Breathing and Functional Movement
Movement is the foundation of everything we do in daily life. At the center of our movement is the trunk.
From the moment we are born, we breathe. With every breath, the diaphragm, rib cage, abdominal wall, and pelvic floor work together to support respiration, posture, and movement.
But what does efficient breathing actually look like?
We rarely think about how we breathe because breathing happens automatically. However, posture, movement habits, stress, pain, and other factors can influence our breathing patterns. Over time, these changes may affect muscle recruitment, trunk stability, and movement efficiency.
Breathing Pattern Disorders
Breathing Pattern Disorders (BPD) can present in many different ways. Some individuals may experience breathing dysfunction alongside anxiety, stress, or low confidence, while others may present with musculoskeletal problems such as neck and shoulder pain, chronic pain, or fatigue.
Because each person presents differently, there is no single breathing strategy that is appropriate for everyone.
From a clinical perspective, breathing should be assessed in relation to the individual’s symptoms, posture, and functional movement rather than simply being classified as “normal” or “abnormal.”
The Rib Cage and Diaphragm
The rib cage plays an important role in both breathing and postural control. During efficient inspiration, the diaphragm moves downward while the lower rib cage expands outward and laterally.
In contrast, some individuals rely excessively on accessory muscles of the neck and upper chest. This may result in excessive elevation of the shoulders and upper rib cage, with relatively limited movement of the lower ribs.
A simple clinical observation is to place your hands gently over the patient’s lower ribs and observe how the rib cage moves during breathing.
Ideally, the rib cage should be able to expand in multiple directions—not just upward or forward.
Breathing and Core Stability
Breathing is also closely connected to core stability.
The diaphragm, abdominal muscles, pelvic floor, and spinal stabilizers work together to regulate intra-abdominal pressure and support the spine. During movement, these muscles must coordinate rather than simply “tighten.”
This is why core stability should not be viewed as abdominal bracing alone. Efficient trunk control requires coordination between breathing and movement.
Research by Hodges and Gandevia has demonstrated coordinated activity between the diaphragm, transversus abdominis, pelvic floor, and multifidus during movement. The diaphragm therefore contributes not only to respiration but also to postural control.
Why Does This Matter?
Breathing is not separate from movement.
When assessing a patient with a movement or postural dysfunction, it can be useful to ask:
- How does the patient breathe at rest?
- Does the breathing pattern change with posture?
- Is there excessive use of the accessory muscles?
- Can the lower ribs expand in multiple directions?
- Can the patient maintain trunk control while breathing?
- Does the breathing pattern change during functional movement?
Breathing retraining should not be considered necessary for every patient. However, when breathing mechanics are contributing to inefficient movement or poor trunk control, addressing them can become an important part of rehabilitation.
Breathing is not simply something we do while we move.
Breathing is part of how we move.
References
Hodges, P. W., & Gandevia, S. C. (2000).
Mantilla, C. B., & Sieck, G. C. (2008).
Vojta, V. (2004).
Vojta, V., & Schweizer, K. (2009).
Page, P., Frank, C. C., & Lardner, R. Assessment and Treatment of Muscle Imbalance.
Recognizing and Treating Breathing Disorders.