There is a lot of misinformation out there on diaphragmatic breathing. Considering how essential proper diaphragmatic respiration is to our overall health and success with a Postural Restoration Institute physical therapy program, we wanted to clear it up a bit. 

Diaphragmatic breathing is NOT belly breathing!

The diaphragm is our primary respiratory muscle and is positioned at the bottom of our ribcage. It attaches to the inner portion of our lower ribcage and the front portion of our lower (lumbar spine). At rest, it is supposed to be in a domed position within the ribcage. When we breathe in, the diaphragm contracts and flattens. This causes negative pressure within the chest and allows us to take in air. When we breathe out, the diaphragm relaxes and returns to its domed position (or at least it’s supposed to) and the air is moved out of our lungs. In order for this to happen, the internal obliques and transverse abdominis (deep abdominal muscles) need to be active to keep the lower ribcage in a proper position. For a more detailed explanation of this action as well as some cool visuals, check out our previous blog Balloons- Quite Possibly The Most Underrated Therapy Tool.

So, what is diaphragmatic respiration supposed to look and feel like? For a relaxed inhale, the lower ribs should move genially out toward the sides, or laterally. Then, the lower ribs will move slightly forward with the abdomen moving along with it in almost a 1:1 ratio. During a deeper breathe, the upper chest will rise slightly after the the lower ribcage and abdomen have begun their movement. 

This can easily be felt by lying on your back and placing one hand on your lower ribcage (just below your breastbone) and another hand on your stomach above your belly button. Be sure to do this when you’re either sleepy or meditating as it is more likely you are naturally diaphragmatically breathing at these times. Feel the gentle lifting and lowering of your lower ribcage and abdomen almost in unison. You should not feel one area moving significantly more than the other, particularly your abdomen moving more than your ribcage.

In order to belly breathe, those essential abdominal muscles must be turned off to allow the belly to be loose enough to take in breath. Once those muscles turn off, the diaphragm loses it’s foundation on which to work. Essentially, when our breath fills our belly, there is no way we are actually using our diaphragm. Additionally, if you think about it, it just doesn’t make sense to breathe this way. There is no lung tissue in the belly. Therefore, why would be focus on moving air into an area that our lungs are not?

If you lie on your back and notice that your belly moves first or farther than your lower ribcage, you need to correct the issue right away. Poor diaphragmatic breathing can cause anxiety, lower back/neck pain, pelvic floor or women’s health dysfunctions (such as incontinence, pain with intercourse, constipation, etc.), GI dysfunction, and many other problems. Typically, individualized, guided restoration of the diaphragmatic breath is needed. Simply doing online research and trying to fix the problem yourself will likely lead you to more misinformation or may cause you to adapt a new, non-diaphragmatic breathing pattern such as overusing the muscles of your neck. Diaphragmatic restoration can be achieved in as little as one visit with the therapists at Integrate 360 Physical Therapy so give us a call today at 314-733-5000!

Written by Lesley Callaham, MPT, PRC on October 16, 2018