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Chronic Pain

Diaphragmatic Breathing Supports a Healthy Body and Mind

How to use your breath to help organs function properly and manage chronic pain.

Key points

  • Many think the act of breathing is centered in the throat and chest, but it is integrated throughout the abdomen, spine, and pelvic floor.
  • Diaphragmatic dysfunction can lead to complications like abdominal pain, incontinence, painful intercourse, and pelvic dysfunction.
  • Breathing deeply and effectively can help ease some of the conditions associated with diaphragmatic dysfunction.
Antonio Guillem/Shutterstock
Source: Antonio Guillem/Shutterstock

This post was written with contributions from Margaret Heaton-Ashby, LMFT, and Kelsey Tunney, DPT.

When you think about your health and specifically any dysfunction in your body, you probably don’t even consider the diaphragm as one of the top five organs to assess. But the diaphragm is a large, specialized muscle that is oftentimes overlooked, especially for something so instrumental and interconnected with other vital systems of the body.

Most of us typically don’t have enough mobility through our trunk; we instinctually protect everything within our ribcage and won’t naturally open up or relax this space. Additionally, we aren’t taught to properly breathe out of our diaphragm. Instead, we use accessory muscles in our neck, specifically the front of the neck. This overuse of those small muscle groups can cause strain and tightness. Oftentimes, we consider breathing to be centered in the throat and chest exclusively. However, we can and should look in the anatomically opposite direction, because the way we breathe is actually integrated throughout the abdomen, spine, and pelvic floor.

When we think about the core, we might think about the abdominals in the front of the belly. The true core is shaped like a soda can, 360 degrees with a top and bottom. So, the core is all of the muscles of the belly, including the front and back walls, with the top being your diaphragm and ribs. The bottom of that is your pelvic floor, the bowl of the pelvis, and all of the muscles that line the bottom of this bowl. This entire system is connected. Therefore diaphragmatic dysfunction can lead to so many other pains and complications. This includes abdominal pain, incontinence, painful intercourse, pelvic dysfunction, and low back pain, among many others.

Breathing deeply and effectively can help ease some of these conditions. On one end, it will help the mobility of the pelvic floor. This is because you will naturally do a little Kegel with a deep exhale. At the very end of a deep breath, you will feel the pelvic floor move naturally up and in as you run out that last bit of air. You shouldn’t be actively trying to do a Kegel; this should be a natural contraction with the breath.

On the other end, when you inhale, you start to get the ribcage moving. Most people are so restricted in their ribs that it can cause pains in the thoracic spine, neck, back, and belly. A good inhalation should move air up into the ribcage, forcing the lungs out and open like you are trying to expand a balloon in all planes of motion. This gets the ribs "unstuck" and more functional from that protective immobile state.


If you would like to work on your core, mobility, and strong breaths, try this sequence of exercises to feel your breath expand different areas of your core. Do this by laying on a comfortable surface, though it can also be done comfortably sitting.

Note: Please don’t get frustrated by these exercises. You have been breathing all day every day for decades and some of these are difficult for many people. Meet yourself right where you are and move on from each stage as you master it, beginning with step 1.

  1. Belly Breathing—Place a hand over your belly button and take a big, slow, deep breath in. Let your diaphragm expand down into the belly. Picture yourself blowing up a balloon inside of your belly. Relax to release the breath and feel your hand naturally fall as your belly balloon deflates. Repeat several times.
  2. Lower Lateral Ribs—Move your hands to your natural waist on each side. Breathe in deep, trying to get your hands to go outward while filling your belly balloon. This is going to start mobilizing your ribcage while still reaping the benefits of deep breathing. Repeat several times.
  3. Lower Back Ribs—If seated, slide your hands backward from the previous spot. If laying, then simply try to feel yourself pressing against the ground or surface you are lying on. Inhale deeply and let the ribs expand into the lower back. You should feel your hands moving outward from the spine, or if lying you should feel the lower ribs pressing into the ground with each inhale. Release the breath, then repeat several times.
  4. Front of the Chest—Place one hand on your heart. Start to inhale deeply, this time inflating a balloon into your chest. Feel your hand rise away from the spine as you open your ribs with each inhale. Relax the breath out, and repeat.
  5. Upper Back—This is easiest done lying down so you can feel the push against the ground from your shoulder blades. With your deep inhales, expand the lungs up and back opening the space between your shoulder blades. By now, you should be able to feel your lungs capable of expanding in a 360-degree range, and your ribcage should feel more open.

If you can’t get through all five of these steps, it's okay. Even spending several minutes a day on step 1 will help with blood pressure, anxiety, colon activity, and more. If you do get stuck on step 1, it could be an indication that you have restrictions in your tissues and ribcage mobility. If this is the case, seek the help of a physical therapist to help you get moving more efficiently.

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