Exploring the Diaphragm’s Role in Posture, Tension, and Core Stability

For manual therapy practitioners, understanding the diaphragm as more than a respiratory muscle opens new doors for clinical reasoning. While often overlooked outside the context of breathing, the diaphragm plays a pivotal role in posture, muscular tension, and core stability—making it highly relevant for massage therapists, myotherapists, Bowen therapists, and other hands-on professionals.

Illustration depicting a woman with blue hair, surrounded by icons of the spine, lungs, and brain, highlighting the diaphragm's role in breathing, posture, and core stability against a light teal background.

The Diaphragm as a Postural Muscle

The diaphragm connects directly to the lumbar spine and lower ribs, and its contraction influences intra-abdominal pressure—a key component of spinal stabilisation. When functioning optimally, it works synergistically with the pelvic floor, deep abdominal muscles, and multifidus to provide dynamic core support. Dysfunctional breathing patterns or diaphragm tension can disrupt this system, leading to postural imbalances and compensatory tension in other muscle groups.

Breathing Patterns and Muscular Tension

Shallow chest breathing—common in clients with high stress levels—recruits accessory muscles such as the scalenes, upper trapezius, and pectorals. Over time, this pattern can contribute to chronic neck and shoulder tension. Encouraging awareness of diaphragmatic (or “belly”) breathing can help clients reduce reliance on these muscles, leading to decreased tension and improved relaxation outcomes from manual therapy.

The Core Connection

Many clients with lower back pain also present with altered breathing patterns. Without proper diaphragmatic engagement, intra-abdominal pressure is insufficient to support the lumbar spine, increasing the risk of instability or strain. Integrating breathing education into your sessions—or working collaboratively with exercise professionals—can complement your manual therapy by reinforcing stability through improved diaphragm recruitment.

Why It Matters for Manual Therapy

As a manual therapy practitioner, evaluating and supporting optimal diaphragm function can enhance your outcomes, especially in clients with postural concerns, persistent tension, or core instability. Palpation techniques, client education, and incorporating breathing awareness into your clinical reasoning can be simple but powerful tools.

Final Thoughts The diaphragm is more than just a breathing muscle—it's a central player in the body’s postural and tension systems. By integrating diaphragm-focused insights into your practice, you can provide a more holistic, effective approach to client care.