| July 14, 2025
Take a breath right now. Notice where it goes. Is your chest rising? Shoulders lifting? Belly moving?
Now let me blow your mind: that simple breath pattern might be why your neck hurts, why you can’t stabilize your core, why you’re anxious, or why you gas out faster than you should during workouts.
Breathing is the only vital function that’s both automatic and under conscious control. You take 20,000+ breaths per day. If you’re doing it wrong, that’s 20,000 repetitions of dysfunction. No wonder everything hurts.
The Breathing Epidemic Nobody Talks About
Studies show that up to 80% of adults are dysfunctional breathers. We’ve literally forgotten how to do the most basic human function properly. Watch a baby breathe—belly expands, chest stays quiet, shoulders don’t move. Watch a stressed adult—chest heaves, shoulders rise, belly sucks in.
What happened? Life happened. Stress, sitting, sucking in our stomachs, and the constant fight-or-flight of modern living rewired our breathing patterns. And these patterns are wreaking havoc on our bodies.
The Anatomy You Need to Know
Your primary breathing muscle is the diaphragm—a dome-shaped muscle that should do 80% of your breathing work. When you inhale properly, your diaphragm contracts and flattens downward, creating space for your lungs to fill. Your belly expands in all directions—360 degrees—as your organs are gently displaced. Your lower ribs expand laterally like an accordion opening, and your pelvic floor descends slightly to accommodate the increased pressure.
When you breathe dysfunctionally, your neck muscles—particularly the scalenes and sternocleidomastoid—overwork to pull air into your lungs. Your shoulders elevate with each breath, creating unnecessary tension throughout your upper body. Your upper chest expands instead of your belly, while your abdomen stays tight and restricted. Often, your lower back compensates by extending excessively, creating a cascade of postural problems.
You’re using emergency breathing muscles for everyday breathing. It’s like driving everywhere in first gear—inefficient and destructive.
How Bad Breathing Creates Pain
Neck and Shoulder Pain
When you breathe with your neck muscles 20,000 times a day, they get overworked. Imagine doing 20,000 shrugs daily. No wonder your neck hurts.
The Compensation Chain: This dysfunction creates a predictable cascade of problems. When your scalenes overwork with every breath, chronic neck pain develops from the constant tension. Your upper trapezius muscles engage to assist with breathing, leading to perpetual shoulder elevation and that feeling of carrying the weight of the world on your shoulders. Forward head posture develops as your body seeks the most efficient breathing position, creating even more strain on your cervical spine. Eventually, tension headaches follow as the accumulated stress in your head and neck region reaches a tipping point.
Lower Back Pain
Dysfunctional breathing destabilizes your core by disrupting the coordinated function of your deep core system. Your diaphragm doesn’t work in isolation—it’s intimately connected with your transverse abdominis (your deep abdominal corset), your pelvic floor muscles that support your pelvic organs, and your multifidus muscles that provide segmental spinal stability.
When your diaphragm doesn’t work properly, your back muscles desperately try to compensate for the lost stability. This leads to excessive lumbar extension as your back muscles overwork to maintain spinal alignment. Load transfer through your kinetic chain becomes inefficient, forcing individual muscles to work harder than they should. The increased disc pressure from poor spinal mechanics creates a breeding ground for injury, while chronic muscle tightness develops as your body fights to maintain stability through tension rather than coordinated muscle function.
The Anxiety Connection
Here’s the mind-body connection: your breathing pattern signals your nervous system. Chest breathing tells your brain “DANGER!” even when you’re safe.
The Stress Spiral: This creates a vicious cycle that’s difficult to break. Shallow, chest-based breathing signals your sympathetic nervous system to activate fight-or-flight responses, even when you’re perfectly safe. Your increased heart rate and heightened alertness create more anxiety, which leads to even shallower breathing as your body prepares for perceived danger. This chronic stress state triggers systemic inflammation throughout your body, setting the stage for a host of health problems that seem unrelated to breathing but are actually downstream effects of this dysfunctional pattern.
You’re literally breathing yourself into anxiety.
The Performance Cost
Reduced Endurance
Chest breathing is remarkably inefficient, consuming 30% more energy than diaphragmatic breathing for the same oxygen intake. This inefficiency reduces your actual oxygen uptake despite the increased effort, while unnecessarily elevating your heart rate as your cardiovascular system works harder to compensate for poor gas exchange. The result is early fatigue that seems disproportionate to your fitness level or the demands of your activity.
Elite athletes breathe better. That’s not coincidence.
