Does breathing correctly affect the pain you may be experiencing? The answer is an absolute ‘YES’, so keep on reading! What is correct breathing? In the presence of pain and/or dysfunction, we tend to breathe using predominantly our neck muscles or upper chest, instead of our diaphragm. This is known as breathing apically. When you are breathing effectively by using your diaphragm, we call this breathing diaphragmatically (pronounced di-a-fram-atticly) – the way to breathe correctly.

To breathe diaphragmatically means to inhale deeply through your nose and exhale through your mouth. When doing this, your tummy just below your ribs should expand like a balloon.

image showing correct breathing using the diaphragm

How do you know if you are an apical or a diaphragmatic breather?

Sit quietly and take a deep breath in. What happens? Does your chest rise or does your belly expand outwards? If your chest rises, this means that you breathe using mainly your associated neck muscles, instead of your diaphragm. Correct breathing means that you should use the right muscles, for the right action, at the right time.

In other words, you ideally want to breathe diaphragmatically when you are at rest, as well as when you are exerting yourself. As you increase the intensity of your exercise, the demand for oxygen becomes greater, so you will breathe using both methods.

What is the diaphragm?

Your diaphragm is a large muscle that separates the thoracic cavity from your abdominal cavity. It has multiple attachments, from as low as your lumbar vertebrae and assists not only with correct breathing but also in stabilising your body. This means that the diaphragm plays a vital role in your core and, therefore, your ability to perform tasks.

Breathing and lower back pain.

Research has shown that people with chronic lower back pain typically have an apical breathing pattern and an increased respiratory rate. By breathing apically and not using your diaphragm, you are essentially deactivating your core.

image showing core structure and diaphragm

How do the diaphragm and the core work together?

Your diaphragm forms part of your core. Imagine your core as a cylindrical canister. It has the diaphragm as the roof, your pelvic floor as the floor and the muscles known as the deep transverse abdominus and multifidus as the sides. See the picture for where each of these body components is located.

If one part of the canister isn’t working, then the rest of its parts won’t work properly either. This is why people with chronic back pain have erratic breathing behaviour, which actually reinforces or reminds the body that there is pain. Unfortunately, it’s not only people with back pain that will have apical breathing patterns. This problem can occur with people suffering from neck pain and even athletes struggling with exercise performance.

Some symptoms of apical breathing.

By using this more shallow method of breathing, there is a wide range of symptoms that can occur, but not all may be evident:

  • pins and needles
  • headaches
  • dizziness
  • concentration difficulties
  • anxiety
  • depression
  • panic
  • heart palpitations
  • tachycardia
  • asthma
  • cramping
  • sleep apnoea
  • exhaustion
  • insomnia

It does not mean that if you have the above, you definitely have erratic breathing patterns, but it is something to think about and be examined by your physiotherapist.

Can I change my breathing pattern and ultimately my pain?

Yes, of course. Fortunately, all it takes is exercise. Not just any exercise, but specific techniques to target the diaphragm and the abdominal canister.
Your physiotherapist can teach you how to change your breathing from apical to diaphragmatic and ultimately help reduce your pain or improve your exercise performance.

This article was submitted by the Woodmead branch of Lamberti Physiotherapy. If you would like to discuss your breathing and symptom of pain with any of their Physios, use this handy appointment form.