The Best Diaphragmatic Exercises: Breath Training for Better Health

The Best Diaphragmatic Exercises: Breath Training for Better Health

In This Article

What—and Where—is the Diaphragm?

In this article, find the best exercises for strengthening your diaphragm and restoring optimal health. But first, let’s get to know the diaphragm better.

– The diaphragm is a large, two-domed, parachute-shaped muscle that separates your chest from your abdomen. It is attached to the ribs, spine, and breast bone. The right side of the diaphragm’s parachute shape is higher, as it is pushed up by the liver below it. The left side is lower because of the location of the heart above it.

– In the chest and ribcage, it plays a major role in the health and function of your lungs, heart, breast, thymus, and thyroid.

– In the abdomen, plays a major role in the operation of your digestive organs.

– In the lower back, the diaphragm attaches to the lumbar spine by way of the psoas and quadratus lumborum muscles. Due to this connection, the diaphragm plays a major role in low back pain.

– There are three major openings in the diaphragm (one for the esophagus and two for major blood vessels). There are also five minor openings for nerves, arteries, and lymphatic vessels.

– With each breath we take, it rhythmically contracts on inhale and relaxes on exhale, massaging the organs that are above, below, and passing through it.

– Over time, the ability to fully contract and relax the diaphragm declines—as do the many functions it supports.

The Mechanics of a Good Breath

With each inhale, the diaphragm contracts in a downward direction, effectively sucking air into the lungs and expanding the ribcage. When the diaphragm relaxes, the natural elastic recoil contracts the ribs, forcing us to exhale. With each fully engaged breath, the ribs act as 12 levers that massage the heart and lungs. This action pumps nutrients into (and wastes out of) the chest cavity with each of the 26,000 breaths we take daily. When the diaphragm gets lazy and stops contracting fully, the rib cage slowly becomes more cage-like and rigid as it squeezes down on the heart and lungs. It is here that many health concerns begin.

In a recent study, 91% of athletes tested had dysfunctional breathing patterns in which the diaphragm was not relaxing and contracting fully. Suppose the athletes of the world do not have healthy diaphragmatic functions. In that case, it is safe to assume that most of us do not either, suggesting the need for regular diaphragmatic exercise.

The Abdominal-Diaphragmatic-Cardiac Massage for Stress and Digestion

A healthy and functional breath requires some crucial muscle contractions.

During a full exhale, the abdominal muscles will contract onto the diaphragm, followed by the diaphragm contracting into the heart. This chain of contraction causes a natural abdominal-diaphragmatic-cardiac massage that activates the vagus nerve located in the heart. Activating this nerve stimulates the parasympathetic nervous system. This sends a calming, rejuvenating, digest-and-repair message throughout the body.

During a full inhale, the abdominal muscles start to relax as the diaphragm, ribcage muscles, and neck muscles contract. A full diaphragm contraction will help stimulate the parasympathetic nervous system receptors in the lower lobes of the lungs. This further helps to convince the body and mind that life does not have to be a constant fight or flight emergency.

The Dangers of Shallow Breathing and Overbreathing

Contrary to these calming benefits of full, deep breaths, when the rib cage is tight and the diaphragm is unable to contract and relax fully, we begin to shallow breathe. This causes many disturbing imbalances. First, we breathe predominately into the upper chest, where most sympathetic nervous system receptors live. This triggers a constant fight-or-flight response, keeping the body in a state of stress. Secondly, shallow breathing causes something called “over-breathing”. With each shallow breath, we breathe more frequently, attempting to intake more oxygen than we can use. In one report with shallow breathers, 75% of the oxygen they took in was exhaled out, unused. While this keeps the oxygen in the blood well-saturated, it has unwanted consequences. Shallow breathing blows off more carbon dioxide (CO2) than is normal, resulting in high oxygen and low carbon dioxide levels—the perfect storm for anxiety. This is why people experiencing a panic or anxiety attack are told to breathe into a paper bag, which increases their carbon dioxide levels and calms them down.

When oxygen levels stay high and carbon dioxide levels stay low in the blood, the bond between hemoglobin and oxygen stays extremely tight. This increases the risk of tissue hypoxia, which occurs when the body’s tissues are not properly oxygenated.

Learn More About Overbreathing Here

How Exercising Your Diaphragm Can Ease Health Concerns

Diaphragmatic Breathing (Pranayama) for Breast Health

In one study, women with breast cancer had significantly more congestion of their anterior diaphragmatic lymph nodes than women without breast cancer. The diaphragm is the main lymphatic pump for the chest and abdominal cavity, helping to move waste and congestion out of those lymph nodes.

See also Pranayama for Breast Health

Pranayama for Occasional Heartburn

When the diaphragm weakens and cannot fully contract or relax, it can compromise the function of the upper digestive organs. Studies have found that deep inspiratory muscle training, which forces the diaphragm to fully relax and contract, has been shown to reverse heartburn, GERD, and indigestion.

See also A Breathing Practice for Occasional Heartburn

Pranayama for Healthy Blood Pressure

A recent study at the University of Colorado at Boulder found that just 3 minutes of this breathing practice can significantly lower blood pressure. Restoring proper diaphragm function can increase the efficiency of the heart’s ability to pump blood while boosting lymphatic drainage—both of which support healthy blood pressure.

See also This Breathing Technique Lowers Blood Pressure

Pranayama for Mood, Energy, and Anxiety

Restoring the blood’s ratio of oxygen to carbon dioxide has been well studied to combat stress and re-establish a normal state of composure and calm in the nervous system. Anxiety clinics in the US during the 1940s and 50s would mix carbon dioxide and oxygen and offer breathing treatments that were state-of-the-art therapy for worry and anxiety.

