Surgery for diseases of the diaphragm. How to determine the optimal aperture value for a lens Methods for diagnosing diaphragmatic hernia

The diaphragm is a muscular plate that is located between the abdominal and thoracic cavities of the body. The function of the diaphragm, on the one hand, is to delimit these cavities; on the other hand, the diaphragm is a respiratory muscle that plays an active role in the breathing process.

Diaphragmatic diseases represent a whole group of diseases. Its various types differ significantly from each other in origin, clinical manifestations, course and prognosis.

Diaphragmatic hernia divided into traumatic and non-traumatic. Traumatic hernias are associated with damage to the diaphragm, which can occur as a result of injury, a fall from a height, or compression of the abdomen due to road traffic and other injuries. In most cases, traumatic hernias are combined with damage to several organs. Treatment is only surgical, carried out according to urgent indications.

Among non-traumatic hernias, the following types are distinguished:

  • hernia of the natural openings of the diaphragm, i.e. holes through which the esophagus, aorta, as well as other vessels and nerves normally penetrate from one cavity to another;
  • false congenital hernias (developmental defects in which the communication between the thoracic and abdominal cavities existing in the embryonic period does not close; such hernias are usually discovered in infancy and require surgical intervention);
  • true hernias of weak areas of the diaphragm (the place where these hernias occur are the so-called “weak spaces” of the diaphragm, i.e. places where the diaphragm is thinner and less strong).

The most common of all these diseases is hiatal hernia. They make up more than 90% of all diaphragmatic hernias, and in the structure of diseases of the digestive organs they occupy 3rd place in frequency after ulcerative and cholelithiasis.

Hiatal hernia occurs if, through the esophageal opening of the diaphragm (the opening through which the esophagus from the chest cavity penetrates into the abdominal cavity), the abdominal part of the esophagus, part of the stomach, or the abdominal part of the esophagus, together with part of the stomach, is displaced into the chest cavity. Sometimes other organs located in the abdominal cavity can move through the esophageal opening of the diaphragm into the chest cavity.

Causes of the disease

Factors that lead to the development of diaphragmatic hernias can be divided into predisposing and producing.

Predisposing factors include: congenital or acquired weakness of connective tissue, traumatic damage to the diaphragm, degenerative changes in the musculo-ligamentous apparatus, etc.

Producing (implementing) factors are all conditions associated with increased intra-abdominal pressure: heavy physical labor, heavy lifting, constipation, large meals and regular overeating.

Symptoms

The clinical symptoms of diaphragmatic hernias are caused by the movement of the abdominal organs into the chest, their bending in the hernial orifice, as well as compression of the lung and displacement of the mediastinum to the healthy side. Symptoms depend on which organs were involved in the pathological process.

With a hiatal hernia, patients complain of belching, pain in the upper abdomen, chest and hypochondrium, shortness of breath and palpitations after eating, especially large meals. On an empty stomach, as a rule, these phenomena are not observed. Some patients experience pain after eating, which brings relief. Characteristic symptoms are the sounds of “gurgling and rumbling” felt by patients in the chest.

Diagnostics

A general practitioner may suspect the presence of a diaphragmatic hernia in a patient based on questioning and examination. To clarify the diagnosis, an X-ray contrast study is performed (before the study, the patient is asked to drink a barium suspension that is harmless to the body) and esophagogastroduodenoscopy (EGDS).

Complications

Sliding hiatal hernias are most often complicated by reflux esophagitis and inflammatory diseases of the esophagus (esophagitis, esophageal ulcer), associated with constant exposure of its mucous membrane to the acidic contents of the stomach.

The most dangerous complication of diaphragmatic hernia is strangulation. The cause of its development can be any factor associated with an increase in intra-abdominal pressure (physical activity, overeating). When a strangulation occurs, pain suddenly occurs in the upper abdomen and in the left half of the chest, there may be vomiting, stool retention, etc. When a diaphragmatic hernia is strangulated, surgical intervention is urgent.

Treatment

Sliding hiatal hernias are not susceptible to strangulation and in most cases do not require surgical intervention. A mechanically and chemically gentle diet with split meals in small portions, drugs to reduce gastric secretion and reduce the acid aggressiveness of gastric contents are prescribed. Patients with a hiatal hernia are contraindicated in heavy physical work, wearing tight belts and bandages that increase intra-abdominal pressure.

Other types of diaphragmatic hernias, as a rule, are an indication for surgical treatment.

Ecology of Health: The diaphragm is the secret center of control and management, one of the "open secrets" of the human body: everyone knows that we have a diaphragm, but no one pays much attention to it or thinks about what it does. After all, there are usually a lot of more interesting things going on.

“The armor blocks anxiety and energy that has not found an outlet, the price of this is the impoverishment of the personality, the loss of natural emotionality, the inability to enjoy life and work.”
Wilhelm Reich

The diaphragm is the secret control and management center, one of the "open secrets" of the human body: everyone knows that we have a diaphragm, but no one pays much attention to it or thinks about what it does. After all, there are usually a lot of more interesting things going on.

When, after eating a lot of junk food, our stomach starts to hurt, we suddenly realize that we have an intestine. When we inhale too much smoke and start coughing, we are reminded of our lungs and their need for fresh air. When we feel sexual desire, our attention is drawn to the genitals.

But the diaphragm? It just doesn't show up in the body picture. And yet it controls our emotional expression more than any other segment.

The diaphragm is a thin, dome-shaped group of muscles that are located directly below the lungs and are in constant motion.

Whenever we inhale, the muscles of the diaphragm contract, moving downward to create space for air to enter the lower part of the lungs. Whenever we exhale, the diaphragm moves upward, pushing air out. It happens automatically, constantly and without interruption, from the moment of our birth until our death. Thus the diaphragm continuously pulsates, continuously moves up and down, and this constant pulsation makes it one of the main means of transmitting energy in the body.

According to Reich, one of the basic principles of human health is that energy should flow freely through the seven segments, moving in waves or impulses through the fluid contents of the body. In this movement of energy up and down throughout the body, the diaphragm is a key site because it is here, more than anywhere else, that energy can become blocked.

Our breathing is, to a certain extent, accessible to conscious control. If we wish, we can hold our breath for a limited time, straining the diaphragm to do this. You can try this right now. Take air into your lungs and hold it. Feel yourself contracting your diaphragm muscles to stop breathing.

This compression significantly reduces the pulsation occurring in the body, preventing the flow of energy. And since the flow of energy is closely related to the expression of our feelings, this means that by tightening the diaphragm, we can also impede the movement of waves of emotions. Thus, we have the ability to control our feelings from this place - which we do.

A little lower is the belly and sexual center, and in a sense, the diaphragm is like a passage leading to our inner animal energy, to all the primary feelings associated either with infancy or with sensuality - with the very foundations of emotions. Whenever we want to cut ourselves off from these feelings, rising either from the belly or from the sexual center, it is the diaphragm that is where we create tension in order to avoid contact with them, to push these primal impulses back, to banish them from sight. and from our consciousness.

