Moving Well, Part 7: Take a Breath


We’ve moved up the chain from the foot to the neck discussing common causes of pain to each joint, and now we discuss an often overlooked aspect of health: breathing. How you breathe can contribute to pain or injury. The act of taking air in and pushing it out is automatic, but the pattern we use to breathe is a habit. Because our society has become more sedentary, many people have begun to use accessory or emergency breathing muscles during every day breathing. This altered pattern can trigger pain a few different ways.

Sternal breathing, or lifting of the sternum while inhaling, should only be used during a state of an emergency–when we are in fight or flight response and need more oxygen. For example, someone having an asthma attack may start to sternal breath to help bring in air. However, when we sternal breathe during day to day activities we send feedback to the brain that we are in a stressful situation. This keeps the brain on high alert and is more likely to trigger a pain signal.

Furthermore, sternal breathing may lead to over breathing, causing a drop in blood carbon dioxide. CO2 is needed in our blood to help oxygen get to our tissues. When CO2 drops our blood pH drops, and this can cause increase feeling of stress, anxiety, and pain. This is what happens when someone hyperventilates. Breathing into a paper bag helps to raise blood CO2 levels by breathing in exhaled CO2.

Lastly, during sternal breathing the diaphragm may not contract as efficiently.  The contraction of the diaphragm creates stability for our core, and without it we our more prone to injury.

To assess breathing, place one hand on your sternum and one hand on your stomach just below your ribs. Notice when you breathe in which hand moves more. You should feel the lower hand move up as the diaphragm contracts into it and little to no motion at the sternal hand. Assess in laying, sitting, standing and during stressful situations because it can change based on your position or situation.

To start retraining your breathing, lie flat on your back with your knees bent. Use the same hand position as above and practice moving the lower hand up as you inhale. Then slide your hands around to the ribs and try to push your ribs out into your hands as you breathe in. Let your exhale be passive as the ribs move back in and resist the urge to actively blow out.  Try to let your exhale be slightly longer than your inhale.  It is important that you exhale all the way.