Learning to Breathe

Breathe in. Breathe out. It’s pretty simple isn’t it? On average, a person will breathe 12 breaths each minute, totaling 17,000 breaths per day. It’s a function that is second nature, and we don’t even think about it. Now, place one hand on your chest and one hand on your belly. Which hand moves when you breathe in? Does your chest rise with each breath? Or, do you feel like your chest and shoulders are relatively quiet and your belly expands?

If you answered “yes” to belly expansion with breathing in, then you are right on the money with your breathing patterns. If you answered “yes” to your chest rising and shoulders moving with each breath, you’re not alone…I’d actually say you’re in the same category as the majority of adults.  Now, let’s take a few minutes to talk about why the way you breathe is so important, why society’s push to have people suck in is so wrong, and how the way you breathe can contribute to complaints from upper back pain and headaches to low back pain and extremity injuries.

The seemingly simplistic, yet vital, task of breathing is actually quite complex, requiring the coordination of multiple muscle groups and a well-developed postural structure.  When you breathe in, the diaphragm should move downward, creating a negative pressure zone in the thorax, and expansion of the belly/abdomen (1). We are hardwired to breathe like this. Have you ever looked at a baby breathing? When an infant inhales, they expand their abdomen 360 degrees. This expansion creates a pressure chamber in the abdomen that helps to protect the spine and even the extremities from injuries. This type of breathing is important for true “core” stability and the engagement of deep stabilizing muscles.

As we age and start sitting for long periods at work and school, certain muscle groups begin to be overused while others are completely ignored. We also fall victim to pop culture’s definition of the “ideal body” by sucking in the belly and working to get that set of six pack abs. We tend to stop breathing with our diaphragm and start breathing from our chest. Breathing from the chest is known as “secondary respiration,” which means that it should be used when doing a lot of physical activity and the body just needs to get more air faster.

So, while there is a time and a place to breathe from the chest, there are some negatives that come along when this “secondary respiration” pattern becomes the primary, and the diaphragm is ignored. When breathing from the chest, we tend to overuse muscles in the neck and upper back to help get enough air into the lungs. This can contribute to upper back pain and even headaches. Breathing from the chest also stops us from using all of the lungs, and creates shallow breaths (1). This less than ideal breathing pattern, if left unchecked for a prolonged period of time, will result in shortening of the diaphragm, hyperinflation of the lungs, and excessive use of accessory respiratory muscles.

Low back complaints often go hand in hand with improper breathing and diaphragmatic function. Research shows that people with mechanical low back pain tend to have decreased movement of the diaphragm, dropping of the pelvic floor complex, and increased breathing rates even at rest (2). Therefore, with education of the proper coordinated control of the diaphragm, pelvic floor, and deep abdominal muscles, improvements in breathing patterns as well as low back pain can be seen.

Using the diaphragm properly when breathing allows for you to get up to a liter more air with each breath, relaxes the superficial muscles in the neck and upper back that tend to be overused with constant “secondary respiration” patterns, and helps to create that necessary core stability to protect the body from injury.

So, how do you retrain your breathing patterns, and where’s the best place to start? Like any new habit, it takes at least a month to retrain your way of thinking and how your muscles function. I always start with teaching my patients about engaging the diaphragm and doing conscious, focused diaphragmatic breathing patterns.

Follow these steps to get started:

                1. Lay on your back

                2. Place your feet on a chair or exercise ball

                3. Place your legs in the 90/90 position (bent at the hips and bent at the knees @                 90 degree angles)

                4. Place one hand on your chest (Hand #1)

                5. Place the other hand on your belly, below your rib cage (Hand #2)

                6. Breathe in and out in a slow and focused manner

                7. Focus on keeping hand #1 quiet/still

                8. Focus on feeling hand #2 move under your expanded belly as you breathe in.

                9. Practice this for roughly 10 minutes each day.

As you progress in this exercise, begin to work on expanding your abdomen to the sides and the back while breathing, with the goal of reaching 360 degrees of expansion with each breath.

The next installment of this “Getting to the Core” series will focus on the walls of the “core” and then we’ll finish up with discussing the pelvic floor muscle complex. All of these muscle groups are vital for stability throughout the body, so it’s important that each group does its job and functions in sync with the rest.

Until Next Time,

Abby Scheer, DC, ART


1.            Boyle KL, Olinick J, Lewis C. The value of blowing up a balloon. N Am J Sports Phys.           Ther. 2010;5(3):179-88.

2.            O’Sullivan PB. Altered motor control strategies in subjects with sacroiliac joint pain during the active straight-leg-raise test. Spine. 2002;27(1):E1-E8