When we talk about a state of emotional splitting in a person, in which one part of the body expresses a certain desire and aspiration, and the other fights with this impulse or rejects it, then such a split often passes through the diaphragm.

This is especially true for situations related to love and sexuality. The heart, located above the diaphragm, expresses a certain desire, while the sexual center located below it may want something completely opposite.

In many ways the mind is constantly fighting against our basic needs, and the diaphragm plays a very active role in this.

Tension associated with internal thinking accumulates in the diaphragm, and therefore anyone who spends a lot of time thinking, planning, reasoning and comparing will inevitably create chronic tension in this segment. This is another aspect of the diaphragm's role as the main control center.

All three basic emotions - fear, anger and pain - are held back by the diaphragm, and the resulting tension manifests itself as rigidity.

The muscles become stiff and difficult to move.

As we move the diaphragm downward, we begin to come into contact with the fear that is held around the core of the energy body, roughly in the area of ​​the physical belly. As soon as the diaphragm begins to allow a downward flow of energy, the abdomen becomes involved in pulsation and at this moment the client comes into contact with fear.

This effect is most pronounced in thin women with flat stomachs. They are easily classified as fear-holding types: they have weak muscles on the periphery of the body, and they themselves are very light, as if they had wings on their heels, or as if their bones were made of light material. With such flat stomachs, one can only wonder where their insides fit.

However, a lot of fear can be stored in a tense belly, and this is the first emotion we encounter when the diaphragm hatch swings open. This can be very frightening because it is often associated with a feeling of helplessness, a fear of not being able to cope with some important problem, or an inability to stand up to some powerful figure.

All the energy of people who hold fear is diverted from the outside world to the center and compressed there. This is their way of escaping from some experienced threat or danger. But such compression leads to physical exhaustion. When the energy is pulled towards the center, all you can do is collapse.

The legs have no energy to stand, the arms have no strength to defend themselves, and the eyes become unseeing and disconnected. This is an extreme case, but I highlight it to show how in people who hold fear, the periphery becomes ineffective due to the inaccessibility of the energy source - after all, all the energy is retained around the core. And only then does it become possible to feel our strength, because the blockage in the diaphragm does not allow us to access the vital energy stored in the lower part of the body.

When the pent-up emotion is anger, the diaphragm stiffens to prevent the energy from moving outward.

In the case of holding pain, it is immobilized in both directions - both during inhalation and during exhalation - so that the feeling itself is blocked.

Add to this the ability of the diaphragm to bisect the body, splitting energy in the manner already described, and you can understand the importance of this segment as a regulator of energy flow. And in conjunction with the throat, it can cause a complete stop of energy, so that any movement stops, and keep everything in a kind of lifeless balance.

The muscles of the diaphragm with the help of tissues and ligaments are attached around the circumference to the inside of the entire chest.

Where the diaphragm connects to the back of the body is where fear is held.

Reich talks a lot about holding fear in the back, saying that the shape of the body in this place gives the impression of expecting a blow to the head from behind. It's the result of a shock, an unexpected attack... everything seems to be fine, and then: "Bang!" The head goes back, the shoulders tense, the spine bends in an arc. It’s not for nothing that we say that a horror film “goes cold at the back” - because it touches the fear held in our backs. Working in this area often brings to the surface surprising and unexpected things hidden there. Topics kept in the back are something secret - that's why we hide them in the back.

Aperture is related to many things

By now you understand that our emotions can be contained, felt and expressed in all segments. But as we move down, these emotions begin to emerge from deeper areas of the body, and their intensity increases accordingly.

In particular, if the client begins to cry at the beginning of the deshelling process, the energy of the tears and crying will be expressed through the eyes, throat, mouth, and perhaps to a small extent through the chest. That is, the energy will remain in the upper body. Looking at the client's body, I see that the energy does not penetrate below the thoracic segment, and the crying is accompanied by high-pitched sounds, a kind of whining and complaints. Or it contains a certain quality of whining - an irritation that would like to turn into anger, but is not strong enough, and therefore can continue forever.

This might interest you:

As I invite the client to breathe deeper and begin to work with his chest, the lungs take increasingly deeper breaths, and then the sobs begin to come from the heart area, rushing through the throat to the mouth and eyes. Then, if the client remains with this crying, there comes a moment when the diaphragm relaxes, the energy descends into the lower segments and deep sobs rise from the abdomen.

You are familiar with the expression “heart-wrenching sobs,” as well as the expression “gut-wrenching pain” or “gut-crushing feelings.” This is a linguistic reference to how the intensity of emotions increases as we descend into the lower parts of the body. published

Wilhelm Reich's techniques

Who would have thought that a simple muscle clamp in the diaphragm could lead to such sad consequences. Fortunately, there are simple exercises that can help you remove the diaphragm clamp. In this article you will learn how to restore the diaphragm

Greetings to readers of the Find Yourself blog! Special greetings to those who suffer from other neuroses. Do you still think the problem is in your head? You are wrong! She's in exactly the opposite place. No, not where you thought. I mean your belly.

Muscle clamps in the diaphragm (spasms of the diaphragm) are a very common cause of various ailments, including sudden rapid heartbeats and arrhythmias, pressure surges, panic attacks, various pains in the hypochondrium and between the ribs, strong pulsations in the solar plexus, dizziness, difficulty breathing and others unpleasant things.

In this article I will tell you how to remove muscle tension in the diaphragm, how to restore mobility to the diaphragm and remove all these painful manifestations.

Why you need to get rid of muscle tension in the diaphragm

I think we won’t go into much detail about the theory. Everyone already knows what a diaphragm is and where it is located.

However, not everyone knows that this most important muscle in the body is not only directly involved in breathing, but is also capable of storing accumulated anger, disgust, disgust and fear. Naturally, in the form of muscle clamps. You literally feel the diaphragm tightening.

Diaphragm spasm is the cause of many bodily problems!

It’s not for nothing that they say that your stomach is cold with fear. All kinds of worries and anxieties also affect the condition of the diaphragm. If the diaphragm is pinched, it hurts, and at the same time it contracts, blocking the movement of blood through the vessels that pass through it. Your hands and feet become cold, your breathing becomes constricted, and you get a panic attack with all that it entails.

When fear becomes chronic, your diaphragm is constantly tense. It even happens that the diaphragm twitches. This gives rise to anxiety, and that, in turn, again brings to life the most hidden fears. It turns out to be a vicious circle.

→ If you think you have this problem with chronic fear, write to me (see). I will help you get rid of it. This will only take an hour. The diaphragm is in close contact with the pericardium, so muscle clamps in the diaphragm directly affect the functioning of the heart.

Panic attack sufferers often complain of pain or heaviness in the left hypochondrium during attacks and worry about their heart. But in reality, the source of this pain may well be a spasm of the diaphragm.

The diaphragm is attached to several lower ribs in front and to the spine at the back. And therefore, muscle tension in the diaphragm often radiates either to the ribs (and we tend to mistakenly consider this as neuralgia) or to the back.

