Understanding The Airway

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In the physiological hierarchy of needs, the body’s number one requirement is air.(1)  Without air the body would die within minutes so it makes sense that the body will utilize as many strategies as necessary to maintain a functional oxygen level in the body.  When the brain perceives that it is under stress, the demand for oxygen increases and the fight or flight response is triggered. This involves increased heart rate, increased blood flow to working muscle, and decreased blood flow to systems that are not required for short term protection such as digestion and the immune system.(2)  This stress response is also reflected in posture and muscle activation.  A very clear example of this is the startle response which involves the body attempting to escape a stressor.(3)  Another example is watching individuals at the end of a marathon.  They inevitably begin to arch their back and push out their chest as they try to pull in more air to keep going.  These are all normal reflexes that the body exhibits to take care of itself.

The stress response is efficient during short term stressors.  Unfortunately, in today’s society we are constantly bombarded with mild stressors which involve everything from going to work, paying bills, and managing home and technology.(4,5)  This puts an individual's body in a state of constant mild distress yielding a prolonged stress response.6  The brain adapts to this stress response and creates a "new" normal "resting" state, one that is resemblant of the marathon runner.  The lower abdominal muscles become less active allowing the low back to tighten and arch. This is an example of a postural change striving to get more air in the body.  Paradoxically, this posture is one of hyperinflation, or too much air in the lungs. This increases blood pH levels, which in turn increases the perceived threat. This is the hallmark of an inefficient breather.  Oxygen utilization is low when stressed. To get more "useful" air in the old air needs to come out more efficiently during exhalation. Over time, if “stuck” in this or an associated survival posture it can lead to musculoskeletal pain complaints such as low back, neck, or even shoulder pain.  The goal becomes to build a body with the capacity to assume multiple postures without getting stuck. The body should be able to go in and out of postures if it is no longer under threat. The most efficient way to reduce a threat is with a respiration emphasis. Respiratory patterns train the brain to decrease the state of threat on the body.  

This concludes Part 1 of the airway.  Though it is not necessarily a requirement to have “perfect” posture or stress management, breathing is something we do thousands of times a day and can be the first step to improving both of these.  

As always, take care and breathe easy!



  1. Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-396.

  2. Cannon, Walter (1932). Wisdom of the Body. United States: W.W. Norton & Company. ISBN 0393002055.

  3. Solomon; Schmidt (1990). "13". In Carol, Field. Human Anatomy & physiology (2 ed.). Saunders College Publishing. p. 470. ISBN 0-03-011914-6.

  4. Schneider S, Schmitt H, Zoller S, Schiltenwolf M. Workplace stress, lifestyle and social factors as correlates of back pain: a representative study of the German working population. Int Arch Occup Environ Health. 2005;78(4):253-69.

  5. Konietzny K, Chehadi O, Streitlein-böhme I, Rusche H, Willburger R, Hasenbring MI. Correction to: Mild Depression in Low Back Pain: the Interaction of Thought Suppression and Stress Plays a Role, Especially in Female Patients. Int J Behav Med. 2017.

  6. Robert M. Sapolsky. Why Zebras Don't Get Ulcers: An Updated Guide To Stress, Stress Related Diseases, and Coping. 2nd Rev Ed, April 15, 1998. W. H. Freeman ISBN 978-0-7167-3210-5