Breathing to Improve Mobility and Alleviate Pain


Breathing is a fundamental necessity that influences many anatomical structures around our core. To help understand the importance of the rib cage and breathing, think about the foundation of a house. The entire house, and everything in the house, relies on a solid foundation. Otherwise, the house will fall apart. The spine, pelvis, and rib cage are similar to that foundation. Many times, Physical Therapy addresses the spine and the pelvis, but neglects to address the rib cage. By introducing specific breathing patterns, we can improve the body’s foundation and thus improve function, mobility, and pain levels.

The Diaphragm

The diaphragm is an important (and neglected) muscle with multiple functions and needs to be trained like any other muscle in the body. The diaphragm is primarily responsible for respiration – however it also plays a crucial role in:

  • Rib cage mobility
  • Thoracic mobility
  • Pelvic floor muscle activation and relaxation and
  • Core stabilization

When you inhale, the diaphragm contracts and descends down into your abdomen. When this occurs, it increases intra-abdominal pressure. Increasing intra-abdominal pressure provides lots of core stability which is crucial for bracing under load.

The Rib Cage

Not only does proper breathing provide core stability, but it can also improve mid-back pain and stiffness. There are 12 ribs in total, and each rib attaches to a segment of the thoracic spine via costovertebral joints. Therefore, any stiffness you feel in the mid back may also be attributed to the lack of mobility at these joints.

When you breathe, the ribs should move in a bucket-handle fashion. This means that the ribs should expand “up and out”. Chronic breathing patterns that involve belly and chest breathing can impair the ribs’ ability to expand this way. In turn, this creates more stiffness at the ribs and further alters movement patterns. This is when specific breathing techniques can make or break a person’s recovery.

Conditions that will Benefit from Breathing

  • Neck and shoulder pain
  • Mid or lower back pain
  • Spinal fractures
  • Pelvic Floor conditions
  • Pelvic/hip pain
  • General stiffness
  • Other orthopedic injuries

Benefits of Breathing

Interventions that include breathing techniques can provide the following benefits:

  • Help increase the mobility of stiff joints that can’t be accessed with typical stretches/mobility routine – costovertebral joints and segmental joints of the spine
  • Stretch muscles that attach to the rib cage and diaphragm – QL, psoas major (hip flexor), intercostals, paraspinals, abdominal muscles, pectoralis major/minor
  • Strengthen the muscles of breathing including the diaphragm, intercostal muscles, and accessory muscles
  • Improve posture by giving postural muscles a biomechanical advantage
  • Improve the functional capacity of the lungs

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