This is the first in a multi-part series on breathing and performance. I think we can all agree that mouth breathing is not ideal. It ruins your date and makes you dread sitting next to a mouth breather on an airplane. But aesthetics aside, it significantly compromises the ability to maintain a packed neck position which, we discussed in the last post on jaw pain, alters the control of the head and neck.

Here’s the deal: with chronic mouth breathing (present in >50% (!) of the population in some studies), the body naturally adopts a forward head posture as a compensation to maintain an open airway. This causes a tilt of the rib cage (overextension fault – we’ve established in previous posts that is a major no-go) to keep the chest upright. What we’ve seen clinically and in the research, is that once the stacked posture of rib cage over pelvis is lost, the diaphragm is at a mechanical disadvantage (becomes less efficient) and its synergy with the abdominals is lost – they both shut down. 

In order to maintain aerobic capacity with decreased diaphragm activity, we adopt a mouth-open upper chest/neck breathing pattern that is both ineffective and costly. This faulty pattern will rob you of performance and exercise capacity because you’re increasing the work of the accessory muscles in your neck and upper chest which is metabolically very costly. With heavy breathing during training, we further challenge this system which is often exacerbated by the cue to “look up” during squats, deadlifts, etc. reinforcing this faulty mouth-breathing pattern.

Furthermore, the more you breathe
(gulp) with the chest and neck, these muscles (SCM, scalenes, pecs) become quite stiff increasing the forward pull and shear on the cervical vertebrae – especially the scalenes as they attach directly onto the spine. It’s pretty common to see this neck breathing pattern in those with cervical radiculopathy (impinged nerve roots) and TMJd. Weird that they often have a forward head posture too, right? (hint – it’s not weird at all) The 1st rib can get chronically elevated as well, limiting overhead shoulder position. The overall result is a destabilizing effect and faulty mechanics in the entire upper quarter.


Here’s the fix: Remember having tantrums as a kid and your mother would tell you to “breathe in thru the nose, out thru the mouth”? Mother was helping you out because by inhaling thru the nose you automatically adopt a more upright, packed neck position.

Try it: take a quick breath in thru your nose. You will automatically sit more upright and bring the diaphragm back into the breathing pattern (which also increases parasympathetic tone – helps you to calm down, your mother knew what she was doing). Now go back to mouth breathing: right away you notice your chest and neck rise instead of belly (diaphragmatic) breathing and your posture drops back into a forward-head, rounded shoulder look – not cool.

Clean up any mobility deficits in the anterior neck and chest (Kelly Starrett of has some great ideas) and start breathing thru your nose. The best part – it’s a reinforcing cycle: it’s hard to breathe in thru the nose with a forward head so by forcing yourself into this pattern more, you are reinforcing a packed neck position. As we discussed previously, a better head-neck relationship improves jaw position and stability.

Improving breathing patterns is hard. I recommend lots of practice at nasal (aka belly) breathing first at your desk or lying on your back while in bed – it will help improve your head-neck position with breathing in an unloaded environment first. Then, as coaches, we can systematically challenge breathing and head-neck positioning in loaded and stressed positions once the athlete better understands this pattern.

More to come on breathing and spine control/performance!

-Seth (take a deep breath bro)

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