By Jo Moore, Senior Chiropractor.
Breathing and Back Pain
Over the holidays I read a book called ‘Breath’ by James Nestor. It had been recommended to me by a patient who had wanted to learn more about how the way we breathe affects our spinal health. It’s no surprise that breathing is foundational and fundamental to all aspects of our health and wellbeing and since we breathe 20-22 thousand times a day, how we breathe can have significant and life changing consequences for our health. One of the most impactful parts of the book for my work as a Chiropractor has been learning about the way we breath and the connection to the body, specifically the spine. I often find abnormal breathing patterns in patients who present with chronic lower back pain and neck pain. This results in a tight diaphragm, causing the lower ribcage to tighten as well as the lower back muscles. It is often difficult for the individual to take a deep breath because the expansion of the rib cage is reduced. When we can’t fully use our diaphragm, we use our upper chest more to breathe. This very often results in tight muscles in the lower back, neck and shoulders, which is a very common presentation to the clinic. Recent statistics show that 80% of people have a breathing dysfunction that is significant enough to impair full functional movement of the spine (Kiesel 2020).
Breathing and Posture
Poor posture and back pain can negatively impact breathing. When we slouch and let our shoulders round and our pelvis rock back, it makes it difficult to allow the ribs and upper back to move normally to allow the diaphragm to move air in and out of the kings. But did you know the opposite is also true? In the book, the author comments that poor breathing can often manifest as repetitive yawning, sighing and coughing. As an adaptation to this, our posture can change and we get a forward shift of the head on the body. This change in alignment is a common cause of spinal pain and often what we observe in patients when assessing their posture in clinic. Good Diaphragmatic breathing helps the posture immensely. The diaphragm, together with the pelvic floor is an important stabiliser of the back and helps the core muscles to activate and keep the spine flexible and strong. When the diaphragm is tight and under utilised, the spine is more reliant on the smaller muscles in the back which can not stabilise the spine as well as the diaphragm. This leads to stiffness and pain in the spine. An interesting study in the European spine journal investigated the relationship between breathing and muscular stabilisation of the lumbar spine. The results found that 50-60% of chronic (long term) low back pain patients shown an altered pattern of muscle control. In particular, this was altered as it related to breathing patterns during simple tasks. So what does this mean? We know that many different muscles play a role in stabilising the spine and the diaphragm is one of them. When patients with lower back pain perform stabilising core exercises to protect their spine from further episodes, proper breathing patterns should be emphasised during these exercises and during day-to-day activities.
So how can you improve your breathing and posture to prevent these problems?
Chiropractic care can help normalise the natural breathing pattern by releasing tension and restriction in the spine, rib cage and diaphragm. This is usually sufficient to release the diaphragm and re-estabilsh the normal breathing patterns but occasionally it is necessary to consciously change our habitual breathing. We can advise you on how to do work on your breathing and engage the diaphragm effectively. Breathing through the nose has also been shown to regulate the nervous system and help to relax and lengthen the tight postural muscles in the back and neck. By being mindful of the air coming in and out of the nose; the belly rising up with the in breath and down with the out breath, it helps you get more oxygen into your tissues which in turn is beneficial for reducing pain. We can also help advise you on your posture; try this: To be in a good posture sit in a chair with your feet on the ground. Try rocking your pelvis forwards and back as far as you can and stop in the middle, you should feel like you are sitting on your pelvic floor muscles rather than your tail bone. Now lift your chest gently like you are displaying a necklace and your ears are over your shoulders. Gentle tuck the chin, imagine being pulled up by an invisible piece of string attached to the back of your head. This makes it easier for your diaphragm to contract and your ribs and upper back to move which increases spinal flexibility and reduces muscular effort therefore making you feel much more comfortable.
If you would like more information or treatment to help just CLICK HERE and book in with Jo for a healthier and happier you!
References
James Nestor – Breath
Kyle Kiesel et al. Exercise intervention for individuals with dysfunctional breathing: a matched controlled trial. Int J Sports therapy 2020.
Roussel N et al. Altered breathing patterns in chronic low back pain patients. European Spine Journal 2009; 16:1066-1020.