Could vanity be giving you neck and back pain?

This blog talks about how most of us don’t breath properly, how this can cause back and neck pain and how we can fix it.

There is so much pressure on us to look good! We have adopted all these techniques to appear skinnier, like poking out our chin to avoid a double chin, standing with one leg behind us and poking out the front hip to appear skinnier but curvaceous. dropping our hips as we walk, trying to emulate a model and now I have noticed we don’t even breath properly to avoid our stomachs protruding!! All of these examples will contribute to neck, back and pelvic pain. Today I am going to talk about the later; how shallow breathing can cause neck and back pain and how we can avoid it.

“we don’t even breath properly to avoid our stomachs protruding!!”

Could shallow breathing be causing my neck and thoracic back pain?

In addition to the vanity of keeping a flat stomach, our busy and stressed lives cause us to take short, shallow breaths, even though we know deep breathing actually helps relieve stress. If stressed, we often shallow breath which instead of lowering the diaphragm to inhale oxygen, we elevate our chest cavity using the accessory muscles in our neck and thorax which can end up causing neck and thoracic pain.

When we inhale, we should see our abdomen expanding as the diaphragm contracts and pushes down from our chest to our abdomen. When we exhale our diaphragm relaxes and moves upwards flattening our abdomen. Our shoulders should stay still and relaxed.

“When we inhale, we should see our abdomen expanding as the diaphragm contracts and pushes down from our chest to our abdomen. ”

How does shallow breathing cause low back pain?

The diaphragm is connected to our core muscles (the transverse abdominis in the front, the multifidus muscles around our spine and the pelvic floor below). If we need to lift something heavy, our body should naturally increase our intraabdominal pressure to splint and support our spine. It does this by contracting the diaphragm down, the pelvic floor up and the core in. Thus we need good movement and strength in our diaphragm to offer this support in these situations. If we don’t use our diaphragm normally by regularly deep breathing, we won’t have the diaphragmatic strength or thoracic mobility to give our back support when we need it. If we don’t support our spine with these muscles, back pain and injury can result.

“If we don’t use our diaphragm normally by regularly deep breathing, we won’t have the diaphragmatic strength or thoracic mobility to give our back support when we need it.”

How can I check that I am breathing with my diaphragm and contracting my core and pelvic floor properly?

Deep breathing will help to strengthen your diaphragm, core, pelvic floor and back stability! More benefits for me learning the sax! If you don’t have a sax handy, practice intentional deep breathing. Try these exercises below to see that you are contracting the muscles correctly.

1.      Diaphragm. Lie on your back and put your hands on your stomach. As you breath in, you should feel your abdomen rise and fall as you breath out.

2.  Transverse Abdominis. Once, you can feel that, put your fingers on your abdomen but just near your hip bones. This is where you will feel your transverse abdominis muscle best. As you breath in these muscles should relax, as you exhale, feel these muscle gently contracting. Think about lifting your abdomen and hip bones upwards to the ribs (rather than down to the spine) on exhalation.

3.      Pelvic floor. Then place fingers of one hand over your perineum (tissue around your vagina, urethra and anus). This can give you a good external indication of pelvic floor contraction. On the inhale, the perineum should move down into your fingers. On the exhalation, you should feel a gentle contraction and lifting of the perineum. This is what you are aiming for.

A weak core and overused diaphragm may be causing headaches or T4 syndrome

If the core and pelvic floor are weak or dysfunctional (not contracting at the right times) the diaphragm is relied on too much to increase intra-abdominal pressure for back support. If the diaphragm is used for stabilisation more than inspiration, accessory muscles in the neck (scalenes) and torso (external obliques) get used more than they should to assist in inspiration. The overuse of these muscles can lead to cervical headaches, thoracic stiffness and T4 syndrome (thoracic and arm pain). A physiotherapist can assess and treat these issues as well as help you learn how to strengthen and coordinate your core and pelvic floor to support your body and diaphragm.

“If the core and pelvic floor are weak or dysfunctional (not contracting at the right times) the diaphragm is relied on too much to increase intra-abdominal pressure for back support.”

Physiotherapists can help determine why your diaphragm is not moving properly

If the diaphragm is not moving properly (after years of not being mobilised with deep breathing), this can lead to stiffness in the lower thoracic and upper lumbar spine which needs mobilising to allow the movement again. The diaphragm is supplied by nerves originating in the neck, so if the neck is stiff this will need mobilising to allow good nerve supply to the diaphragm. Likewise, if muscles such as the quadratus lumborum (low back) and psoas (hip flexor) are tight the diaphragm cant move properly to expand the lungs. Physiotherapists can assess any asymmetries in your diaphragmatic breathing, what is causing the diaphragm not to move properly and give you the appropriate treatment and exercises.

Then you can return to diaphragmatic breathing to relieve stress, prevent the neck and back pain and tightness returning and promoting relaxation and a healthy wellbeing.

“Physiotherapists can assess any asymmetries in your diaphragmatic breathing, what is causing the diaphragm not to move properly and give you the appropriate treatment and exercises.”

Summary

Deep breathing is important for relaxation but also to prevent neck and back pain developing.

Diaphragmatic breathing can help activate your core and pelvic floor too.

Shallow breathing is common in our busy lives so certain stiffness’ may need to be assessed and treated by a physiotherapist to allow you to breath deeply and completely again.

Melli Tilbrook is the Director and Physiotherapist of Mummyotherapy