The Diaphragm – Part 2 Back Pain, Neck pain, Rib pain!

The vicious cycle of diaphragmatic effects featuring poor posture, desk ergonomics & much much more.

Welcome back to the diaphragm diaries! In this episode we will be discussing the types of problems that the diaphragmatic system can both cause and be affected by. We will also discuss how these issues can lead to or play a role in many common patient complaints such as neck and back pain. In our third chapter we will talk about how your osteo can help with such issues by treating our friend the diaphragm and what you can do to help yourself.

Now, I know what you’re thinking – only serious respiratory issues could possibly affect the mighty diaphragm! While I understand why you think that, you must remember that the diaphragm has so many anatomical connections and plays so many roles in the body that it can be affected by something as simple as desk posture or the way you sleep. If you need a refresher on the anatomy or functions, please feel free to re-visit the first stunning chapter in the diaphragm diaries. I’ll wait while you do so.

Great you’re back! How glorious was the first chapter. So many highs and lows! Now, let’s get down the business.

Let’s talk respiration

Have you ever thought about your breathing? Other than when you’re dying at the end of a hot yoga class while your gorgeous teacher tells you to expand your lungs and chakras while they casually perform a flawless headstand.

on hand stand

Everyone just follow me… it’s easy! Let’s get a green juice after class!

No, I mean more regular, everyday breathing. Not running, or doing yoga or meditating. Just as you sit still and quietly. Have you ever thought about your breathing?

Never? Great – let’s try an experiment. Take 5 breaths. Not deep breaths, just normal run of the mill breaths and pay attention to them.

Which part of your body is moving most?

Is it your belly? Side ribs? What about your chest? Did you breathe through your nose or your mouth? How’s your breath? Did you have garlic for dinner?

These are important questions and tell us a lot about not only your respiratory habits (or whether you need a mint) but also about your posture. For an osteopathy, a patient’s breathing style will often give important clues about neck or back pain.

Let’s try something else. Let’s all have a seat – if you’re on a packed train you can do this when you get home – it’s worth it, I promise.

Now, I want you to slump your upper body forward – no sitting nicely, really roll over your belly, round those shoulders and collapse into the posture your mum always told you off about. Are we there? Great. Now take 5 of your normal breaths and note how your breathing has changed. It will feel easier to breathe through your mouth and upper chest but your breath will be more shallow unless you make the effort to take a deep breath.

Now since we’re talking about it, try to take a deep breath. It’s tough isn’t it!

Obviously we know where this is going and if you sit up nice and tall and lean into your backrest and repeat the exercise, everything will be a lot easier. You can happily breathe through your lower ribs and you won’t feel like you’re sucking the air in through your mouth.

So what does it all mean?

In the exaggerated posture, I asked you to try in our little experiment, your poor diaphragm was squashed (that’s a medical term) and it was tough to do it’s job properly. As a result, you had to start to rely on your secondary muscles of respiration and particularly those located in your neck and upper chest. Do you see where I’m going with this?

The more often we sit with this kind of ‘slump’ posture, the more effort it takes to breathe and the more participation we need from muscles whose primary job isn’t respiration. Those guys usually get pretty tired and eventually, they tighten up and start to cause other chain reaction biomechanical changes in your neck and upper chest which can lead to neck pain and back pain.

I know the posture we tried was exaggerated, but if you think about your desk posture at the end of the day, or when you’re watching TV, sitting in the car, playing on your Playstation etc., it may start to resemble that little experimental slouch. Multiply that over time and we start to have a good explanation or a contributing factor for a cranky neck or upper back.

Additionally, some of those poor postures over time can lead to other biomechanical issues which can impact on the diaphragm. For example, immobility through your upper back and ribcage can further restrict the ability of your diaphragm and ribs to expand and contract fully which can again shorten your respiratory capabilities.

So how do I fix this?

Well, improved posture is a good start, but there’s much more that you can do the help the diaphragm do a stellar job and ensure happy secondary muscles of respiration and avoid your respiration being a pain in the neck.

Next time in the diaphragm diaries we will talk desk ergonomics, mindfulness, anxiety and what your osteo can do to help the mighty diaphragm.

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