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Neck and shoulder pain? Tight or painful chest? Stressed at work? This article might help!

Neck and shoulder pain? Tight or painful chest? Stressed at work?
Neck and shoulder pain? Tight or painful chest? Stressed at work? Does your pain keep returning? Breathing patterns can contribute to, or even cause chronic muscular pain. Discover more here – and what you might do to start finding relief…

The role of the breath

The breath has many functions; it is involved in the exchange and regulation of oxygen/carbon dioxide, and the optimal performance of the brain, organs and tissues. It assists digestion, it helps push fluids around the body, it permits communication, and it mobilises the spine, ribs and shoulders.

Our breath is intimately intertwined with our body’s emotional responses and stress levels. How so? – The primary muscle of breathing is the diaphragm – this is motor controlled by the phrenic nerve. Phren means ‘mind’ or ‘brain’ in Greek – and the phrenic nerve forms a direct connection, like an umbilical cord, between the mind and body.

What has all this got to do with my painful shoulders?

When we feel stressed at work, we have an ‘alarm bell’ in our brains called the Amygdala. The word Amygdala is Greek for ‘Almond’ – and the Amygdala is a small, almond shaped piece of our brain that alerts us to anything that threatens our survival. However, like a smoke alarm – it can’t tell whether you’ve burnt the cooking, or the house is on fire. It’s job is simply to ring the alarm FAST and AUTOMATICALLY.

Once this alarm system is ‘set off’, in turn it sets off a ‘sprinkler system’ of hormones such as adrenaline and cortisol.

This stress response system is also known as the fight/flight/freeze response. It creates a number of physiological changes, one of which is muscular tension. This can translate to neck and shoulder pain as well as a tight, painful chest.

The fight/flight/freeze response

The mechanisms that alert and control our stress response haven’t changed since we were hanging out in caves. They are based upon the primitive instinct for survival.

Let’s just imagine you are sitting in your homely cave, eating a delicious dinner, and minding your own business. A Sabre tooth tiger strolls past the mouth of the cave, and you have 3 choices;

1. Run up, and punch him on the nose (fight)
2. Try to run past him and escape (flight)
3. Or sit very, very still, and hope he doesn’t notice you (freeze)

Neck and shoulder pain? Tight or painful chest? Stressed at work? The fight/flight/freeze response explained

Most of us have probably heard of the fight, or flight responses – the heart races as the blood flows to the limbs in preparation for action. The freeze response, or breath holding, is less talked about – but is especially relevant for those with suffering with neck and shoulder pain, or a tight, painful chest who seek deep tissue, or sports massage.

The freeze response, or ‘breath holding’

The freeze response, or breath holding happens when we feel fear, anticipation, or when we are waiting for more information before making a decision.

Imagine it’s late afternoon on a Friday. You’ve only got a couple of hours left to work, before you’re due to head out for pre-planned, romantic date. Without warning your boss comes along, dumps a huge file on your desk, and asks for it to be dealt with before you leave.

What do you do?

1. Stand up, and without a single word, proceed to punch them in the head? (fight)
2. Grab your coat, and run out the door? (flight)
3. Or sit very still, and hope that this problem will somehow go away without devouring you? (freeze)

Neck and shoulder pain? Tight or painful chest? Stressed at work? The fight/flight/freeze response explained

We might have considered hitting the boss, or running away to the arms of our waiting lover, but most of us would have made a quick appraisal of the situation, and decided that we were actually looking forward to our pay cheque at the end of the month.

Breath holding is a primitive survival instinct, and when we are under stress, physiological stress responses are AUTOMATIC. When we freeze, unless we are extremely body aware, we will not usually notice it.

Breath holding also happens when we have an injury, or we’re in physical pain – and we are fearful that further movement will exacerbate our pain.

So what’s happening to our body when we ‘freeze’?

Our breathing becomes shallow
Our ribs move less.
Our muscles become tense

In other words, we are ‘playing dead’ – remember the Sabre tooth tiger? If he doesn’t see us in his peripheral vision – we just might survive!

