Why Athletes Get Injured: The Breathing and Movement Foundation Nobody Is Addressing
By Nicole Tavernier, Somatic Educator, Oxygen Advantage® Instructor & Play Zone Pro Coach • The Functional Living Method™ • Tantien Integrative Medicine • 211 Montowese St, Branford, CT 06405
Dysfunctional breathing is a documented cause of core instability, impaired functional movement, and increased musculoskeletal injury risk in athletes — including ACL injury. At Tantien Integrative Medicine in Branford, Connecticut, Nicole Tavernier, Somatic Educator, Oxygen Advantage® Instructor, and Play Zone Pro Coach, works with athletes to identify and retrain dysfunctional breathing patterns as the foundation for injury prevention, performance, and recovery.
Most athletes who come to me with recurring injury have one thing in common: no one has ever assessed how they breathe.
They’ve done the rehab. Strengthened the glutes, the hips, the core. Worked with physical therapists and athletic trainers who are genuinely skilled. And yet the injury keeps coming back, or the pain never fully resolves, or something in how their body moves still isn’t right.
What’s almost never been looked at is the foundation underneath all of it.
My name is Nicole Tavernier. I’m a somatic educator and Oxygen Advantage® instructor at Tantien Integrative Medicine in Branford, CT. The work I do — The Functional Living Method™ — is not physical therapy, and it’s not fitness. It’s the layer underneath both: functional breathing, somatic movement, and nervous system capacity and resilience building, woven together to address what conventional training and rehab consistently leave out.
This article is about what that missing layer actually is, why it matters for athletes, and what the research says about it.
The Functional Living Method™ — What It Actually Is
Before I get into the science, I want to be clear about what I do — because it’s commonly misunderstood as “just breathing.”
The Functional Living Method™ works through three interconnected doorways, each targeting a different level of the same system:
Functional breath work, rooted in the Oxygen Advantage® method, retrains how you breathe in everyday life — not just during a breathing exercise. It addresses dysfunctional patterns such as chronic mouth breathing, over-breathing, and low CO₂ tolerance, with the goal of breath that actually regulates your nervous system rather than just maintains survival.
Somatic movement, drawn from Feldenkrais and Hanna Somatics, works with your nervous system’s existing patterns directly. These are not exercises in the conventional sense. They are slow, precise invitations for your nervous system to notice what it’s doing — the bracing, the guarding, the habitual postures — and discover that it has other options. As Moshe Feldenkrais himself observed: “As we become aware of what we are doing in fact, and not what we say or think we are doing, the way to improvement is wide open to us.” When safety registers, the holding dissolves. Not because it was forced, but because the system recognized it no longer needed to brace.
As a certified Play Zone Pro coach, I use the Play Zone methodology — developed by Michael Allison of Smarter Coaching LLC and rooted in Polyvagal Theory (Stephen Porges, Ph.D.) — to help athletes understand and navigate their Performance Hierarchy. The body’s nervous system follows a predictable sequence of survival states: the Play Zone (safe, energized, connected), the Mobilized Fight Zone (aggressive, attacking), the Mobilized Flight Zone (anxious, scattered, afraid), and the Immobilized Zone (shutdown, discouraged, disconnected). Most athletes under pressure drop out of the Play Zone and into one of the defensive zones without realizing it — and stay there. The goal is not to eliminate activation. It is to build the capacity to recognize which zone you’re in, navigate back toward the Play Zone, and sustain the blended state of safety plus mobilization plus connection that peak performance actually requires. What athletes often call “mental toughness” or being “clutch” is really a physiological skill — the ability to keep the body grounded and flexible while staying energized. That is State Flexibility™ expressed in athletic terms.
The through-line connecting all three is State Flexibility™ — the capacity to move fluidly between nervous system states, to activate when needed and recover fully, to stay present under pressure, and to access the full range of states your body was designed for. This is not about being calm. It’s about resilience and State Flexibility™.
For athletes, the most immediately relevant doorway is usually breath work — because of its direct, documented connection to core stability, movement quality, and injury risk. But breath work alone is not the method. It’s the starting point.
