let’s talk about breath, baby!!
why your neck hurts and your pelvic floor is a mess
Welcome back, oxygen enthusiasts! Today we're diving into something you do 20,000 times a day without thinking about it: breathing. Specifically, why you're probably doing it wrong, and how that's connected to literally everything else that hurts.
If you've been on my table and I've put my hands on your ribs or asked you to breathe while I'm working on your hip, this is why. Chances are, regardless of what you come in with, I have ranted at you at some point about the mysterious magic of your diaphragm. Your breath is the foundation of your nervous system regulation, your core stability, and your ability to not be a walking tension pattern. No big deal. You may or may not be attuned to it yet, but it’s actually quite likely that the mechanics of your breath are not functioning at their optimum capacity (and it isn’t your fault, but there’s a LOT you can do about it!!!!).
diaphragmatic breathing vs. the chaos you're probably doing
Let's start with how breathing is supposed to work.
Your diaphragm—that dome-shaped muscle at the base of your ribcage, like a shelf for your lungs and heart—should do about 70-80% of your breathing work. When you inhale, it contracts and pulls down toward your pubic bone, creating space in your lungs. This pushes your belly out (yes, OUT), expands your ribs in all directions (360-degree breathing), and gently increases pressure in your abdomen.
When you exhale, it relaxes back up, your belly draws in like a corset, and everything returns to center.
This is efficient. It's calming to your nervous system (hey there, ventral vagus circuit!!). It promotes good oxygen exchange and keeps your accessory breathing muscles (your neck and shoulders) from doing a job they were never meant to do full-time.
Now the trap we get stuck in: paradoxical breathing.
Paradoxical breathing is when everything goes backward. Your belly sucks IN when you inhale. Your chest heaves UP. Your shoulders rise toward your ears. You're using your neck muscles—the scalenes, sternocleidomastoid, upper traps—to haul air into your lungs like you're constantly running from a bear.
Why does this happen? Chronic stress, forward head posture, weak core, old injuries, or just... habit. Your nervous system gets stuck in sympathetic overdrive, and suddenly chest breathing becomes your default.
The problem? Those accessory muscles weren't designed to be your primary breathing apparatus. So you end up with chronic neck tension, jaw clenching, poor oxygen efficiency, a constantly activated stress response, and a core that can't stabilize properly. Yikes.
forward head posture: the silent breathing assassin
Your head weighs 10-12 pounds. For every inch it moves forward, you add about 10 pounds of strain to your neck. Three inches forward (extremely common if you work at a computer) is 30-40 pounds of extra force. (ISN’T THAT WILD?!?!)
When your head juts forward, a cascade of mechanical disasters occurs:
Your anterior neck muscles get short and tight, pulling your first rib up and restricting thoracic expansion
Your upper back rounds forward, squishing your ribcage
Your shoulders roll forward, limiting chest expansion
Your diaphragm's position and angle change, making it mechanically less efficient
The result? You literally cannot breathe well. Your body compensates by chest breathing, which reinforces the forward head posture through chronic neck tension, which makes breathing worse, which increases tension... It's a feedback loop of dysfunction.
And it's not just about neck pain. Poor breathing = chronic sympathetic activation = impaired digestion, sleep, recovery, and mental health. Your diaphragm also acts as a lymphatic pump, so dysfunctional breathing affects immune function. You might even develop TMJ issues because forward head posture often comes with mouth breathing and altered tongue position.
Your posture is strangling your breath, and your breath is reinforcing your posture. Cool cool cool.
the core canister: anatomy edition
Here's where it gets really interesting, and where I absolutely GEEK out. Your core isn't just your abs—it's a pressure system, a capsule with four walls:
Top: Diaphragm
Front/sides: Transverse abdominis (your deep core muscle, wrapping around like a corset)
Back: Multifidus and spinal erectors
Bottom: Pelvic floor
These structures create and manage intra-abdominal pressure (IAP), which is essential for spinal stability, force transfer, organ support, continence, and—you guessed it—breathing.
Here's how it should work:
Inhale: Diaphragm contracts/pulls down. Transverse abdominis and pelvic floor lengthen / relax downward to accept the pressure. Your belly, ribs, and pelvic floor all expand 360 degrees.
Exhale: Diaphragm relaxes up. TA and pelvic floor contract, inwards and upwards toward your spine and sternum. Everything returns to center.
The diaphragm and pelvic floor should move together—both descending on inhale, both ascending on exhale. It's a coordinated dance.
When paradoxical breathing enters the chat:
If you're sucking your belly in while breathing, or holding your breath and bracing constantly, you create abnormal pressure dynamics. Your pelvic floor gets hammered with downward pressure without the rhythmic release it needs. The coordination falls apart.
This leads to:
Pelvic floor dysfunction from fatigue/imbalance/chronic tension (incontinence, prolapse, pain)
Lower back pain
SI joint issues
Structural issues/ chronic pain
Hernias
And here's the kicker: all those crunches and planks you're doing to "strengthen your core"? If you can't breathe while doing them, you're just teaching yourself to hold your breath and brace. True core stability means maintaining pressure control while breathing normally.
