Very often people wonder why I encourage breathing as an exercise. The common reason for questioning is that everyone knows we need to breathe in order to stay alive. While this is true, it’s also very common to develop poor quality breathing and thus compensations which affect how we function.
The diaphragm is the main muscle of inspiration. It is located mid thorax and separates our upper and lower trunk. It is typically described as a dome, but I think it looks like a parachute. There are 2 sides of the ‘chute’ which attach to the lumbar spine, the xiphoid process and ribs 7-10 and at the aponeurosis in the center called the Central Tendon. The ‘lines’ of the chute are called crura and attach at lumbar vertebrae 1-3 and their intervertebral discs. There are 3 openings in the diaphragm that allow the inferior vena cava and Vagus nerve, the esophagus, and the aorta to pass from the thoracic cavity to the abdominal cavity. The inferior vena cava (which brings blood back to the heart) and the Vagus nerve (which controls the muscles of the voice box, regulates heart rate, controls our fight or flight response and keeps the gut working normally) pass thru at thoracic (T) level 8; the esophagus (which moves food to the stomach) passes thru at T10 and the aorta(which brings blood toe the body) passes thru at T12. Anything that affects the regions where these structures pass thru can affect the function of the structure that passes thru.
In this video, Dr Kathy Dooley provides more information about how the diaphragm connects to internal organs.
The diaphragm is innervated by the phrenic nerve which originates at Cervical vertebrae 3-5. If there is inflammation, injury or dysfunction around C3-5 this can create dysfunction on breathing mechanics and decreased mobility of the diaphragm. This in turn can contribute to compression and irritation at any of the 3 passageways for the inferior vena cava, esophagus, or aorta. When this happens there may be symptoms of GERD, circulatory changes in your lower extremities and changes in digestive function and the fight or flight response.
Of course, if you have any medical issues it is always wise to be seen by a physician to rule out a serious problem. In addition to your medical workup , if you are experiencing reflux, lower extremity circulation issue (such as cold, blue feet or varicose veins) irritable bowel symptoms, if you’ve had an injury to the mid-cervical region or feel stiff in your mid-thoracic region, you may benefit from an assessment of your breathing mechanics.
Learning to correct faulty breathing mechanics can change your life. While the corrective exercises are relatively simple, they’re not easy. Getting the respiratory diaphragm to work efficiently often includes strengthening your neck muscles, your core and your pelvic floor as these all have an effect on the diaphragm. Including some form of breath work into your daily routine will likely be an ongoing process, but isn’t that better than having to be cut open for surgery or having to take medication with other side effects? Owning your breath, correcting postural stiffness and learning to move more efficiently not only improves your overall mobility but it will also allow a better quality of life with less internal organ distress.
For more information and details about the above, check out the resources below.
A J Eherer, F. N. (2011, December). ResearchGate.Net. Retrieved from Positive Effect of Abdominal Breathing Exercise on Gastroesophageal Reflux Disease: A Randomized, Controlled Study: https://www.researchgate.net/publication/51857290_Positive_Effect_of_Abdominal_Breathing_Exercise_on_Gastroesophageal_Reflux_Disease_A_Randomized_Controlled_Study?fbclid=IwAR1ZyGxCnhQkO0KsTN3CdyR2d-k4Z_iMrOjgx9DmKbUM9yYErefsMYvQD3A
Andrew Ming-Liang Ong, L. T.-T.-L.-T. (2018). Diaphragmatic Breathing Reduces Belching and Proton Pump Inhibitor Refractory Gastroesophageal Reflux Symptoms. Clinical Gastroenterology and Hepatology, 16:407–416.
Dooley, D. K. (2015, November 20). DOOLEY NOTED: Diaphragm Connections to Organs. Retrieved from YouTube: https://www.youtube.com/watch?v=i59XJjOAMBk&t=48s
Eherer AJ1, N. F. (2011, December 6). PubMed.gov. Retrieved from Positive effect of abdominal breathing exercise on gastroesophageal reflux disease: a randomized, controlled study.: https://www.ncbi.nlm.nih.gov/pubmed/22146488
Jones, O. (2018, August 13). Teach Me Anatomy. Retrieved from Teachmeanatomy.info: https://teachmeanatomy.info/thorax/muscles/diaphragm/
Shahid, Z., & Burns., B. (2019, January 11). NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470191/
Wake Gastroenterology. (2019). Retrieved from ake Gastroenterology : Your partner for better digestive health: https://www.researchgate.net/publication/51857290_Positive_Effect_of_Abdominal_Breathing_Exercise_on_Gastroesophageal_Reflux_Disease_A_Randomized_Controlled_Study?fbclid=IwAR1ZyGxCnhQkO0KsTN3CdyR2d-k4Z_iMrOjgx9DmKbUM9yYErefsMYvQD3A