Dysfunctional Breathing Patterns Have Been Associated With Several Musculoskeletal Conditions
Have you ever thought twice about the way you breath?
Properly diaphragmatic breathing results from using our primary respiratory muscles (the diaphragm and external intercostals), causing expansion of the abdomen. However, many rely on accessory respiratory muscles in the upper chest and shoulders rather than the diaphragm – which result in dysfunctional breathing patterns. Dysfunctional breathing patterns have been associated with musculoskeletal conditions such as low back pain, chronic neck pain, and chronic ankle instability. And on the contrary, diaphragmatic breathing patterns correlate with improved postural and core stability, reduction musculoskeletal injuries and in physiological stress.
The prevalence of dysfunctional breathing has been reported as between 29 and 74% in asthmatics, and 62-73% in physically active, healthy adults. In athletes, the prevalence of dysfunctional breathing patterns is not known, nor is it known whether dysfunctional breathing in athletes confers a greater injury risk.
A study was performed in a Japanese population on a wide variety of athletes in competitive sports ranging from elementary school athletes to professional athletes (maximum age 25). It demonstrates that the prevalence of dysfunctional breathing was extremely high (90.6%) in athletes. The authors hypothesized that the higher proportion of dysfunctional breathing in athletes may be due to greater physiological and psychological stress due to the demands of competitive sport, but this remains to be further studied. There are a few drawbacks of this study. Of note, these athletes were only assessed in the standing position, which may increase the proportion of dysfunctional breathers due to the increased respiratory demand (as compared to supine and sitting). Prior studies have suggested assessing breathing in multiple positions. Also of note, this study does NOT determine the clinical significance of dysfunctional breathing patterns – i.e. we do not know if these breathing patterns actually confer a greater risk of injury.
However, this is an interesting study that draws attention to an area where further research is needed – and is one which reminds us to think again about the way we breath:
- Place one hand on your chest and one on your abdomen
- Inhale slowly through your nose and focus on expanding your abdomen rather than your chest
- Exhale slowly
By: Sarah DeParis, MD and Helena Zhang, BS
Journal Reference:
- Shimozawa, Yuka1; Kurihara, Toshiyuki2; Kusagawa, Yuki3; Hori, Miyuki3; Numasawa, Shun4; Sugiyama, Takashi1; Tanaka, Takahiro3; Suga, Tadashi2; Terada, Ryoko S.5; Isaka, Tadao1; Terada, Masafumi1. Point Prevalence of the Biomechanical Dimension of Dysfunctional Breathing Patterns Among Competitive Athletes. Journal of Strength and Conditioning Research: May 24, 2022 10.1519/JSC.0000000000004253 doi: 10.1519/JSC.0000000000004253
A recent study called Treatments for Anxiety: Meditation and Escitalopram (TAME) compared an 8-week standardized evidence-based mindfulness-based intervention (mindfulness-based stress reduction, MBSR) with medication for the treatment of anxiety disorders. The study included over 200 adults with a diagnosed anxiety disorder that were assigned to either 8 weeks of the weekly MBSR course or taking a medication for anxiety called escitalopram. The MBSR course involved weekly 2.5 hour classes, 45-minuter daily home exercises, and a day-long weekend retreat during the fourth or sixth week. The classes and home exercises involved mindfulness meditation, body scans (directing attention to one part of the body at a time to increase inward awareness), and mindful movements such as stretching. At the end of the 8 weeks, the results showed that the mindfulness program was just as effective at reducing anxiety as medication.