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And Breathe....

And Breathe…about the diaphragm.



I could talk on and on about the diaphragm and the importance of the breath. Breathing is a function of the autonomic nervous system. It happens automatically. If we didn’t breathe, we would not be alive.


But there are many life circumstances that can compromise our breath. There are countless physiological processes that are affected when we do not breathe efficiently. I won’t go into those right now but will likely in a future writing.


What I see in my work as a hands-on practitioner and observer of the human form is that many have inefficient breathing patterns. Their breathing might be rapid, shallow, high into their chest or just localized in their belly. This can manifest from many realms – stress, anxiety, depression, pain, injury, posture, illness, surgery or not being ‘in their body’.


As I tell my clients “Breath is life”. The better, more efficient breath, the more vitality we have. When we are re-learning a pattern, we need to practice and re-teach the body and nervous system a new way.


Have you ever watched an infant breathe? Wow! Talk about a full body breath!


There is a lot written about ‘proper’ breathing. I have studied and regularly practice many forms.

I will often educate my clients about the importance of the diaphragm and how if we don’t breathe efficiently, we recruit other muscles to do the work of breathing. I find for me that understanding the anatomy and how things work help me to embody and heal parts that are not working well in my body. So I often share my experience with my clients.

Here are a few factoids about the diaphragm muscle…


The diaphragm muscle is a dome shaped muscle that sits inside your ribcage. It is the primary muscle of breathing.


There are holes in the top of the diaphragm where the esophagus meets the stomach, where the aorta and vena cava pass through to the lower body.


When we often don’t realize about the diaphragm is that the heart sits right on top of it – firmly attached by a sleeve of connective tissue. Every breath you take, the heart gets a little massage.


Another thing – attached to the underside of the diaphragm are quite a few organs – on the right side is the liver, the gall bladder, and the hepatic flexure portion of the large intestine. On the left side is part of the liver, the stomach, the spleen, and the splenic flexure portion of the large intestine. These organs are stuffed inside the bottom of the diaphragm and are attached via ligaments and connective tissue.


Remember that everything in the body is designed to move. All of the above structures should move with every breath and every movement.


When we have had an injury, illness, surgery, have ‘poor posture’, are a chest breather, hold in our emotions, or have a lot of stress, our diaphragm takes the impact. We then begin to use other muscles to help us breath – for instance, the scalene muscles. The scalene muscles attach to the top of the ribcage. So, if our breath is shallow we use our scalenes to fill the upper part of the lungs.

Do you have clients with chronic neck pain? Thoracic outlet? Pain at the top of the shoulders where the scalenes attach? Think diaphragm.


Do you work with clients who have had car accidents? Seat belt and air bag injuries to the ribs and diaphragm are very common and often overlooked. We tend to concentrate on the sore neck or back muscles.


Do you work with people who have broken their ribs? Ribs can get very sticky and forget how to move. They normally roll upwards with an inhale and downwards with an exhale. But they can lose their normal movement pattern. This can cause back or chest pain, decrease shoulder movement and of course diminish the capacity for breath.


Do you work with clients who suffer from stress or anxiety? One of my teachers said, “all stress and trauma go to the diaphragm”. Think about it…. When you are under stress, having anxiety, what is your breath doing? Likely it is held – either in an exhale or an inhale.


There are a variety of ways to bring more freedom to the ribs and diaphragm – techniques ranging from gentle to robust and from active to passive. I love self-help exercises and I also think there is great benefit from getting skilled bodywork especially if you have had an injury.


I am learning firsthand about ribs and breath. A few years ago, I took a dramatic bike fall. As I describe it “I tried to wrap my ribcage around my handlebars. Neither of which was very flexible”. It has taken a bit of bodywork and lots of personal attention to get the left side of my ribcage to fill with my breath. I share below one of my favorite exercises that has helped me heal.


If you want to breathe more efficiently, I find it helpful to remember the anatomy of the diaphragm. It is a dome and should move kind of like a jellyfish. The top of the dome descends (moves inferiorly) with an inhale. And rises back up with the exhale. It should move in the front, on the sides and in the back. Most people only get the front moving (if at all).


Here is one of my favorite Self-help breathing exercises...


One way to encourage the breath into the back body is to take up “Child’s Pose”.


If you are not able to rest your belly or chest on your knees, use a pillow or yoga blocks. Your legs or pillow or blocks will create resistance so when you breathe into your belly, the air is ‘forced’ into the back body. This helps to expand the ribs and train the diaphragm to breathe more fully – circumferentially.


You can also do this from a chair if your knees or hips don't like to be squished.



Take some deepish breaths into your belly. Notice the expansion into your back body – your back lower ribs.


Notice if it is easier to breath into one side vs the other. If for instance you do not notice any movement in your left back body, use your attention to encourage the air into that side. Another option is to increase the resistance in the front by adding a stiffer pillow or use a yoga block. Or you can extend your arm overhead and do a small side bend and then breathe into that tightness.


Due to the stubborn nature of my rib injury, I use the yoga block tucked into the front side of my ribs – sometimes just on the left side. This restricts front breathing to encourage back breathing. And I happy to say that my ribs are moving more freely and I no longer feel like I am having a heart attack when I am doing hearty cardio sports such as skate skiing and mountain biking.


This is just the tip of the diaphragmatic/thorax iceberg. There are so many layers to understand. There are so many tiny little joints in the thorax! But more on that later.


Would you like to learn more about this all important often forgotten area of the body?


Elizabeth McClain and I will be teaching the Thoracic Synthesis class September 9-11, 2023 in Bend, Oregon.

We will be addressing the structures that I have discussed above and many others. You will learn a variety of approaches to release the diaphragm and all muscles of breathing. You will learn to mobilize the ribs including the all-important first rib. We will draw from our many years of accumulated experience and education (6 decades!) and share from the worlds of osteopathy, orthopedic massage, visceral manipulation and craniosacral therapy. The techniques you will learn will change the way you see the body and uplevel the way you work with your clients with pain.

Registration is now open and the class is filling. Come play!








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