Through December last year, the instruction I gave to most clients as they left was to breathe.

There was a real spate of people with stiff necks and aching shoulders, who were a little on the stressed side (as appears to be the norm in December).  And that seems to have continued into the new year…

As I did some assessments and moves to relax the body, something became more evident.  They really weren’t breathing !

Some had very light, shallow breaths.  Others could inhale deeply, but in doing so their neck tensed, ribcage pulled up and belly sucked in.

Relaxed easy breathing seemed rare.  There was little expansion of the diaphragm and rib cage.  Tummies were staying flat throughout the breath.

Many had poor posture.  Head well forward, shoulders rounded.

And when it came to muscles in the neck… some of them were like steel cables !


breathe diaphragm


how do you really breathe ?

Diaphragmatic breathing uses contraction and expansion of the diaphragm, a muscle between the thoracic and abdominal cavities.  Intercostal muscles, between the ribs, assist the diaphragm.  When the diaphragm contracts, air is drawn into the lungs, the chest rises and the belly expands.  On exhalation, the lungs collapse as the air leaves, and the diaphragm simply relaxes.

Diaphragmatic breathing has a scientific name – eupnea.  Eupnea is natural, effective form of breathing done by mammals (including humans), which maximises air intake with minimal effort by muscles.

This type of breathing occurs when people are in a state of relaxation, when there’s no stress or danger in their environment.  Unsurprisingly, many use this type of deep breathing as a way to trigger the body to begin to relax.

Shallow breathing (or chest breathing) draws only a minimal amount of air into the lungs.  The diaphragm is not drawing the air into the lungs, but various muscles have taken over to enable breath instead.  Muscles in the neck and shoulders lift the rib cage to pull air in (often with the tummy contracting to help).

Shallow breathing commonly accompanies other conditions – anxiety, stress, panic attacks, and asthma.

While the stress of the end of the year was evident in most, many realised that this was how they normally breathe !

shallow breatheshallow breathe

using muscles to breathe

Try taking a deep breath.

If you find that your tummy sucks in, your rib cage lifts up and forward, your neck tenses, and you get taller, then you’re shallow breathing.

When shallow breathing, the diaphragm doesn’t work well.  Muscles in the chest (pectoralis minor, serratus anterior) and throat area (scalenes, sternocleidomastoid) are often recruited to try to help make breathing happen.

The pectoralis minor muscles are small muscles, deep in the upper chest.  The muscle attaches the front of the shoulder blade (near the tip of the shoulder) to the 3rd, 4th and 5th ribs. When used for deep breathing, they lift the upper ribs during inhalation.  The pectoralis minor is the muscle largely responsible for rounded shoulder posture, which then causes upper back pain.

The serratus anterior muscle sit under the arm, attaching the surface of upper 8 ribs to the shoulder blade.  They’re usually used for shoulder movement, but can also help raise the ribs on inhalation, often strained by hard or heavy breathing.  Tightness in these muscles can result in headaches or hand/wrist pain.

The sternocliedomastoids (SCM) are the prominent V-shaped muscles of the throat.  They attach behind the ear to the collarbone and sternum.  When inhaling deeply, they help to lift the top of the ribcage.  Their main role is to move and stabilise the head, but also commonly cause forward-head posture and headaches.

The scalenes reside deep in each side of the neck, attaching the sides of the neck to the first and second ribs.  Like the SCM, their main role is to move and stabilise the head, and also elevating the ribcage on deep inhalation.  When scalenes cause pain, it’s not generally in the neck !  They tend to cause pain into the chest, down the arm, and into the shoulder blade.

breathe inhale exhale

How did we learn to breathe this way ?

When we’re very young, the body naturally knows how to breathe using the diaphragm.  It’s as we grow older that breathing patterns often change, due to a range of possible reasons.

Kids are sponges.  They learn from others, imitate what others do.  When shallow breathing is what others around them are doing, they copy.  And soon they’re shallow breathing as their normal breathing too.

From the time we start school, sitting in chairs is the norm.  Hips are flexed to 90 degrees.  Shoulders often become rounded with forward head posture, causing the rib cage to move further toward the pelvis.  The stomach is compressed from above and below.  Using the diaphragm to breathe, with the stomach and ribcage expanding, becomes difficult to do.

Cultural expectations are that we have a flat stomach.  This encourages us to suck in our stomach, rather than be comfortable with stomachs sticking out, especially on every inhalation.  Tight belts, tight clothing, compression underwear and bras are designed to stop the stomach and ribcage expanding.

Medical conditions such as asthma, or smoking, can make breathing laboured.  Lungs don’t work well, so other muscles are recruited to compensate

Anxiety and shallow breathing are strongly linked.  When anxious, the body feels it is in state of danger.  The fight/flight response kicks in, and breathing becomes short and shallow, ready to respond.  However, continued shallow breathing can also keep the body in that fight/flight state, resulting in increased anxiety.

