When I treat patients with chronic neck and shoulder pain, one of the first things I check is their breathing pattern. Sounds pretty basic, right? I mean, who really needs to be taught how to breath? You would be surprised how many people are using the wrong muscles to breath.
Let’s take stroll down memory lane back to Human Anatomy and Physiology. We have a large dome shaped muscle, called the diaphragm that goes from the front of our lumbar spine (low back) to the lower six ribs. When it contracts, the diaphragm flattens down to pull air in, filling our belly.
When we use our belly muscles to breath, we are influencing our nervous system as well. Our autonomic nervous system can divided into two main area, parasympathetic and sympathetic. When we are relaxed and not in pain, we are usually in parasympathetic tone: muscles are relaxed, blood flow to muscles is maximized, and our chest and neck muscles are relaxed.
Sympathetic tone is just the opposite, our “fight or flight” system: this is charactarized by chest breathing which increases the tension in our neck and upper shoulder muscles that can lead to pain. Chest breathing should not be your normal pattern in a relaxed mode. The muscles of the neck and shoulders are known as accessory breathing muscles and should only come into play under high need situations (high impact exercises, ran up a flight of stairs, etc). Characteristics of chest breathing individuals include frequent breath holding and sighs.
Test time. How can you tell how you are breathing? First of all, lie down and get comfortable.
- Place one hand on your chest, just below your collar bones. The other hand on your belly.
- Now breath normally and check to see which hand is moving. If you are breathing with your chest muscles, your top hand will move. If you are using your belly, as you should be, your top hand will be stationary and your your bottom hand will raise and fall with each breath.
- If you are already belly breathing, congratulations! If you realize you have been chest breathing, don’t worry, you can make some changes, it just takes practice.
The easiest position to learn to belly breath is lying down, then standing, and finally in sitting. If you are having trouble learning to breath in to your belly, you may need to place a book on your stomach and then breath in and “push” the book up and let it fall back down with exhalation. Social norms tell us to “suck in our gut” so letting our stomach muscles relax is sometime pretty difficult to do, but essential for proper air exchange.
So, why do we need to practice belly breathing anyway? Because concentrating on breathing correctly with your diaphragm is the quickest way to begin self quieting, leading to a greater sense of relaxation.
Now that you have mastered the art of belly breathing, here are some tips to help you maximize your state of relaxation:
- Make sure you are completely exhaling each breath, slow and steady.
- With each breath, visualize yourself “sinking” further in to your bed or chair as your muscles become more relaxed.
- Become aware of areas of your body that you may be holding tension in and let those areas relax with exhalation, becoming “heavier”.
Belly breathing can be particularly effective with those individuals that have difficulty sleeping secondary to pain or just the inability to “shut things down” for the night. Daily practicing of belly breathing will make it much easier and more natural feeling. Be patient with yourself as we have often learned to be stressed for many years and are now just starting to practice how to relax again. Good luck!