Article written and designed by Cosimo Simeone, Msc, PgdDip, Bsc, Physiotherapist

The diaphragm is the most important muscle of the respiration. It’s just situated below the lungs and is innervated by the phrenic nerves, which correspond to the radices C3-C5 of the cervical spine. Breathing can be divided in two parts: inspiration and expiration.

During inspiration diaphragm contracts and goes down, pulling down the internal organs. During the expiration diaphragm relax and goes back in its initial position.

Diaphragmatic breathing is also known abdominal or belly breathing. Due to the accelerated and stressing rhythms we live nowadays, most of us don’t have a good diaphragmatic respiration.

For this reason most of the people breath with thorax, instead with abdomen and diaphragm. This could have some impacts on our physical and mental health too.

In this article I will dive into the diaphragmatic respiration and its potential benefits to our health. Moreover I will explain the symptoms and ways to start to use again your diaphragm when you breath and improve your health.

Types and signs of incorrect respiration:

Shallow breathing, also called chest breathing, means taking small breaths into the chest using the muscles between the ribs. It can lead to fast breathing and not getting enough air into your lungs.

Many people do shallow breathing without realizing it. It can be linked to anxiety, stress, and health issues like asthma, pneumonia, and more.

Sometimes, shallow breathing, called hypopnea too, can be a serious problem if not taken seriously and can lead to hypoventilation.

It might be mistaken for a sleep disorder. Because during sleep, the intercostal muscles of the thorax do not perform the breathing action. In fact is the diaphragm depurate to the breathing during sleep.

Another incorrect respiration is the paradoxical breathing. Where the diaphragm is basically working in the opposite way described before. So in inspiration is goes up and in expiration goes down. The causes behind this incorrect respiration can be different such as nerve disorders, trauma, and infection.

Individuals experiencing paradoxical breathing symptoms might find themselves struggling with a persistent sense of breathlessness. Often accompanied by excessive sleepiness, even after extended periods of rest.

Fatigue becomes a constant companion, remaining unrelieved by sleep, causing frequent nighttime awakenings that disrupt the natural sleep cycle. Physical activities become more challenging, as the body’s capacity for exercise diminishes.

In addition, breathing becomes noticeably faster than normal. If you experience long term symptoms, you should see your doctor to have a correct diagnose and prevent complications.

How to use the diaphragm and breath properly?

Starting to use the diaphragm can be tough, especially if you’re used to shallow breathing. To begin, lie on your back on a flat surface or in bed, making sure your knees are bent. If it’s more comfortable, you can use a pillow under your head and knees for added support.

Place one hand on your upper chest and the other on your belly, just below your rib cage. Take a slow, deep breath in through your nose, focusing on filling your lower belly with air. As you do this, the hand on your chest should remain still, while the one on your belly should rise.

Now, gently contract your abdominal muscles and release them as you exhale through pursed lips. Watch as the hand on your belly returns to its original position.

If lying down isn’t convenient, you can also practice this while sitting in a chair with your knees bent. Make sure your shoulders, head, and neck are relaxed.

It’s helpful to practice this breathing exercise for about five to ten minutes, several times a day if possible. In this video you can also see how the diaphragmatic breathing is performed.

Also a Physiotherapist could help you to restore the mobility of the diaphragm and reduce its tensions. You can book here an appointment with one of our experts.

Benefits of Diaphragmatic Breathing:

Incorporating diaphragmatic breathing into your daily routine can have a positive impact on your physical and mental health. It offers several benefits for health and well-being:

  1. Stress Reduction: It helps you to relax, reducing the production of stress hormones like cortisol. This can help lower stress levels.
  2. Enhanced Oxygenation: It can improve overall oxygen supply to cells and tissues. This can boost energy levels and cognitive function.
  3. Lower Heart Rate and Blood Pressure: Deep breathing can help reduce heart rate and blood pressure, contributing to better cardiovascular health.
  4. Improved Posture: It has attachments to both Thoracic (T7-T12) and Lumbar (L1-L3) vertebrae. So it could stabilize the spine. For this reason has been connected to low back pain, if not working properly.
  5. Enhanced Digestion: Proper diaphragmatic breathing aids in the functioning of the parasympathetic nervous system. It supports digestion and can reduce symptoms of indigestion and bloating.
  6. Better Sleep: It can be useful for improving sleep quality, helping individuals fall asleep more easily and experience more restful sleep.
  7. Enhanced Focus and Concentration: It can help clear the mind and improve focus.
  8. Immune System Support: Diaphragmatic breathing may indirectly support the immune system. By reducing stress and promoting relaxation
  9. Emotional Regulation: It can assist in emotional regulation, providing a healthier way to cope with and manage emotions such as such as sadness, fear, panic attacks, anxiety, and anger.
  10. Improved Lung Function: It promote the full expansion of the lungs, which enhances oxygen exchange. This can be beneficial for people that suffer of asthma or chronic obstructive pulmonary disease (COPD).

Risks and Contraindications of Diaphragmatic Breathing:

Diaphragmatic breathing isn’t a complete solution by itself. It’s not enough to manage issues like anxiety, asthma, or COPD.

In reality, relying solely on it might make anxiety worse if it doesn’t seem effective. If you have anxiety, you can use diaphragmatic breathing as one part of your coping strategy, but it’s crucial to consult your doctor for more effective anxiety treatments.

For individuals dealing with respiratory conditions like asthma or COPD, starting diaphragmatic breathing can be a bit tough. Initially, it might make your breathing feel harder, and you could get more tired. To benefit from it, you’ll need to gradually build up your practice over time.

While diaphragmatic breathing is generally a safe practice for people of any age or experience, certain precautions should be considered:

  1. People who’ve had heart surgery or are recovering from heart issues should be careful.
  2. If you’re recovering from injuries like rib cage damage, spinal injuries, collarbone fractures, severe osteoporosis, or head and neck injuries. It’s important to approach it with caution.
  3. Pregnant women should not be pressured to do this type of breathing, as it can put extra pressure on the abdomen. If they choose to practice, they should take breaks to rest and relax.
  4. If you’ve been diagnosed with dyspnea (a condition of slow breathing), use caution and seek guidance when attempting it. This practice can reduce the number of breaths per minute, which may not be suitable if you require a certain amount of oxygen to keep your organs functioning. In such cases, it’s best to avoid or practice with care.

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