- 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
- External auditory meatus (external part of the ear canal)
- Spinous process of C7 (7th vertebrae of the neck)
- Acromion process (tip of the shoulder)
- Greater trochanter (top part of the upper leg)
- Anterior (in front of) to the middle of the knee, and a state where the skeletal system is in balance
- 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.
Muscles of Inhalation
Muscles of Exhalation
Non-muscular anatomic structures:
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
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).