Photo by 123RF

Photo by 123RF ()

Not a Parachute

Separating your chest cavity from your abdomen is a muscle shaped like a dome when relaxed. This dome is tethered at many points to the lower rib cage, the vertebrae of the low back, and at least two sets of low back muscles, giving it a somewhat parachute-like appearance. This is the diaphragm.

When you breathe in, the diaphragm is the star of the show. It contracts, flattening out its relaxed dome-like shape. Think of an accordion held vertically. Now imagine the musician pulling the lower end of the accordion down. This creates space within the accordion. Nature does not like empty space. Opening up the accordion causes air to rush in. This is analogous to what happens when the diaphragm contracts. The flattening of the muscle creates space in the chest cavity, causing air to fill your lungs.

Complex Circuitry

Many of the muscles in your body are controlled by just one or two nerves. The diaphragm is different. The nerves that send the command to contract or relax – the motor nerves – originate from three pairs of nerves in the neck. The nerves that feed back information to your brain – the sensory nerves – originate from six pairs of thoracic (mid-back) nerves. Of your 31 pairs of spinal nerves, nine pairs are involved in controlling this one muscle.

When you realize how many functions besides breathing can be affected by the diaphragm, the complexity of its circuitry is not surprising. In the illustration, you will see that major blood vessels pass through the diaphragm, causing it to interact with the cardiovascular system. The food tube (esophagus) travels through it on its way to the stomach – a clear connection between the diaphragm and the digestive system. The tethering of the diaphragm to vertebrae of the low back, and its relationship to major low back and pelvic muscles highlight the importance of this muscle for low back function.

The influence of multiple spinal nerves on diaphragm function is one of the reasons that chiropractic adjustments can help it to function optimally. One of our patients was a 53-year-old Army veteran with a 20-year history of chronic obstructive pulmonary disease (COPD). He noted that he frequently inhaled a great deal of dust during his service as a tank driver. Under chiropractic care, we were able to improve his breathing capacity and reduce his fatigue. This published case is just one of several papers demonstrating the benefit of chiropractic adjustments for respiratory function.

Building Breathing Power

What would you do if you wanted to increase the power of the biceps muscles in your arm? Would you lift barbells? Perform curls against rubber tubing? Practice isometrics? What all of these have in common is resistance. You build the power of a muscle by working it against resistance.

The diaphragm and the other muscles of breathing are skeletal muscles – the same sort of muscle tissue found in the biceps. Their power can be built by resistance exercise, just like any other skeletal muscle.

A simple, low-tech way to work your respiratory muscles against resistance is pursed-lip breathing. Deeply inhale through pursed lips, as if you were sucking the air through a straw. Deeply exhale through pursed lips, as if you were blowing up a balloon. Try for ten repetitions once or twice per day. If that becomes comfortable, try doing pursed lip breathing while taking a brisk walk.

Cautions: The first time you practice pursed lip breathing, remain seated. Progress to standing or walking only if you do not experience dizziness.

If you have COPD (chronic obstructive pulmonary disease), consult with your health care provider before practicing pursed lip breathing. It may be advisable to skip the inhalation phase of pursed lip breathing, especially if you have the emphysema form of COPD.

As in any form of exercise, you have to put in effort to gain benefit. However, if you experience sharp pains, dizziness, or any other discomfort out of proportion to ordinary exercise effort, give it a rest for a day or two before trying again. If it keeps happening, consult your health care provider.

Enjoy the Benefits

Pursed lip breathing can enhance the benefits of exercise and chiropractic adjustments. In addition to improved breathing, you may find your digestion and cardiovascular function improving as well.

{Above: Illustration of the diaphragm, showing its attachments to the lower rib cage and the lumbar vertebrae in the lower back. It is closely related to two major muscles of the low back and pelvis – the psoas major and quadratus lumborum. A major vein – the inferior vena cava – and a major artery – the aorta – pass through it. The food tube – esophagus – also passes through this major breathing muscle.}

Source for This Article

Masarsky CS. Complex Circuitry for Complex Machinery [The Wide-Angle Lens]. Asia-Pac Chiropr J, 2022; 3:2. URL:

Masarsky CS, Weber M. Chiropractic Management of Chronic Obstructive Pulmonary Disease. J Manipulative Physiol Ther, 1988: 11: 505-510. Abstract:

About the Author

While serving as a medical specialist (MOS 91-B) in the U.S. Army Reserve, Dr. Masarsky earned his Doctor of Chiropractic degree from New York Chiropractic College in 1981. He is in the private practice of chiropractic in the Virginia suburbs of Washington DC with his wife and partner, Dr. Marion Todres-Masarsky. For research citations related to this article or appointment information, contact Dr. Masarsky at 703-938-6441 or Also visit his practice’s website:, and You Tube channel:

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