How Breathing Patterns Affect Musculoskeletal Pain

When people think about musculoskeletal pain, they often focus on muscles, joints, posture, or movement patterns. But one important piece that is frequently overlooked is breathing.

Breathing patterns can have a significant influence on muscle tension, posture, movement quality, nervous system regulation, and even pain sensitivity. Dysfunctional breathing patterns may contribute to ongoing pain, stiffness, fatigue, and difficulty recovering from injury.

Understanding how breathing affects the body can provide valuable insight into persistent musculoskeletal issues.

Breathing Is More Than Just Oxygen

Breathing is not simply about getting air into the lungs. It is a complex mechanical process involving:

• The diaphragm
• Rib cage
• Abdominal muscles
• Pelvic floor
• Spine
• Nervous system

Because breathing happens thousands of times per day, inefficient breathing mechanics can place repeated stress on the body over time.

If breathing patterns become dysfunctional, the body often compensates by overusing other muscles, particularly in the neck, shoulders, chest, and low back.

The Role of the Diaphragm

The diaphragm is the primary muscle used for breathing. It sits beneath the lungs and works together with the abdominal muscles, pelvic floor, and deep spinal stabilizers to help manage pressure within the trunk.

When functioning well, the diaphragm:

• Supports efficient breathing
• Assists with trunk stability
• Helps regulate pressure through the abdomen
• Reduces unnecessary muscle tension
• Encourages relaxation through the nervous system

However, many people develop shallow, upper chest breathing patterns due to stress, pain, injury, posture, or prolonged sitting.

When this happens, the diaphragm may become less effective and other muscles begin compensating.

Overuse of Accessory Breathing Muscles

With shallow or chest-dominant breathing, accessory muscles in the neck and shoulders often work harder than they should.

These muscles include:

• Scalenes
• Sternocleidomastoid
• Upper trapezius
• Pectoral muscles

Over time, this increased workload can contribute to:

• Neck pain
• Shoulder tension
• Headaches
• Jaw tension
• Mid-back stiffness
• Rib cage tightness

Many people with chronic neck and upper back discomfort unknowingly breathe this way throughout the day.

Breathing and Low Back Pain

Breathing mechanics can also influence the low back and pelvis.

The diaphragm works closely with the deep core system, including:

• The pelvic floor
• Transverse abdominis
• Multifidus muscles

Together, these muscles help create stability and pressure management through the trunk.

When breathing mechanics are altered, pressure management and muscular coordination may also change. This can contribute to excessive tension, guarding, or inefficient movement strategies around the low back and pelvis.

In some cases, individuals with chronic low back pain may:

• Hold their breath during movement
• Brace excessively
• Breathe shallowly during exercise
• Struggle to coordinate breathing with movement

Improving breathing patterns may help reduce unnecessary tension and improve movement efficiency.

The Connection Between Pain and the Nervous System

Pain does not only affect muscles and joints — it also affects the nervous system.

When someone is in pain, breathing often becomes:

• Faster
• More shallow
• More guarded

This may increase activation of the sympathetic nervous system, also known as the “fight or flight” response. Here’s more on this topic.

As the nervous system becomes more sensitized:

• Muscles may stay tense longer
• Pain sensitivity may increase
• Recovery may feel slower
• Sleep quality may decline

Breathing can influence this cycle in both positive and negative ways.

Slow, diaphragmatic breathing may help:

• Reduce muscle tension
• Improve relaxation
• Support nervous system regulation
• Decrease protective guarding
• Improve body awareness

Posture, Rib Cage Mobility, and Breathing

The position and mobility of the rib cage and thoracic spine can significantly affect breathing mechanics.

Poor posture, prolonged sitting, or stiffness through the upper back may limit rib cage expansion and reduce diaphragmatic efficiency.

This can lead to:

• Reduced thoracic mobility
• Increased neck and shoulder tension
• Altered movement patterns
• Increased fatigue during activity

Addressing mobility, posture, and breathing together is often more effective than focusing on one area alone. 

Signs Your Breathing May Be Contributing to Pain

Some common signs of dysfunctional breathing patterns include:

• Frequent neck or shoulder tension
• Chest-dominant breathing
• Feeling unable to take a deep breath
• Rib cage stiffness
• Breath holding during exercise or lifting
• Jaw clenching
• Chronic stress or anxiety
• Fatigue during activity
• Feeling “tight” through the upper body

Read all about how breathing and pain can be intertwined. 

Breathing Retraining and Physiotherapy

Breathing retraining is not simply about “taking deep breaths.” It involves assessing:

• Breathing mechanics
• Rib cage movement
• Posture
• Muscle tension patterns
• Nervous system regulation
• Coordination between breathing and movement

Treatment may include:

• Diaphragmatic breathing exercises
• Rib cage mobility work
• Postural strategies
• Manual therapy
• Movement retraining
• Relaxation and nervous system regulation techniques

At Move Authentically Physiotherapy in Kingston, we assess breathing patterns as part of a whole-body approach to musculoskeletal pain. Our training in breathing pattern disorders helps us identify how breathing mechanics may be contributing to tension, pain, fatigue, and movement dysfunction. Book with us today, to start reducing your pain.