Breathing Gone Wrong: How It Wrecks Your Spine & Posture
- Dr. Lucas Marchand
- Jul 1
- 6 min read
Why How You Breathe Affects Your Back — A Sioux Falls Chiropractor Explains
By Dr. Lucas Marchand, DC — MyChiro Mobile Chiropractic, Sioux Falls, SD
There's a question I ask at almost every new patient assessment that reliably produces a surprised look: where does your belly go when you take a deep breath?
Most people pause. Some say out. Some say up. A meaningful number aren't sure. When I watch them take a breath, the answer is usually visible immediately — the shoulders rise, the chest expands, and the belly does almost nothing. The diaphragm, the muscle that should be driving the whole thing, is barely participating.
This matters for a reason that almost nobody explains to patients: the diaphragm isn't just a breathing muscle. It's also the primary pressure regulator for the spine.
What the Diaphragm Actually Does
The diaphragm is a dome-shaped muscle that sits at the base of the ribcage, separating the chest cavity from the abdomen. When it contracts during inhalation, it flattens downward — and that downward movement increases the pressure inside the abdominal cavity. That pressurization is not incidental to breathing. It's a structural event.
The technical term for it is intra-abdominal pressure, and it functions as a form of internal bracing for the lumbar spine. When the diaphragm contracts properly, the transverse abdominis — the deepest layer of the abdominal wall — responds in coordination. The pelvic floor engages at the base. The multifidus muscles along the posterior spine activate. Together these structures create a pressurized canister around the lumbar spine with every breath cycle, reinforcing it from the inside.
This happens approximately 20,000 times per day. Most of those 20,000 repetitions are supposed to be subtle acts of spinal stabilization. When the diaphragm contracts correctly, the spine gets braced 20,000 times. When it doesn't, it doesn't.
What Happens When Breathing Goes Wrong
The most common pattern is chest breathing — the shoulders-rise, ribcage-expands variety — where the diaphragm contributes minimally and the accessory breathing muscles (scalenes, sternocleidomastoid, upper trapezius) do the work instead. This is a compensatory pattern that most people develop gradually, often accelerated by prolonged sitting, chronic stress, or any condition that makes diaphragmatic breathing uncomfortable, including low back pain itself.
The downstream effects accumulate over time rather than appearing suddenly.
The deep stabilizers that depend on diaphragmatic coordination — the transverse abdominis, the multifidus — become underactivated. Without reliable input from the diaphragm's pressure cycle, they stop functioning as primary stabilizers and become more like passive tissue. The body compensates by over-recruiting the superficial global muscles: the erector spinae, the quadratus lumborum, the upper trapezius. These muscles weren't designed to be primary stabilizers. They're designed for movement and load transfer. Asking them to serve as the primary support system for the lumbar spine is like asking a sprinter to carry a heavy pack all day — they can do it, but not without eventually breaking down.
The result, in most patients, is chronic low-grade tension in the lower back and neck that doesn't fully resolve between episodes, combined with a spine that is genuinely less stable than it should be because the internal bracing mechanism is not functioning correctly.
The Thoracic Spine Connection
There's a mechanical link between chest breathing and thoracic restriction that's worth naming specifically, because it comes up constantly in clinical practice.
When the diaphragm is underused and the accessory muscles are overworking, the ribcage tends to become fixed in a position of chronic elevation — slightly lifted and forward, corresponding to a mild but persistent state of inhalation. The thoracic spine, which articulates directly with the ribs, adapts to this positional demand by becoming restricted in extension. The mid-back loses its ability to move through full range.
A restricted thoracic spine compounds the problem from above: it limits shoulder mobility, loads the cervical spine with compensatory demand, and shifts the mechanical environment for the lumbar spine unfavorably. In clinical practice at MyChiro, thoracic adjustment is almost never isolated to just the thoracic spine — it's part of addressing a connected chain that includes breathing pattern, rib mobility, cervical compensation, and lumbar loading.
The breathing pattern didn't just cause back pain in isolation. It created the mechanical environment in which back pain became likely.
How to Assess Your Own Pattern
This doesn't require a clinical setting. Place one hand on your chest and one hand on your belly. Take a full breath in.
If the chest hand moves first and moves more — chest breathing, accessory muscle dominant. The diaphragm is underperforming its stabilizing role.
If the belly hand moves first and the chest hand barely moves until the end of a full breath — diaphragmatic breathing, pressure cycle intact.
Most people with chronic low back pain, chronic neck tension, or postural complaints discover on this test that their breathing pattern has been part of the problem for years without anyone pointing it out.
What Restoration Looks Like
Addressing dysfunctional breathing in a clinical context involves two parallel tracks — the structural and the neuromotor — which address different parts of the same problem.
The structural piece involves the thoracic spine and ribcage directly. When the thoracic spine is restricted in extension and the ribs are locked in elevation, the diaphragm physically cannot descend fully during inhalation regardless of how much the patient tries to breathe correctly. The geometry doesn't allow it. Thoracic adjustment at MyChiro restores extension and rib mobility, which changes the mechanical environment the diaphragm is working in. Most patients notice an immediate difference in their ability to take a full breath after thoracic work — not because they were instructed to breathe differently, but because the structure that supports diaphragmatic descent has been restored to its proper position.
The neuromotor piece involves retraining the coordination pattern itself. Two exercises are clinically useful for most patients.
Crocodile breathing: Lie face down, forehead resting on the back of your hands. In this position, the chest is unavailable to expand, which forces the diaphragm to do the work. Breathe in slowly, focusing on feeling the belly expand into the floor. Exhale fully. Repeat for two minutes. Most patients feel the diaphragm engaging within a few breaths — sometimes for the first time they can consciously recall.
90/90 wall breathing: Lie on your back with your knees bent at 90 degrees and feet resting flat on a wall. Place one hand on the belly and one on the chest. Inhale through the nose, directing the breath into the belly while keeping the chest still. Exhale fully. The wall provides sensory feedback for pelvic position and the setup naturally encourages diaphragmatic descent. This is the drill most useful for patients specifically trying to reconnect the breathing-stabilization loop, since the position activates the pelvic floor and transverse abdominis in coordination with the breath.
These aren't complicated. They don't require equipment. They're most effective done for two to three minutes immediately before or after the exercises a patient is already doing for their back complaint.
The Clinical Relevance in Sioux Falls
In nearly a decade of mobile chiropractic practice, the breathing assessment has changed how I approach a meaningful number of cases that weren't resolving the way they should have. Patients who had been adjusted repeatedly for low back pain and were getting temporary relief followed by recurrence — some of them had a dysfunctional breathing pattern underlying the whole thing. The adjustment addressed the restricted joints. The breathing was re-creating the mechanical conditions that produced the restriction within a few weeks.
Changing the breathing pattern didn't replace the adjustment. It changed whether the adjustment held.
This is the kind of thing that's hard to assess in a six-minute clinic visit. One of the advantages of a mobile practice where the visit is unhurried and the provider is the same person every time is that these patterns become visible across visits. The patient who always presents with the same three restricted segments and whose improvement doesn't hold — eventually that history points somewhere upstream.
Getting Assessed in Sioux Falls
If you've been managing back pain, neck tension, or postural complaints that don't fully resolve — and nobody has assessed your breathing pattern as part of the clinical picture — it's worth having that conversation.
MyChiro serves Sioux Falls, Brandon, Tea, Harrisburg, Renner, Canton, and the surrounding area. The clinic comes to you. Same-day appointments are usually available.
Book your visit here. Or call or text (605) 201-4862.
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