Compromised Core Stability
Can’t hold a plank? Check your breathing. The diaphragm is your deep core’s ceiling. Without proper diaphragm function, your core’s ability to manage intra-abdominal pressure fails completely. Spine stability suffers as your deep core system can’t coordinate effectively to support your vertebrae during movement. Power transfer from your legs through your trunk decreases dramatically, making every athletic movement less efficient and more demanding. Ultimately, your injury risk increases exponentially as compensation patterns develop and overuse injuries become inevitable.
Limited Mobility
Breathing dysfunction creates whole-body tension through interconnected fascial and muscular chains. Your ribcage becomes rigid and locked in position, unable to expand and contract properly with each breath. Your thoracic spine stiffens as the muscles around it work overtime to stabilize what should be a mobile, breathing-responsive structure. Shoulder mobility decreases as tight respiratory muscles restrict overhead movement patterns. Even your hip flexors tighten as your body adopts postural compensations to optimize the inefficient breathing pattern you’ve developed.
You can’t move well if you can’t breathe well.
The Breathing Assessment
Test yourself right now:
Test 1: The Hand Test
Place one hand on your chest and the other on your belly, then breathe normally for 10 breaths while paying attention to which hand moves more. In optimal breathing, your belly hand should move significantly more than your chest hand, indicating that your diaphragm is doing the primary work of breathing rather than your accessory respiratory muscles.
Test 2: The Breath Hold
Take a normal breath in, followed by a normal breath out, then hold your breath without taking another inhale. Time how long you can comfortably hold before feeling the urge to breathe. A healthy breathing pattern should allow you to hold for 20 seconds or more, indicating good carbon dioxide tolerance and efficient breathing mechanics.
Test 3: The Rib Expansion
Wrap a tape measure around your lower ribs at the level of your xiphoid process. Exhale fully and note the measurement, then inhale as deeply as possible and measure again. Your ribcage should expand 2-3 inches during deep inspiration, indicating good lateral expansion and diaphragm function.
Test 4: Breathing Rate
Count your breaths for one full minute while at rest in a comfortable position. A healthy breathing rate should be 8-12 breaths per minute, indicating efficient gas exchange and nervous system balance. If you’re breathing more than 16 times per minute regularly, this suggests breathing dysfunction that’s keeping your nervous system in a heightened state.
The Breathing Retraining Protocol
Stage 1: Awareness (Week 1-2)
Practice Position: Lying on back, knees bent, one hand on chest, one on belly
The 4-7-8 Breath: This foundational pattern helps establish proper breathing mechanics and nervous system regulation. Inhale through your nose for a count of 4, hold your breath for 7 counts, then exhale through your mouth for 8 counts. Complete 4 cycles twice daily to begin retraining your breathing pattern and activating your parasympathetic nervous system.
Goal: Belly moves, chest quiet
Stage 2: Control (Week 3-4)
Practice Position: Sitting, then standing
360-Degree Breathing: This technique teaches you to breathe into your entire ribcage rather than just your belly. Place your hands on your lower ribs and focus on expanding them laterally as you inhale, feeling them widen like an accordion. As you exhale, feel your ribs gently compress back toward center. Practice 10 breaths three times daily to develop this crucial lateral expansion pattern.
Goal: Lateral rib expansion
Stage 3: Integration (Week 5-6)
Practice During Movement:
Breathing Squats: This exercise teaches you to coordinate proper breathing with movement patterns. Inhale as you descend into the squat, allowing your diaphragm to lower and create stability, then exhale as you ascend, using your breath to assist with core activation and power generation. Focus on matching your breath rhythm to your movement speed, performing 10 repetitions twice daily.
Goal: Coordinate breathing with movement
Stage 4: Challenge (Week 7-8)
Add Resistance:
Loaded Breathing: Challenge your breathing pattern by adding gentle resistance. Start by placing a light weight on your belly and breathing to lift the weight with each inhalation. Progress this exercise to various positions including planks, where you must maintain proper breathing mechanics while supporting your body weight and fighting gravity’s effects on your ribcage.
Goal: Maintain pattern under load
Specific Breathing Fixes
For Neck Pain
The Scalene Release Breath: Target overworked neck muscles with this specific technique. Place your hand on the painful side of your neck, then inhale deeply into your belly while keeping your neck muscles completely quiet and relaxed. As you exhale, gently stretch your neck away from your hand, using the exhale to facilitate release. Perform 10 repetitions three times daily to retrain these overused respiratory muscles.
For Back Pain
The Core Breathing Pattern: This technique reestablishes the connection between your diaphragm and deep abdominal muscles. Lie on your back with knees bent, exhale fully while gently flattening your lower back against the floor, then inhale while maintaining this neutral spinal position. Build endurance by holding this coordination for longer periods, eventually progressing to planks where you maintain the same breathing-core connection against gravity.
