Here’s a number worth sitting with: most adults take somewhere in the region of 20,000 breaths a day.
Now here’s the question that follows from it. Which muscles are performing them?
If the answer is mainly your diaphragm, that’s a large workload distributed to the muscle designed for it.
Moreover, Neck and Shoulder Pain can follow when the work shifts forward.
Consequently, muscles at the front of the neck do more work, and they contract thousands of times daily.
This adds to holding your head up, turning it, and stabilizing your shoulder.
That’s a plausible and frequently overlooked contributor to persistent neck and shoulder tension, and it’s one almost nobody has assessed.
The Muscles That Shouldn’t Be Doing Much
Breathing is supposed to be primarily a diaphragm job. The diaphragm sits beneath your lungs, contracts downward, and draws air in. When it does its job well, your lower ribs widen and your belly moves.
Several other muscles are classed as accessory breathing muscles — available when you need more air, such as during exercise or exertion. Two of the main ones sit in your neck:
The scalenes, running deep along the side and front of the neck, which lift the upper ribs.
Sternocleidomastoid, the prominent rope running from behind the ear to the collarbone, which lifts the sternum.
Both are supposed to be occasional contributors. In a breathing pattern that’s shifted toward the upper chest, they become regular ones.
Why This Matters for Pain
Both of these muscles have well-documented referral patterns, and both are prominent in neck and shoulder presentations.
Scalene muscles have one of the largest referred pain areas among muscles studied in workers with Neck and Shoulder Pain. However, their referral travels down the front and back of the shoulder, into the arm, and sometimes into the hand. This pattern is regularly mistaken for a nerve problem.
Sternocleidomastoid refers into the face, ear, behind the eye, forehead, and top of the head, and is associated with dizziness and visual disturbance.
So a breathing pattern that recruits these muscles constantly isn’t a neutral habit. It’s a load, applied thousands of times daily, to muscles whose referral patterns look exactly like the complaints people bring in.
Test Your Own Pattern
Three simple checks. None require equipment.
The hand test. Sit comfortably. One hand on your upper chest, one on your belly just below the ribs. Breathe normally for a minute without trying to change anything — this is harder than it sounds, since attention alters the thing you’re measuring.
What you want: the lower hand moving more than the upper. What’s common: the upper hand doing most of the moving, and sometimes the shoulders rising slightly with each breath.
The shoulder check. Watch yourself in a mirror while breathing normally. Do your shoulders or collarbones lift visibly with each breath at rest? At rest, they shouldn’t.
The rib check. Place your hands around your lower ribs, fingers pointing forward. On an inhale, do the ribs widen sideways into your hands? A pattern dominated by upper chest movement often shows very little lateral rib expansion.
And notice your rate. Rapid, shallow breathing at rest is a pattern worth addressing. Counting your breaths for a minute while sitting quietly gives you a baseline.
What Shifts a Breathing Pattern
Stress and anxiety. The most common driver. Threat responses produce faster, shallower, upper-chest breathing, and if the stress is chronic the pattern becomes the default.
Sustained postures. A forward head and rounded upper back mechanically restrict how well the lower ribs can expand, so the body finds air where it can.
Pain itself. People in pain hold their breath and brace, particularly around a painful area.
Habitual abdominal bracing. Holding your stomach in constantly — for appearance or out of habit — restricts diaphragmatic descent directly.
Respiratory conditions and nasal obstruction. Genuine restrictions in airflow change the pattern for good reason. Worth mentioning to your physician rather than assuming it’s a habit.
Deconditioning. Being out of shape means more breaths are taken near your capacity.
Retraining It
This is skill work rather than exercise, and precision matters more than effort.
Start lying down, knees bent, one hand on the chest and one on the belly. Lying removes the postural demand and makes the pattern easier to find.
Breathe in through your nose, aiming for the lower hand to rise and the upper to stay relatively still. Don’t force the belly out — you’re allowing the diaphragm to descend, not performing a movement.
Let the exhale be longer and passive. Most people over-focus on the inhale. The out-breath is where the relaxation happens, and lengthening it gently is one of the more reliable ways to shift the pattern.
Aim for lateral rib expansion, hands around the lower ribs, feeling them widen.
Keep it short and frequent. Two to three minutes, several times a day, beats a single long session. This works by changing a default, and defaults change through repetition.
Then progress the position. Lying, to sitting, to standing, to walking, to during activity. A pattern that only exists when you’re lying on the floor thinking about it hasn’t changed anything about your 20,000 daily breaths.
Attach it to existing habits. Every red light, every time you sit down at your desk, every time you finish a call.
Two Honest Caveats
Don’t over-breathe. Deliberate deep breathing done too vigorously or too long can leave people lightheaded or tingly. Gentle and unhurried is the aim. If you feel dizzy, stop and breathe normally.
And this isn’t a cure-all. Breathing pattern is one plausible contributor among several to neck and shoulder tension, and the evidence base here is not as strong as the enthusiasm in some corners of the wellness world. Treat it as a worthwhile piece to address rather than the answer to everything.
Where Hands-On Work Fits
Retraining the pattern reduces the ongoing load. It doesn’t undo what’s accumulated in muscles that have been working overtime for months or years.
The two halves work together: soft tissue work addresses the current state of the scalenes, sternocleidomastoid, and everything around them, while the breathing work stops you rebuilding it within a fortnight. Clinical guidance for neck pain consistently points toward manual therapy combined with active approaches rather than either alone.
A practical note: the scalenes sit deep and close to important structures. Work in this area should be skilled, appropriately gentle, and never aggressive — and it isn’t appropriate for everyone, which is why assessment comes first.
When to See a Physician First
Emergency care for chest pain or pressure, breathlessness that’s new or severe, sweating, nausea, or pain into the jaw or left arm. Also for sudden severe headache, facial droop, slurred speech, or one-sided weakness.
Prompt medical assessment for breathlessness on exertion that’s new or worsening; a persistent cough; breathlessness lying flat or waking you at night; progressive weakness or numbness in an arm or hand; numbness in both hands; clumsiness or a change in your walking; neck pain after trauma; fever, unexplained weight loss, or night sweats; or dizziness with visual disturbance, swallowing difficulty, or slurred speech.
Breathlessness is a symptom that deserves medical evaluation rather than being assumed to be a pattern problem.
Let’s Look at What’s Driving Your Tension
If your neck and shoulders keep tightening back up within days of feeling better, something is reloading them — and it’s worth finding out what.
Castrell Neuromuscular Therapy offers a free discovery visit at no cost and no obligation. You’ll get a thorough assessment of your neck and shoulder musculature, your breathing pattern, and the positions and habits feeding into them, plus a plan combining hands-on work with the retraining that makes it hold.