The Amazing Diaphragm: How Your Breathing Predicts Health

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The Amazing Diaphragm: How Your Breathing Predicts Health

The respiratory diaphragm measures mere millimeters in thickness, but its influence can exact multi-system effects that ultimately dictate your long-term health and well-being. Understanding the anatomy, physiology, and mechanics of deep diaphragmatic breathing, especially through yoga practice, can transform your health.

The evidence-base that provides the link between diaphragm use and systemic health is strong, which means if you are experiencing any type of pain and impairment – it can be vital to see a therapist who assesses diaphragmatic function.

Perhaps the strongest indicator of a person’s health can be found through observing the breath. Learning to control the breath can also have the quickest effect on your overall health, especially the main driver of it: hormonal regulation (read: breathing better means quicker weight loss, better digestion, less back pain, improved mood, increased libido, and better sleep).

Read on for the latest information on the relationship between diaphragmatic function and overall health:

What Science Says About the Diaphragm and Health:

“The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing – an experimental study.”

  • Pain Connection: Not just breathing in general, but a very specific way of breathing, can reduce pain and improve neuroendocrine function.

“Anatomic Connections of the Diaphragm: Influence of respiration on the body system.”

  • Digestion Connection: The diaphragm is connected to your colon by the phrenicocolic ligaments – which means, if you aren’t breathing well, likely, your digestion is going to be affected.
  • Cardiovascular & Cardiopulmonary Connection: The diaphragm is connected to the vagus nerve by way of the phrenic nerve, which means, if you want to control your heart rate, pulse, and blood pressure without drugs, then the diaphragm is the FIRST STOP to better cardiovascular and cardiopulmonary health.
  • Dental Connection: The diaphragm is supplied by the phrenic nerve, which in turn affects the trigeminal ganglia, which means, improper breath habits can even result in dental pain.
  • Sleep Apnea or Poor Swallowing: Sleep is another big predictor of future health, and the diaphragm is intimately connected with the trigeminal system via the hypoglossal nerve, which supplies the floor of the mouth.

“Can meditation slow rate of cellular aging? Cognitive stress, mindfulness, and telomeres.”

  • Training breathing through meditation, also has another BIG plus: preservation and maintenance of telomeres. What are telomeres? They are part of your DNA. Telomere degradation is associated with increased cancer risk and premature aging, but meditation and breath training can reduce your risk of both cancer and premature aging.

“Physiology of long pranayamic (yogic) breathing and how it shifts the autonomic nervous system.”

  • Slow, deep, belly breaths can improve your stress response. It’s important to be aware of your stress response and improve upon it – the stress response has been correlated with hormonal dysregulation, sleep problems, PTSD, chronic depression, chronic pain, metabolic syndrome (i.e. obesity, diabetes), and cardiovascular disease. In short – if we want to enjoy a long, happy life, we need a healthy stress response. The quickest way to do that is through the breath.

Here is an informative post by women’s health therapist, Dr. Jessica Reale, PT, DPT, WCS, which I encourage you to read: Six Reasons Why the Diaphragm May Be the Coolest Muscle in the Body. It also includes helpful instructional videos from Julie Wiebe, PT. Highlights include:

  • Our diaphragm contracts through breathing – but it is under both conscious and unconscious control.
  • The diaphragm (if used correctly) can improve spinal mobility, because of its intimate connections to the spine in multiple places.
  • The diaphragm is a KEY member of a group of muscles which determine and control postural stability, which means treating back, neck pain, pelvic pain, and a host of other conditions, requires addressing breathing first.
  • Retraining the diaphragm can reduce back pain and urinary incontinence. That’s a HUGE reason to get your diaphragm checked out.
  • Slow, deep, belly breaths can reduce pelvic pain. Not only can diaphragmatic breathing reduce pelvic pain – but it can reduce pain felt with any condition, including fibromyalgia, headaches, and even childbirth.

Here is one more article with a fantastic graphic of how breathing affects health. Clifton-Smith T, Rowley, J. (2011). “Breathing pattern disorders and physiotherapy: inspiration for our profession.”

Thinking Beyond Physical Structure

Finally, here is a fabulous little ditty from Dr. Matthew Taylor, PT, PhD, author of Fostering Creativity in Rehabilitation, that welcomes us to transform our typical frame of reference on the diaphragm’s status.

As we discover the intimate relationships that make up postural control and stability (https://www.youtube.com/watch?v=HTkFuPLZ3Uk) , my concern is that we slip into a mechanistic perspective of tuning the instrument without truly knowing “who” is the instrument. By that I mean, it’s fairly easy to hold onto the pelvic floor as something more than a sling of muscles and sustain it’s very personal nature to the being. The diaphragm, well that’s just in the “guts” and we can mash, perturb and facilitate it like a stubborn carburetor, forgetting it’s behavior merely mirrors the deepest state of the person. And that new diaphragm…the glottis (read more: Effect of Airway Control by Glottis Structures on Postural Stability (2013), the third member of this merry or not-so-merry trio…that’s our voice, our way of being known in the world. So please colleagues, hold the intention that we humans are being breathed by something so much more mysterious and bigger than we can understand.
We aren’t the breathers, and as such, humility and gentleness toward those we are privileged to sit with should rule our practice. Then marvel at the return of the rhythm that is every human’s dignity when you’ve supported them in sensing and claiming all three.

While there are many more important structural connections that make the diaphragm such a well-connected superstar, we need to remember the wise words and work of Stephen Hawking, which encourage us to keep our minds open to the greater ever-changing, design of the universe – we don’t yet fully understand it, much less our diaphragm. It is capable of much more than we have yet discovered.

But for now, the take-home message is that working with a therapist can help you gain control of the diaphragm and use it to affect every system in your body, as well as your mind – and thus, improve your present and future health.

Breathe Better Now

Get started with these simple instructions below:

  1. Recognize the “red flag” signs of poor breathing:

Poor breathing, also called, shallow, thoracic, chest, or clavicular breathing, “looks” like this:

  • On inhale, the chest will heave upwards and expand with little or even reverse (pulling in) expansion in the belly area. A poor breather will breathe through the mouth instead of the nose. The muscles of the neck may pop or stand out during inhalation. The inhale will be short and not very long.
  • On exhale, the belly will expand instead of relaxing in a passive drawing in action.

This type of breath does not allow for proper oxygen exchange because it only utilizes the upper portions of the lungs and does not allow for use of the respiratory diaphragm.

  1. Know what a proper breath looks (and feels) like.

The gold standard breath needed during labor and delivery is the belly breath, also called the abdominal or diaphragmatic breath.

  • On inhale, the belly expands naturally and without force. This is because the diaphragm must descend and shift the abdominal contents slightly outward and downward. The same action can be felt in the pelvic floor, which is described by physical therapist Julie Wiebe as a “piston effect.” (video) There should also be no tension in the neck, face, or shoulders.
  • On exhale, the belly naturally and passively retracts as the diaphragm returns to its original position.
  • Normal breaths per minute (BPM) is around 12-15. Yogic breathing can teach you to lower your respiration rate to as little as 2 BPM. However, typically I will aim to have patients attain 4-6 BPM during yogic breathing sessions. As little as a few minutes of deep breathing can begin to change your stress response and improve your health.
  • Also, don’t be afraid to vocalize. I won’t get into specifics, but trust me, allowing yourself to simply even sigh or lightly moan through an exhale, can deepen the systemic experience and effect of the breath on your psyche.

Free Resources

Free Guided Breathing & Meditation Podcasts with Ginger were recorded live in the Blue Ridge Mountains of NC.



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