Diaphragmatic breathing is very important in preventing overuse of the neck and chest muscles. Most commonly the breathing is done through the chest and shoulders. We take about 20,000 breaths in 24 hours. If these breaths are done with the chest and shoulders, the shoulders are drawn up and neck is drawn forward. The same muscles that support the neck become overused.
Proper breathing is done through the belly with the diaphragm being depressed. This allows for the desired downward positioning of the shoulders. The depressed diaphragm assumes a dome shape and braces the trunk for better support of the upper body.
Diaphragmatic breathing frequently requires training and instruction by a physical therapist or a yoga instructor and should be practiced daily for it to become a natural way of breathing.
This is considered part of strengthening because the diaphragm does become stronger through this type of breathing.
Once the strengthening exercises are learned. They should be performed independently at least twice a week. A routine performance of strength based posture exercises can prevent many problems that arise from poor posture and can be compared to brushing ones teeth in prevention of cavities.
At completion of a typical physical therapy program, we recommend transitioning to community-based exercise. Working with an experienced athletic trainer can be motivational and allow for continued progress.
Yoga is also very effective in improving postural positioning and postural muscle strength.
Overhead and shoulder height exercises such as Military Shoulder Press, Shoulder Shrugs, Side and Front Flies are not recommended due to their propensity to overuse already fatigued muscles.
Aerobic exercise is critical in improving the health of overused muscles. Aerobic exercise increases heart rate which in turn improves circulation and with it delivery of oxygen and nutrients and elimination of toxins. ( See discussion of causes of neck and shawl pain at beginning of the article).
Aerobic exercise should be done for forty-five minutes at least two days a week with four days a week being optimal.
Examples of aerobic exercise include brisk walking, elliptical machine use, jogging, cycling in an upright position.
Swimming is typically not recommended due to its tendency to overuse fatigued muscles and create more tightness in the chest and shoulders.