• Aleks Thornton

Do you wake up with a Stiff or painful neck, low back or headache?

Morning stiffness can often be caused by having difficulty breathing correctly in your preferred sleeping posture. Often stomach sleepers wake up with neck pain or stiffness because of poor posterior rib and diaphragm expansion. This leads to an overuse of neck muscles in order to get a proper breath in causing neck stiffness and pain.

Injuries, accidents, bad movement patterns (sports and weightlifting), inactivity (deskwork) and stress can alter which breathing system we use (neck and shoulder breathing Vs. abdominal breathing). This can contribute to spine stiffness, headache, neck and back pain.

Can bad breathing patterns lead to morning stiffness or pain?

Diaphragm breathing allows for optimal pressure control in the thorax, abdomen, lowback and pelvis. The diaphragm is broad muscle with horizontal and vertical fibres. It’s attachment can be separated into three parts the sternal origin, rib origin connecting to the lower 6 ribs and cartilage and the Crura at inserting onto the Lumbar spine at L1-2.

Connections of the diaphragm

Other supportive breathing muscles like the transverse abdominis, internal/external abdominal obliques, pelvic floor, pectoralis minor and serratus anterior along with your intercostal muscles which sit between the ribs help regulate rib expansion. The ribs are attached to the lungs by a connective tissue called endothoracic fascia, which allows the lungs to fill with air on a breath and naturally recoil on a breath out.

When this breathing system is working properly, your bottom ribs have a tend to expand laterally and posteriorly with a bucket handle movement (think a handle on the side of a bucket). The higher ribs along with the chest bone and collar bones expand with a pumping handle type movement (think old fashioned water pumping handle). On an optimal breath in your ribs expand and your diaphragm drops expanding the bottom of the lungs and building a stable wall of pressure to support your back, thorax and pelvis.

In order for your lungs not to collapse while the diaphragm contracts , the lung tissue is attached at the top to the first and second rib, vertebrae C6 and C7 via the pleura-vertebral ligaments and a little connection to the collar bone. Front neck muscles: sternocleidomastoids and scalene musculature suspend these structures to counteract the diaphragms downward pull.

Endothoracic fascia lies between rib, muscle and the parietal pleura (lung cavity)

Neck and Collarbone Breathing over rely on these secondary breathing muscles and ligaments at the top of your lungs. This tends to lead to shallow and quick breaths and underactive diaphragm and incorrect rib movements. This can also lead to over activation and increased tension in these top secondary respiratory muscles and neck muscles. This in part explain why stomach sleepers wake up with neck pain. Poor posterior rib and diaphragm expansion means they rely on overuse of neck muscles causing morning stiffness.

Ligaments attaching lung ontoribs and neck (C6-7)

Learn Diaphragmatic Breathing the to create stabilizing pressure force and an inner strength which pushes from the inside out creating a wall of pressure to hold up the vertebral column (left: frontal view, right: sagittal view of abdominal cavity). The diaphragm can be re-educated by specialized Neurodynamic stabilizing exercise in a variety of positions and movements.

Abdominal pressure created by diaphragm. (left: frontal view, right: sagittal view)

Aleks Thornton

Registered Physiotherapist & IMS Provider

Fallingbrook Wellness

1204 Kingston Rd, Scarborough


416.694.4800 ex 7



©2018 by Aleks Thornton