Why The Way You Breathe May Be Causing You Pain

At rest, an adult will take more than 20,000 breaths in a single day. The overwhelming majority of which are involuntary, meaning we don’t have to think about it. We don’t need to focus on our lungs filling with oxygen or expelling carbon dioxide. We don’t need to worry about how much air we inhale or when to breathe deeply or quickly. It just kind of happens for us. But what if I told you that the way you breathe may be causing your shoulder, back and neck pain?


To understand the connection between breathing and pain, you first need to understand Diaphragmatic Breathing (a.k.a Belly Breathing). This is the process in which your diaphragm lowers and rises to expand and compress your lungs. Your diaphragm is a dome shaped muscle that sits below your lungs and is designed to control expansion of the chest cavity. As you inhale, the diaphragm contracts and flattens creating space for the lungs to inflate. Inversely, the diaphragm rises under the lungs as air is forced out. When done properly, you will notice expansion and compression of the abdomen. However, when breathing becomes dysfunctional, you will likely notice the rise and fall of the shoulders and chest.  


Dysfunctional breathing is the result of muscles of the chest, neck, and back contracting to raise the chest cavity in place of a dysfunctional or weak diaphragm. These muscles are meant only to assist when forceful breathing is necessary and should play a very minimal role in normal breathing mechanics. Muscles located in the neck, chest, lower back and abdomen create a sort of pump to force air out. We can feel these muscles contract violently when we sneeze or cough. However, when such muscles are overused; remember those 20,000 breaths per day, they become exhausted and worn down leading to discomfort or even injury.


A number of behaviors can cause dysfunctional breathing, most of which are learned over time.

  1. Smoking makes breathing difficult by damaging the lungs and breathing tubes that carry air to and from the lungs. This requires the recruitment of more muscle to inflate and deflate the lungs.

  2. Sitting in a Chair has a negative effect on our breathing mechanics as well. Seated with the hips flexed at a 90 degree angle pushes up on the diaphragm preventing the expansion of the lungs. Sitting with poor posture compresses the chest cavity making it nearly impossible to fully inflate the lungs.

  3. Posture may determine how you breathe. The tendency to ‘slouch’ or ‘suck it in’ often prevents us from truly expanding or abdomen making it difficult for the diaphragm to do its job. Instead we promote chest or shoulder breathing in an attempt to hide our belly.  

  4. Stress creates tension in the upper body, namely in the face and neck, leading to chest and shoulder breathing. These days we experience stress on a daily basis, at work, at home, or in bumper to bumper traffic.

  5. Lack of Practice also plays an important role in dysfunctional breathing. The diaphragm is a muscle and you must be able to control it in order to breathe effectively. Practicing diaphragmatic breathing will increase diaphragm strength and make proper breathing effortless.


It starts with practicing proper diaphragmatic breathing. This can be tricky and will require your focus. You first need to understand and feel what it is like to breathe properly. Try this exercise.

  1. Lie flat on you back with one hand on your belly and the other hand on your chest.

  2. Inhale through the nose and exhale through the mouth at a pace of about 4 seconds in and 5 seconds out.

  3. Try to breathe using your diaphragm, making the hand on your belly rise and fall before the hand on your chest. The more you practice the more control you should gain.

  4. The goal here is to feel for the expansion and compression of your abdomen (belly) with minimal rise and fall or your chest.

  5. Doing this on the floor will give you the greatest feedback.

You are essentially learning a new habit so give this time. Practice daily and take notice of  your breathing throughout the day.


Learning to breathe properly has the potential to relieve pain-causing tension in the shoulders, back and neck. By reducing the stress on muscle designed to merely assist your breathing you may effectively reduce your chances of a crick in your neck, shoulder pain, and stress related tension in the upper body. From a performance standpoint optimizing your breathing will improve your aerobic capacity and ability to recover from intense exercise. Diaphragmatic breathing can also aid in relaxation, reduce anxiety, and improve vagus nerve function.

If you would like to learn more about how you can optimize your health and performance, contact the Ethos Fitness + Performance team or visit our Blog.