In sports the most valuable player is not always the flashiest, or the most talked about but everyone knows a person a team would not function without. The body is the same way. Its most valuable player is not the most a glamorous or talked about. It's not the pecs, biceps, chest or glutes. My patients, athletes, and students are probably tired of me talking about the true Most Valuable Muscle the thoracic diaphragm. This post will hopefully let you know why I am so adamant about this subject and to give you some insight into the thoracic diaphragm.


First I must give a big shout out to three individuals who really sparked my research and interest on this topic. Dr. Brett Winchester, Dr. Beau Beard, and Dr. Austin Panter are doing phenomenal work in the chiropractic field as well as in many arenas in sports.


A little intro into the anatomy and physiology of this topic, the thoracic diaphragm is a dome like sheet of muscle and tension attachments that serve as the main muscle of respiration and plays a very big role in the breathing process. It also serves as an important anatomical landmark that separates the thorax from the abdomen. The diaphragm attaches from the lumbar vertebrae and goes to the lower border of the ribs and sternum. There are also very important structures that pass through the thoracic diaphragm. These include important nerves like the phrenic (motor control for breathing) and vagus (CN-X, heart, digestive system, skeletal muscles, taste), also the esophagus, and vascular structures such as the aorta and inferior vena cava. If you haven't already noticed this is a very important structure that can affect multiple systems of the body.


Further, the diaphragm forms the floor of the thoracic cavity and the ceiling of the abdominal cavity. This is important because it is perfectly located there for core support as well as function. When air is drawn into the lungs (inhale), the thoracic diaphragm contracts and pulls a tendon in the middle of the diaphragm downward into the abdominal cavity. This enlarges the thorax and allows air to inflate the lungs because of negative pressure system (which basically means we have to work to get the air in). While the diaphragm is contracting downward towards the pelvic floor the pressure in the abdominal cavity is increasing at a rapid rate! Think of an inflated balloon in between your hands (your hands are the diaphragm and pelvic floor muscles and the balloon is the air in the abdominal cavity). As your hands move closer to one another the pressure in the balloon rises. This pressure that builds up is known as intra-abdominal pressure. This pressure that is built up between the diaphragm and the pelvic floor is the best stabilizer of the spine. I have heard it referred to by many in the health world as the anatomical weight belt of the body. If you want to truly strengthen your spine, get out of pain, and prevent further injury you MUST start breathing correctly. If you don’t start breathing correctly, it is open season for injury of the spine.


Most individuals equate poor breathing with low back pain, which is true, but the lumbar spine is not the only area of the spine that is majorly affected. As we age and continue to head down the path of sitting more than we are up moving, we forget how to use the thoracic diaphragm properly. When we don't use the diaphragm properly we become chest/shoulder breathers. The average person takes around 24,000-25,000 breathes per day (24 hours). Can you imagine doing any other movement or exercise improperly 25,000 times a day? Can you imagine the repercussions it would have on the body?


When we use these improper muscles as our main breathing muscles it can lead to things like shoulder tension, dull achy mid back pain, headaches, indigestion, acid reflux, and in some cases increased blood pressure. 


Try these tips to start to retrain the body on how to use the thoracic diaphragm.

1. Lay face up
2. Bend the knees to 45 degrees feet flat on the ground
3. Place hand #1 below the sternum on the lower rib
4. Place hand #2 below the belly button on the stomach 
5. Take a deep breathe in through the nose 
6. As you inhale focus on only trying to move hand #2 with your stomach 
7. The better you get the less hand #1 will move 
8. Exhale through the mouth slowly 
9. Do this exercise for 10-12 minutes at the start and end of each day 


You will find that this motion will more than likely be tough and don't get discouraged if you cannot do this motion on the first, second or third try. This is something that we have to retrain the brain to do! Remember those 25,000 breaths a day? Don't get discouraged if you can't retrain your body with 20 deep breaths, keep trying.


There are some positive side effects to breathing properly. These include but are not limited to, less stress physically and chemically because you are getting the proper amount of oxygen and releasing proper amounts of carbon dioxide. You may experience increased energy and more efficient movement. You may experience a decrease in back pain and headaches. You may notice that your resting heart rate decreases and that you don't get winded as easily. If you experience any of these you may be breathing properly and you should continue to do so.


Thank You.

Dr. Benjamin Hendrix, D.C.