BREATHING PATTERN DISORDERS AND FUNCTIONAL MOVEMENT |Int J Sports Phys Ther. 2014 Feb
Normal breathing mechanics play a key role in posture and spinal stabilization.
Breathing Pattern Disorders (BPD) have been shown to contribute to pain and motor control deficits, which can result in dysfunctional movement patterns.
How we breathe is linked to our posture which is linked to pain, so there’s hope that by changing our breathing patterns, we might lessen our pain.
The Functional Movement Screen™ (FMS™) has been shown to accurately predict injury in individuals who demonstrate poor movement patterns.
The role BPD play on functional movement is not well established. Furthermore, there is currently no single test to clinically diagnose BPD. A variety of methods are used, but correlations between them are poor.
Functional movement is defined as the ability to produce and maintain an adequate balance of mobility and stability along the kinetic chain while integrating fundamental movement patterns with accuracy and efficiency
- Postural control deficits,
- poor balance,
- altered proprioception, and
- inefficient motor control
have been shown to contribute to pain, disability, and interfere with normal movement
Individuals with poor posture, scapular dyskinesis, low back pain, neck pain, and temporomandibular joint pain exhibit signs of faulty breathing mechanics.
Thoracic breathing is produced by the accessory muscles of respiration (including sternocleidomastoid, upper trapezius, and scalene muscles), dominating over lower rib cage and abdominal motion.
Over‐activity of these accessory muscles have been linked to
- neck pain
- scapular dyskinesis,and
- trigger point formation.
Vickery suggested that decreased abdominal motion, relative to upper thoracic motion, confirms poor diaphragm action.
The diaphragm is the key driver of the respiratory pump with attachments onto the lower six ribs, xiphoid process of the sternum, and the lumbar vertebral column (L1‐3). Hodges et al. stated that since the diaphragm performs both postural and breathing functions, disruption in one function could negatively affect the other.
The purpose of the present study was to investigate whether a relationship exists between breathing pattern and functional movement.
The results from this study show that a relationship exists between elements of BPD and functional movement
Breathing Pattern Disorders and Functional Movement
Cook proposed the musculoskeletal system would migrate toward predictable patterns of movement in response to pain or in the presence of muscle imbalance.
Hruska proposed the existence of a thoracic dominant breathing pattern resulted in hypertonicity of the accessory muscles of breathing, which in turn prevents the diaphragm from returning to an optimal resting position. As the diaphragm plays a key role in pressure generation, the change in the length‐tension relationship of the diaphragm results in altered pressure generation.
Lee et al suggest that this process challenges deep motor patterns that control trunk stability, resulting in a negative effect on body mechanics and motor control patterns. As normal movement is achieved through a balance of mobility and stability, changes in trunk stability will result in sub‐optimal movement and could lead to dysfunction
This is supported by O’Sullivan et al who found that individuals who presented with sacroiliac joint pain exhibited altered motor control strategies and alterations of respiratory function while performing a low‐load task. Specifically, a decrease in diaphragmatic excursion was observed. The length and curvature of the diaphragm and the size of the zone of apposition influence its power and efficiency, thus a decrease in diaphragmatic excursion has negative consequences to postural stability and optimal respiration
This is in accordance with Roussel et al, who showed that individuals with low back dysfunction exhibited altered breathing patterns during movements where the core stability muscles were challenged.
Correct breathing has therefore been proposed as a possible foundation for the correction of dysfunctional movement patterns
Kepreli et al showed that individuals who demonstrate thoracic breathing patterns also have neck pain and a forward head posture
McLaughlin et al demonstrated that individuals who suffered with neck pain presented with poor respiratory chemistry. Interestingly, following an intervention program to address breathing dysfunctions and manual therapy to address thoracic cage mobility, respiratory chemistry improved, pain scores decreased, and functional improvements were observed.
A forward head posture has been shown to affect shoulder biomechanics and postural balance. These factors may also have a negative effect on performance of the FMS™, but further research is needed to draw definite conclusions.
The present study showed that both biochemical and biomechanical measures of BPD are significantly associated with scores on a screen of functional movement.
Individuals who exhibited signs of BPD were likely to demonstrate greater movement dysfunction as represented by lower scores on the FMS™
These findings provide evidence for incorporating breathing evaluations into clinical practice by clinicians and trainers, as they could be contributing to problems with motor control and movement.
Future research is needed to validate breathing re‐education programs and the role they have in treating pain disorders, preventing injury, and improving movement patterns.