The diaphragm, being a centrally located muscle, when it becomes facilitated, its effects can be felt throughout the entire body. There are many reasons why the diaphragm becomes facilitated. One of these is emotional stress which causes the diaphragm to contract. Another is poor breathing habits. This results in chest breathing with the scalenes,serratus posterior inferior, quadratus lumborum, and the intercostals becoming overburdened. Regardless of the cause, let’s examine the effects of a facilitated diaphragm. The diaphragm, along with the upper trapezius, neck extensors, pectoralis minor,iliacus, and the jaw muscles, has the potential to be one of the most facilitated muscles in the body.
A great example of this is a client who played water polo and had a chronically tight diaphragm. Her parents took her to every respiratory expert in the area. No one could determine the exact cause of her discomfort. I examined her diaphragm with palpation and found it to be extremely tight and painful. I then began using the NeuroKinetic Therapy protocol to assess for muscle/function imbalance. I performed the manual muscle tests first by having her hold her breath and secondly with her breathing out. The muscles that were inhibited included the neck flexors, pectoralis major bilaterally, humeral flexors and extensors bilaterally, psoas bilaterally, rectus femoris bilaterally, gluteus maximus bilaterally, and several gait patterns which I will describe later. As you can see, the diaphragm was extremely overburdened. We then began the process of releasing her diaphragm and retesting all of the above muscles/functions. Over a process of several weeks the diaphragm progressively released and the inhibited muscles/functions became available. She was able to go back to playing water polo at a competitive level.
Because of the motions involved in playing water polo, I had to get creative with gait patterns. Not only were the normal gait patterns investigated, such as flexion and extension of the contralateral humeral and hip flexors and extensors, but also abduction and adduction of the humerus and femur. Rotational patterns were also examined such as bringing the right arm towards the left knee. Cleaning these up really helped to solidify the changes we were making in the motor control system. Of course after each session she was given exercises to do which mimicked what we did. Due to her discipline and hard work she was able to return to competition quickly.
The diaphragm, with its connections to the thoracic and lumbar erectors, quadratus lumborum, and the psoas, is considered a core muscle. It is also connected to the jaw muscles, abdominals, and the pelvic floor through the Valsalva maneuver. These are also considerations for inhibition when dealing with a facilitated diaphragm. It is most likely that the abdominals,psoas, and the pelvic floor muscles will be inhibited.
The diaphragm must be considered as a possible source of facilitation when dealing with global inhibition. Release of the diaphragm and reestablishing the neural pathways to the inhibited muscles/functions is critical in rehabilitation.