However, the most common reason for the appearance of muscle tension in the diaphragm today is an uncomfortable, “crouched” posture at the desk. In this position, breathing becomes inadequate, as if the diaphragm is locked in place. Add chronic stress to the mix and you get all those nasty things I mentioned above.

Moreover, we often tend to unconsciously hold our breath when we are working hard or overly focused. And once the breath is held, then the diaphragm remains motionless and freezes in place, turning from an elastic plate into a rigid bridge that divides our body in half.

If you know anything about Chi energy, you will understand that a blocked diaphragm prevents your Chi energy from circulating freely. Your top and bottom are literally disconnected.

Diaphragm spasm symptoms

Finding out whether there are clamps in the diaphragm is quite simple. While sitting or standing, exhale completely, fold the fingers of both hands into a “beak” (see below section on self-massage of the diaphragm) and plunge them under the ribs. Take a deep breath into your chest (not your stomach!), inhale as hard as you can, and continue to hold your fingers deep under the ribs. If you feel tension or pain in any place during a strong inhalation, this is the place where the diaphragm is pinched.

Start checking from the center (under the spoon) and gradually test all points of the hypochondrium in both directions. This way you will find stress points that you will need to work with next.

Diaphragm spasm and panic attacks

I myself have been looking for the reasons for my panic attacks for a long time. I blamed it all on stress, poor diet, sedentary lifestyle, excessive consumption of mate, etc.

Of course, all this influences. But the main reason always eluded me, although nagging pain in the hypochondrium occurred periodically. I thought it was a stomach problem. I even once decided to swallow a rubber hose (gastroscopy) at an appointment with a gastroenterologist. Pleasure, you understand, is still there.

As a result, the doctor found nothing, shrugged his shoulders and put forward the theory that these could be so-called “hunger pains.” I didn’t understand a damn thing either and didn’t bother about it anymore.

But pain in the hypochondrium continued to occur from time to time. If you massage it, remember it a little, it will seem to let you go. Sometimes it would go away for a long time, and I would happily forget about it.

After the first panic attacks occurred, these pains began to be felt more clearly. I thought it was a spasm of some muscle in the abdomen. Sometimes it was felt between the ribs, and I, like many, thought it was some kind of neuralgia or something similar.

It is important to know! Any exercises and massage are only a temporary remedy. You must understand that the psychogenic nature of muscle tension cannot be treated simply with exercises and massages, much less with pills.

For complete healing, it is necessary to remove the emotional charge that led to the appearance of muscle tension. A competent psychologist or psychotherapist will help you with this. You can write to me (see section). Or independent work - auto-training, etc.

Now you know how to remove muscle tension in the diaphragm. Be healthy! And subscribe to our channel on Telegram.

Igor Levchenko. Psychologist, life coach. I help people cope independently with fears, neuroses, panic attacks, etc.
Contacts: Instagram , Facebook , In contact with, Skype.

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Comments:

    Alexander

    29.05.2018

    Have you cured the spasm? I've had it for 4 months already. It puts pressure on the left side of the solar plexus and doesn’t go away until you lie down. At work, everything either squeezes or gurgles somehow. If you don’t eat for a long time and then eat a big meal, it starts to feel pressure in your stomach after 30 minutes. You lie on your back and it goes away. I used to have panic attacks until I figured out how to deal with them. Everything is treated on the back.

    Igor Levchenko

    29.05.2018

    Hello, Alexander!

    Not that he cured it, but rather removed it. Temporarily. After all, it’s like an old habit; if it has already manifested itself, it can turn on again at any moment. You just need to periodically relax and do self-massage. It helps.

    Olga

    30.06.2018

    Hello, Igor. I have a very strong diaphragm spasm. Sometimes I wake up at night in pain. I did the exercises from your article. I don't understand if I'm doing it right. There is no relief. It seems that because of my fullness I can’t get my hands where they need to be. And there is not enough strength in farts.

    Igor Levchenko

    01.07.2018

    Hello Olga!

    Tell me, how long do you do these exercises?

    As for the correct execution and pressure, don’t worry about that. Do it as you please. Over time, you will “find” the right approach. The main thing is not to overdo it and do everything gently and slowly.

    I also recommend doing a short abdominal massage before bed. While lying in bed, place the palms of your hands (one on top of the other) on your stomach and gently massage in a circular motion. First clockwise, then counterclockwise. 30 times in each direction.

    Olga

    01.07.2018

    Igor, I’ve been doing exercises recently. I take it and throw it away. Precisely because I am not sure that I am doing the right thing. The picture shows everything well. On my hands it looks completely different. I can't use my fingers like that. And the hands are weak. It seems that the exercise on the side doesn’t put any pressure on me at all. I heard about massage. Thank you.

    Igor Levchenko

    01.07.2018

    Olga, you are in too much of a hurry. If the clamp is strong, then it “accumulated” for quite a long time, for some people for years. So it would be naive to expect results from several sessions. At a minimum, positive changes can be felt after a month or two of constant work.

    As I said, there is no need to worry about the correct execution. The main thing is to just do it every day, or better yet several times a day. Do it the way it works. Try it!

    Olga

    01.07.2018

    The massage at the end of the article is the only thing that works

    Olga

    01.07.2018

    Igor, I understand. But bad breath is scary and you want quick relief. That's why I'm looking for urgent help.

    Igor Levchenko

    01.07.2018

    Olga, then it’s better to look for an experienced manual technician.

    Alexander

    29.07.2018

    Tormented by fears. At first I thought it was extrasystoles, but the Holter showed 0. Sharp tremors in the chest or solar plexus and then a strong fright with heat that almost radiates from the sun. I can not understand. This happens after eating or during physical activity. Maybe the diaphragm. Because during physical activity, pulsations are still felt away from the sun.

    Igor Levchenko

    30.07.2018

    Hello, Alexander!

    It looks a lot like a diaphragm. Try doing the exercises for a week or two, look at the results and then write whether it helped.

    Eugene

    31.08.2018

    Hello, I tried the exercises, it really does get easier. Also, I noticed that when running, problems with the diaphragm go away, I wonder what is causing this?

    Igor Levchenko

    01.09.2018

    Hello, Evgeniy! Glad the exercises are helping you. When running, just like when walking quickly, breathing becomes more active and uniform. This helps the diaphragm reach the desired tone and gradually relax, and in addition, serves as a kind of massage.

    Larisa

    11.10.2018

    Thank you very much for the article, very interesting

    Igor Levchenko

    11.10.2018

    Please, Larisa! If you have any questions, please contact us.

    AND

    15.10.2018

    Igor, good afternoon. How is your health? I have had this clamp for a very long time, I even know what triggered it. I was afraid to inhale because I feel pain when I inhale. I looked for answers from psychologists. But no one helped. And miraculously, I came across an article and yesterday I did the whole exercise, when I did the second one, I experienced relief that had not been there for a very long time... but temporarily, the pain returned. Tell me, did you manage to overcome these feelings? Or are they coming back? Is there a chance that in a month or two I will get rid of this completely?