Your core and your breath are inseparable. You can't fix one without the other.
restoring 360-degree breathing: the practical stuff
Before we go into analyze&judge mode:
I want to underscore that dysfunction of the diaphragm and the breath mechanism is EXTREMELY common in modern western culture. The postures we hold at computers or in the car, or even relaxing with a movie or video game are simply not conducive to full, expansive breath. Be curious and honest with yourself as you examine your breath, but stay kind and sweet as you (likely) identify a few spots where the breath just doesn’t move. I don’t judge your body’s patterns of being, and I hope you won’t either.
Okay, first, assess yourself:
Lie on your back, knees bent, one hand on chest and one on belly. Breathe normally for 10 breaths.
Good: Belly hand rises first and more than chest. Ribs expand sideways. Low back gently presses into floor.
Not great: Chest hand rises more than belly hand.
Oh no: Belly pulls IN while chest rises.
If you need retraining (and you probably do), here are some starting points:
Crocodile breathing: Lie face-down, forehead on your hands. Breathe into your back and sides, feeling your ribs expand into the floor. This position makes chest breathing nearly impossible.
Wall breathing: Stand against a wall, hands on lower ribs. Inhale through your nose, expanding ribs sideways into your hands. Exhale slowly through pursed lips.
Child's pose breathing: In child's pose, breathe into your back body. You should feel your lower back expand on inhale.
90-90 hip lift: This is a Postural Restoration Institute (PRI) classic. It repositions your pelvis and ribcage while retraining diaphragmatic breathing. Google it—it's worth learning.
And for your posture:
Chin tucks throughout the day (practice giving yourself as many chins as possible)
Doorway pec stretches
Upper back strengthening (rows, face pulls)
Raise your screen to eye level
Wall angels for awareness and strength
box breathing: your nervous system reset button
Box breathing is simple, portable, and used by everyone from Navy SEALs to meditation practitioners. It's perfect for practicing controlled diaphragmatic breathing and regulating your nervous system. It’s a gorgeous way to “massage” the vagus nerve and engage the parasympathetic response (see: previous posts on the vagus nerve and dysautonomia!!!)
The pattern: Each phase is the same length (start with 4 seconds):
Exhale completely for 4 counts
Hold empty for 4 counts
Inhale through your nose for 4 counts
Hold full for 4 counts
Repeat 4-10 rounds
Key points:
Breathe into your BELLY, not your chest
Maintain good posture (no forward head!)
Adjust the count to your comfort level
Start with a full exhale to activate your parasympathetic nervous system
Use it for: calming pre-performance anxiety, transitioning between tasks, falling asleep, managing acute stress, building breathing awareness.
Daily practice: 5 minutes morning and evening. This builds neural patterns that eventually become automatic.
a note on grief, emotion, and the breath
Here's something that might sound woo-woo but shows up on the table constantly: your diaphragm stores emotion. Specifically, grief.
In Traditional Chinese Medicine, the lungs are associated with grief and letting go. The lung meridian runs through the chest, shoulders, and arms—all the places we armor up when we're protecting our hearts. When grief gets stuck (because who has time to actually process their feelings? in this economy?), it often manifests as restricted breathing, tight chest muscles, and a diaphragm that's more like a rigid plate than a fluid, moving muscle.
Your diaphragm is literally a bridge between your heart and your gut. It's the barrier between your emotional center and your instinctive center. When you hold your breath—which you do unconsciously during stress, grief, or overwhelm—you're essentially hitting pause on feeling.
This is why people sometimes cry during breathwork or when I release their diaphragm (hey there, craniosacral therapy…). It's not dramatic; it's just your nervous system finally feeling safe enough to let something go that's been held for a while.
The breath is the bridge between your conscious and unconscious, your body and your emotions. When we restore breathing, we're not just fixing mechanics—we're creating space for whatever needs to move through you.
the bottom line
Your breath controls your nervous system. Your posture controls your breath. Your core depends on your breath. Every single fascial train in your body passes through your abdomen, and a lack of integrity here will affect the entire system. Everything is connected, and when one thing goes wrong, the whole body compensates.
The good news? You can retrain this. Start with awareness. Notice how you're breathing right now. Is your belly moving? Are your shoulders creeping toward your ears? Is your head jutting forward?
Pick one or two exercises. Practice box breathing daily. Pay attention to your posture. Be patient—these patterns took years to develop. If you’re curious about how to become more aware and engaged in your abdominal capsule and the way it all moves in tandem, let a girl know! I’ll devote 5 min of your next session to teaching you how to use your transverse abdominis (on the house, because it is my Roman Empire and I love any excuse to talk about it…)
Your body wants to breathe properly. Sometimes it just needs a reminder of how. And if you're on my table and I'm doing something weird with your ribs? Now you know why.
✨ Stay well, stay curious, and stay connected to your breath ✨