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The Diaphragm: What is it? How can we improve it?

The Diaphragm is a large and complex muscle with multiple attachment points, meaning it has widespread effects around the body. Its efficiency will affect areas both above and below the muscle and our posture will influence how well the diaphragm works. Adults breathe on average 12-20 times a minute which means around 20,000 breaths a day. Respiration is vital as it ensures the body receives enough oxygen to function and also removes waste products such as carbon dioxide. As the diaphragm is the primary muscle used in respiration it is important we know how to improve its effectiveness.

The diaphragm is a thin skeletal muscle that sits at the base of the chest and separates the abdomen from the chest. It is a dome-shaped muscle that is located below the lungs and heart and is the primary muscle used in respiration. It has 3 origin points that stem from the sternum, ribs and the lumbar spine, which then insert into the central tendon of the diaphragm. There are also three openings in the diaphragm which allows certain structures to pass through between the chest and the abdomen.







There are two domes of the diaphragm, the right dome is positioned slightly higher than the left due to the position of the liver underneath. The diaphragm has two surfaces, thoracic and abdominal. The thoracic diaphragm is in contact with the membranes of the heart and lungs, the pericardium (a fibrous sac that encloses the heart and great vessels) and pleura (a sac around the lungs). The abdominal diaphragm is in direct contact with the liver, stomach and spleen.



As mentioned previously the diaphragm is the main muscle of respiration.

  • When the muscle fibres contract, the diaphragm is flattened and air enters the lungs.

  • During inhalation the external intercostals (muscles between the ribs) aid this movement by contracting and lifting the rib cage.

  • When the diaphragm relaxes it domes and air flows out of the lungs.

  • During exhalation the internal intercostals contract and lower the rib cage.




Poor alignment and posture with forward head carriage and slumped thoracic spine means your diaphragm cannot contract and relax as effectively. ​

  • As your body still demands oxygen it will recruit back up breathing muscles around the chest and neck and create unnecessary compensation.​

  • The neck muscles (Sternocleidomastoid and scalenes) are not efficient or designed to be used as respiratory muscles constantly throughout the day. ​

  • They will fatigue and can create trigger points that will contribute to tightness, neck and jaw pain and headaches.​

  • These back up (accessory) muscles only work the upper lungs and so only encourage short and shallow breaths, so less oxygen is taken in and contributes to feeling short of breath, which is common in stressful situations.

Therefore, it is important to work on adapting our posture to allow the diaphragm the optimum position to work effectively. This can be done in a variety of ways, one of them through foam rolling the thoracic spine and incorporating movements such as extension and side flexion. A massage ball or tennis ball can also be used into the pectoral (chest) muscles as tightness in these muscles can cause the shoulders to protract and round forwards. It is also important to consider the lumbar spine and the support it has anteriorly from your core muscles, so it is beneficial to work on strengthening the core stability muscles to provide support and also allow the diaphragm to contract and relax efficiently.





As the diaphragm is a skeletal muscle this means it can be exercised with the use of. diaphragmatic breathing. Improving diaphragm strength will increase lung efficiency by using more of your lung capacity and increasing your oxygen uptake. It can also reduce blood pressure, heart rate and stimulates the vagus nerve and the parasympathetic nervous system which can encourage relaxation and reduce stress.​


Diaphragmatic breathing can help with conditions that effect how you breathe such as, asthma, anxiety, COPD and stress.


How to practice diaphragmatic breathing:

  • Lie on your back with one hand on your chest and one on your stomach. ​

  • Breathe in through your nose, ensuring your stomach is pushing up rather than your chest.​

  • Then slowly exhale through your mouth, feeling your stomach lower and making the exhale a few seconds longer than the inhale.

  • Repeat 5 times.



Due to location of the diaphragm and the abdominal contents there is a relationship between the diaphragm and the pelvic floor due to pressure changes that occur during respiration.

  • When we breathe in the diaphragm flattens, which pushes the abdominal contents down, this means the abdominal muscles tighten slightly and the pelvic floor drops and lengthens.​

  • Then when we exhale the opposite happens, the diaphragm relaxes and domes up, and the pelvic floor contracts.​

  • If we have to cough or shout, exhale forcefully, this means the pelvic floor has to contract more, this is where people may struggle with continence.

So we can also learn to improve the control of the pelvic floor through diaphragm breathing.

Start by practising the diaphragmatic breathing, then after a few breaths bring your attention to the pelvic floor. As you breathe out squeeze the pelvic floor muscles and as you inhale relax them.

One of the ways to work on incorporating breath into exercise and using it to control movement is through Pilates. At The Studio we offer clinical one to one Pilates, group classes and also strength and conditioning sessions. We can also help to improve posture and reduce pain and tightness that can build up over time from being in prolonged positions. If you would be interested in booking or would like to enquire then please contact our reception via email or call 01628639532!



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