    Igor Levchenko

    15.10.2018

    Hello, I.! Thanks for asking about health! Everything is fine, I wish the same for you :)

    As for the clamps in the diaphragm, not everything is so simple with them. Yes, relief may come the first time, which already shows the right approach. But if the clamp appeared a long time ago, then it will not be possible to get rid of it in one, two or three times. It takes time and patience.

    In addition, old clamps also create a certain body pattern. You can call it a habit. For example, the habit of holding your breath when you are concentrating, or sitting at the table slightly bent to one side. All this seems to reinforce the habit. And if some unexpected stress happens again, the clamp may work again according to the old scheme.

    However, everything is not so sad. If you persistently practice, then over time this habit will weaken, and perhaps even disappear completely. In any case, even if a tension arises, you will deal with it much faster and easier, simply because you will know how. It's like an old dislocation - it hurts a little and hello! But if you learn how to set it yourself, you can quickly put it back in place, and without the pain that was there before.

    By the way, I found for myself an “express method” for removing the clamps in the diaphragm. This is when you suddenly feel that you are “pressing”, then you immediately exhale deeply, put your fingers under your ribs and after that take a deep breath through your chest alone, without the participation of your stomach. And you remain in this position for 10 seconds. It is enough to do this 1-3 times and the clamp immediately releases. When you know where it usually pinches, you can press on the correct point quite precisely.

    Try it too.

    AND

    15.10.2018

    Thank you! If I had immediately understood what was wrong with me, I would not have let it get to such a state that I have almost chronic tension. Maybe go to a chiropractor? Or will this not speed up recovery?

    Igor Levchenko

    15.10.2018

    Please! You can go to a chiropractor if he is smart. Perhaps he will suggest something else useful. Whether this will speed up recovery is difficult to predict in advance. Only your body knows about this.

    Elena

    01.12.2018

    Hello Igor! I really liked your articles on the fight against PA. How many times have I tried to do exercises with the diaphragm. But after that, I constantly started having problems with the gastrointestinal tract and eventually had to be treated. I know that there is gastritis and also cardia due to sphincter insufficiency. Could this be the reason for PA? I have been suffering from these PAs for about 8 years now.

    Igor Levchenko

    01.12.2018

    Hello, Elena!

    If you have problems with the gastrointestinal tract, then exercises should be done very carefully. It is better to start with a gentle massage of the diaphragm without pressing hard.
    PAs themselves arise due to stress, as do diseases of internal organs. Therefore, first of all, you need to get rid of stress. Active physical exercise, brisk walking, swimming, etc. are great for this. And, of course, meditation practices.

    Madina

    03.12.2018

    Hello Igor. Can this clamp hurt specifically at night and or when you lie down? Especially on the right? Thank you

    Igor Levchenko

    03.12.2018

    Hello Madina!

    Yes, it's quite possible. However, it is better to be checked by a doctor to rule out liver disease.

    Elena

    19.12.2018

    Hello Igor!
    I have a very strange cough, I sleep great, I get out of breath during the day. The spasm and cough are dry and suffocating, it feels like there is not enough air, it is relieved under a hot shower or during exercise. No medications help, no matter what I tried. All tests are good and my lungs are clear, there is no asthma or allergies. Do you think this could be a diaphragm spasm?

    Igor Levchenko

    19.12.2018

    Hello, Elena!

    If it's not a bronchospasm (which is doubtful, otherwise you wouldn't be able to exercise), then it's likely that it's a diaphragm issue. Try starting with a diaphragm massage, as described in the article. Write about the results later.

    Elena

    19.12.2018

    I started with a massage as you advise, and I’ve also been doing Strelnikova breathing exercises for about a week. What do you think about this gymnastics, does it also work on the diaphragm?

    Hope

    16.01.2019

    Hello. Igor. For about a month I have had constant pain in my left hypochondrium. It started with a sharp pain after an unsuccessful bend in the car. I have stage 3 scoliosis. I bent down in the car to pick up a fallen glove, and a sharp pain pierced me. I thought that the rib had gone behind the rib. Today I was in the hospital. The therapist didn't find anything. She sent me to a traumatologist. He suggested that the pain was in the area of ​​the diaphragm. So your article is just in time. I just have this question for you. Can I do similar exercises if I have a curvature of the spine? Wouldn't this make it worse? Although I’ve been suffering for a month now, so I still decide to try some of your exercises. Thank you in advance.

    Igor Levchenko

    16.01.2019

    Hello, Nadezhda!

    Exercises can and should be done. Just be careful, of course:) Start with the simplest ones and with a massage. Then tell us about the results.

    Konstantin

    19.01.2019

    Hello! I have had this problem due to stress for about a year now, and I have been diagnosed with Reflux and a hiatal hernia. At the same time, there are triggers from the back. Do you think the diaphragm could be spasming and be the main reason for this? and will your exercises help?

    Igor Levchenko

    19.01.2019

    Hello, Konstantin!

    Yes, this could very well be the case. You can check whether there is a clamp in the diaphragm quite simply: exhale, bury the fingers of both hands under the ribs (see the picture on self-massage in the article) and take a deep breath into your chest. Precisely with the chest, not the stomach! It is important. And so sequentially pass on both sides from the center to the sides.

    If in some place you feel pain or strong tension while inhaling, this is the place of clamping. This place will need to be worked on more actively in terms of massage. You can simply hold your fingers while inhaling in this place for 10 - 15 seconds. Then let go, rest a little, catch your breath and repeat again. Do 4 - 5 repetitions.

    Do the exercises carefully and monitor your well-being. If reflux symptoms worsen, put off exercise for a while and only do self-massage.

    Exercises can help, but as with any practice, consistency is needed. Write in 2-3 weeks about your results.

    Konstantin

    20.01.2019

    Hello, I checked - I have a tightening pain that radiates into the esophageal tube right under the xiphoid process, and further to the sides there is almost no pain.

    Igor Levchenko

    20.01.2019

    Konstantin, then it’s better to look for an experienced chiropractor to set the hernia. Perhaps then there will be no need for exercise.

    Konstantin

    22.01.2019

    How do you imagine the process of “reducing the muscle of the esophageal opening of the diaphragm” by a chiropractor?;)

    Igor Levchenko

    22.01.2019

    Konstantin, for example, like this https://www.youtube.com/watch?v=7l9P_SOSgC0 (see from the 5th minute)

    Elizabeth

    27.01.2019

    Thank you for such a useful story.
    The other day I got really angry and my stomach hurt after that. I thought that maybe from hunger, I ate, but the pain did not go away. I remembered that I already had such pain three years ago, then I went to a gastroenterologist, swallowed a sword and a capsule, but they found nothing. They decided it was neuralgia. And here we go again! On the third day of pain, I decided to google the symptoms and once again look for what it could be, obviously excluding all ulcers, etc. . And in the end I came across a spasm of the diaphragm. Having entered the diagnosis into a search engine, I came across your story and recognized myself in it. And now I’ve been doing exercises and massage for the second day. It became much easier. I was even able to teach a dance lesson without writhing in pain.

    Thank you so much for taking the time and possibly helping these hundreds of people and me!

