The diaphragm is one of those muscles that remains largely un-noticed and ignored 
(unless you get hiccups !) and most of the time does its job relentlessly day and night without fail.
Yet, when I assess people for lower back pain this is the muscle I start with. You may think this is a little curious.
The reason I start with this is because its an important core muscle. It forms the top of a ‘box’ of core muscles, that provide the stability needed to support the lumbar spine during everyday activities. Like all boxes, if one side is weak or imbalanced – so is the box.
If the ‘box’ is weak the lumbar spine can find itself moving into positions it doesn’t like, and that can mean pain.
The diaphragm is a dome shaped muscle that is connected to the top three lumbar vertebrae, the bottom of the sternum and across to the lower ribs and so it has an important role in helping to stabilise the lower back.
When we breathe, the dome contracts allowing a reduced pressure in the upper body so that air may enter the lungs. As we breathe in, we should see is the stomach rise as the ‘dome’ contracts, and then fall when we breathe out. If you look at young children -
this is what you see.
I usually see exactly the opposite in adults:
The stomach is drawn in, the pressure goes up in the chest, and in order to breathe the chest has to be expanded. Not only are the lungs only partially filled – so the amount of
oxygen delivered to the body is reduced – but the diaphragm isn’t used and so
it gets weaker through lack of use.
Remember the shaky box !
A weak diaphragm results in a weakened core and a risk of increased lower back pain.
To get things right, try this simple exercise every day:
- Lie on the floor face up with knees slightly bent.
- Place your hands lightly on your stomach
- Concentrate on breathing in using the diaphragm, not using the chest, and
- feeling your stomach rise.
- Let the stomach fall naturally when you breathe out.
- When you have got used to this – place a book on your stomach and do it all again.
Now do it standing.
