We could spend hours going into the diaphragm if we wanted to. For the purpose of today, I’m using the KISS principle (Keep It Simple stupid). Lets just start with the anatomy…
Think about some of the attachments for a second… Xiphoid Process, Inner Surface of Lower 6 ribs, Upper 2 or 3 Lumbar Vertebra… There are even some fibers that his Psoas Major. The point is as follows: If you are NOT looking at breathing at the very beginning of treatment, you are probably missing something huge. If you are NOT using breathing as the start of core stability- guess what… Your not doing right by your patient client. The diaphragm is an integral part of the “inner core”- Diaphragm, pelvic floor, multifidi and transverse abdominals. If any of these aren’t working- you’re dead in the water.
We must use the philosophy of regress to progress and what is the most basic of tasks that we do as human beings. Breathe. Start there, assess the persons ability to utilize their diaphragm and then move on. Some ideas- start by assessing in supine with their knees flexed and feet flat, move to legs elevated at 90/90, assess in sitting, assess in high kneeling, assess in half kneeing, assess in tandem stance, assess in single leg stance. Get the point here?
Now, let me preface this next part with the fact that I fully understand every individual has their own strategy for breathing based on the activity that they are doing, their body type, their history and how their nervous system functions… BUT- every single person should be able to lie on their back and isolate out the diaphragm and “belly breathe” without excessive use of the accessory muscle groups. This is basic core 101. If you cant isolate the diaphragm you have no business doing planks, get ups, or any other type of core work for that matter.
Most of the time all it takes is a little manual therapy to release the fascial surroundings of the lower ribs, abdomen and then some cueing for retraining to correct the neural pathways and BOOM- it will come back online and they will start to learn new strategies…
Now- take it a step further. What if you have T-Spine and/or L-Spine Mobility issues? Or Hip mobility issues? You’ve got to fix those first because as in my previous blog- mobility needs to come before stability. Once you have fixed all of the mobility (true mobility” issues (see the previous blog), get back to retraining the diaphragm, teaching proper strategies and initiating the progression of movements. One awesome way of locking in fundamental core stability is simply by using segmental rolling patterns and crawling patters… Stay tuned for the next blog which dives into ROLLING!
I hope this helps some of you and I hope this gets people thinking. And don’t forget to go visit and like the Medical Minds In Motion FB page:https://www.facebook.com/MedicalMindsInMotion?ref_type=bookmark
It’s basic, it’s simple, there are never any absolutes but when push comes to shove- just breathe.