    Igor Levchenko

    27.01.2019

    Hello, Elizaveta!

    Thank you for your response too! Comments like this are very inspiring. Glad I could help in some way :)

    Catherine

    07.02.2019

    Lying on a roller also removes the diaphragm clamp well: https://www.instagram.com/p/BtfX6l-HYSx/

    Igor Levchenko

    07.02.2019

    Ekaterina, this is unlikely. And the author of the post on Instagram does not write anything about the effect of the roller on the diaphragm. The roller works mainly with the spine and back muscles. The diaphragm is located across the body, and it is simply impossible to reach it with a roller. The only point is where the diaphragm attaches to the spine. If there are trigger points there, then the roller can still help somehow. But in the overwhelming majority, the clamps in the diaphragm occur on the side of the abdomen, and you can only reach them with your hands.

    Love

    17.02.2019

    Hello Igor! I had stress, I had blood pressure, PA, fear, anxiety... I went to a neurologist, a psychotherapist, and was treated with psychotropic drugs, which helped. Today I don’t understand what this condition is, the chest is compressed, the heartbeat increases, at the same time it all rises up to the throat, it’s hard to explain, nervousness, fear, the same thing during the day.. If you have encountered such a problem, please tell me what exercises should be done.

    Igor Levchenko

    17.02.2019

    Hello, Love!

    The fact is that the stress accumulated in your body has not gone away. No psychotropic drugs can drive him away. It remains in the form of muscle strain, which produces all these unpleasant effects.

    Therefore, the first thing to do is relieve tension. Active walking at a brisk pace helps with this. At least 30 - 40 minutes a day.

    In addition, Dr. Kurpatov has an excellent “tension-relaxation” exercise that I talked about. Give it a try. It relieves tension well.

    Dima

    23.02.2019

    Hello Igor. I’ll briefly tell you about my symptoms: 2 years ago I felt interruptions in my heart, I checked my heart, everything was fine, and so for a year, every two months I felt these interruptions in my heart, well, every time I checked it (Holter ECG ultrasound, tests) everything with a good heart - thank God, I checked like an astronaut, one might say.
    I think I’ll check my stomach myself of my own free will because none of the doctors even came close to thinking that I had a hernia of the stomach, the gastroenterologist said that from his experience the extrasystoles I have from a hernia of the stomach, which I was convinced of because after a strict and correct diet I I lost 20 kg, and they have disappeared for me; extrasystoles have not bothered me for 6 months.
    But for the last 3 months I have been bothered by strange symptoms: a burning sensation in the left side of the chest - when I change the position of the body they stop or disappear altogether, during emotional communication I also feel a burning sensation in the chest or on the left side under the ribs where the DIAPHRAGM is located, it can burn between the shoulder blades or at times I feel warmth in my neck or left arm. When walking, it can sting between the shoulder blades or under the left rib; when I stop, the pain goes away in the same second.
    And an important symptom that worries me very much is: at moments I feel strange sensations in my head, that is, as if it were giving me a signal, it looks like I should now lose consciousness of something that is not there, I would call it like the ebb and flow of something, waves in my head and so on, this often happens when I am concentrating on something, that is, when I am sitting on the phone or in front of the computer, or going to bed and want to fall asleep, or going to the store.
    I don’t have a headache: I did a TC on the blood vessels and everything was fine.
    I have a hernia of the thoracic region of the 8th-9th vertebrae.
    The day before yesterday I did your exercises, and yesterday everything was fine, that is, there was no burning sensation and these waves in my head, but today I do the exercises and it doesn’t help: (the same waves, also burning sensations.
    Question: Could these symptoms be related to the diaphragm?
    Thank you very much, and sorry for writing so much!!!

    Igor Levchenko

    23.02.2019

    Hello Dmitry!

    Yes, it is quite possible that all this is connected with the clamping of the diaphragm, but even a doctor cannot say for sure. Try to continue doing these exercises and self-massage. One or two days is not enough. It will be possible to determine more accurately after 3-4 weeks of daily exercise. This is about burning sensations.

    Regarding the hot flashes in the head. There may be options here. You say they happen when you focus your eyes on something for a long time. This may be due to both overstrain of the neck muscles and tension in the abdominal muscles.

    Additionally, concentrating on something usually causes you to hold your breath. Next time you're working on a computer or using your phone, make sure you're not holding your breath. This can also cause tension in the diaphragm, and therefore all these unpleasant symptoms.

    Dima

    23.02.2019

    Thank you for your quick response. I’ll answer you right away, holding my breath, I already know it all by heart.
    I concentrate for maybe 2 to 5-7 seconds.
    In the morning I get up for another hour, everything is fine, and after that it all starts: a burning wave in the head and pain, as if someone had stuck a knife.
    After the exercise of stretching the diaphragm, there is a strong burning sensation under the left rib for 5-10 minutes and then turns into a simple, normal, not strong burning sensation.
    Thank you!

    Igor Levchenko

    24.02.2019

    Please, Dmitry! Do a light massage of the diaphragm 4-5 times during the day. This will ease the burning sensation and get the muscles in order faster.

    Guzel

    01.03.2019

    Good afternoon, Igor. I was diagnosed with VSD by a respiratory and cardiologist. Dysfunction. The most disturbing complaint is lack of air. It all started while running very fast 3 months ago. There was chest pain right in the center, severe lack of air, tachycardia. And it’s like I’m wearing a corset. After that, within 3 months. I was treated for tracheobronchitis, osteochondrosis, Tietze syndrome, and IBS was even suspected (based on ECG results). There is no pain in the heart. I checked the heart, there is a prolapse, but it’s not scary. Sedentary work. Sometimes I feel like I can't breathe at all. Or I control my breathing. I mostly breathe through my chest. And after sleep everything is fine, and when I lie relaxed, I breathe with my stomach. Could it be muscle tightness? Gymnastics is not always possible, shortness of breath begins again. Thank you.

    Igor Levchenko

    01.03.2019

    Hello, Guzel!

    We have already chatted, but I will still duplicate my answer here.

    This is definitely a spasm of the pectoral muscles, and one that lasts for a long time. That is, nothing really hurts, it just constantly presses on your chest and doesn’t allow you to breathe. Right?
    Therefore, after sleep, the condition improves a little, because... When you sleep, you breathe from your belly. In this case, you need to do special gymnastics. Look here. It is also useful to do exercises for the diaphragm, because many people also have it tight.

    In addition to gymnastics, you need to more often monitor how you breathe and deliberately switch to belly breathing. After a few days of practice, this becomes familiar. The fact is that by breathing through your chest, you literally do not allow the air to escape back. The chest is already swollen like a balloon. Belly breathing releases the pectoral muscles.

    Tatiana

    08.03.2019

    Hello, I watched a webinar about visceral self-massage of the abdomen and for the first time came across the topic of diaphragm spasm as the cause of a bulging abdomen. And I myself noticed how, after I started going to the gym and lifting weights, my stomach literally fell out. I had it before because of weak transverse abdominal muscles, but after lifting weights and improper breathing during exercise, it became even worse. And it’s no longer possible to breathe through the chest; the diaphragm puts pressure on the internal organs, which begin to bulge forward and, in turn, put pressure on the pelvic diaphragm. Female organs can also drop.
    This is how simple and important our diaphragm is!