See also Breathing Exercises for Improving Your Mood

Pranayama for Healthy Heart and Lungs

The breathing technique called inspiratory muscle training (designed to strengthen the diaphragm) is used in hospitals for heart and lung concerns as well as for strengthening lungs after respiratory illnesses such as COVID-19. Ayurvedic pranayama techniques similar to this muscle training are effective at boosting diaphragmatic strength.

See also Strengthen Your Lungs Now: Learn Pratiloma Pranayama

Pranayama for Immunity

There are numerous studies linking nose breathing and pranayama breathing exercises to a stronger immune system.

See also Ayurvedic Nose Breathing for Stress and Immunity

The Best Ayurvedic Exercises to Strengthen the Diaphragm

Learning the Three Phases of Breathing

  1. Activating the Diaphragm: Lie down on your back or sit up straight with one hand on the belly and the other on the chest. Take a long, slow breath in through the nose, only moving your belly. Feel the diaphragm expand. The hand on your belly should be the only hand that moves. Repeat this ten times.
  2. Learn Chest and Clavicular Breathing: In the same position, take another inhale to fill your belly, then continue to fill your ribcage/chest. Feel the hand on the chest expand upward. Finish your inhale by breathing into the upper lobes of the lungs toward the collarbones (clavicular breathing) and filling the entire upper chest, feeling your chest and shoulders raise up.
  3. Take a Full and Complete Breath: Putting it all together, start by breathing slowly into the belly, then into the chest, and then into the upper chest—inhaling like a wave from the belly to the chest. With practice, this can be performed more rapidly with fluid breathing from the belly, chest, and upper chest. This is how you would normally breathe during exercise and breathing or pranayama practices.

Diaphragmatic Warm Up

This series of exercises prepare the diaphragm for activity and can alleviate exercise-related side-aches.

  • Using the same method of 3-phase breathing from above, take 10 maximum inhalations through the nose while raising the arms straight up over the head. Reaching as high as you can, breathe in as deep as you can.
  • Repeat the same breathing practice of 10 maximum inhalations with arms overhead while also lateral (side) bending your torso to the right. Repeat the same 10 maximum inhalations while lateral bending to the left.
  • Finish this exercise by bringing your arms back down to your sides. Inhale normally and exhale through the nose 10 times, exhaling each breath to your fullest extent. As you fully exhale, feel your navel naturally move towards your spine as your abdominal muscles contract. This exercise will fully relax the diaphragm. 

Breathing While Stretching the Diaphragm

These exercises are designed to free the attachments of the diaphragm to the ribs and spine, increasing spinal flexibility and creating a more elastic rib cage. These practices are best used in preparation for exercise, yoga, breathing, and medication practices.

  1. Child’s Pose: Kneel on the ground, with buttocks touching heels, and bend forward over your thighs. Keep your knees wide apart so the belly and diaphragm have room to fully contract and expand. Through your nose, take 10 comfortable but deep belly-chest-upper chest breaths.
  2. Sphinx Pose: Lie on your belly with elbows on the floor at a right angle under your shoulders (like a sphinx). Through your nose, take 10 comfortable but deep belly-chest-upper chest breaths as you gently open the front of your body and raise the chest and head.
  3. Gentle Supine Spinal Twist: Lie on your back. Bend the left knee and bring it across the right side of the body into a gentle spinal twist. Turn your head toward the opposite side. Through your nose, take 10 deep belly-chest-upper chest breaths in this position. Repeat on the opposite side with the right knee.
  4. Bridge Pose: Lie on your back. Bend your knees with both feet flat on the floor. Lift your hips off the floor as high as is comfortable. Bring your hands together on the floor under your back, opening your chest. In this position take 10 deep nasal belly-chest-upper chest breaths.
  5. Optional – Camel Pose (modified): Kneel on both knees with your toes tucked under, keeping your torso and hips in line with your knees. Slowly and gently reach back your hands to grab your heels. Open your chest as much as is comfortable. Take 10 deep nasal belly-chest-upper chest breaths in this position.

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Dr. John

3 thoughts on “The Best Diaphragmatic Exercises: Breath Training for Better Health”

  1. This is the best information! I feel inspired to focus more and more on breath. I am a massage therapist and have been trying to work In more intercostal massage and getting the rib cage to get out of “lock down”. Breath is so important for every human function, I am noticing shallow breathing across the board with clients. I will share this article!
    Thank you for your wisdom and knowledge, I have been following you for many years! 🙏🏻🙏🏻🙏🏻

  2. Hello John,
    I’ve been a fan and follower of yours for many years. I’m also a certified Yoga Therapist (American Viniyoga Institute-Gary Kraftsow) and an Ayurvedic Lifestyle Counselor (American Inst of Vedic Studies-David Frawley) as well as a neuromuscular therapist. Reading your exercises for strengthening the diaphragm above, I’m disappointed.
    For inhale: Please explain how expanding the belly, then ribs then chest actually strengthens the diaphragm and diaphragmatic function. How does that facilitate the contraction and downward movement of the diaphragm on inhale? You mention raising the shoulders. Doesn’t that create unnecessary stress in the SCM and scalenes?
    For exhale: You don’t mention the use of the accessory muscles of expiration – contracting the abdominals gradually during exhale to assist the upward movement and relaxation of the diaphragm. Wouldn’t that action (contract/release) help strengthen diaphragmatic action, and massage the lymph nodes in the abdominal cavity?
    I would love to receive your reply.


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