Breathing is a critical piece of the movement equation and is one that has been almost ignored until recently. Many people simply breathe, and call it “good” if they do not suffocate, unfortunately this is far too simplistic as there is a “right” and a “wrong” way to breathe.

Unfortunately, we know that the majority of people fall toward the “wrong” way and incorrect breathing patterns lead to a gamut of movement dysfunctions. Improper breathing can lead to dysfunction as high as the TMJ (though some osteopathic physicians see proper breathing as having a mobilizing effect on the skull) and as low as the hips. In between, breathing plays a powerful role in cervical posture, carpal function, shoulder health, thoracic spine mobility, and lumbo-pelvic-hip stability via intra-abdominal pressure mechanisms. Better control at the pelvis, leads to more favorable mechanics of the joints above and below, making breathing a powerful ally in preventing lower extremity injury common in runners like sports hernia, runners knee, and athletic pubalgia.  Restoration of proper breathing patterns can reduce tone in the majority of cervical muscles, aid in the reduction of forward head posture, and reduce tone of the hip flexors.

The biochemical effects of hyperventilation have powerful effects on fascial constriction and there are primary and/or accessory muscles in each and every fascial line presented by Thomas Myers. As we understand from the concept of tensegrity, it then stands to reason that breathing limitations alter all fascial lines, and ultimately lead to movement dysfunction. One could go as far as to say that due to the relationship between the obliques and intercostals of the lateral line, improper breathing can result in reduced function of the “anterior X” that controls and produces torque, and subsequently running, walking, and skating mechanics can be altered. An inability to check torques appropriately though the LPH complex is yet another risk factor for running related hip and lower extremity dysfunction.

Proper breathing certainly provides great benefit to the athlete, is inimitable, and is of huge benefit to a vast array of movement dysfunction. Thus, there is little question that breathing must be a core competency. As the great neurologist Karel Lewit said, “If breathing is not normalized, no other movement pattern can be.”

So how does one go about normalizing breathing patterns as Dr. Lewit suggests?

First, before we go about correcting anything, we need to understand if something needs to be corrected at all. Proper breathing involves the diaphragm contracting to compress the abodminal cavity, making more space for the lungs to expand.

The best way to assess this is simply have the athlete in a seated position, palpate the lower ribs, the sides of the abdomen, and the iliac crest, and have him breath. Ideally, the athlete will expand his ribs into your hand with minimal elecation of the ribcage until late in the breathing cycle if at all. If he is unable to do so in seated, I suggest regression to supine positions (like in the first exercise below.

Once the quality of the player’s breathing proficiencies are identified, proper correction can commence. I typically begin my athletes’ training at level where they first demonstrated poor patterns. If patterns look good in supine, but not prone, I will start them in prone. If they look fine in prone, but not seated, then training begins in seated positions, etc. Below are a few of my favorite breathing exercises. Supine breathing is a great first step for many and can be progressed quickly. Ideally the bottom hand will rise vertically, and the top hand will demonstrate minimal movement.

Once the supine breathing is well patterned, I often progress to prone prayer position to work on facilitating posterior and lateral ribcage expansion. According to physical therapist Diane Lee, she finds posterio-lateral expansion to be most restricted in those with lumbo-pelvic-hip dysfunction like SIJ pain, gron strains, and sports hernia. It is one of the harder positions to master, so providing some feedback by sprining on the posterior rib cage at the end of expiration and cuing the athlete to “breathe into my hands” often help solidify patterns.

While there are some exercises designed simply to focus upon breathing and breathing only, it is critical to be able to breathe efffectively thorough an abdominal brace, so I challenge athletes in a number of positions and exercises that are traditionally seen as “rotational stability” and “anterior core” exercises. One of my current favorites is the breathing bench dog with hip flexion as it provides a great rotational stability demand, is lower level, and the contraction of the psoas develops a strong fixed point for diaphragmatic contraction.

Remember as with all we do as coaches, we should be constantly assessing and thinking about ways to help our athletes succeed. Understanding, coaching, and integrating breathing pattern work is no exception.

Best regards,

Carson Boddicker

Boddicker Performance