Like the smoke alarm in the earlier example, the stress response does not differentiate between threats – therefore a sabre tooth tiger and a demanding boss can (and do) both inspire the same biochemical reaction.

Neck and shoulder pain? Tight or painful chest? Stressed at work? The fight/flight/freeze response explained

Our physiological systems are just doing their jobs – and responding, unconsciously and automatically, to the ‘threat’ they are presented with.

When this is repeated day after day in our workplace, the constant ‘threat’ can cause our muscles to stiffen, and feel hard and stuck – leading to chronic pain and dysfunction.

Typical complaints are tight, sore, frozen shoulders, stiff necks, neck and shoulder pain, tight/painful chest and sore backs.

Sound familiar?

Ouch! So what happens next?

If not acknowledged, and dealt with adequately, stress can cause health problems, of which muscle pain (and neck, chest and shoulder pain and stiffness) can be one of the first obvious symptoms. The long term effects of stress are well documented; they include feeling tired and run down, frequently getting ill, muscle soreness and headaches – all warning signs that your body needs some kindly attention. Beginning your journey to wellness through awareness of breath can provide an insight into exactly how much YOU can do to take part in stepping OUT of repetitive, unhealthy cycles of stress…


How do I eradicate neck and shoulder pain caused by breath holding?

It can be very worrying to have pain and not know what has caused it – and whether it will ever go away!

The good news is muscular pain caused by work related stress is usually very treatable. It is important however to firstly find out if there are any other underlying mechanical reasons for your neck or shoulder pain, such as an old injury.

Breath holding might be holding your neck and shoulder muscles tense in an attempt to protect the injury site. Going to a good sports and remedial massage therapist or soft tissue therapist can help get to the bottom of your pain – and help you understand it. A good sports and remedial massage therapist will refer to another specialist if they feel it needs further investigation.

We’ve written a popular article ‘Why do my neck and shoulders hurt at work’ which also may help you build a bigger picture of the variety of factors that contribute to neck and shoulder pain.

Breath holding is just one feature of respiratory patterns, and breathing patterns can vary hugely between people. It can be helpful to develop an awareness of your breathing pattern with the assistance of a therapist or teacher.

Meditation/mindfulness and/or yoga taught by a good teacher can be a great start in developing general breathing awareness. A good manual therapist who specialises in breath/body awareness is also a very good start. ‘One to one’ work can be very effective in fast tracking learning – whether this is Yoga, Pilates, Sports and Remedial Massage or any other type of bodywork. What is important is the knowledge of the teacher and the working relationship you have together.

What do City Sports Massage do?

At City Sports Massage in London we are passionate about helping clients to experience the relationship between their breath and body, in order that they may discover freedom from pain, and a deep understanding of the often pervasive mechanisms of the stress response.

We work with many different professions – variety is something we LOVE! We specialise in working with people in pain. Whoever they are, and whatever they do.

At City Sports Massage we always aim to put YOU in the driving seat – giving you a greater awareness and understanding of your body, so that you can take the steps YOU need, OUTSIDE of the clinic, to stay pain and stress-free.

Whichever route you go…Remember to let your breath be your friend. It’s always there for you. Make friends with it – get to know it!

Please note that this article is for general information purposes only. If you are suffering from a medical condition, diagnosis should be carried out by your Doctor, or a medical professional. City Sports Massage are not liable for the content of any external websites.

© Jon Gee 2014 Jon Gee is the founder of City Sports Massage, a team of sports massage therapists based in London who combine deep-tissue massage therapy with stress-reduction and body-awareness techniques. Jon has worked with body dynamics for almost two decades, and specialises in treating pain that is chronic and longstanding. He often incorporates the teaching of mindfulness, breathing and body awareness skills, in order to help clients self-manage, and be less reliant on massage/bodywork treatments. Jon also teaches other health practitioners, and has written articles on his teaching methods for the peer-reviewed Journal of Bodywork and Movement Therapies.
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