Lower Back Massage

Why the Way We Breathe Can Effect Your Back Pain

In Information, Self Help by Katie Evans

I talk to my clients a lot about breathing in regard to their pain and mention the diaphragm and pelvic floor in most sessions. This seems to astonish clients and they are baffled (if not shocked) to my explanations.
So in this post, I will try and shed some light on it
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Your diaphragm and pelvic floor are the two muscles that set the top and bottom of your torso. A lot of people who exercise try to strengthen their transverse abdominals and their oblique muscles and they often say “I do plenty of core work”. This can include Pilates to try and eliminate back pain, but what we tend to forget about is the two muscles that close the cylinder so to speak. The diaphragm and the pelvic floor.

If you want your transverse abs to work well, they need to contract.  (You might have tried pulling your belly button in before), and in order for your transverse abs to contract to the best of their ability, your diaphragm has to lengthen.

A diagram of the pelvic floor

Holding your breath, anticipating the pain

A lot of my clients who come to me with lower back pain, are often out of breath, talking very quickly and are experiencing a lot of pain. 

When they go to move, what’s the first thing they do?
They hold their breath. If they go to pick something up, they hold their breath. The problem is that when we hold our breath, we are shortening and tightening our diaphragm.

The transverse abdominal muscles
The transverse abdominal muscles

So, if you want your obliques and transverse abdominals and core muscles to be able to contract effectively, we need your diaphragm to lengthen. But most people do the complete opposite, which is when we take a breath in, we try to tighten everything because of the anticipation of pain, but in actual fact, this is the complete opposite to what we need to do.


You may have disc problems and sciatica, but my question would be, “What specifically contributed to your back pain in your history?” I’ll also investigate any other previous injuries as well. It’s about putting the jigsaw puzzle together for you. 

What we know from research, is that when you’ve had a previous injury, your brain will do a great job of protecting that injured site. This is a great short term benefit, but in the long term when the pain has gone, we still use some of these movement strategies that we used when we had an injury.

So, it’s not uncommon if you come to me with back pain, that I will look at your ankle, knee, hip, shoulder and even hand because I have to piece the puzzle together to see what is not doing its job properly. What is causing the lower back to do too much work?

It’s not just a physical trigger

Not only do physical stressors contribute to altered movement habits, but also non-physical stressors. When we have trauma or when we have high periods of stress, our breathing pattern tends to change

Naturally, what tends to happen is we go into a bit more of a fight or flight mode and our breathing rate increases. This then affects how the diaphragm works. The diaphragm is a spinal stabilizer as well as keeping us alive by breathing. So, when our breathing rate increases and we get a little stressed, we get anxious. We might be starting to hyperventilate a little bit and get a little bit of anxiety.  Our diaphragm isn’t functioning as efficiently as it should be and we tend to lose that ability of the diaphragm to stabilise the spine.  That becomes compromised and then our lower back may have to use other muscles slightly more and eventually we cannot relax our lower back muscles. 

Tackling the combination of physical and non-physical

It’s this combination of non-physical and physical stressors that need to be tackled. I focus my treatment on restoring your ability to relax. I set exercises that take into account breathing in conjunction with exercises that acknowledge your previous injuries.  This is a very different approach and many clients’ facial expressions are of bewilderment but the results soon change their perceptions.


Part of my discovery session is to chat to you thoroughly about YOU in order to try to find the actual contributing causes of why your brain has notified you of a painful back, and for you to stop and say “there’s a problem here”.

In your life and in the lead up to having back pain, you may have had an increased amount of stress for a prolonged period, or maybe emotional stress or trauma in your life related to a life-changing event. This may have caused your respiratory system to increase.

I will listen to you and build a bespoke treatment plan to get you back to where you want to be.

So why not come in for a discovery session or book a full hour’s consultation? 
I’ll give you an honest opinion of what I think is causing the problem and how long I think it will take to put you on the road to recovery.