    Igor Levchenko

    08.03.2019

    Hello Tatiana!

    Yes, you need to be very careful with the diaphragm. This is especially true for strength exercises with weights. Please tell us if the webinar about visceral self-massage of the abdomen was useful, did you manage to do something yourself and what were the results? I’m sure this will also be very useful for readers of the Find Yourself blog.

    Tatiana

    19.03.2019

    Hello, I liked the webinar, but for the most part it is just informational; the master will give all the exercises in a paid special course on self-massage of the abdomen. Your suggested exercises seemed very good to me, but for some reason I’m still too lazy to start doing them. There is motivation to study, but there is even more laziness.

    Igor Levchenko

    19.03.2019

    Hello Tatiana!

    If you are still too lazy, it means your motivation is not yet strong enough. Those who are “pressed” specifically have no time for laziness :)

    Vladimir

    22.03.2019

    “Advanced yogis perform this exercise 108 times”... comment from a yogi - 108 times is generally the minimum, advanced ones do 500-1000 times. Exhale sharply with a movement of the abdomen (navel) towards the spine and slightly upward. As short as possible so as not to lose carbon from the blood and not get dizzy. Compensation for dizziness is the accumulation of carbon, which occurs best during a delay in exhalation (there will be no desire to breathe as long as there is little CO2).
    To open the diaphragm and lungs, I recommend prana-vyayama, which includes arm rotations, forceful exhalations, and different beatings on the chest. Something somewhere can be worked out without understanding. I also recommend listening to Leonid Gartsenstein on breathing, this is yoga therapy.
    And if the clamps return, then study the respiratory cycle and try applied kinesiology. It describes the order of movements and the work of muscles. For example, the press may not work if the ribs are unstable, and then they tie the ribs with a towel, stretch them and inhale forcefully. In fact, you need to look for what and why.

    Igor Levchenko

    22.03.2019

    Hello, Vladimir!

    Thank you for such a detailed and useful addition! Everything is very clear and to the point. Thanks also for the recommendations. I am sure they will be useful to many readers.

    Maria

    04.04.2019

    I recently started having panic attacks, I've had two so far. I immediately began to delve into myself, thinking about what could be the reason. Over the course of a month there were different options. I noticed that I felt tightness in my chest, and that’s where it all begins. I decided to read something about aperture clamps. I opened this article. And at the very beginning I read “Special greetings to those who suffer from panic attacks and other neuroses.” Super))) So I'm looking in the right direction. Thank you very much for the article. I did all the exercises and massage, there is no longer any pressure, it was there in the morning. I will do it regularly.

    Igor Levchenko

    04.04.2019

    Hello Maria! Glad I could help :)

    Irina

    10.04.2019

    Igor Levchenko

    10.04.2019

    Irina, thank you for sharing! If you want, we can chat (preferably VKontakte or Skype). Perhaps I can help you.

    Tatiana

    14.05.2019

    Igor, hello! Thank you very much for the article and the suggested exercises to relax the diaphragm. I have two specific questions for you:
    1) can pinched diaphragm be associated with professional singing? (due to the fact that the process of singing itself, despite diaphragmatic breathing, does not require a large volume of air and is supported by constant tonic standing of the diaphragm)
    2) do you have any information on the possible relationship with diaphragm clamps of bronchial asthma?
    Thank you in advance!

Article publication date: 06/03/2015

Article updated date: 11/08/2018

The diaphragm is the main respiratory muscle in humans. If a hole or thinning of some area appears in it, and through it the abdominal organs penetrate or protrude into the chest cavity (less often, vice versa), this is a diaphragmatic hernia.

This hernia is dangerous because the intestines, stomach or esophagus that have penetrated into the chest cavity compresses and prevents the heart and lungs from working normally. Also, this position of the organs has a bad effect on the digestive organs themselves, since they are easily pinched in the tendon or muscle ring of the diaphragm through which they exited.

A diaphragmatic hernia can be acute or chronic. A chronic hernia may not bother the patient for a long time. Then the following symptoms occur (they are also signs of an acute hernia): chest pain, heartburn, belching, difficulty breathing, a burning sensation in the chest. These manifestations of the disease definitely prevent a person from leading a full life.

Diaphragm hernias of various types are a very common disease of the digestive system. It occurs in every tenth young person, and from the age of 50 it is found in every second. It is also diagnosed in 7–8% of people who complain of chest pain and cardiac dysfunction.

It is simple to cure such a hernia: the surgeon performs an operation in which the protruded organs are put back into place, and the diaphragm defect is sutured and strengthened. Medicines do not fight the problem, but only eliminate the symptoms and prevent complications of the disease.

What happens with a diaphragmatic hernia (anatomical information)

The diaphragm is a large parachute-shaped muscle that is located below the lungs and attaches to the costal arches. It has a peripheral muscle and a central tendon part. The vena cava passes through the tendon part to the heart, and in the muscular part there is an opening for the esophagus.

Click on photo to enlarge

The opening for the esophagus is the “weak spot” where diaphragmatic hernias most often form (they are also called hiatal or hiatal hernias). Through it, the esophagus, stomach, and sometimes the intestines exit into the chest cavity.

Normally, in a healthy person, the esophagus is secured by muscular and fibrous ligaments. But if muscle tone decreases, if the left lobe of the liver decreases (atrophies), or a person loses weight so much that the fatty tissue located under the diaphragm disappears, then the esophageal opening “stretches.” Because of this, the ligaments holding the esophagus weaken and the angle at which the esophagus enters the stomach increases (this causes the reflux of gastric contents upward).

The diaphragm is conventionally divided into three parts: lumbar, costal and sternal. In each of them, muscle fibers have their own direction. At the junction of these parts there are triangular sections that are quite pliable. This creates the conditions for the intestines to come out or protrude here. These are already different diaphragmatic hernias.

The structure of the diaphragm and muscles of the posterior abdominal wall.
Click on photo to enlarge.

Types and classification of hernias

There are two main types of diaphragmatic hernias: traumatic (develop under the influence of penetrating wounds and surgical interventions) and non-traumatic.

Each of this species is divided into two more subspecies:

    True, when there is a hernial sac (that is, the protruding organs are wrapped in a thin film - peritoneum or pleura). This way, either a loop of intestine or a section of the stomach flowing into the duodenum, or both of them, can exit. These hernias can be strangulated.

    False hernia - without a hernial sac. The gastrointestinal organs simply exit through the hole in the diaphragmatic muscle. This condition is possible for the esophagus or the initial parts of the stomach.

There are also non-traumatic hernias:

  • congenital;
  • neuropathic - caused by a violation of the nervous control of the diaphragm area, due to which this area is greatly relaxed;
  • hernias of the natural openings of the diaphragm: esophagus, aorta and vena cava.

The symptoms of various types are not very specific, allowing a diagnosis to be made only by signs. To prescribe the correct treatment to a person, classification is needed.