The stress of life tends to concentrate itself in the upper body.  The muscles in that area are used to carrying the burden.  The jaw is tense and clenched.  Shoulders and neck are tight.  And sometimes continue to stay active, taking over the breathing.

“We are a society of shallow breathers: afraid of moving our bellies, afraid of expressing ourselves, living our lives in chairs, and stressed out by our busy minds. Instead of breathing with the diaphragm, people tend to breathe with upper body musculature that is inadequate to the task, with a cascade of musculoskeletal consequences and vulnerabilities.”  [quote from]


breathe shallow stress

What’s the impact on our body ?

Chronic shallow breathing can manifest itself in many ways, from emotional/stress to physical aches and restrictive movement.

Shallow breathing can be seen as both a cause of the problem, as well as the result of the problem.  Shallow breathing can put the body into a cyclic state of stress.  Stress causes shallow breathing, and shallow breathing causes stress.

Stress-related conditions commonly accompanies shallow breathing.  Panic attacks, anxiety and stress generally involved breathing shallowly.  The sympathetic nervous system is in constant overdrive, ready to respond to a threat.  Hyperventilation can occur, breathing shallowly and very fast, exhaling more than inhaling.

Chronic stress associated with shallow breathing not only impacts cortisol levels in the body, but it’s believed to also result in lower amounts of lymphocyte.  These lymphocytes are a type of white blood cell in the body’s immune system.  Weakened immune systems result in the body being more susceptible to contracting illnesses, and extending healing times.

Breathing with the neck and chest also creates tension in muscles not designed for breathing.  Muscles in shoulders, neck and ribcage are being used to breathe, rather than move the arms or head.  Pain referred from these muscles can often be felt in other parts of the body – resulting in headaches, arm and shoulder aches, or pain through the upper back and neck.

As these muscles in the neck and chest are over-used, the may tighten and shorten, and impact on posture.  The pectorals play a big role in rounding the shoulders.  The scalenes and sternocleidomastoid play a big role in forward head posture.  This rounded, head forward posture can then create further tension, resulting in more aches and pains, up and down the body.  I’ve seen many with tight scalenes and this posture experience headaches, neck and shoulder aches, restricted movements in the neck, and some fairly severe arm pains.

Bowen lower back

Bowen Therapy

Bowen Therapy is a very gentle form of bodywork.  Small, gentle, precise moves are made on muscles, tendons, ligaments and nerves, triggering the body to begin a healing process.  The treatment initiates changes in the body that may continue for up to a week.

While most commonly known for helping back pain and postural issues, Bowen Therapy also helps calm the body’s nervous system.  The entire body is influenced during a Bowen treatment, through restoring balance in the autonomic nervous system.  The Bowen moves prompt a shift from the stressed, sympathetic “fight or flight” mode, to parasympathetic “rest and repair” dominance.

There is a clear influence of Bowen moves along the body’s fascia lines – supporting muscle coordination, postural alignment, and overall structural and functional integrity.  A Bowen treatment aims to help the body as a whole – helping bring the body back into balance, while also addressing the problem being experienced.

Bowen neck relax

Bowen Therapy to help you to breathe

Bowen Therapy can help you get your breathing back on track.

With the Bowen treatment helping to prompt a shift from that stressed fight/flight to a more relaxed parasympathetic state, the body will naturally start to relax a little.  Breathing will be able to come more easily.

The Bowen treatment also aims to bring the body back into balance.  Helping improve posture and alignment allows the body to function optimally. Gentle Bowen moves can also help relax those tight neck muscles and stuck diaphragm.

I’d love to say that Bowen Therapy alone can help.  But the reality is that if breathing doesn’t change, the body will revert back, the symptoms will return.  Re-learning how to breathe is key to long-term relief.  This is something that requires both practice, as well as some time and patience.

The exercise I sent most home with was a very simple one: Lie on your back in a quiet place, placing one hand on your stomach, the other on your chest.  As you breathe in, try to have your chest stay still, your stomach expand.  As you breathe out, try to have the stomach pull back in, while the chest remains still.

For many clients, just realising how they were breathing was almost a revelation.  Changing breathing patterns of a lifetime is a slow process for some.  A number of my clients have conceded that they may never change how they breathe, and accept they need regular Bowen to help.  Other clients were able to resolve their aches within a few sessions, by actively working on breathing between sessions.  Bowen to relax the body and muscles, together with practicing breathing, had their neck and shoulders feeling relaxed again, their mood less anxious.

As I write this, I’m reminded of the huge smile on the face of one client last month.  A few Bowen sessions and some real practice on breathing better.  In the last session, she was breathing again, her shoulders weren’t aching, she was feeling great !  It’s a pity that I probably won’t need to see her again, won’t see that wonderful, happy, pain-free smile…



image credit:  gif’s of breathing by John Pierce (Own work) [CC0], via Wikimedia Commons