Get Your Diaphragm into Shape

Diaphragmatic Weakness

Effective breathing can only be achieved through proper diaphragm functioning.

What is the diaphragm?

The diaphragm is a dome-shaped muscle that separates the thoracic cavity from the abdominal cavity. The contraction of the diaphragm is what creates the negative pressure in the thoracic cavity that allows air to be drawn into the lungs and thus serve as the primary muscle in breathing (respiration). In addition to breathing mechanics, this muscle also plays a key role in the body’s structural alignment and also has an impact on how we respond/manage stress stimuli.

Issues related to a weak diaphragm:

  • Poor breathing mechanics
  • Fatigue
  • Headaches
  • Back, neck or shoulder pain
  • Digestive problems
  • Sleep Apnea and other sleep disorders
  • TMJ (jaw) pain/clenching

Train Your Diaphragm

Since the diaphragm is a muscle, it can become restricted or tight leading to inefficient breathing patterns, and reduced oxygen supply to the body. This in turn can contribute to many of the problems as already noted.

The good news is that these restrictions can be released through various mobilization techniques and specific breathing exercises to allow a more freely moving diaphragm. Once proper mobility is restored, we can move towards training and re-patterning the diaphragm.

Learning to efficiently use your diaphragm under load/duress while still maintaining postural and strength goals is essential for optimal performance. 

Here is a clip from a recent Health and Wellness event we presented:

There are several ways to help establish better diaphragm function and patterning. Many individuals work on patterning exercises while others use apps to help breathe in a more rhythmic pattern. The first focus should always be on encouraging abdominal breathing (versus chest breathing which is shallow and dysfunctional), as abdominal breathing ensures proper diaphragm utilization. The best way to achieve this is doing a simple supine 90/90 breathing exercise which allows for focus on engaging the diaphragm while maintaining a neutral spine.

Supine 90/90 Diaphragm Breathing steps:

  • Find a comfortable, quiet place where you can fully concentrate on noticing your breathing pattern.
  • Lie on your back on the ground, with feet up against the wall or on a chair to maintain 90 degrees angles of your knees and hips.
  • Place one hand on your chest and one on the tummy while maintaining a neutral spine (avoid arching your back).
  • Focus on breathing in (inhale) through the nose and then breathing out (exhale) through the mouth.
  • This drill may be a little difficult at first especially if you are more of a chest breather, but do not rush and take your time as technique is important.
  • Work on this exercise for 5 minutes (2x/day).
  • Once the lying (supine) position is mastered, then you can move to doing this in a sitting or other functional position.
  • The key is to encourage a 360 degree breathing into the rib cage sides, abdomen and back, like expanding a balloon.
  • The hands are placed as shown to ensure minimal movement on the chest and assessing rib cage/abdominal movement (which indicates proper diaphragm functioning).

To help further diaphragm mobility and strength, Honsberger Physio+ has incorporated the POWERbreathe tool as a proactive at-home training tool to help clients

 improve breathing stamina by mobilizing and strengthening the diaphragm. This trainer functions by creating a resistance to your in-breath using a precisely calibrated, spring loaded ‘pressure threshold’ valve (acting like a dumbbell for your diaphragm). Breath training using the POWERbreathe creates a more effective and efficient way to develop diaphragm strength, and has 10 levels of progressions to adapt to varying needs whether you are look for stress management, an athlete, or just recovering from an infection and/or surgery.

The PowerBreathe can be purchased through our online store or in any of our clinics. We will provide a custom training program for all clients based on your specific needs.

For more information on diaphragm assessment and training, or if you are looking to learn how to use the POWERbreathe, please email me directly at

Written by

Jason Varghese, R.Kin, CAT(C), B.Sc.
Director of Corporate Care
Certified Athletic Therapist

Orthopedic Rehabilitation
105-675 Cochrane Drive, Markham, ON L3R 0B8 P (905) 940-2627 F (905) 940-3136 HONSBERGER@HONSBERGERPHYSIOPLUS.COM
81 Temperance Street, Aurora, ON L4G 2R1 P (905) 841-0411 F (905) 841-7311 AURORA@HONSBERGERPHYSIOPLUS.COM