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The Diaphragm: The Ultimate Multitasker

If you've ever found yourself lying down in a yoga class, you may have been challenged to place one hand on your heart and one on your belly. Then the cue follows to "breathe air into your belly" so that your belly hand rises towards the ceiling and your heart hand remains relatively still. Other than perhaps frustrate you or cause some confusion, what is

the purpose of this?

Belly breathing, or diaphragmatic breathing, means that as you inhale, your diaphragm moves down towards your pelvis which causes your belly to expand outwards if the belly muscles are relaxed. Ideally, your trunk expands outwards in a 3-D fashion; front, sides, and back but when you're lying down it is the easiest to see your belly move. Obviously, air isn't actually going into our bellies or we would be in big trouble. As the diaphragm moves down, it allows air to be collected into our lower lungs. The ability to belly breathe is an incredibly important skill because it addresses the excursion and strength of the diaphragm. The diaphragm is an amazing muscle that plays so many roles in our body as well as our general well-being. Let me explain.

The diaphragm lives up here. This is as if I'm looking up your ribcage while lying on the ground. It has ligament and fascial attachments to the xiphoid process (tip your sternum/"chest plate"), your ribs, your psoas ("hip flexors"), and your lumbar spine (low back). It is in the shape of a dome with the convex side facing upwards towards your head. When you inhale, the dome flattens as it moves down towards your pelvis and when you exhale, it returns back to its dome shape.

The diaphragm doesn't always get used to its fullest potential. Emotions that are usually considered negative, pain, or past trauma may cause us to take less breaths using our diaphragm and instead we become what's lovingly called a "chest breather". That is what happens when only your chest expands or elevates towards your head as you inhale and the diaphragm with the belly aren't moving much at all. Chest breathing requires more work from muscles in the neck. This signals "uh-oh" to your brain, which leads to more chest breathing and tighter neck muscles. Quite the cycle to be in!

Why should we care about the lovely diaphragm? It is the ultimate multitasker. I mean, if I was this efficient when I multitasked, I would multitask every day all day! If you've ever received an email reply from me in the middle of the workday that made no sense, then you have witnessed just how good I am at multitasking... Your diaphragm is part of the dream team that is known as your core. In studies, it has shown that the diaphragm contracts with each step we take to aid in stability of our trunk. For that same purpose, it also helps with our posture and postural control. It acts as a pump to keep the lymphatic fluids (immune system stuff) and blood moving through our veins. Your heart is more efficient from diaphragm movement, which increases cardiac output (how much blood goes out per contraction) and decreases blood pressure. As it moves down, it massages our belly organs which aids digestion. It helps us swallow, throw up, and take a poo. Breathing with the diaphragm (specifically long exhales) helps stimulate our vagus nerve, which is the shining star in our parasympathetic system. This system is known for rest, digest, and heal.

Now that you know some of the many functions the diaphragm does, you can imagine all the issues that may exist when it isn't used well. This can mean the diaphragm doesn't move downward very well when someone isn't taking a nice full inhale and/or the

diaphragm doesn't move upward very well when someone doesn't take a nice long exhale so it is sitting too low. I frequently see both of these scenarios in the clinic! I have also seen poor neck position affect how well the diaphragm is recruited, since the nerve that supplies the diaphragm comes from the middle of the neck. Fascinating! Symptoms can include neck pain, shoulder pain, back pain, pelvis pain, incontinence (difficulty holding urine when you have to pee or while laughing/sneezing/coughing), irritable bowel syndrome (IBS), and anxiety.

Alright, you get it! The diaphragm is super cool! How do we know if we are using it properly? This is what you do. Stand in front of a mirror and just breathe like you always do. Watch. What are your neck muscles doing? What is your chest doing? What is your ribcage doing from front to back and side to side? What is your belly doing? What is your low back doing? Are you clinching your jaw? If it's hard to tell, take the time to place your hands on one area at a time with each inhale/exhale cycle. What is moving or not moving? Do some muscles get harder or tighter with each inhale? Remember, the pattern we would like to see is a 3-D expansion of your trunk: all sides of the ribcage expand outward during an inhale. At rest, there should be minimal chest rising upward towards your head and the neck muscles should remain relatively soft.

If you would like to show your diaphragm some love, here are some things to try (all inhales are to be through the nose):

  • Lie on your back with knees bent and feet flat on the floor. One hand on your belly, the other hand on your heart. Can you allow your belly hand to rise more than your heart hand? Then, can you let both hands raise together?

  • Lie on your back with your knees bent touching each other and feet flat but wide apart. With each inhale, can you feel your pelvic floor (area between your rectum and your front private part) relax or let go towards your feet? As you exhale, does your pelvic floor gently elevate?

  • In child's pose position (while on the floor, sit back towards your heels with your big toes touching and knees spread apart while reaching both arms forwards and resting your head on the floor or on a pillow), can you inhale and feel your low back and back of the ribs expand?

  • Practice the exhale: Blow out all of your air by blowing into a balloon as long as you can. Or, see if you can make your exhales longer than your inhales by counting the time it takes to perform each one.

  • Reinstate your natural breathing rate: Lying on the floor, exhale all of the air out of your lungs until there's nothing more to breathe out. Then patiently wait until your body wants to take the next inhale naturally.

  • Lying on your side, can you inhale into the side of the ribs that are facing up towards the ceiling and feel them expand?

  • Can you experience a 3-D expansion of your ribcage while lying down, on hands and knees, in sitting, and ultimately in standing?

  • Here's a fun experiment: What happens to your breathing when you slump in your chair? How about when you stand like a military soldier with your chest up? What about when your head is really far forward in front of your shoulders? What about when you're on your phone or your computer? Where is the expansion with each inhale? What is your jaw doing?

Child's Pose,

although hands are traditionally flat on the ground and in line with the shoulders

If any of these tasks seem foreign or are just difficult, you are not alone. I help people tap into their diaphragm's potential every day! For my breathing explorers, find some breathing exercises on YouTube from a reputable source, like this one made by a physiotherapist with an amazing accent. For all my readers out there, check out Breathe by James Nestor. For anyone, schedule an appointment if you would like to dive deeper. Happy breathing!

Information for this post was gathered from this research article.

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