Put simply, a lot!
Next to the heart, the diaphragm is the most important muscle in the body. Recent research shows that dysfunction of the diaphragm is associated with low back pain. The diaphragm is a large muscle separating the chest from the
abdomen, is the primary breathing muscle, as well as part of the core muscles.
The core muscles are a spherical boundary of muscles that surrounds the abdominal cavity. They include the: diaphragm, pelvic floor, lumbar musculature, abdominal muscles and rectus abdominis. These muscles work together to stabilize the spine, pelvis, hips, and support the function of chest and abdominal organs.
Gray’s picture of diaphragm. Note the circumferential attachments to back, ribs, and sternum.
Proper breathing requires the diaphragm to flatten and descend into the abdomen with inspiration, and doming upwards into the chest cavity with exhalation (there is much more, but to keep it simple we will stop there). Because the diaphragm connects from the back to the front of the body, it requires coordinated muscle activity from the anterior abdominal muscles and core muscles, in order to function efficiently.
Dysfunction from the diaphragm can occur from a problem with the muscle itself or from any of the components of the core musculature; examples include: smoking, prior abdominal or pelvic surgery, deconditioning, abdominal hernias, open heart surgery, etc. A less efficient diaphragm leads to overactivity of the secondary breathing muscles (intercostals, scalenes, and sternocleidomastoids), and back muscles. Dysfunction of the diaphragm can also lead to core dysfunction. This cascade of events can then lead to back pain, neck pain, pelvic floor problems, hip problems, etc.
Without addressing the function of the diagphram, exercises to treat neck pain, back pain, pelvic floor problems, and hip problems can fail. Treatment should be aimed at restoring the function of the diaphragm through special breathing exercises that work on coordinating the activity of the diaphragm with core musculature and restoring balance to the secondary breathing muscles.
Valley Sports and Spine Clinic has trained alongside select physical therapists from Blacksburg, Christiansburg, and Radford to develop techniques, adapted from the Postural Restoration Institute, for evaluating and treating diaphragm problems. If you have neck pain, back pain, urinary incontinence, bowel difficulty, or hip problems, you may need to have your diaphragm function evaluated and treated. We can help!
Ethan Colliver, DO
Valley Sports & Spine Clinic Giving you Back your Life