For Anxiety
The Vagus Nerve Breath: This specific rhythm activates your vagus nerve and parasympathetic nervous system to reduce anxiety. Inhale for 4 counts, hold for 4 counts, exhale for 6 counts, then hold empty for 2 counts. The longer exhale activates your parasympathetic response, while the rhythm creates nervous system coherence. Repeat for 10 complete cycles whenever anxiety arises.
For Performance
The Power Breath: This technique optimizes breathing for athletic performance and explosive movements. Take a quick, sharp inhale through your nose to create internal pressure and core stability, then forcefully exhale through your mouth during the explosive portion of the movement. Practice matching this breathing pattern to your lifting cadence, using the exhale to enhance power production and maintain core stability under load.
Real Breathing Transformations
Jason, CrossFit athlete: “My coach noticed I was holding my breath during lifts. Learned to breathe properly. Added 30 pounds to my squat and stopped having back pain. Breathing was the missing link.”
Maria, chronic neck pain: “20 years of neck pain. Tried everything. PT showed me I was breathing with my neck 20,000 times a day. Fixed my breathing, pain gone in 6 weeks.”
David, anxiety sufferer: “Thought I needed medication. Turns out I was breathing myself into panic. Daily breathing practice changed my life. Haven’t had a panic attack in months.”
The Daily Breathing Practice
Morning (2 minutes)
Start your day with 10 deep belly breaths before getting out of bed. This gentle awakening sets your nervous system in a calm, regulated state for the entire day ahead while helping to improve morning stiffness by promoting circulation and gentle spinal movement through diaphragmatic action.
Midday (1 minute)
Take five conscious breathing breaks throughout your workday, using each breath as an opportunity to reset your posture and release accumulating tension. These mini-breaks interrupt the stress cycle and prevent the shallow breathing patterns that develop from prolonged sitting and concentration.
Pre-Workout (2 minutes)
Include breathing exercises as part of your warm-up routine to activate your core system and optimize performance. Proper breathing preparation ensures your diaphragm is functioning optimally, your core is engaged, and your nervous system is in the ideal state for training.
Evening (5 minutes)
End your day with 4-7-8 breathing exercises that activate your parasympathetic nervous system and prepare your body for restorative sleep. This practice helps transition your nervous system from the day’s stresses into a calm, recovery-oriented state that promotes both sleep quality and overnight healing.
Common Breathing Mistakes
Forcing It
Breathing should be gentle. You’re not inflating a balloon.
Chest First
Belly expands first, then ribs, then minimal chest.
Overbreathing
More isn’t better. Slower and deeper is.
Breath Holding
Common during exercise. Always breathe.
Mouth Breathing
Nose breathing is optimal except during intense exercise.
When Breathing Isn’t Enough
See a physical therapist if breathing exercises increase your pain rather than relieve it, or if you find yourself unable to coordinate proper breathing with movement patterns despite consistent practice. Structural issues such as rib restrictions or spinal dysfunction may limit your ability to expand properly, while underlying respiratory conditions require professional guidance to ensure breathing exercises are appropriate. Many people also benefit from manual therapy to address physical restrictions in the ribcage, diaphragm, or surrounding muscles that prevent normal breathing mechanics.
Insurance Coverage for Breathing Dysfunction
Many insurance plans cover physical therapy for breathing-related issues, particularly when they’re connected to chronic pain conditions that affect your daily function. Postural dysfunction that creates breathing restrictions is often covered, as is treatment for core instability that prevents proper diaphragm function. Even stress-related disorders that manifest as physical symptoms may qualify for coverage when breathing dysfunction contributes to the problem.
At Evo PT Group, we integrate breathing assessment and training into our treatment plans. We accept most insurance and Medicare.
The Breath of Life
You can go weeks without food, days without water, but only minutes without breathing. Yet we spend more time thinking about what we eat than how we breathe.
Your breathing pattern affects every aspect of your existence in profound ways. It influences every movement you make by determining your core stability and postural alignment. It affects every thought you have through its direct connection to your nervous system and brain oxygenation. It impacts every cell in your body through oxygen delivery and waste removal. Ultimately, it colors every moment of your life by determining whether you exist in a state of stress or calm, tension or ease.
Fix your breathing, fix your body. It’s that simple and that profound.
Your Next Breath
Right now, take a proper breath by drawing air in through your nose, allowing your belly to expand naturally as your diaphragm descends. Feel your ribs widen laterally as your lungs fill completely, then exhale slowly and completely, allowing your body to naturally return to its resting position.
That’s one. Only 19,999 to go today.
Ready to breathe your way to better health? Schedule an evaluation at Evo PT Group and let’s assess your breathing pattern and its connection to your pain or performance issues.
Remember: You’re only as healthy as your breathing pattern. Every breath is an opportunity to heal or harm. Choose wisely.