Better Breathing: The Oxygen Solution

One thing I can’t understate is the importance of realizing that compensational breathing patterns are the origin of so many instances of joint and muscle pain. In fact, I would venture to say that the vast majority of back pain is due to altered breathing mechanics.

The common “tight” muscles that massage therapists and trainers come across all tend to be accessory muscles of breathing, or are directly affected by dysfunctional breathing mechanics.

The psoas has muscle fibers that tie directly to the diaphragm.
The SCMs attempt to lift the chest to facilitate airflow.
The scalenes likewise attempt to lift the chest.
The QL is an accessory muscle of breathing.
The paravertebrals get tight due to altered breathing mechanics.
The quads and hamstrings are at the mercy of the position of the pelvis, and the position of the pelvis relies on symmetrical breathing.

Take home point: if you aren’t addressing breathing mechanics, resolution of pain is difficult.


  1. Sam Inalkas says

    Neal, amazingly insightful website and videos. God bless you. My symptoms are similar to what you had initially (left si low back pain, poor right ankle dorsiflexion, right right calves etc). I have been doing PRI exercises, including balloon breathing, diligently but am getting very sore in my low back. Wonder if this could mean that all the flexion is irritating my back? I know LAIC suggests avoiding extension so was a bit confused. Is this soreness normal? Best wishes, Sam

  2. admin says

    Hi Sam, soreness in the lower back is not what I’ve normally felt or seen with clients. The only time I’ve seen that happen is when people had something more complicated involved, such as a visual processing issue. Do you have any feet, dental, or visual issues?

    • Sam says

      Greetings Neal! No, no visual, dental, feet issues. Nearly all the nuances you mentioned with LAIC are relatable (particularly consistent left lower back/si area pain, poor right ankle dorsiflexion, tight right calf, achy left hip flexor, tight left tfl/itb area). I do the exercises in the following sequence – 90-90 bridge with balloon breathing, left hemibridge with hip shift, side lying scissor slides, knee to knee, adductor pullback, right glute max, right side left glute med. The left adductors had spasm initially but that has subsided slowly and I can also feel the left glute med and right glute max getting stronger. But the low back soreness is strange (also get a similar feeling in the left ITB area) post my exercises. Basically it feels as if the SI/LB area pain point is getting irritated and stays that way across the day, particularly while sitting. Best wishes

      • admin says

        Sam, left sided pain can be stubborn. If you e-mail me at I can send you a document that I wrote for my clients that’s all about the management of left sided pain.
        Usually, left SI issues are due to pelvic/femoral instability but you can’t forget that it’s not only leg muscles that stabilize, but also the left abs (internal obliques and TAs). Most left sided pain people need a hefty does of left ab concentration and ribcage retraining.

  3. Sam says

    Dear Neal, Greetings. Following up on your suggestion will send you an email. Also, just wanted to publicly express something – the quality of information that you are sharing on PRI (and well being in general!) is top notch and the detail with which you share nuances around both symptoms and solutions is in another league. I haven’t yet seen a jump in my progress but am quite certain that this is the right path for me. Best wishes, Sam

Leave a Reply

Your email address will not be published. Required fields are marked *