What Is Dysfunctional Breathing and How Does It Affect Athletes?
Functional breathing means using your diaphragm as the primary respiratory muscle, breathing through your nose, and producing a coordinated movement of the upper rib cage, lower rib cage, and abdomen with each breath. This is the standard Nicole Tavernier assesses in every athlete she works with at Tantien Integrative Medicine in Branford, CT.
Dysfunctional breathing — or a breathing pattern disorder — happens when that pattern breaks down. The most common version is thoracic-dominant breathing: the chest rises, the upper accessory muscles do most of the work, and the diaphragm stays relatively inactive. This becomes a default pattern, operating all day without the person being aware of it.
Research using resting end-tidal carbon dioxide (ETCO₂) and resting respiratory rate found that 70% of subjects studied had disordered breathing (Bradley et al., 2014). A separate study found that participants with poor breathing patterns scored significantly lower on the Functional Movement Screen™ (FMS™) test — a standardized clinical tool for assessing movement quality — while 87.5% of those who passed the FMS™ were classified as diaphragmatic breathers. Breathing pattern and movement quality are not separate variables. They measure the same underlying system.
A related study by Stephens et al. (2017) found that after just 8 weeks of diaphragmatic breathing training, participants showed measurable improvement in balance — specifically a decrease in errors during single-leg balancing. The diaphragm was not just breathing. It was stabilizing.
What Is the Core and Why Does Breathing Control It?
There is a deeply entrenched misconception in athletic training and rehabilitation about what the core actually is. As Dr. Stuart McGill, one of the world’s leading spine researchers, put it in 2009: “There’s so much mythology out there about the core. The idea has reached trainers and, through them, the public that the core means only the abs. There’s no science behind that.”
In functional movement science, the core is understood as a three-dimensional pressure canister — a box. Each wall of that box is a distinct muscle group, and they only function as a stability system when working in coordination:
The Diaphragm — The Lid
The diaphragm sits at the top of the box. When it contracts during inhalation, it descends and flattens, generating what is called intra-abdominal pressure (IAP) — a hydraulic stabilizing force that supports the spine and pelvis. This pressure works like an inflating balloon: it has a stabilizing effect on the spine during loading, lifting, and movement. When the diaphragm isn’t functioning properly, the entire pressure system of the core is compromised from the top down. As physiotherapist Josephine Key (2013) concluded, breathing is “a root mechanism for core control” and is integral to postural stability.
The Transversus Abdominis — The Front Wall
The transversus abdominis (TVA) is the deepest abdominal muscle, wrapping the trunk like a corset. Unlike the rectus abdominis, it doesn’t flex the spine — it compresses and stabilizes it. There has been debate in the literature about whether the TVA alone stabilizes the spine (Allison & Morris, 2008; Lederman, 2010), and the consensus is clear: the TVA cannot function optimally without the diaphragm generating appropriate IAP above it. Training the TVA in isolation — which most “core training” programs do — misses the mechanism entirely.
The Multifidus — The Back Wall
The multifidus muscles run along either side of the spine and provide segmental vertebral control during movement. They are deep stabilizers, not prime movers, and they work in direct coordination with the TVA and diaphragm. Multifidus dysfunction is consistently found in people with chronic low back pain — often as a downstream consequence of a core system that was never properly integrated.
The Pelvic Floor and Hip Muscles — The Base
The pelvic floor forms the base of the box, moving in direct coordination with the diaphragm: descending on inhalation, recoiling on exhalation. When breathing is dysfunctional, this coordination breaks down. The hip muscles at the base — including the abductors and external rotators that are critical for knee stability — are part of this same foundational system.
Why the Box Must Work Together
Core stability, breathing, and posture are inextricably linked by the pressure generated in the abdominal cavity by the movement of the diaphragm. Fully functional breathing generates optimal IAP, which generates better spinal stability. You cannot train one wall of the box in isolation and expect the system to function. Yet this is precisely what most core training programs do.
“If the posture is ‘good,’ so too is the breathing pattern and conversely, if the breathing pattern is healthy, so is the posture.”
— Key, J. (2013). Journal of Bodywork and Movement Therapies
Popular core exercises — pelvic tilts, stability ball work, hip bridges — are routinely prescribed in physical rehabilitation, but breath work is not (Kovar, 2014). This is the gap. Worse, research has shown that people with spino-pelvic pain syndromes subjected to individual muscle group and high-load training strategies are likely to further imprint disrupted motor patterns and worsen symptoms (Key, 2013). The problem isn’t that athletes aren’t doing enough core work. It’s that the core work is missing its foundation.
As Dr. Paul Sly, an Oxygen Advantage Master Instructor and chiropractor, describes it: “We are finally coming around to the idea that functional breathing, recruiting a strong diaphragm with appropriate timing, is a big part of core stabilization.”
Posture, Back Pain, and the Breathing Connection
The connection between breathing and posture runs in both directions. A healthy breathing pattern depends on good postural alignment — because the lower rib cage can only expand laterally if there is sufficient space between the thorax and pelvis for the diaphragm to descend. And good postural alignment depends on functional breathing — because IAP is what keeps the spine stable under load.
People with back pain tend to brace the superficial muscles of the abdomen and diaphragm, which restricts the diaphragm’s movement and limits IAP generation. This sets up a compensation pattern: the outer muscles tighten to provide the stability the inner system can’t, which worsens breathing mechanics, which further compromises core stability. Up to 50–80% of adults suffer from lower back pain at some point in their lives (Fatoye et al., 2019). It’s worth asking how many of them have ever had their breathing pattern assessed.
The instability doesn’t stay in the low back. As Bundy & Leaver (2010) note, instability in the lumbar spine can cause stiffness in the thoracic spine, leading to compensating movements in the shoulder — including pain and tears in the rotator cuff tendon. The trunk and pelvis are the center of the kinetic chain. When they’re unstable, every joint above and below pays a price.
A thicker, stronger diaphragm indicates better respiratory muscle strength, which goes hand in hand with functional breathing (Kocjan et al., 2018). The diaphragm is a striated muscle — the same type that moves the joints. It responds to training. It also deteriorates with disuse, compensation, and chronic shallow breathing.
Breathing Pattern Disorders and Functional Movement
Functional movement is defined as the ability to produce and maintain sufficient mobility and stability along the kinetic chain while accurately and efficiently completing fundamental movement patterns (Bradley et al., 2014). More simply: all systems working in harmony to ensure healthy movement of the limbs.
Breathing is not separate from this. It is the mechanism by which the movement system is organized and stabilized before anything else happens.
The Functional Movement Screen™ (FMS™) is a performance enhancement tool used widely in athletic assessment. The Selective Functional Movement Assessment™ (SFMA™) is its clinical arm, designed to arrive at a diagnosis. What the research shows is that breathing pattern quality predicts FMS™ performance. Athletes who breathe dysfunctionally move dysfunctionally — and that pattern of movement puts them at risk.
The research also shows that disordered breathing is remediable. Fresh neural connections can restore the central nervous system’s motor control patterns (Chapman et al., 2016). This is not a fixed structural problem. It’s a learned pattern that can be unlearned. That is exactly what functional breath work and somatic movement address.
How Does Dysfunctional Breathing Increase ACL Injury Risk?
For athletes in cutting, pivoting, and jumping sports — soccer, basketball, lacrosse, skiing — the stakes are highest at the knee. This includes athletes across Connecticut, from youth club sports to collegiate and recreational competitors throughout New Haven County and the Shoreline.
Core stability training has been shown to improve knee kinematics, reduce knee valgus angle during landing, and strengthen the hip abductors and external rotators that protect the knee (Saki et al., 2023). But these programs consistently miss the diaphragm. If the lid of the box isn’t working, the stability you’re trying to build doesn’t have a foundation.
“If breathing is not normalized, no other movement pattern can be.”
— Chapman et al. (2016), International Journal of Sports Physical Therapy
How Does the Functional Living Method™ Address Breathing and Movement in Athletes?
When an athlete comes to me, we start by looking at what their breathing is actually doing — not what they think it’s doing. Upper chest rising, shoulders lifting, belly still or moving paradoxically. Breath held during exertion. Mouth breathing that has been the default for so long it’s invisible. These patterns are common, consequential, and almost never addressed in standard athletic training.
Functional breath work, using the Oxygen Advantage® framework, retrains these patterns at the level of the central nervous system’s motor control — not just as a relaxation technique. When the diaphragm is restored to its proper role, the inner core activates the way it’s supposed to. The box comes back online.
Somatic movement then addresses the compensatory patterns the body has been running — the bracing, the guarding, the learned restrictions that developed in response to injury, pain, or years of high-demand training without this foundation. These are not stretches or strengthening exercises. They are neurological re-education: slow, precise invitations for the nervous system to recognize its own patterns and discover that it has other options.
As a certified Play Zone Pro coach, I use the Play Zone methodology for the third doorway. Rooted in Polyvagal Theory, this framework teaches athletes to recognize their position in the Performance Hierarchy in real time — to notice when they’ve shifted from the Play Zone into a fight, flight, or shutdown state — and to build the capacity to navigate back. This is not visualization or positive thinking. It is physiological awareness and skill: learning to read breathing rate, posture, muscle tension, facial expression, and energy level as real-time data about which zone you’re in, and developing the intentional tools to shift. Breathing is one of those tools — which is why all three doorways of the Functional Living Method™ are connected. The breath work builds the physiological foundation. The somatic movement addresses the held patterns. The Play Zone work builds the awareness, resilience, and navigational capacity to use that foundation under the actual conditions of competition.
This is not a replacement for physical therapy, strength training, or sport-specific conditioning. It is the layer underneath those things that makes them work properly. The athletes who get the most from this work are often the ones who have already done everything right and still have something that isn’t resolving.
Which Athletes Benefit From Functional Breathing Assessment in Connecticut?
This work is particularly relevant if you are:
• An athlete dealing with recurring injury that hasn’t fully resolved despite treatment
• Someone who’s been told their core is weak but core exercises haven’t fixed the underlying problem
• A competitive or recreational athlete who wants to address injury risk before it becomes injury
• A young athlete — or the parent of one — who has had an ACL injury or is in a high-risk sport: soccer, basketball, lacrosse, skiing
• Anyone returning to sport after injury who wants to make sure the foundation is actually solid before loading the system
• An athlete whose tension, fatigue, or recovery time doesn’t match their fitness level
Athletes and coaches in Connecticut — including New Haven County, the Shoreline, Middlesex County, and surrounding areas — who want access to functional breathing assessment and The Functional Living Method™ without traveling outside the state
I work with athletes in person at Tantien Integrative Medicine in Branford, CT, and virtually for those outside the area.
Frequently Asked Questions
What is The Functional Living Method™?
The Functional Living Method™ is a somatic education approach developed by Nicole Tavernier at Tantien Integrative Medicine in Branford, CT. It is not therapy and it’s not fitness. It combines functional breath work rooted in the Oxygen Advantage® method, somatic movement drawn from Feldenkrais and Hanna Somatics, and nervous system capacity and resilience building using the Play Zone methodology — rooted in Polyvagal Theory and developed by Michael Allison of Smarter Coaching LLC. The goal is State Flexibility™ — the capacity to move fluidly between nervous system states, meet challenges and recover fully, and sustain the blended state of safety plus mobilization plus connection that peak performance requires. For athletes, the breath work component has the most direct connection to core stability and injury prevention, but the method addresses the full system.
What is the core box and why does it matter for athletes?
The core box is a way of understanding the core as a three-dimensional pressure system: diaphragm on top, transversus abdominis at the front, multifidus at the back, and the pelvic floor and hip muscles at the base. All four walls must work in coordination — driven by proper diaphragm function — to stabilize the spine and protect the joints during athletic movement. Most core training programs address the outer walls while leaving the inner coordination — which depends on functional breathing — completely unaddressed.
Can dysfunctional breathing cause ACL injuries?
Research has established a link between breathing pattern disorders, core dysfunction, and musculoskeletal injury risk including ACL injury. The mechanism is direct: a dysfunctional diaphragm compromises the inner core stability system that is supposed to protect joints before movement occurs. This is consistently underscreened in athletic populations and worth evaluating in any athlete with recurring injury or persistent movement problems.
How do I know if I have a dysfunctional breathing pattern?
Common signs include habitual mouth breathing, the chest rising more than the belly during rest, breath-holding during exertion, and low CO₂ tolerance (feeling breathless at relatively low effort levels). Many people with dysfunctional patterns have no idea — the pattern has been their normal for so long it’s invisible. A functional breathing assessment looks at your pattern at rest, during movement, and under mild challenge.
Is this relevant for youth athletes?
Yes. Research has found that the highest prevalence of dysfunctional breathing patterns is in younger athletes — middle school and elementary school students — not collegiate athletes. Addressing breathing patterns early supports better movement development and reduces injury risk during the years when foundational patterns are being established.
What is the Play Zone and the Performance Hierarchy?
The Play Zone methodology, developed by Michael Allison of Smarter Coaching LLC and rooted in Polyvagal Theory (Stephen Porges, Ph.D.), describes a predictable hierarchy of bodily states that every athlete moves through: the Play Zone (safe, energized, relaxed, connected — the optimal state for peak performance), the Mobilized Fight Zone (aggressive, attacking, angry), the Mobilized Flight Zone (anxious, defensive, scattered, afraid), and the Immobilized Zone (shutdown, discouraged, disconnected). Under pressure, athletes drop out of the Play Zone and into defensive states automatically — and often stay there without knowing it. The goal is to build the awareness to recognize which zone you’re in and the capacity to navigate back to the Play Zone. What gets called ‘mental toughness’ in sport is really a physiological skill — the trained ability to find and hold a state of grounded, flexible, energized readiness even when the pressure is highest.
Do you work with athletes virtually?
Yes. Breath work assessment and retraining, somatic movement instruction, and nervous system capacity and resilience building can all be done effectively via Zoom. I work with athletes in Connecticut and beyond.
How does this fit with physical therapy or athletic training?
The Functional Living Method™ works at the layer underneath physical therapy and athletic training — the breathing and neurological foundation that makes those interventions more effective. It is complementary, not competitive. Many athletes find that movement work becomes significantly more effective once the breathing foundation is addressed.
If you're an athlete in Connecticut — or anywhere — and any of this resonates — if you've done everything right and something still isn't resolving — a conversation is the right place to start. Nicole works with athletes in person at Tantien Integrative Medicine in Branford, CT and virtually with athletes across the country.
Is dysfunctional breathing common in competitive athletes?
Yes — and more common than most coaches and athletes realize. Research using standardized functional movement assessments found that athletes with poor breathing patterns scored significantly lower on movement quality tests, while 87.5% of those who passed movement screening were classified as diaphragmatic breathers. A separate study found that 70% of subjects had disordered breathing based on resting CO₂ and respiratory rate measurements. Dysfunctional breathing is prevalent across all athletic levels and age groups, with the highest rates found in younger athletes.
What is the Oxygen Advantage® method and how does it apply to athletic performance?
The Oxygen Advantage® is a functional breathing system developed by Patrick McKeown, grounded in the physiology of carbon dioxide tolerance, nasal breathing, and diaphragmatic activation. It is not a relaxation technique — it is a performance and movement foundation. At Tantien Integrative Medicine in Branford, CT, Nicole Tavernier uses the Oxygen Advantage® method to assess and retrain dysfunctional breathing patterns in athletes, restoring diaphragm function as the foundation of core stability and movement quality.
What is the Play Zone and how does it affect athletic performance?
The Play Zone is a peak performance state described in the Play Zone Pro coaching framework, developed by Michael Allison of Smarter Coaching LLC and rooted in Polyvagal Theory (Stephen Porges, Ph.D.). It is a blended state of physiological safety plus mobilization plus connection — grounded, energized, and ready to respond. Athletes who develop the capacity to access and sustain the Play Zone under competitive pressure perform with less tension, hesitation, and reactivity. What is commonly called mental toughness or being clutch is a trainable physiological skill, not a personality trait. Nicole Tavernier works with athletes on Play Zone capacity as part of The Functional Living Method™ at Tantien Integrative Medicine in Branford, CT.
Can somatic movement education help athletes recover from injury?
Yes. Somatic movement education, drawn from Feldenkrais and Hanna Somatics, works directly with the nervous system's learned movement patterns — the bracing, guarding, and compensatory restrictions that develop after injury or years of high-demand training. These are not exercises. They are precise, slow invitations for the nervous system to recognize existing patterns and discover that other options are available. As Moshe Feldenkrais observed, awareness of what we are actually doing — rather than what we think we are doing — is what opens the path to improvement. At Tantien Integrative Medicine in Branford, CT, Nicole Tavernier integrates somatic movement education into athletic recovery work as part of The Functional Living Method™.
Where can athletes in Connecticut access functional breathing assessment and somatic movement education?
Athletes in Connecticut can access functional breathing assessment, Oxygen Advantage® breath retraining, somatic movement education, and Play Zone Pro nervous system coaching at Tantien Integrative Medicine, located at 211 Montowese St, Fl 1, Branford, CT 06405. The practice serves athletes from Branford, New Haven, Guilford, Madison, Milford, North Haven, Wallingford, and throughout New Haven County and the Connecticut Shoreline. Virtual sessions are also available for athletes outside the local area.
Schedule a free 15-minute consultation: https://www.power2patient.net/online-scheduling/init/1a808ca3d0e6a408bb2644cab1a5f5b9f3918f20
The Functional Living Method™ with Nicole Tavernier • Tantien Integrative Medicine • 211 Montowese St, Fl 1 • Branford, CT • 475-252-4177
Sources and References
1. Allison, M. R. (2021). The Play Zone: A Paradigm Shift in Performance Psychology. Smarter Coaching LLC. theplayzone.com
2. Allison, G. T., & Morris, S. L. (2008). Transversus abdominis and core stability: has the pendulum swung? British Journal of Sports Medicine, 42(11), 930–931.
3. Bradley, H., & Esformes, J. (2014). Breathing pattern disorders and functional movement. International Journal of Sports Physical Therapy, 9(1), 28–39. PMID: 24567853
4. Bundy, M., & Leaver, A. (2010). A Guide to Sports and Injury Management. Elsevier Health Sciences.
5. Chapman, E. B., Hansen-Honeycutt, J., Nasypany, A., Baker, R. T., & May, J. (2016). A Clinical Guide to the Assessment and Treatment of Breathing Pattern Disorders in the Physically Active: Part 1. International Journal of Sports Physical Therapy, 11(5), 803–809. PMID: 27757292
6. Fatoye, F., Gebrye, T., & Odeyemi, I. (2019). Real-world incidence and prevalence of low back pain using routinely collected data. Rheumatology International, 39(4), 619–626.
7. Key, J. (2013). ‘The core’: understanding it, and retraining its dysfunction. Journal of Bodywork and Movement Therapies, 17(4), 541–559.
8. Kiesel, K., Rhodes, T., Mueller, J., Waninger, A., & Butler, R. (2017). Development of a screening protocol to identify individuals with dysfunctional breathing. International Journal of Sports Physical Therapy, 12(5), 774–786.
9. Kocjan, J., et al. (2018). Impact of diaphragm function parameters on balance maintenance. PLoS One, 13(12), e0208697.
10. Kovar, E. (2014). Core-strengthening exercises that help with back injury rehab. ACEFitness.org.
11. Lederman, E. (2010). The myth of core stability. Journal of Bodywork and Movement Therapies, 14(1), 84–98.
12. McGill, S. M. (2009). Quoted in: Reynolds, G. Is your ab workout hurting your back? New York Times, June 17, 2009.
13. Saki, F., Shafiee, H., Tahayori, B., & Ramezani, F. (2023). The effects of core stabilization exercises on the neuromuscular function of athletes with ACL reconstruction. Scientific Reports, 13, 2202.
14. Stephens, R. J., et al. (2017). Effects of diaphragmatic breathing patterns on balance: a preliminary clinical trial. Journal of Manipulative and Physiological Therapeutics, 40(3), 169–175.
