Try this:

• Sit or stand with your head hanging down, eyes looking to the floor, back slumping, with shoulders rounding forward
• Take a deep breath in

What do you notice? Your muscles in your thorax (torso) become compressed and breathing volume is restricted. Furthermore, the forward head posture restricts airflow through your neck. The esophagus and trachea in your neck region provide a passage for oxygen from your mouth into your lungs.

Ideal Static Posture is a state where the skeletal system is in balance without muscular strain.

The ideal posture whilst standing in a static state, it is defined as a vertical line passing through 6 landmarks on the body:¹

1. External auditory meatus (external part of the ear canal)
2. Spinous process of C7 (7^th vertebrae of the neck)
3. Acromion process (tip of the shoulder)
4. Greater trochanter (top part of the upper leg)
5. Anterior (in front of) to the middle of the knee, and a state where the skeletal system is in balance
6. Slightly anterior (in front of) to the lateral malleolus (outer side of the ankle)

Dynamic posture is defined as varied positions of the body during movement.

Similar to ideal posture in a static state, the ideal posture in movement (dynamic) is a where the musculoskeletal system is in biomechanical balance for optimal performance and injury prevention.

Proper inhalation process:³

• Diaphragm extends caudally (toward the pelvic floor) with symmetry while flattening and compressing the internal organs
• Lower rib cage expands symmetrically in a lateral (outward), ventral (forward) and dorsal (backward) direction
• The abdominal walls expand equally
• The sternum moves ventrally (forward) while the intercostal spaces between the ribs expand
  

Proper breathing pattern “requires synchronized concentric activity of the diaphragm and pelvic floor, as well as eccentric activity of all muscles that insert into the thorax and abdominal wall muscles” ²; no activation of scalene and other accessory breathing muscles.

Table: The Primary & Accessory Muscles of Inhalation & Exhalation⁴

The table highlights the primary and accessory muscles associated with proper breathing patterns.

The diaphragm is the primary muscle responsible for providing 70-80% of the inhalation force.³

If there is breathing muscles disorder the accessory muscles replace the primary movers.⁴

“Improper sequencing during an abdominal breath can alter motor control patterns of postural muscles and spinal stabilizers resulting in pain and/or dysfunction.”⁵

Conclusion

Therefore, proper breathing patterns should not be forgotten when performing postural enhancement and spinal stabilising for neck or back pain!

Either when you are standing or moving, ensure that your head is not hanging too forward relative to your torso (i.e. forward head carriage) to allow proper function of your respiratory system. Additionally, if you have a neck pain or discomfort, make sure you get it assessed by your doctor or physical therapist (e.g. chiropractor or physiotherapist).

1.Kendall, F, McCreary, E (1983). Muscles testing and function, with posture and pain. Baltimore, MD, Williams & Wilkins.
2.Kolárˇ P Šulc J Kyncˇl M, et al. (2012). Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther;42(4):352-362.
3.Simons DG Travell JG Simons LS. (1999).Travell & Simons’ myofascial pain and dysfunction: upper half of body. Vol 1: Lippincott Williams & Wilkins.
4.Perri MA Halford E. Pain and faulty breathing: a pilot study. J Bodyw Mov Ther. 2004;8(4):297-306.
5.Chapman, EB, Hansen-Honeycutt, J, Nasypany, A, Baker, RT, May, J (2016). A CLINICAL GUIDE TO THE ASSESSMENT AND TREATMENT OF BREATHING PATTERN DISORDERS IN THE PHYSICALLY ACTIVE: PART 1. Int J Sports Phys Ther;11(5), 803-809.