Beyond the Tongue: Why Breathing Patterns Matter in Myofunctional Therapy
What are we missing when we only look at the tongue?
The tongue gets a lot of attention in myofunctional therapy, and for good reason.
We look at where it rests, how it moves, how it functions during swallowing, and whether it can comfortably maintain the position we are working toward.
But over the years, I have found myself thinking more and more about what is happening around the tongue. Because the tongue doesn’t exist on its own.
It belongs to a person who is breathing, swallowing, chewing, talking, sleeping, moving, and responding to the world around them.
And that brings me to something I pay very close attention to in my work:
Breathing.
Not only whether someone breathes through the nose or the mouth, but how they breathe.
Is their breathing quiet and easy? Is there a lot of movement in the upper chest? Do they frequently sigh or feel the need to take a bigger breath? Can they breathe comfortably through the nose while sitting, walking, talking, or sleeping?
The more I learned about breathing, and the more people I worked with, the harder it became for me to separate breathing from oral function.
I can teach someone where their tongue should rest. We can work on lip seal, swallowing, chewing, and oral posture.
But then that person leaves my office and goes back to living their life.
They aren’t thinking about their tongue every minute.
But they are breathing.
All day. Every day.
And that matters.
A resting posture has to feel natural
One of the things we often work toward in myofunctional therapy is a comfortable oral resting posture: lips gently together, nasal breathing, and the tongue resting in an appropriate position.
But I don’t want someone closing their mouth simply because I told them that is where their lips belong.
I want that position to feel natural and sustainable.
And this is where an important distinction comes in.
Nasal breathing is not the whole story
Breathing through the nose doesn’t necessarily tell us everything about the breathing pattern.
Someone may be breathing through the nose but still breathe rapidly, rely heavily on the upper chest, frequently sigh or take larger breaths, or simply feel that breathing requires more effort than it should.
So I don’t only look at where someone breathes.
I am interested in how they breathe.
Because if we are trying to establish an oral resting posture that eventually becomes automatic, it makes sense to consider whether breathing comfortably supports that posture.
If you want the mechanics of this in more detail, I wrote about them in Mouth Breathing: Mechanics and More.
People don’t live in isolation
This is something I come back to again and again in my work.
We can isolate muscles when we exercise them, but people don’t live in isolation.
The tongue functions alongside the lips, jaw, airway, respiratory muscles, posture, nervous system, sleep, and the many habits a person has developed over a lifetime.
What happens when you stop thinking about it?
This becomes especially important when we are trying to change something that has been happening automatically for years.
I can show someone exactly where their tongue should rest. We can strengthen and coordinate muscles. We can practice swallowing and work on lip seal.
But being able to perform something during a therapy session is only the beginning.
The real question is: What happens when you stop thinking about it?
What happens while you’re answering emails, making dinner, walking down the street, watching television, or sleeping?
Ultimately, that is where we want the new pattern to live.
And breathing is part of that environment.
Breathing sits between the automatic and the conscious
Breathing fascinates me because it sits somewhere between the automatic and the conscious.
We don’t wake up every morning and remind ourselves to breathe. Our bodies take care of that for us.
At the same time, we can consciously influence our breathing. We can notice its rhythm and mechanics. We can become aware of unnecessary effort. We can explore movement through the diaphragm and lower ribs. We can experience what quieter, gentler breathing feels like.
This is where breathing re-education can become useful.
The goal isn’t to make someone spend the rest of their life monitoring every breath.
Quite the opposite.
We bring conscious attention to something for a period of time so that, with practice, a different pattern may eventually require less conscious attention.
Myofunctional therapy works in a similar way.
In the beginning, someone may frequently think:
Where is my tongue?
Are my lips relaxed?
How am I swallowing?
But I don’t want someone thinking about their tongue forever.
We practice with awareness because ultimately we are working toward a function that feels more natural.
There is no single breathing exercise for everyone
There isn’t one breathing exercise that is appropriate for everyone.
Before introducing breathing work, I want to understand the person sitting in front of me.
I observe breathing mechanics and patterns. I look at nasal breathing comfort. I pay attention to movement through the chest, abdomen, and lower ribs. Most importantly, I listen to how the person describes their own breathing. This is a large part of what happens during an assessment.
Depending on the individual, our work may include awareness of breathing mechanics, gentle lower-rib and diaphragmatic movement, comfortable nasal breathing, quieter and lighter breathing, humming, carefully selected breath-control exercises, relaxation, and body awareness.
I also pay attention to the relationship between breathing and the nervous system. Breathing changes when we are relaxed, excited, concentrating, exercising, worried, or sleeping. It isn’t a mechanical process happening separately from the rest of us.
Some people need very little breathing work.
Others benefit from spending more time on it.
The point isn’t to add breathing exercises simply because I can.
The point is to notice whether breathing is part of the picture.
When the answer isn’t another exercise
This may be one of the most important lessons in this work.
If someone cannot comfortably breathe through their nose, I don’t simply tell them to close their mouth and try harder.
I want to understand why.
There may be allergies, inflammation, structural concerns, or other reasons nasal breathing is difficult. Persistent nasal obstruction may need to be evaluated by an ENT or another appropriate healthcare professional. Symptoms that raise concern for sleep-disordered breathing may require further evaluation as well.
Breathing re-education cannot remove a physical obstruction, and myofunctional therapy should not replace appropriate medical care.
Sometimes helping someone means recognizing that what they need next isn’t another exercise.
They need another professional at the table.
I am not treating a tongue
None of this makes the tongue less important.
If anything, it has made me appreciate how much the tongue is connected to everything happening around it.
When I work with someone, I want to know:
How do they breathe when they aren’t thinking about breathing?
Where does the tongue go when they aren’t thinking about their tongue?
Can the lips rest together comfortably rather than being held together?
Can the jaw relax?
Can swallowing become efficient without constant conscious correction?
And can these functions begin to work together?
We all carry patterns that our bodies have practiced thousands and thousands of times, sometimes for decades. Changing those patterns takes awareness, repetition, patience, and time.
It also requires curiosity.
Instead of only asking, “What is the tongue doing?”
Sometimes we need to ask:
“What is happening around it?”
For me, breathing is an important part of that answer.
Because ultimately, I am not treating a tongue.
I am working with a person.
And that changes what I choose to look at.
This article is for educational purposes only and is not intended to diagnose or treat a medical condition. Persistent nasal obstruction, breathing difficulty, or symptoms of sleep-disordered breathing should be evaluated by an appropriate healthcare professional.