Flexible chest and breathing as a premise for correct spine function

Flexible chest is needed not only for effective breathing, but also for correct function and stabilization of the spine. If the flexibility is restricted, missing movements of the whole chest segment are compensated in a more loose cervical and lumbar spine, which results in pain in those areas.


IMG 2009The chest is composed of ribs, which are connected by joints to the sternum bone in the front, and in the back with the thoracic vertebrae. The ribs are rotating in its joints - the upper ribs are directing forwards, and the lower ribs to the sides.

The mobility of the thoracic spine is very important for other segments of the spine. The chest is therefore flexible unit. If everything is working, each rib should rotate in one direction with inhale and back with exhale.


There is an incorrect idea about whenever someone says: “take a deep breath” most of us will take a big deep breath, stretch the chest as much as possible, pulling shoulder blades together and clenching the abdomen. What happens with the chest in such case? Absolutely nothing. The ribs barely moved, we just lifted the whole chest upwards. Such deep breath definitely doesn’t expand the chest forwards, to the sides of backwards.


The breastbone moves physiologically forward during inhale, not upwards, as we see it by the breathing mentioned above, during which we involve and overload the so called auxiliary breathing muscles (neck muscles, shoulder blade muscles and spinal erectors of the lumbar spine), which overloads a lot the lumbar and cervical spine. The result of such breathing is not just limited capacity of the lungs because we will fill only the upper part of the lungs, but it is mainly formation of painful syndromes, blockages and disc herniation in the cervical spine as well as lumbar spine. We won’t get rid of this pain unless we will affect the flexibility of the thoracic spine and whole thorax (chest). The chest has to be relieved manually, with mobilizing techniques, as well as aimed exercising.

Why can’t we do such sure thing as breathing, automatically and correctly? Incorrect breathing appears in people already during development of the first year of life, when we didn’t go through an ideal psychomotor development, on the other hand with more age comes more stress , long term static burden in school, being at work, pregnancy for women. During such breathing we do not use the diaphragm as the main breathing muscles, but just the auxiliary breathing muscles. These muscles can only lift the chest up. That closes the vicious cycle. Wrong activity of the muscles leads to restricted flexibility of the chest, and the restricted flexibility enables only upper type of breathing.


If you want to expand your ribcage, it doesn’t matter on the depth of the inhale, but mainly where do you direct the inhale, meaning which muscles will we activate. Try to change the idea of “correct” posture with expanded chest. Instead of that, move your chest down with exhale, as if your ribs would drop down and to the sides. At the same time slightly open your shoulders to the sides, as if you’d want to push two walls that are pushed on you from both sides. Inhale all the way down to your stomach and groins, as if you’d want to fill your pelvis with air.

Now that you have your trunk filled with air, you can compare your trunk to a barrel. Imagine that your abdomen, chest and the lower back are forming the wooden walls of the barrel. Diaphragm is placed in the thorax similarly as the cover of the barrel. If we press on the cover of the barrel, we will squeeze the content of the barrel, and the content the creates pressure on the walls. Similarly work the diaphragm by putting pressure on the internal organs, which creates intra abdominal pressure affecting the abdominal muscles, ribs, lower back and pelvic floor. Such pressure works preventively against functional defects of the spine and thorax, against overloading of the soft structures and structural damages (for example herniated disc). The influence of the diaphragm is much wider. It affects also the tension in the muscles of the legs through the pelvis, or it also affects chest and shoulder and tension in the arm muscles.

With such breathing we will not secure quality coordination of the trunk muscles and diaphragm - that has to be learned individually, but we will at least little bit ease up the overloaded cervical and lumbar spine. We will work with you individually. Next to the above mentioned soft mobilizing techniques, which we will use to mobilize the stiff chest, we will also work on effective breathing within the concept on a neurophysiological basis, especially by using elements from DNS according to Dr. Kolář.


Stretching shouldersStretching backBack massageMobilizing lower backMoving the pelvisRotating the backMassage of The ChestMassaging the backTraction thoracic spine

Instructions for exercises during pain in the thoracic spine and ribs

  • First aid during pain in the thoracic spine and ribs
  • Exercises during pain in the thoracic spine and ribs
  • Exercises during pain in the thoracic spine and ribs with help of second person
  • Exercises during pain in the thoracic spine and ribs with exercising device

FYZIOklinika physiotherapy Ltd., Prague, Czech Republic

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