Breathing dysfunctions and incorrect breathing behaviour can lead to far reaching physiological changes in the body and produce varied symptoms and deficits:
- Disturbance of the mechanics of breathing which includes the rate, depth and rhythm. Locus of breathing (upper chest or diaphragm) and the use of accessory muscles other than the diaphragm. This impacts on our musculoskeletal system with alteration of muscle function, posture and core stability.
- Disturbance of blood biochemistry resulting from over breathing behaviour with alteration of blood CO2 level, blood pH, electrolyte balance, blood flow, haemoglobin chemistry and kidney function. This disturbance produces symptoms of hyperventilation syndrome.
Mechanics of breathing
The diaphragm is the primary inspiratory muscle at rest. Its correct activation via diaphragmatic breathing to initiate inspiration with no accessory muscle activation results in an efficient, effortless breath and promotes core stability as the diaphragm is a key muscle of the deep stabilisation system of the lumbopelvic spine. Accessory muscles of breathing are located around the neck, upper chest and upper shoulder region. Its use in quiet breathing results in faulty breathing mechanics of upper chest breathing and subsequent alteration of posture with the following:
- forward head thrust
- rounded shoulders and winging of scapula
- rigidity of rib cage and cervical and thoracic spine
This alteration can result in the following symptoms:
- headaches, neck and back pain from joint stiffness and muscle spasms
- shoulder pain with altered shoulder function and rotator cuff injuries
- temperomandibular joint dysfunction and jaw and facial pain
Diagnosis of faulty breathing
Diagnosis requires a thorough examination with postural analysis and assessment of breathing mechanics.
Treatment of faulty breathing
Treatment of faulty breathing may involve the following:
- manual treatment for myofascial and vertebral releases
- postural correction exercises
- training of diaphragmatic activation during inspiration with deactivation of accessory muscles
Over breathing affects blood chemistry via the alteration of blood carbon dioxide level. Over breathing expels excessive amounts of Co2 from our lungs, which in turn reduces the CO2 level in the blood (hypocapnia) affecting the pH level. Hypocapnia results in altered cellular functioning in all body systems and is responsible for the myriad of symptoms in the hyperventilation syndrome. Breathing is a learned behaviour and is determined by our past experiences and is also impacted by our breathing mechanics.
Symptoms of hyperventilation syndrome
- Breathing shortness of breath, feeling of suffocation
- Chest tightness, pressure, pain
- Skin sweaty, cold, tingling and numbness
- Heart palpitations, irregular heart beats and rapid heart beats
- Emotion apprehension, anxiety, panic
- Head headaches, dizziness, balance disturbance, disorientation, head fog, impaired concentration
- Senses blurred vision, dry mouth, fatigue
- Musculoskeletal muscle pain, weakness, muscle fatigue, increase muscle tension
- Abdomen nausea, cramps, bloating, diarrhoea
These changes are due to alteration of blood chemistry resulting from hypocapnia.
Detection of overbreathing
Overbreathing may not be obvious but is readily detected by using a CAPNOMETER which is a non invasive technique of measuring the CO2 level in the exhaled air through the nose. This is an office procedure performed at Northside Physical Medicine and not requiring special preparations. The results are immediately available and can be analysed by our doctor who then proceeds to formulate a corrective action plan.
The Caponometer is also used at Northside as a visual feedback tool to educate and enhance our patient’s performance in corrective actions to change faulty breathing behaviour.
Breathing dysfunctions and faulty breathing behaviour are common conditions which often coexist and requires musculoskeletal assessment and measurement of CO2 levels for accurate diagnosis.
Dr. Michael Mock
Dr. Sue Leong
- diagnostic model
- trigger point injection & muscle energy release
- ligamentous & fascial release
- joint manipulation & release
- platelet rich plasma
- joint injection
- muscle scar tissue hydrodissection
- shoulder joint hydrodilation
- real-time ultrasound core training
- prescriptive exercises
- breathing dysfunction & capnotrainer