Diaphragmatic Breathing

Diaphragmatic Breathing -

“Breathe Yourself Into Alignment”

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Centered Physical Therapy

If you have come to see me for Physical Therapy, I might have told you that you are a “neck breather” or “you do not know how to breathe.” For those who have not come to my office you might be thinking, what the heck does that mean? And why do I care? You thought you were here to treat your hip, back and neck pain? Let’s first learn about Diaphragmatic Breathing.

Did you know?

Did you know that faulty breathing can actually be the reason you are in a chronic state of pain, which is leading to your hip, back and neck pain? Do I have your attention yet?

Let me explain…

Our “true core” is ultimately related to the diaphragm. If we cannot efficiently breathe, we cannot efficiently move.

The diaphragm is a respiratory muscle that allows us to utilize full lung capacity. Your diaphragm is the the breathing muscle that keeps us alive and its only function is to ensure we continue to breathe.

Did you know?

We take 20,000 breathes a day, which means it is reinforcing our posture with each breath. For most of us this is reinforcing our bad habits and poor postural habits. The body has one goal and one goal ONLY: to figure out a way to create the space needed to get enough air into our lungs. That’s it. If we aren’t breathing we are dead. The “twisting” and “tweeking” our body does to ensure adequate air inhalation is vital for survival.

These changes made by our body is how posture begins to change (mostly for the worse). The result = tight tissues and excess tension in our body. As we place demands on our body, it is only a matter of time before some parts of our body begin to break down.

Let’s get specific…

When your body becomes twisted, the tissues begin to work overtime. The body then has to recruit additional muscles to help accomplish the task of breathing. Look at it this way, it’s like playing on a team, you ideally want the strongest and most talented players to be on the floor because you have a better chance of winning right? What would happen if the first string of players couldn’t play anymore or got hurt, then you have to count on the second, third and even the fourth string players to beat the opponent? More specifically if you have a 5’6″ power-forward posting up against a 6’2″ center- who do you think has the advantage? Same idea here with the body, if you have to utilize smaller, less efficient muscles to accomplish a task that they are not designed to do, those muscles will become angry and less capable of completing the task properly. Essentially, adding to the overall stress of the body.

The posture:

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The twisted position that is often seen for those who do HAVE tension or pain include an arched lower back and ribs that flare out forward.  The pelvis is tipped more forward and front neck muscles cause your head to be pulled forward. This posture puts your stronger “first string” muscles on the bench and recruit the the smaller, less capable muscles into action.

Let’s go back to the diaphragm. This structure is “supposed” to be a domed or rounded position inside your ribcage that acts as a pump to get air in. If your ribs are flared up and outward, that means your diaphragm is now flattened and unable to efficiently pull air up into your lungs. The result, those weaker muscles working harder, viola! There is your neck pain, shoulder pain, and back pain!


Feeling is knowing


Try this:

  • First, take a deep breath in and hold if for 10 seconds. Look at your posture, what do you see? What do you feel? This is call a state of inhalation, which puts your body in an extended state. If you are unable to get the air out, your body now will stay in this position regardless of what you are doing and reinforce this posture 20,000 times a day.


  • Now, try exhaling or blowing all the air out and hold for 10 seconds. Look at your posture now. Hopefully you are seeing more ribs down. This is a position that most of us are not used to and it might even be difficult for you to remain in this position for 10 seconds.

In order to change your posture, you first must learn how to EXHALE!

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I invite you to challenge yourself and observe your breathing during the day. The body strives to get air in, but rarely do we even get enough air out. The optimal position of the diaphragm will change your posture and ultimately decrease your pain.

Improved Breathing = Reduced Stress

The twisted upper ribcage also produces compression of the sympathetic nervous system. Located in the back of the spine is the sympathetic ganglion. This is responsible for the “fight-or-flight” response. It is a system that helps with stress. The ribs flaring in the front creates more space, which means the opposite is true with the ribs in the back.

When the ribcage in the back is compressed toward the spine, less space is available causing compression on the ganglion.  The compression causes the body to live in an up-regulated state. This means elevated heart rate, increased anxiety and increased fatigue. It’s basically means you are unable to relax.

When you allow for repositioning of  the ribcage, the pressure is now relieved and the nerves are turned off and you can relax.


Diaphragm Breathing

  1. Lie down on the ground with your legs bent
  2. Place your hands on the sides of your belly below your ribs
  3. Attempt to bring the air in sideways and toward the floor INSTEAD of letting your belly come up (it will rise, but try to not let it be the only place the expansion happens)
  4. This will allow you to maintain your abdominals engaged as you bring air into the chest cavity

**Breathing this way will allow you to elongate your spine and gain some stability while maintaining a “true core.”**

How to “UNTWIST” your upper body

Plank Exercise

  1. Start on your hands and knees with your shoulders over your hands and hips over your knees. Feet are hip width apart. Nose in line with your fingertips
  2. Tuck your pelvis under so your back rounds up – Feel your abdominals engage. Remain in this position.
  3. Push your hands firmly into the floor and feel your shoulder blades engage. (TIP – only push and round as much as you can tolerate and do not let your shoulders hike up toward your neck. Keep them “tucked into your back pockets”)
  4. Breathe in through your nose and out through you mouth. Each exhale (air out) push more with your hands if able and tuck more to engage abdominals. Hold the exhaled position for 3 seconds and then repeat 5 times.
  5. Position can be advanced to toes (extending legs out) as long as you hold the pelvic tuck and rounded abdominal posture.

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Deanna Elliott, PT, DPT

(541) 237-4136

Centered Physical Therapy


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