Balance (and breathing)

Balance.  What does this word conjure up for you?

Time management.  Crow pose.  Stable ecosystems.  Olympic weightlifting.   Fear of falling.  Jenga.  Composition and symmetry.  Relationships.  We aim for balance in many ways.  In the context of optimizing movement, balance can be affected by addressing any or all aspects of functionality.  Flexibility, strength, coordination, stress and emotional regulation, mindfulness, concentration, and finding flow.

Today I want to frame the broad and varied concept of balance around breath and the diaphragm. The reason why I think balance can be acheived through breath awareness is twofold: mindfulness reduces the stressors that throw us off balance metaphorically, and the main muscle of breathing, the diaphragm, is also a spinal stabilizer and therefore it’s optimal function helps us acheive physical balance.

The breath.  The breath is a thread that connects human functionality.  In some cases our breath adapts accordingly, and in some cases (for example yogic kriyas and pranayama, kettlebell swings, heavy weightlifting) there is a reason for us to voluntarily control the pattern of our breath.  For the most part our breath is automatic and occurs without our conscious effort.  However, when we tune in to it and connect to the inhale and exhale, whether it is from a spiritual or athletic perspective, the results can be amazing.  Reduced pain, better athletic performance including balance, greater sense of wellbeing and improved digestion are a few outcomes related to improved breathing.

illustration of the diaphragm. (no muscle acts in isolation.)

The diaphragm. The diaphragm is well known for its role as the principal muscle of respiration. Its role is multifactorial:  breathing, pain perception, the emotional sphere, gastroesophageal functions, facilitating venous and lymphatic return, and given it’s anatomical attachments to the spine, it plays an essential role in the maintenance of lumbar spine stability.

Physical balance.  The diaphragm plays a major role in lumbar spine stability and because of this, your ability to balance is directly correlated with your ability to breathe properly.  Some of it’s work in this sphere is automatic – the diaphragm is active milliseconds before movement occurs – and some of the work is up to our conscious efforts.  We can’t control those automatic reflexive actions but we can control our rib (or thorax) position, which optimizes the movement of the diaphragm.  In other words, the function of the diaphragm is not only respiratory, it’s also postural.  It’s anatomical attachments serve to support the thorax and spine and when our position is optimal, we will more likely move in a balanced pain-free way.

Let’s move this into a physical practice…

Crocodile breath.  This position allows you to focus on the movement of the diaphragm and helps to teach the diaphragm to move properly.  It allows you to breathe using your diaphragm more and your upper chest and neck muscles less. Lie on your belly, support your forehead with your hands, elbows at shoulder height, option to put a bolster under your shins.  Breathe normally and notice where your diaphragm is located.  You will feel it moving from the area around your lower ribs and into your belly.  Be sure to give yourself plenty of time in this position. If there is any pain, stop and find a position of comfort…otherwise stay here and breathe for 3-5 minutes. For a more detailed description check out this Yoga International article.

Positioning and posture in regular life.  Every once in a while check in to see if you can detect whether your jaw (the hard palate to be precise), your diaphragm and your pelvic floor are parallel.  Here’s an image (that I made on my computer – sorry it’s a little rough) to illustrate:

Screen Shot 2020-04-22 at 2.11.07 PM

Many of us use our strong low back musculature to lift and move. This is simply a pattern or habit, which can lead to “rib flare”, anterior pelvic tilt, posterior thoracic tilt or other non-ideal positions.  To change this pattern, while in standing or seated try to tuck your front low ribs away from your t-shirt and take a deep breath into your low back.  If you are shifting and swaying and not able to sense if your lower thorax is parallel to your pelvic floor, it might be easier to do this lying on your back with your upper back and head propped up on pillows.  Tuck your ribs in, away from your shirt, and take a deep breath into your low back. You are not aiming to acheive “perfect posture” but rather to train yourself to more often be in a position that allows for optimal breath. If you feel accomplished with this new habit, try finding this position in plank, chaturanga, or while placing a bowl on the top shelf of your kitchen cupboard. Stacking your diaphragm over your pelvis sets you up for success when life throws you off balance.

Adding load.  When you increase the intensity, frequency, speed or weight of your exercise, you in effect are adding load.  The stakes get a little higher and your breathing is even more important.  I am not going to go into the mechanics of sports or exercise in this blog post but please send me a message if you have specific questions.  Here are a few guidelines:

  1. Breathing is the most important thing.  In the words of Gray Cook, “if you can’t breathe there, you shouldn’t be there”.  To be safe, ensure your body is in a position to allow your diaphragm to move optimally.  Remember, the diaphragm plays a role in spinal stability.
  2. No one muscle is more important than the other.  Train healthy movement rather than individual muscles. (See #1)
  3. Avoid movements that create pain or breath holding.
  4. Our bodies are intelligent!  Our automatic reflexes that occur before gross movement are not conscious.  Our bodies know what to do to maintain balance.  Create habits that optimize your body’s intelligence such as good movement patterns (working with a manual therapist can facilitate this), healthy nutrition, stress management, and optimizing your breath (see #1)

Take a moment to find balance, breathe deeply and enjoy healthy movement.  As a manual therapist I am here to help you in any way I can.  I am here to facilitate ease, educate and inspire, so please contact me if you have any questions.


E.Dulger, S.Bilgin, E.Bulut, D.Inal Ince, N.Kose, C.Turkmen, H.Cetin, J.Karakaya. The effect of stabilization exercises on diaphragm muscle thickness and movement in women with low back pain. J of Back and Musculoskel Rehab 2018 vol. 31, no. 2, pp. 323-329

P.W. Hodges, J.E. Butler, D.K. McKenzie, S.C. Gandevia. Contraction of the human diaphragm during rapid postural adjustments. Journal of Physiology 1997 505.2, pp.539—548 539

J.Kocjan, B.Gzik-Zroska, K.Nowakowska, M.Burkacki, S.Suchon, R.Michnik, D.Czyzewski, M.Adamek. Impact of diaphragm function parameters on balance maintenance. PLoS One. 2018; 13(12): e0208697

P.Kolar, J.Neuwirth, J.Sanda, V.Suchanek, Z.Svata, J.Volejnik, M.Pivec. Analysis of Diaphragm Movement during Tidal Breathing and during its Activation while Breath Holding Using MRI Synchronized with Spirometry. Physiol. Res. 2009 58: 383-392

P.Kolar, J.Sulc, M.Kyncl, O.Cakrt, R.Andel, K.Kumagai, A.Kobesova. Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy 2012 April 42:4

P.Kolar, J.Sulc, M.Kyncl, J.Sanda, J.Neuwirth, A.V.Bokarius, J.Kriz, A.Kobesova. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol 2010 109: 1064–1071

R.Takazakura, M.Takahashi, N.Nitta, K.Murata. Diaphragmatic Motion in the Sitting and Supine Positions: Healthy Subject Study Using a Vertically Open Magnetic Resonance System. J of Magnetic Resonance Imaging 2004 19:605-609


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