Causes of the disease

Predisposing factors to the development of hernia Provoking factors

Diaphragm injuries

Sports and industries where you need to lift weights

Connective tissue weakness (congenital or acquired)

Pregnancy

Dystrophy of muscular-ligamentous structures

Long difficult labor

Age over 50

If at least one of these conditions is present, then diaphragmatic hernias very easily appear under the influence of provoking factors from the right column.

Chronic constipation

Constant overeating

Obesity

Diseases of the stomach and intestines

Diseases of the lungs and bronchi that cause frequent coughing

Ingestion of alcohol or chemical compounds that cause burns and scarring of the esophagus

Characteristic symptoms

The symptoms of a hernia will differ depending on whether it is a traumatic hernia or not.

Symptoms also depend on:

  • whether the disease developed acutely (quickly),
  • or the hernia penetrated from the abdominal cavity into the thoracic cavity for a long time (chronic course),
  • or the hernia has been strangulated (compressed) in the hole from which it came out.

Acute diaphragmatic hernia most often manifests itself with the following symptoms:

  • Chest pain that gets worse when coughing.
  • Heartburn (feeling of heat behind the lower part of the sternum and acidic contents in the mouth). It intensifies when lying down, when bending forward or down. Heartburn also appears if you lie down immediately after eating.
  • Belching with air or sour contents, which appears even during sleep and can be the cause of frequent bronchitis and pneumonia (due to food fragments entering the respiratory tract with air expelled from the stomach).
  • Difficulty swallowing (a “lump” appears not in the throat, but in the sternum area) of liquid food, water; It is especially acute when eating in a hurry. In this case, solid food most often goes well.
  • Bloating.
  • Constant cough.
  • Difficulty breathing (a person feels that he cannot “catch his breath” or that he does not have enough air).
  • A burning sensation behind the sternum.
  • Rapid heartbeat after eating.
  • Rumbling or "gurgling" in the chest.

If a person has developed chronic diaphragmatic hernia, he does not feel anything for a long time. Subsequently, the same symptoms develop as in the acute version.

Symptoms of a strangulated diaphragmatic hernia:

    severe pain in one half of the chest (most often in the left),

    loss of appetite,

  1. bloating,

    gases stop passing.

How to make a diagnosis

In order for the prescribed treatment to be adequate, it is necessary not only to make a diagnosis, but also to determine the type of hernia (which organs go through and where, whether there is a hernial sac or not). To do this, 4 examinations are prescribed:

    X-ray examination of the chest and abdominal cavities. Before the procedure, you cannot eat for 6 hours, and 10–20 minutes before you need to drink a barium mixture, which you are given and asked to drink in front of the radiography room. This method allows you to monitor in real time the movement of barium through the esophagus into the stomach.

    Fibrogastroscopy (FGDS) is a study in which the patient will need to swallow a special probe (tube) equipped with a camera at the end. The study is carried out on an empty stomach. Only according to FGDS, the diagnosis of “hernia” is not made, but the degree of damage to the mucous membranes of the esophagus, stomach, and duodenum by hydrochloric acid is determined; establish the fact of bleeding from the vessels of the gastrointestinal tract located in the hernial sac.

    pH-metry – measurement of acidity in the stomach and esophagus. The procedure is carried out using a thin probe.

    If necessary, during FGDS a biopsy of the esophageal mucosa is performed.

If the doctor suspects a strangulated diaphragmatic hernia, an X-ray of the abdominal and chest cavities is performed without injecting barium. If the diagnosis is confirmed, the patient is prepared and operated on as an emergency.

X-ray of a patient with a hiatal hernia. The arrow indicates the part of the stomach that has penetrated into the chest

Hernia treatment methods

A diaphragmatic hernia can only be completely cured through surgery, especially if the hernia is true and can be strangulated at any time. But in 4 out of 10 cases, after such treatment, the hernia reappears, so the surgical method is rarely resorted to (2–15% of cases).

Conservative therapy is more often used (for example, due to contraindications or the patient’s disagreement with surgery).

Therapy without surgery

Conservative treatment does not cure diaphragmatic hernia, but it helps:

    reduce the degree of reflux of gastric contents into the esophagus, and intestinal contents into the stomach;

    reduce the acidity of gastric juice;

    cure gastritis, ulcers;

    start the normal direction of peristalsis (intestinal movements through which food moves).

Conservative treatment involves following a daily routine, diet and taking medications.

Diet

Meals should contain 1800–2000 kcal/day.

Six diet rules:

    Eliminate simple carbohydrates (sweets, baked goods) and foods that cause fermentation (legumes, cabbage, carbonated drinks and beer) so as not to provoke the release of swollen intestinal loops or stomach into the chest cavity.

    Remove acidic foods from your diet (sour juices, pomegranates, lemons, cherries, raw apples), which can aggravate the disease and provoke the development of ulcers or erosion of the mucous membrane of the stomach or esophagus.

    Avoid foods that cause excessive secretion of gastric juice or pancreatic enzymes: smoked, fried, peppered foods, dishes with spices, pickled vegetables, barbecue.

    Be sure to include in your diet foods that will make the intestines work and prevent the development of constipation: boiled beets, prunes, dried fruits.

    It is useful to drink 100 ml of alkaline mineral water half an hour before meals: “Borjomi”, “Slavyanskaya”, “Polyana Kvasova”, “Jermuk”.

    Eat small portions, often. Never go to bed after eating.

Based on reviews from people who used conservative treatment, they not only had to eat at least 3-4 hours before bed, but also slept only in a semi-sitting position, without leaning on pillows. To sleep, they either bought a functional bed with a headrest whose height could be changed, or placed 1–2 bricks under the legs of the bed at the head.

Medicines

Diaphragmatic hernia is treated with the following drugs:

(if the table is not completely visible, scroll to the right)

Group name Example of a drug What is it used for?

Anticholinergics

Atropine, platiphylline

Reduces the production of gastric juice

Antispasmodics

No-shpa, riabal, papaverine, halidor

Eliminate hypertonicity of the muscles of the stomach and intestines, reduce pain

Drugs that reduce the production of hydrochloric acid

Ranitidine, famotidine, omeprazole, nolpaza

Reduces the synthesis of hydrochloric acid in gastric juice

Enveloping

De-Nol, vikair

Prevents the destructive effect of hydrochloric acid on the cells of the stomach or esophagus

Aluminum and magnesium preparations

Almagel, phosphalugel, Maalox

Neutralizes excess gastric acidity

Surgical intervention

This treatment, although it is the only “healing hernia”, is still rarely used: in 2–15% of cases due to frequent relapses of the disease. Surgery is absolutely indicated for ulcers of the esophagus that have led to either narrowing or bleeding.

Surgeons perform 3 types of operations:

    Suturing the opening (hernial orifice), from which the organs emerge, with special sutures, followed by strengthening it with a polypropylene mesh.

    Fixation of the stomach to the anterior wall of the abdomen after “putting it in place.”

    Suturing the fundus of the stomach to the wall of the esophagus.

