abdominals and pelvic floor muscles are important for motor control and postural support as well as for breathing. If their function is compromised there is an increased susceptibility to low back pain and injury.At NJPTA, we take a unique approach in treatment, which includes an extensive assessment and treatment using manual therapy interventions, neuromuscular exercises (90/90 Diaphragm breathing, Buteyko breathing) and dry needling. These are all helpful tools in restoring and maintaining motor control/postural stability.Below is an illustration of optimal breathing from Integrative Core Dynamics: