The Foot-Airway Connection: How Your Foot Posture Influences Breathing

When we think about optimal breathing, most of us immediately picture the lungs, diaphragm, and maybe even the nasal passages. Rarely do we consider the role of our feet — and yet, the way our feet contact the ground and support our posture plays a direct role in the alignment of our entire kinetic chain, including the position of the ribs, diaphragm, jaw, and ultimately, the airway.

As a functional podiatrist and human movement specialist, I’m deeply passionate about the foot’s role in total-body health. And the connection between foot posture and breathing is yet another example of how foundational our feet are to everything we do — including how we breathe.

From the Ground Up: Understanding the Postural Chain

The body functions as an integrated system, where changes in one joint or segment inevitably influence those above and below it. When the foot collapses — as we often see in overpronation or flat feet — the tibia internally rotates, the knee drops inward, and the femur rotates medially. This chain reaction causes the pelvis to tip anteriorly, increasing lumbar lordosis and pushing the ribcage into a flared, extended position.

Why does this matter?

Because ribcage and diaphragm positioning is critical to proper breathing mechanics. A flared ribcage and extended thoracic spine reduce diaphragm efficiency and promote shallow, chest-dominant breathing patterns. These compensatory patterns can contribute to stress, poor core stability, and even impaired oxygen exchange over time.

The Diaphragm and the Pelvic Floor: Partners in Respiration

The diaphragm doesn’t function in isolation. It works in concert with the pelvic floor, the transverse abdominis, and the deep spinal stabilizers. When foot posture is compromised, the alignment of the pelvis — and therefore the relationship between the diaphragm and pelvic floor — is disrupted.

An anteriorly tilted pelvis, common in individuals with collapsed medial arches, elongates and weakens the pelvic floor muscles. This disconnection from the diaphragm affects not only breathing but also core control and continence — further illustrating the wide-reaching influence of foot function.

Airway and Jaw Position: A Surprising Link

Even more fascinating is the relationship between foot posture and the craniocervical region. Postural compensations that begin at the foot can travel up the chain, resulting in a forward head posture and changes to jaw positioning.

A forward head posture narrows the oropharyngeal airway space and contributes to dysfunctional breathing, mouth breathing, and even sleep-disordered breathing like snoring or obstructive sleep apnea.

It may seem extreme to say that your feet influence your airway — but the postural cascade that begins at the ground truly has the power to shape our breathing patterns and craniofacial alignment.

Correcting Foot Posture to Support Better Breathing

As with most integrative issues in the human body, the solution isn’t isolated to just one area. Improving breathing begins with addressing postural alignment, which means we must start with the foundation: the feet.

Interventions to support optimal foot posture and breathing may include:

• Short foot exercises to strengthen the intrinsic foot muscles and restore arch integrity

• Sensory stimulation through textured insoles to increase foot-to-core stability

• Diaphragmatic breathing drills to reconnect the breath with the deep core

• Postural re-education to align the ribcage over the pelvis

• Footwear with minimal interference to promote natural foot function and proprioception

When we integrate foot function with core and breath retraining, we create a synergistic effect that supports not only better posture and movement — but also more efficient and balanced breathing.

Final Thoughts

It’s easy to underestimate the feet. They’re often tucked into shoes, hidden under socks, and overlooked in most rehabilitation and wellness programs. But when we begin to see the foot as a critical sensory and postural foundation, we uncover its role in everything from spinal alignment to breathing capacity.

So, the next time you take a deep breath — ask yourself: What are my feet doing right now?

Because every inhale starts from the ground up.

Dr. Emily Splichal, DPM, MS, CES, is a functional podiatrist, human movement specialist, and founder / CEO of Naboso. She is internationally known for her work in barefoot science, sensory integration, and movement longevity.