Owner and responsible for the site and content: Afinogenov Alexey.

The human muscular system has more than 400 muscles. And there are a small number of working muscles working 24 hours a day. Not least among them are the respiratory muscles. The inconspicuous muscle the diaphragm plays a major role in the breathing process. Control of breathing begins with control of the respiratory muscles. Let's try to figure out how the diaphragm works when breathing. And if, in addition to the diaphragm, we have 399 more muscles in our queue, why do we need to actively work on the diaphragm?

This powerful muscle separates the chest and abdominal cavities. Outwardly, it looks like a twin dome of an umbrella. From the top of the dome, which is both tendon center diverge radially muscle fibers, which are attached along the periphery to the sternum, costal arches, free ends of the last two ribs and lumbar vertebrae. When a muscle contracts, its attachment points move closer together, i.e. the top of the dome goes down and our umbrella becomes flat. With relaxation, the muscle returns to its original position.

The diaphragm works around the clock, lowering like a piston with each breath, making room for the delicate tissue of the lungs to unfold and fill it with air. This main muscle of inspiration. The excursion (movement) of the diaphragm during quiet breathing is 1-2 cm, during deep forced breathing - 6-8 cm. Each centimeter of movement of the diaphragm is an additional volume of air carrying oxygen for the body tissues.

In addition, the diaphragm is an ordinary muscle, the same as on the limbs and torso. With the difference that the result of its work is breathing, and not movement in space. It, like any other muscle, can be weakened and not cope with its function, it can be excessively shortened. Dysfunction of the diaphragm manifests itself in limited respiratory movements. The work of many organs that depend on it is also disrupted.

On top of the diaphragm lies the heart and lungs, below the abdominal organs - the stomach, liver, spleen, intestines. With each downward movement of the diaphragm, “squeezing” blood from the liver and spleen, which are a depot of venous blood in the body, which activates the work of these organs and increases venous return to the heart.

The pericardium, which covers the heart and forms the pericardial sac, is tightly fused with the tendon center of the diaphragm and with each respiratory movement its dense tissue is stretched, improving blood supply to his own and the heart muscle.

The position of the diaphragm directly affects the position of the heart - the higher the diaphragm, the more it compresses the heart. The lower the diaphragm, the better conditions are created for the heart to work in the diastole phase.

The diaphragm has several openings for the aorta, inferior vena cava and esophagus. The aorta passes between the crura of the diaphragm (muscle cords that attach to the vertebrae) in close proximity to the spine. The diaphragm has little effect on it. As the legs contract, the aortic bed deepens, and even with intense breathing, arterial flow is not disturbed.

On the contrary, the condition of the other two perforating structures - the esophagus and the inferior vena cava - is determined by the muscular work of the diaphragm. So, when contracting, the muscle fibers, shortening, stretch the tendon center, and the opening of the vena cava takes on a four-sided shape.

Facilitates the movement of venous blood from the lower extremities, abdominal and pelvic areas. As you exhale, the diaphragm relaxes, the opening takes the form of a slit and plays the role of a venous valve to prevent the reverse flow of blood. The diaphragm is the body's venous pump. If its excursion is insufficient, venous stagnation is formed, and the body’s blood circulation worsens. On the contrary, deep breathing actively “displaces” blood throughout the body. Against the background of muscle work, increased blood flow correlates with increased metabolism (metabolism) in tissues and organs.

Now let's think about the esophagus. The opening of the esophagus is muscular; here the diaphragm solves the problem of the muscular sphincter between the esophagus and the stomach. When it contracts, the lower esophageal sphincter strengthens(cardia) and the contents of the stomach are not thrown into the esophagus. Weakening of the muscle contraction of the diaphragm leads to the formation of gastroesophageal reflux (reflux of gastric contents into the esophagus) and diaphragmatic hiatal hernia.

To summarize, the therapeutic effects of breathing with active excursion of the diaphragm are:

  • an increase in respiratory volumes and, as a consequence, an increase in gas exchange and blood oxygen saturation;
  • improving venous outflow from the lower extremities, abdominal and pelvic areas;
  • increased venous return to the heart, as a result, increased systemic circulation;
  • massage of the abdominal organs, improving blood flow in them.

And of course, the most important function of the diaphragm is participation in breathing. Inhalation is active muscular process of expansion of the thoracic cavity. The leading role in this belongs to the diaphragm. For most people, it provides 2/3% of ventilation and is a support for the work of the remaining respiratory muscles.

  • Inhalation begins with a radial contraction of the muscle fibers of the diaphragm, as a result, the points of attachment of the fibers begin to approach each other.
  • Initially, the peripheral osteochondral attachment sites of the diaphragm serve as fixation and the tendon center descends ( increase in the vertical size of the chest cavity).
  • Then, due to the tension of the mediastinum (above the diaphragm) and the resistance of the mass of the abdominal organs (below the diaphragm), the tendon center is fixed.
  • continued contraction of the muscle fibers of the diaphragm raises the lower ribs ( expansion of the transverse dimension of the chest)
  • the point of fixation is the costovertebral joints, the ribs rising (verticalizing) raise the sternum
  • due to the rise of the sternum and contraction of the intercostal muscles, the middle and upper ribs rise ( the chest expands in the anteroposterior direction)
  • The inhalation ends with the lifting of the upper part of the sternum and collarbones by contraction of the scalene and sternocleidomastoid muscles.

As a result, the chest cavity expands in all directions. By negative pressure gradient air fills the lungs.


The position of the chest during exhalation (A) and inhalation (B) and the diaphragm during exhalation (a), normal inhalation (b) and deep inhalation (c)

Connection with the abdominal muscles

Exhalation occurs predominantly passively, due to the relaxation of working muscles. Except for the little “but”. Aperture works in dynamic equilibrium with the muscles of the anterior abdominal wall (often called the abs). When you inhale, contraction and flattening of the diaphragm expands the chest cavity and tends to move the abdominal organs. This is possible due to the relaxation of the abdominal wall muscles - and a noticeable protrusion of the abdomen.

As you exhale, the tone of the abdominal muscles increases, increasing intra-abdominal pressure, they push the internal organs upward, raise the tendon center of the diaphragm and reduce the volume of the chest cavity. With the return of the diaphragm, the ribs and sternum descend. After relaxation, the muscles are again ready to inhale.

The diaphragm and abdominal muscles are antagonists. As you inhale, the diaphragm is contracted, the abdominal muscles are relaxed. As you exhale, it’s the other way around: the diaphragm is relaxed, the abdominal muscles are actively contracting.

Learning to feel your diaphragm is important in any breathing exercise. To feel the movements of the diaphragm, you need to concentrate on the arch of the lower ribs along the entire perimeter of the chest. When you inhale, tension arises there; this is the diaphragm.

Conscious control over the activity of the diaphragm consists of regulating the rhythm of its contractions. Breathing through the diaphragm is called abdominal or diaphragmatic breathing.

Knowing where the diaphragm is and what its role is, you can perform breathing exercises consciously. And awareness is the key to the success of any business.