5 Systems. 10 Health Problems. 1 Solution, The Diaphragm.

Diaphragm and organs

The diaphragm is central to almost every physiological process and anatomical movement in the body. It has a hand to play in diseases of every organ and in pain throughout the body. Diaphragm health is so important is because of its:


1. Central location in the body between the thorax and the abdomen
2. Ability to regulate the cardiovascular and respiratory systems
3. Role in the postural and movement system.


The Conscious and Unconscious Role of the Diaphragm

The diaphragm is the primary breathing muscle. Like the heart, it is working all the time even when we’re not thinking about it. Unlike the heart, it also has a secondary role to play in posture and a tertiary role to play in massaging the abdominal organs. That means we can consciously change its shape and function depending on how we want to use it. It also means, its shape and function can change due to the health of other organs in the body.

Think about it.

We are born on our first breath, starting with an inhalation;
We die on our last, finishing this life on an exhalation &
Every single breath in between those two matter.

With every breath we take, our lungs, heart, guts, nerves and muscles are stirred. Even more nifty is that an inhale increases sympathetic tone north of the diaphragm – increasing heart rate and blood pressure. While it increases parasympathetic tone south of the diaphragm, decreasing activities of the abdominal organs with it. An exhalation has the opposite effect on the body.

Inhaling = to live
Exhaling = to die

Yogi’s believe that we have a set amount of breaths in a lifetime. Based off an average breathing rate of 15 breaths per minutes (which is pretty high in my opinion), we take almost 8 milllion breath a year.

1,000 breaths in an hour
22,000 in a day
154,000 in a week
7,920,000 in a year.


How Stress Affects the Diaphragm

However, everyday stimuli influence the rate and depth of our breathing. They can alter our Optimal Resting Breath Wave to a dysfunctional breathing pattern.  Some factors encourage us to inhale (take air) or to exhale (let air go). Think about your life. What do these typical stimuli encourage you to do:

stressed woman

 inhaling pollutantsbaby cryingtech stresswoman work stress

(check these posts out I did some time ago if you want to know more about stress and health or breathing and health).

Any time we are tense, worried, anxious, any time we hurt ourselves or experience a sorrow we inhale and tend to hold the breath.
The onset of the industrial and tech revolutions in the last 150 years has compounded the frequency and intensity of dis-stresses in our life and dysfunctional breathing patterns. We are now afraid to let go, relax, to go with the flow and exhale freely.
So pause for a moment now and think about the last time you stopped to breathe freely?

breathe in nature

Diaphragm Retraction = Body Dysfunction

Since the diaphragm is a striated muscle (like the muscles of your leg) it is subject to the phenomenon of retraction, becoming less pliable and more restricted when exposed to numerous stresses. Once retracted, diaphragm health has a knock-on effect of dysfunction throughout the entire body, causing a plethora of disease and pain. In my practice as The Health Performance Coach, I’ve seen a retracted diaphragm have knock-on effects in 5 systems with 10 dysfunctions. They are:

  • Muscle Strains & Back Pain; Myo-fascial Network
  • Constipation & Reflux. Abdominal Cavity
  • Allergies & Asthma Respiratory
  • Anxiety & Panic Respiratory & Nervous
  • High Blood Pressure & Heart Arrythmia’s Cardiovascular

1. Diaphragm Health & Pain

“It is not possible to restore original functions, posture rebalance, freedom from pain, without restoring diaphragm freedom first”.

Dr. D. Raggi

Stabilization of the whole kinetic chain begins with the diaphragm as part of the abdominal cylinder. By its downward descent during inspiration and during postural exertion the diaphragm works like a piston to increase pressure on the organs. The increased intra-abdominal pressure acts against the abdominal and pelvic floor musculature stabilizing the whole abdominal region in an ‘eccentric-isometric’ fashion.

In an ideal scenario, this ‘eccentric-isometric’ muscle activity is proportional to the degree of exerted muscle work and to the demands of the motion. If greater muscle activity is needed, the diaphragm flattens; however, its excursions during breathing are smaller. Therefore, the diaphragm in this situation favours postural function. During significant exertion, a person usually holds their breath to increase postural stabilization and the diaphragm is primarily activated for its stabilization function. However, it is well established that altered breathing patterns have immediate negative effects on postural stability and balance.


