Understanding how breathing integrates with our neuromuscular system helps us understand how breath can be a high leverage tool for working with movement related pain. We know that breathing exercises are great for reducing stress and lowering inflammatory markers. They can also helps us move better.
In the first part of this series, I describe the foundation of primitive reflexes present at birth - such as sucking and grasping - that combine with a healthy baby's innate curiosity about their surroundings to initiate the developmental movement process. This process builds reflexive stability, the unconscious coordination of muscles across the body that balances mobility and stability and allows us to think about, for example, where we are walking rather than consciously initiating the myriad micro movements that constitute walking.
Breath movement is central to reflexive stability.
In basic biomechanical terms, respiration is simply changing the shape of the thoracic cavity around the lungs. That shape change shifts the pressure differential across the alveoli and permits the exchange of gases. It takes muscular action to change the shape of the thoracic cavity.
The thoracic diaphragm is the primary muscle of respiration, but there are a few dozen muscles in the abdomen, chest, back, neck, and pelvis that can contribute to the constant shape shifting depending on the situation. Some of them, such as the intercostals or the serratus posterior superior and inferior, directly raise or lower the ribs. Others, such as the abdominals or pelvic floor, can contract in opposition to diaphragmatic movement in order to shape the location or rate of breath movement, or to create intra-abdominal pressure that helps protect spinal joints and transfer force across the body.
The muscles that drive and shape breath movement also shape our body wide postures and movements. Every one of the muscles involved in respiration, including the diaphragm, has several context-dependent functions that shift constantly between respiratory, stabilizing/postural, or prime mover. As an integrated system, those muscles perform all three functions at the right time. That is, the system has reflexive stability.
In a newborn, breath movement is the primary movement. Her diaphragm drives the show. The other muscles of her torso offer no resistance to the waves of breath. Even if our other trunk muscles get an aquatic workout in the womb, they still lack the strength that comes with moving around in gravity. They also lack much of the tone that comes with accumulated emotional experience.
In the video below, take note of the movement in both the front and sides of her torso all the way down to her pelvis. With many infants, you can also feel breath movements up and down their spine in the back.
After a few months, life gets a bit more complicated for her neuromuscular system as she begins to lift her head to look around and maybe even prop herself up on her arms. A baby's desire to explore her surroundings begins to build muscular strength and coordination.
As she makes her first movements the baby's torso muscles begin to develop the multi-tasking ability to support and move her body while continuously changing the shape of the thoracic cavity in order to breathe. This ability to unconsciously integrate breath movements with postural and limb movements is part of the development of reflexive stability.
What does this have to do with adults?
It's impossible for an actual human of any age to have a perfectly functioning reflexive stability system but the ideal of an integrated system gives us some direction when faced with movement related challenges and pain.
Our habitual, unconscious postures and movement patterns are a result of our brain's perception of what is most efficient given our body's experience of our environments (chairs, shoes, etc), illness, injury, and emotional armoring. The classic example is the limp that develops in response to pain from a sprained ankle that never fully goes away even after the ankle is no longer painful. A baby unconsciously holding her breath just before intense crying is a harbinger of the degree to which emotional experiences throughout life can "take our breath away."
As we develop our unique movement patterns through life, we all develop some parts that are stronger or more coordinated and others that don't move as well or just seem to just be along for the ride. Breath movement is no different.
Our resting breath movement may be focused in the center of our belly, our chest, or our neck. Many of us lose breath movement in our sides and back. It could be from a self-reinforcing cycle of anxiety and shallow breathing. Some of us have a belly-heavy breathing pattern with stiff, dense tissue wrapped around a ribcage that never moves much.
What happens when our breath movement is restricted to a narrow range of its full potential? In my work with clients I find that persistent back, hip, and neck pain are often associated with severely restricted habitual breathing patterns. A growing body of research is drawing connections between dysfunctional breathing, dysfunctional movement, and pain. (study, study)
What can we do about it?
When I do muscle testing and neuromuscular retraining with clients, I pay close attention to where and how they breathe. Breath holding during a simple, light movement is a sign that something isn't quite working right. I will often say "it doesn't count if you hold your breath" which is a paraphrase of Dr. Vladimir Janda, one of the pioneers of modern rehabilitation: "If you don't own breath, you don't own movement."
Amazingly, conscious focus on bringing breath movement into non-habitual areas can be a powerful neuromuscular resest.
I routinely see chronically tense muscles release or chronically weak and inhibited muscles regain function only when subtle, relaxed breath movement and awareness expand into a previously constricted or out-of-touch area.
While our body’s ability to breathe, stabilize, and move at the same time should ideally be an unconscious process as it was when we first figured out how to move our bodies, conscious practice is a useful step in recovering reflexive stability when we are faced with pain and movement challenges. It works for prevention, too!
The first step is to pay attention to where your breath moves easily and where it doesn't. Keeping a relaxed even breath, gently try to get a little movement in that area. The more subtle and relaxed you can be, the better. That's where the neuromuscular magic happens.
Place your hands on your side ribs. Imagine your ribs are bucket handles or louvers opening away from your sides.
Don't get any movement? Get more relaxed. This is one time where faking it until you make it is a completely legitimate strategy.
Just the process of bringing your awareness and touch there will help to tilt the system in a more adaptable direction.
Place one hand on your chest, one on your belly. Which one moves more? Which one less? Try to slowly, gently even them out.
Place your hands just inside the bony points of your pelvis. Can you bring breath movement all the way down there? Can you breath there and in your chest at the same time?
Lie face down and press your thumbs into the space on your low back between your ribs and your pelvis. Can you feel breath movement there? Do you feel it more on one side or the other? Can you even them out?
These simple drills can be helpful when dealing with flare up of back, hip, pelvic, neck, or shoulder pain. They can help with coordination of core muscles for smoother and stronger movement. They may help you gain perspective on the subtle patterns in your body that underlie many postural and movement challenges.
The next step is to bring that awareness into everyday life. Notice those daily movements where you hold your breath when you move - tying your shoes, going up stairs, driving a car. Consciously try to bring unforced breath into that movement. You may find weakness and instability in that same movement. You may need to back off a bit and focus more until your body learns a new way of doing it. Think about fluidity of breath and fluidity of movement. Lasting change happens first at the subtle levels.
The muscle testing, hands on work, and movement therapy I do with clients can greatly help the process of uncovering sneaky compensations and restoring reflexive stability and the breath-integrated movement that we naturally earned very early in life.
Related: Breathing through your nose can have huge health benefits.
Limited breath movement and overuse of secondary breathing muscles often goes hand in hand with chronic overbreathing, which basically means breathing too fast and too shallowly, typically through the mouth, reducing the amount of CO2 in the blood and straining the body’s homeostatic biochemical balance.
Chronic overbreathing is a sign of a nervous system tipped too far in the direction of the sympathetic (fight or flight) system at the expense of the parasympathetic (rest and restore) system. Dysfunctional breathing patterns in general and overbreathing in particular are contributing factors to a long list of ailments including back pain, neck pain, pelvic pain, sleep apnea, insomnia, anxiety and other mood disorders, peripheral neuropathy, muscle cramps, chronic pain, incontinence, restless leg, hypersensitivity to light and sounds, and more. Paying attention to how you breathe and learning how to reduce your breathing volume is a simple and vital skill. Read more here about overbreathing and the health benefits of reducing your breath volume.