Diaphragmatic Breathing: Functional Patterns

Breathing is one of the most important contributors to spinal stability during our daily lives, especially during exercise. Proper breathing patterns can help create an “anatomical back belt” that provides continuous abdominal bracing around the spine. The importance of stability around the entire spine is paramount, as this is an essential line of defense against low back disorders.  These disorders can be caused by abnormal movement patterns of the spine into strenuous forwards and backwards bending.  Poor posture, sitting for long periods of time, and picking up things off the floor are a few of the activities that can contribute to these strenuous forces.  All of these are quite common in most of our day to day and can even occur while exercising.

Breathing doesn’t just create spinal stability, it is also extremely important to our physiological capacity for sustaining life.  We are consistently bringing in oxygen, as it is required by the cells of our various tissues to facilitate the production of energy.

A conscious focus on breathing has always been emphasized when any form of stress is placed on the body, especially during training. However, most of the time we focus on breathing in during the eccentric portion of an exercise and breathing out during the concentric portion.  This method of breathing focuses on providing our tissues with oxygen, but fails to create stability around the spine and maximize the amount of oxygen we can take in (inspiratory capacity). Dysfunctional breathing mechanics, which dominate our population, can facilitate dysfunctional movement patterns and may even hinder us from reducing oxidative stresses placed on our body during exercise.12

Functional breathing patterns dissociate the breathing cycle from the ability to maintain core stability, which is required for true stability of the spine to be present. The main muscle responsible for functional breathing is the diaphragm. The diaphragm forms the floor of the thoracic cavity and has attachments to the ribs, sternum, spine, fibrous pericardium that encapsulates the heart and connective tissue in the area.3 During inspiration the diaphragm contracts and is drawn downwards into the abdominal cavity, much like the cylinder in a car engine. Similar to the cylinder in a car engine, it increases the pressure within the abdominal cavity, creating “intra-abdominal pressure” or IAP. During expiration, the diaphragm relaxes and ascends to its “resting” position.3 Intra-abdominal pressure, along with activation and bracing of the abdominal wall (muscles surrounding the spine) creates the cylinder of protection around the spine and also created a stable point for the mobility of connected joints. 

In addition to the diaphragm, our external intercostal muscles (which run between our ribs) elevate the rib cage.3 However, the vast majority of the lung expansion during inspiration should occur into the space created by the diaphragm.  

Many of us are chest breathers, also known as apical breathers. When we breathe in, our chest rises and our upper ribs expand to make room for the expansion of our lungs, rather than our diaphragm increasing the space for the lungs to expand downwards. Years of dysfunctional breathing patterns have created a neurological disconnect between the breathing cycle and the activation the diaphragm, and rather, has increased reliance on the external intercostal muscles to create room in the thoracic cavity for the expansion of the lungs.  This limits the total inspiratory capacity we can inhale and also does not help create stability around the spine, denoting dysfunctional breathing.

Dysfunctional breathing patterns have been shown to contribute to pain, muscular imbalance and motor control alterations, which can result in dysfunctional movement patterns.1 Furthermore, in a recent study, diaphragmatic breathing has been shown to increase the antioxidant defense status in athletes after exhaustive exercise, facilitating a decrease in the level of cortisol (the stress hormone) and an increase in the level of melatonin (a potent antioxidant).2

Functional Rehabilitation of Breathing: A Sneak Peek

Functional rehabilitation of diaphragmatic breathing is based on the dynamic neuromuscular stabilization (DNS) model. DNS is based upon the concept of ontogenesis, which is the development of an anatomical or behavioural feature from its earliest stage of maturation. As we develop and mature, we create neuromuscular programs that control our movement and the function of our anatomical body. Through years of injury, pain, poor posture and a seemingly decreased attention to our physical health, much of the population has reprogrammed these neuromuscular connections as compensations, and essentially, dysfunctional movement.

One great way to facilitate diaphragmatic breathing is through crocodile breathing.

How to: Crocodile breathing starts with you lying face down. Place your hands on top of each other and rest your forehead on the back of your hands. Slowly inhale through your nose or mouth. You should be consciously making an effort to breathe into your belly and low back, creating intra-abdominal pressure. As this occurs, your belly will expand into the floor, providing you with feedback. You should be feeling minimal expansion of the chest wall into the ground. The floor is a great external feedback mechanism in this exercise. Then you may slowly exhale. Repeat that 10-20 times. From here, diaphragmatic breathing can be done in different positions based on the developmental approach discussed through DNS, until compensations are eliminated in each position and function is restored.

Written by: Danny Dulay
Feel free to contact with questions: danny@catalyst-health.ca 


1.     Bradley H, Esformes J. Breathing pattern disorders and functional movement. International Journal Of Sports Physical Therapy (2014, Feb); 9(1): 28-39.
2.     Martarelli D, Cocchioni M, Scuri S, Pompei P. Diaphragmatic breathing reduces exercise-induced oxidative stress. Evidence-Based Complementary And Alternative Medicine (2011); 9(3): 24-30.
3.     Moore, Keith L., and Dalley, Arthur F. (2006). Clinically Oriented Anatomy: Fifth Edition. Philadelphia, PA, USA: Lippincott Williams and Wilkins.


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