Shoulder pain can be caused by various factors, such as physical trauma, repetitive injuries, anatomical defects, or poor posture. One of the common remedies for shoulder pain is poor ribcage positioning, which can be improved through breathing exercises.

One of the common mechanical issues that contributes to limited shoulder mobility and pain is poor ribcage positioning. When the rib cage is not able to expand properly, it can affect the position and function of the shoulder blades, which are designed to glide over the rib cage.

There are two ribcage variations that can lead to poor shoulder mechanics:

1. A wide infrasternal angle (ISA), which is the angle formed by the lower edges of the rib cage at the sternum. A wide ISA (>90 degrees) indicates a flared rib cage, which means that the ribs are positioned outward and upward. This can cause shallow breathing, reduced diaphragm function, and increased chest wall stiffness.
2. A narrow ISA (<90 degrees) indicates a depressed rib cage, which means that the ribs are positioned inward and downward. This can cause restricted breathing and reduce lung capacity.

Both wide and narrow ISA can affect the alignment and stability of the shoulder blades, which can impair the shoulder joint movement and cause pain. Therefore, it is important to assess and correct the ISA and rib cage position to improve breathing and shoulder function.

‍

How to improve rib cage position with breathing

One way to improve rib cage position is to perform exercises that target the diaphragm and other muscles involved in respiration, such as the intercostals, abdominals, obliques, serratus anterior, and scalenes. These exercises can help increase rib cage mobility, enhance diaphragm activation, and reduce chest wall tension.

The video below describes the basic anatomy of breathing and what muscles are involved.

Some remedies for shoulder pain include exercises that focus on breathing:

Crocodile breathing

Prone diaphragmatic breathing over a ball

Bear Breathing

These exercises can be performed daily or as part of a warm-up routine before exercise or physical activity.

How Diaphragmatic Breathing Helps with Chronic Pain

Breathing is a vital function that we often take for granted, but it can also be a powerful tool to improve our health and well-being.

One of the most important breathing techniques to help relieve chronic pain is diaphragmatic breathing. This is a type of breathing that involves using your diaphragm, the large muscle that separates your chest and abdomen, to draw air into your lungs.

Diaphragmatic breathing, also known as deep breathing, can help reduce chronic pain through several mechanisms:

Release of Endorphins: Deep diaphragmatic breathing can stimulate the release of endorphins, the body’s natural painkillers. These chemicals can help reduce the perception of pain.

Reduction of Stress: Due to an activated an activated fight or flight response, chronic pain is often associated with high levels of stress and anxiety. Diaphragmatic breathing can help reduce stress by activating the body’s relaxation response, which in turn can decrease the sensation of pain.

Improved Oxygenation: Deep breathing can improve the oxygenation of the body, including pain-affected areas. Better oxygenation can promote healing and may reduce the intensity of chronic pain.

Muscle Relaxation: Chronic pain can cause muscle tension and spasms. Diaphragmatic breathing can help to relax muscles, which can alleviate pain and discomfort.

How to Perform Diaphragmatic Breathing

To practice diaphragmatic breathing, you can lie on your back with your knees. Place one hand on your chest and the other on your belly, just below your rib cage. Breathe in slowly through your nose, letting the air fill your belly and make it rise. The hand on your chest should remain still. Then tighten your abdominal muscles and exhale through pursed lips, making a whoosh sound. The hand on your belly should move down as you empty your lungs. You can also practice this technique while sitting or standing, as long as you keep your posture relaxed and upright.

You can do this exercise for five to 10 minutes, several times a day.

How to Perform Box Breathing

Another breathing technique that can help you improve your breathing mechanics and improve ribcage expansion is box breathing. This is a technique that involves inhaling, holding, exhaling, and pausing for the same amount of time, usually four seconds each. To practice box breathing, you can sit comfortably with your back straight and your feet on the floor. Close your eyes and focus on your breathing. Breathe out slowly through your mouth to empty your lungs. Then breathe in through your nose for four seconds, filling your lungs with air. Hold your breath for four seconds, keeping your chest still. Then breathe out through your mouth for four seconds, making a whoosh sound. Pause for four seconds before repeating the cycle.

You can do this exercise for five minutes or longer, depending on how you feel.

The next time you are experiencing unexplained shoulder pain we, at Stretch Affect, can assess how your shoulder blades sit on your ribcage as well as implement remedies for shoulder pain.