In altered breathing patterns, postural activation of the abdominal cylinder and its fascial connections are impaired, leading to loss of stabilization of the spine. Observable changes emerge through overuse, misuse and abuse of the structures responsible for normal posture, leading to changes in which some muscles shorten and tighten while others are inhibited and weaken. Common dysfunctional patterns emerge, known as Janda’s Syndrome, with inevitable modification of optimal function.
Some of Janda’s adaptations include:

• Forward head posture.
• Reduced efficiency of the pelvic floor muscles.
• Extension of the low back, resulting in a misalignment of the whole body.

Janda’s adaptations in posture affect local stabilization of the abdominal cylinder and widespread, global influences including:

→ Loss of strength.

→Loss of flexibility.

→Pain & trigger points.

→Referred pain to the chest, shoulders and arms.

→Pain mimicking angina.

→Back pain.

→Repeated strains of leg muscles.

2. Diaphragm Health, Reflux & Constipation

The diaphragm drapes like a blanket over the upper abdominal organs, partially touching them. The stomach, to the left, attaches to the diaphragm. The liver attaches to it on its lateral, superior and posterior surfaces. The stomach, pancreas, gallbladder and the small intestine lie just below the diaphragm. Together, these are responsible for digestion and assimilation of food, while the large intestine and colon take care of re-absorption and elimination.

Diaphragm and organsIn the back of the body near where the diaphragm inserts, the kidneys are filtering and regulating the concentration of water and solutes in the blood as well as excreting wastes in the form of urine. Further down are the reproductive organs – the testes and prostate glands or the ovaries and uterus.

Every time the diaphragm pulses, it directly influences the abdominal organs, either individually or as a unit, by changing their shape. It has a caudal peristaltic effect (downward away from its center) to the furthest reaches of the abdominal cavity and anal sphincter. This effect is akin to a stone being cast into a pond. It causes ripples in the water from its center to the edges.

When the diaphragm beats with each breath, all these organs are massaged, rolled, churned and bathed in new blood, fluids and oxygen. The organs get squeezed and released like sponges.

It prevents, in this way, the onset of reflux. Reflux manifests itself by many associated symptoms including heartburn, regurgitation, pain and bronchial asthma. Diaphragm dysfunction is one of the essential causes of Reflux as it considered being an external sphincter for the oesophagus.

Similar to postural trunk stabilization, correct co-activation of the abdominal cylinder is essential for defecation. Therefore, diaphragm dysfunction also presents in problems with constipation.

3. Diaphragm Health, Allergies and Asthma

The dysfunctions of the respiratory systems are perhaps the most obvious ones when it comes to a faulty diaphragm. That’s because it is so well known that the diaphragm is the primary breathing muscle. Once retracted, the body can’t aerate the lungs as efficiently. Eventually this leads to a re-patterning on muscles, whereby the person becomes a chest breather.

Young man resting on the stairs after running

Chest breathers are known to use less of their lung capacity than diaphragmatic breathers. This begins a vicious cycle of feeling like you need more air in followed by breathing more, followed by feeling like you need more air.

But this doesn’t really make too much sense, does it?

Well, it does if you understand that the body doesn’t really care how much air you have in your lungs (that’s just a holding reservoir of air). It cares about the quantity of oxygen in your cells (down in your body). And the Bohr effect in physiology tells us that the quantity of air in your cells is dependent on carbon dioxide levels in your blood. If you want to learn more about the role of CO2 in the health of your body, check this blog post out here)

Now here’s where it gets interesting. By breathing more air in, you also blow-out more air. The air you blow out is full of carbon dioxide. As you feel like you need to breathe more, you are concurrently, blowing out more CO2.

This gives you the feeling like you need more air (because of the lack of CO2 in your blood, the oxygen isn’t actually getting to your cells).
This can result in you becoming more sensitive to allergies from food, exercise, environment and exercise as well as developing asthma-like symptoms!

So there you have it, reduced diaphragm movement leads to chest breathing leads to “feeling” like you need more air leads to bigger breathing patterns and blowing off CO2 leads to breathing more leads to sensitivity to triggers for allergies and asthma.

4. Diaphragm Health, Anxiety and Panic

This is an interesting one. Go back to your cycle of big breathing – “feeling the need” to breathe more – decreasing CO2 levels – and entering into the long term, chronic cycle.

This cycle also has another effect on the body. CO2 is inherently linked to the pH of the blood. Changing the blood pH has a direct effect on brain chemistry. In the long-term, this makes people susceptible to anxiety, panic and even depression disorders.

