If you look at my 5 stages of rehabilitation, you’ll see that I have in stage 1 ‘master the skill of optimal breathing’. This is an extremely important part of good movement because, as described by Bordoni et al (2016):

‘Diaphragm’s activity is fundamental in the maintenance of posture and body position changes and influences the pain perception, usually decreased during the inspiratory apnoea.’

They also report a link between depression and diaphragm dysfunction, which can be improved with exercise and manual therapy. Pain perception can be altered through better breathing quite simply because the brain gets more oxygen which allows it to function optimally.

The diaphragm itself is a large muscle and attaches itself to the sternum, lower ribs and low back vertebrae. Low back pain can very often be associated with stress, which can lead to poor breathing, which leads to a tightened diaphragm, which clenches the low back and reduces movement.

Whenever there is any reduced movement in the body, it negatively impacts on the whole system and the diaphragm is no exception.

Common causes of diaphragm shortening include (among others):

  1. Incorrect breathing habits
  2. Stressful situations at work or home
  3. Injury
  4. Surgery
  5. Medication
  6. Exams
  7. Illness
  8. Sleep apnea
  9. Overload in activity

Optimal breathing also means optimal oxygenation and this can ONLY be achieved through NASAL breathing. A lack of good oxygenation can manifest itself in many ways:

  1. Headaches
  2. Body aches and pains
  3. Heart conditions
  4. Grinding teeth
  5. Sleep apnea
  6. Dizziness
  7. etc

A lot of injuries can impact the diaphragm and it can go unnoticed or unaddressed by your treatment provider. But you can take the power into your own hands right away by following the below instructions and always maintaining optimal breathing, especially after injury.

Self-test

First, let’s do a quick test.

  1. Take a normal breath in and time how long you can exhale for. Don’t pause between the exhalation and inhalation but you can hold the air out. When you need to breathe back in, that’s your end point. Note your time.
  2. Repeat this test but instead hum after you have inhaled for as long as you can, until you really can’t make another sound. Did your time change?

The ideal number I look for is 20 seconds or longer but 15 seconds and up is good. Were you close? If not, you could benefit plenty from the following breathing practice.

Breathing practice

  1. Lie or sit in a comfortable position. Get your body as relaxed as you can.
  2. Keep your lips together, jaw relaxed.
  3. Put your tongue on the roof of your mouth, just behind the top teeth, as if you were about to make an ‘N’ sound.
  4. Breathe in through your nose as quietly as you can.
  5. Exhale for as long as you can. Pause at the end and swallow before breathing back in again.
  6. As you breathe back in, keep it as light and quiet as you can. Avoid gasping or taking excessive amounts of air in.
  7. Practice this daily for 10 breaths at a time or try a continuous 5 minutes.

Alternative practices would include taping your mouth, such as when watching TV or doing light exercise, or using a Somnifix strip while you sleep.

We breathe about 11 million times a year so it’s worth getting this right! Those with conditions like asthma or a childhood spent coughing, even if much improved in those regards, can often be left with shortened breathing patterns. I’ve seen people barely able to breathe out for more than 3 seconds to those able to go the full 20 seconds so it is highly variable. But thankfully like any muscle, it can be improved with training, though it could take some people months of consistent practice to nail it, depending on other factors.

Lois Laynee (where I got many of my facts above) is an expert on the subject if you would like to learn more.