Posture and Breathing

by Stephanie Sharpe
Exercise Science Editor

Proper spinal alignment, (aka good posture) from the head to the lower back, creates a stable platform for correct breathing. A person with proper posture is able to increase thoracic cavity volume, which is an increase in the amount of oxygen that is drawn into the lungs during inhalation.  This ultimately leads to more energy.  Posture can be thought of as the measure of mechanical efficiency of muscles, balance, and neuromuscular coordination (Optimal Breathing Mastery, 2014). Posture is the position the body will assume to maintain balance and stability with the least amount of effort but also the maximum amount of support.

Rib and spinal mobility are also reduced by poor posture and have a negative effect on normal breathing. Studies have shown that breathing patterns are greatly influenced by the position of the trunk of the body and posture has a strong influence on how well the respiratory muscles can work (Romel, Lo Mauro, D’Angelo, Turconi, Bresolin, Pedotti, & Alverti, 2010). Thus, as explained in Postural-respiratory synergy (PRS), respiration not only changes with posture but posture changes with respiration (Kuznetsov & Riley, 2012).

A common faulty posture is the kyphotic posture, also known as “hunchback” and is seen as a smooth rounding of the back when bending forward. This posture results from different potential causes (see box opposite page) like sitting for long periods of time with poor posture. This faulty posture can stretch supporting muscles and ligaments which then pull thoracic vertebrae out of the normal position. The upper back muscles are lengthened while chest muscles are shortened. Recent studies show that postural kyphosis can have negative effects on physical and respiratory function as well as cause neurologic problems (Lou, Lam, Hill, & Wong, 2012). Kyphosis causes the torso to collapse and the lungs to be squeezed. Rounded or hunched shoulders can restrict the rise and fall of the diaphragm also reducing the amount of oxygen drawn into the lungs (Iowa Chiropractic Clinic, 2014). A kyphotic posture can also cause neck, shoulder, and back pain.

Forward head posture is another common posture malady. Continual use of computers, video games, texting, watching TV as well as using heavy backpacks can lead to forward head posture (FHP). The repetitive movements that take place during these types of activities strengthen nerve and muscle pathways to move more easily into the forward head position.

Forward head posture can flatten the normal curve of the neck which can result in disc compression and early arthritis. This head position is also responsible for tension headaches, jaw pain, pinched nerves and blood vessels, chronic strains, and can even restrict breathing (Nikitow Chiropractic Wellness Center, 2014). FHP alignment causes strain on posterior neck muscles.

Forward head posture causes imbalances in muscles; some become tight and short while others become weak. It can cause weakness in deep cervical short flexor muscles and mid-thoracic scapular retractors such as the rhomboids, serratus anterior, and the middle and lower fibers of the trapezius. It can also result in a shortening of the opposing cervical extensors, upper trapezius, levator scapulae, and pectoralis muscles (Harman, Hubley-Kozey, & Butler, 2005, Muscolino, 2011).

Psychosocial factors such as depression, anxiety, and insecurity may also cause poor posture. A person who is constantly slouching with poor posture will have muscles, tendons, and ligaments that are shorter than those of someone who has good posture. Trying to sit or stand up straight when accustomed to slouching will cause these muscles, tendons, and ligaments to tighten. In response, the entire upper body will tighten and reduce the ease of breathing. Other side effects of poor posture include: headaches, anxiety, fatigue, poor circulation, and poor sleep patterns (Clark, Sutton, & Lucett, 2014).

Since posture has an effect on breathing, good posture allows for better exercise abilities. It provides an adequate oxygen supply for the muscles, good circulation, and less fatigue. Strengthening the core muscles will help to improve posture and increase the ease of proper breathing and thus proper exercising.

Exercises to Improve Posture
Anyone suffering from posture maladies is encouraged to seek professional advice.  Some exercises Doctors, physical therapists, or professional trainers may recommend include the “prone cobra”, which can strengthen the weak muscles in the back; and self-myofascial release (self-massage) with a foam roller which can increase the mobility of the upper back. It is also important to stretch the pectoralis as well as the latissimus dorsi. Strengthening abdominal muscles help posture problems as well (Norris, 2011).


Deep cervical flexor and shoulder retractor strengthening as well as cervical extensor and pectoral muscle stretching should be incorporated into an exercise program for someone with forward head posture. Strengthening and stretching exercises must be repeated and continued in order to reduce and even eliminate FHP (Harman, Hubley-Kozey, & Butler, 2005).

Poor posture can be improved, and should be improved for the betterment of general health.  Beyond self help work one can do, finding a good personal trainer who understands the causes and resulting health issues related to faulty posture can benefit over-all health.

Clark, M.A., Sutton, B., Lucett, S.C. (2014). NASM essentials of personal fitness training (4th ed.). United States.
Harman, K., Hubley-Kozey, C.L., and Butler, H. (2005). Effectiveness of an exercise program to improve forward head posture
Journal of Manual & Manipulative Therapy, 13(3), 163-176.
Iowa Chiropractic Clinic. (2014). Does posture really affect breathing and lung capacity?  (
Kuznetsov, N. A., & Riley, M. A. (2012). Effects of breathing on multijoint control of center of mass position during upright stance. Journal Of Motor Behavior, 44(4), 241-253.
Lou, E., Lam, G., Hill, D., & Wong, M. (2012). Development of a smart garment to reduce kyphosis during daily living. Medical & Biological Engineering & Computing, 50(11), 1147-1154.
Optimal Breathing Mastery. (2014). Posture and breathing. (
Norris, C. (2011). Posture: Part 2. Sportex Dynamics, (29), 15-18
Romel, M., Lo Mauro, A., D’Angelo, M.G., Turconi, A.C., Bresolin, N., Pedotti, A., & Aliverti, A. (2010). Effects of gender and posture on thoraco-abdominal kinematics… Respiratory Physiology & Neurobiology, 17(3), 184-191.of gender and posture on thoraco-abdominal kinematics… Respiratory Physiology & Neurobiology, 17(3), 184-191.

There are several causes of kyphosis in adults. The first is congenital – a condition present from birth. A congenital spine problem affects the development of the spine. The second cause is traumatic, which means it is caused by a trauma or injury to the spine. Third are “iatrogenic factors”; these are from the effects of medical treatment or surgery. Finally, osteoporosis can cause kyphosis in adults. Osteoporosis is a condition that leads to major losses of bone mass, leaving the bones brittle and prone to fractures. Osteoporosis is the most common cause of kyphosis in adults and is more common in women than men.

– from University of Maryland Medical Center

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