Think about it.panic face

Let’s say you’re faced with a fearful situation – like you’re about to be attacked by an alsation guard dog. What happends your breathing?
You take a big breath in and hold it, right?

Well, we don’t get faced often with guard dogs. Rather our fight or flight response comes in chronic, low grade doses from an angry boss, a pissed off spouse, an annoying child, or a difficult work colleague. Nowadays, it comes in drips and drabs.

But our body is still that of a caveman. Our response is still the same – we breathe big, we secrete adrenaline and our body wants to get the hell out of there. The only difference is we stay in that fight or flight mode for years. So much so that our body gets used to being in fight or flight most of the time. We are on edge. We can’t sit and relax .we get jittery or lash out often. Given enough time in this state, our bodies will tell us more clearly that it doesn’t like being in this state. Our body’s develop states of anxiety, panic and depressive disorders. All this can simply come from a retracted diaphragm and altered breathing states.

5. Diaphragm Health, The Cardiovascular System, High Blood Pressure & Arrythmia

Similar to the lungs, the heart is attached to the diaphragm by its fascia. It adheres to the diaphragm at its outer wall and leaves an imprint on the central tendon. Furthermore, the largest artery and vein in the body, aorta and vena cava respectively, both pass through the diaphragm. Every action of the diaphragm alters the shape of the heart and it becomes an external sphincter for the aorta and vena cava. So much so, that blood pressure and heart rate increases when the diaphragm contracts on inhalation and slows on an exhalation.

blood pressure

There are many studies which link the quality of the diaphragm to heart rhythm. My experience was somewhat enlightening for me though. I had an online client come to me for allergies. As we went through his medical history it turned out he also had poor sleep patterns, a heart arrhythmia (irregular beat) and his heart rate average 30 beats per minute. This is an amazing heart rate for a pro athlete, but not so for an unfit 40 something year old man who couldn’t do work on his farm due to his health condition.

I started by showing him some breathing exercises for his allergies and sleep. Once he got a hold of those and embedded them into his daily routine I layered a diaphragm release technique into his program. Within two weeks of exercises his heart returned to a normal rhythm and his average daily heart rate climbed to a (normal) 60 beats per minute. That year he didn’t suffer once with allergies and his sleep vastly improved.

These exercises are all included in the Breathe: 1st Principles Program in a structured format. Check it out if you’ve an interested in restoring your diaphragm to its natural rhythms, mastering the foundations of your breath and taking your Health Performance to the next level.



Brown, R. And Gerbarg, P., (2012) The Healing Power of Breath. Shambhala Publications.
Chaitow, L., Bradley, D. & Gilbert, C., (2014) Recognizing and Treating Breathing Disorders. A Multidisciplinary Approach. 2nd Ed. Elsevier
Duranti, R., Sanna, I. Romagnoli, M. Nerini, F. Gigliotti, N. Ambrosino, G. Scano. “Walking modality affects respiratory muscle action and contribution to respiratory effort.” Pflugers Arch. 2004 May; 448 (2): 222-30.
Farhi, D., (1996) The Breathing Book. Good Health and Vitality Through Essential Breath Work. St. Martins Press
Grimstone, S.K., P.W. Hodges, “Impaired postural compensation for respiration in people with recurrent low back pain.” Exp Brain Res. 2003 Jul; 151 (2): 218-24. Epub 2003 May 21.
Hodges et al. (2002). “Coexistence of stability and mobility in postural control: evidence from postural compensation for respiration.” Experimental Brain Research
Kiryu S, Loring SH, Mori Y, Rofsky NM, Hatabu H, Takahashi M. “Quantitative analysis of the velocity and synchronicity of diaphragmatic motion: dynamic MRI in different postures.” Magn Reson Imaging. 2006 Dec;24(10):1325-32.
Lum, L.C., (1975). “Hyperventilation: The Tip and the Iceberg.” Journal of Psychosomatic Research. Vol 19 pp 375-383
McKeown, P., (2003) Asthma-Free Naturally. AsthmaCare
Timmons, B. H. & Ley, R., (1994) Behavioral & Psychological Approaches to Breathing Disorders. Plenum Press





Leo Daniel Ryan

For 10 years I have dedicated my professional life to coaching clients and personal trainers to achieve their goals. I have worked at the highest levels of industry in both Ireland and Canada.