Breathing is something we do thousands of times every day, usually without thinking about it.
But breathing isn’t completely separate from the way we move. The diaphragm, rib cage, spine and surrounding muscles all work together during respiration, which is why breathing patterns can be of interest when assessing musculoskeletal function.
Long periods spent sitting, stress, pain and muscular tension can all influence the way we breathe.
So what role does the diaphragm play, and can changing the way you breathe be useful?
What is the diaphragm?
The diaphragm is a large, dome-shaped muscle situated beneath the lungs, separating the chest from the abdomen.
It is the principal muscle involved in breathing.
When you breathe in, the diaphragm contracts and moves downwards. This increases the space within the chest, allowing the lungs to expand.
As you breathe out, the diaphragm relaxes and moves upwards again.
The diaphragm attaches to the lower ribs, sternum and lumbar spine, giving it a close anatomical relationship with the rib cage and back.
Why are osteopaths interested in the diaphragm?
Breathing involves considerably more than the lungs.
The ribs, thoracic spine, abdominal muscles, diaphragm and a number of muscles around the neck and chest all contribute to respiration.
If movement in one area becomes uncomfortable or restricted, other muscles may have to work differently.
For example, someone experiencing back or rib pain may unconsciously change the way they breathe because taking a deep breath is uncomfortable.
Likewise, somebody who spends long periods sitting at a desk may become accustomed to a relatively fixed position through the chest and upper back.
An osteopathic assessment may therefore consider movement of the ribs, spine and surrounding muscles alongside the area where symptoms are being experienced.
What is diaphragmatic breathing?
During relaxed diaphragmatic breathing, the diaphragm moves downwards as you breathe in and the abdomen gently expands.
This is sometimes called “belly breathing”, although the air itself is still entering your lungs rather than your abdomen.
Breathing doesn’t have to involve the diaphragm exclusively. Movement of the rib cage is also a normal and important part of respiration.
The aim isn’t therefore to decide that chest breathing is “wrong”, but to encourage relaxed, comfortable breathing without unnecessary muscular tension.
Can slow breathing help you relax?
Slow, controlled breathing is widely used as a relaxation technique.
When we’re stressed or anxious, breathing can become faster and more irregular. Deliberately slowing the breath can help some people feel calmer and more relaxed.
This may also be useful when muscular tension is associated with stress.
Breathing exercises aren’t a treatment for every cause of pain or anxiety, but they are simple, free and can be practised almost anywhere.
How does posture affect breathing?
Try taking a deep breath while sitting heavily slumped forwards and then repeat it while sitting in a more comfortable, upright position.
You’ll probably notice a difference.
The position of the trunk can influence the movement available to the diaphragm and rib cage.
That doesn’t mean there is one perfect posture that everybody should maintain throughout the day. In fact, regularly changing position is generally more useful than trying to hold yourself rigidly in a supposedly perfect posture.
If you work at a desk, standing up and moving periodically gives both your musculoskeletal system and your breathing mechanics some variety.
Breathing, the ribs and back pain
The diaphragm attaches around the lower rib cage and to the lumbar spine, while the ribs themselves connect to the thoracic spine.
For someone experiencing back, rib or upper-body discomfort, it can therefore be useful to consider how these areas move during breathing.
Depending on the individual assessment, an osteopath may use hands-on techniques around the spine, ribs and surrounding muscles alongside movement and breathing exercises.
Try a simple relaxed breathing exercise
You can try this simple exercise at home:
- Sit or lie somewhere comfortable.
- Place one hand gently on your upper chest and the other on your abdomen.
- Breathe in slowly through your nose and allow your abdomen and lower ribs to expand comfortably.
- Breathe out slowly without forcing the breath.
- Keep your shoulders and jaw relaxed.
- Continue for several comfortable breaths.
Don’t worry about taking the biggest breath possible. Slow and comfortable is more important than deep and forced.
Stop if you feel dizzy or uncomfortable.
Osteopathy, movement and breathing in Cambridge
At The Form Practice in Hardwick, Cambridge, our osteopaths consider how different parts of the musculoskeletal system interact rather than looking only at the exact location of pain.
For some patients, movement of the spine and ribs or muscular tension around the chest and back may form part of that assessment.
If you’re experiencing persistent back, neck or musculoskeletal discomfort, you can book an osteopathy appointment to have your symptoms assessed.