The Diaphragm - Not just for Breathing

In a previous article I discussed the proper mechanics of the diaphragm during normal respiration. This article is to build upon those principles and to inform you of current research just released that shows the importance of proper diaphragm function as it relates to neck and low back pain.

Karel Lewit, MD, practicing in Prague, Czech Republic, is considered by many to be “The Father of Manual Medicine” and I am one that agrees 100%. His knowledge and clinical expertise has been and continues to be an inspiration to me. Dr. Lewit has said for year that “if breathing is not normalized—no other movement pattern can be”. This statement made years ago is finally being brought to the forefront through research performed by his protégé Pavel Kolar, PaedDr., PhD.

In the December 2011 Journal of Orthopaedic and Sports Physical Therapy, Dr. Kolar published a study that showed that individuals with Low Back Pain had altered diaphragm activity when compared to individuals that did not have low back pain. Specifically the diaphragm did not move as much and also had a higher resting position in those with Low Back Pain when compared to those that did not. What this study shows is that how the diaphragm moves during normal inhalation and exhalation has an effect on how much “core stability” we truly have. Before we can move our arms or legs we have to have a stable core and proper diaphragm activation is the first step.

So now hopefully you are thinking “what is proper breathing because I’m obviously alive and thus I must breathing ok….right”?? Well…not necessarily. If you place one hand on your chest and one hand on your belly and take a normal breath in you should see your belly hand rise as we breathe IN. If your diaphragm is working correctly your belly should expand during inhalation due to the diaphragm lowering and increasing the pressure inside your abdomen. The increased pressure in our abdomen helps support our core which is the best way to prevent low back injuries. If we do NOT breathe with our diaphragm, then what are we breathing with? In most cases we are using our neck and chest muscles to help “lift” our chest more than we are “dropping” our diaphragm and causing excessive neck tension and poor core stability --- Thus the neck and low back pain.

Normal breathing will decrease neck tension and increase core stability in individuals that do not breathe as described above…..just as Dr. Lewit’s quoted, “If breathing isn’t normalized – no other movement patterns can be “. If you want to watch someone with normal breathing watch a toddler! As I watch my baby boy breathe, his breathing pattern is correct and it gives me a good reference for what I want to see in my patients.

If you have tried traditional care, including chiropractic, physical therapy, or medication and still have pain or just are looking for a highly effective option without severe side effects, give us a call at 615-302-4747 or visit As always, Get In Motion Spring Hill.