The Role of the Diaphragm in Trunk Stability
Top Contributors - Carin Hunter, Ewa Jaraczewska, Jess Bell, Kim Jackson and Merinda Rodseth
Diaphragm: Balance, Gait and trunk stability
- Diaphragm plays a big role as a trunk stabilizer in addition to balance and walking in conjunction work abdominal muscles and paraspinal muscles.
- plays a role in respiration and trunk stability by controlling intra-abdominal pressure and reducing the stress on the spine through cooperative action with the abdominal and pelvic floor muscles (23)
Diaphragm : core stabilizer
- Muscle of Abdominal Straining
The contraction of the diaphragm will assist in the contraction of the muscles of the anterior abdominal wall in raising the intra-abdominal pressure will normal processes like micturition, defecation, and parturition.
- Weightlifting Muscle
When a person takes and holds a deep breath, the diaphragm will assist the muscles of the anterior abdominal wall to raise the intra-abdominal pressure. This maneuver is also called as Valsalva maneuver and is used to augment heart murmurs and classify them whether they are clinically right-sided or left-sided.
Diaphragm and the CORE!
- The diaphragm, the multifidus muscle, the transverse muscle of abdomen, and the pelvic floor muscle, act as one unit at the center of functional kinetic chains
- Michael et al. noted that the co-contraction of the abdominal muscles and the diaphragm increases intra-abdominal pressure, fixes the trunk, and reduces the stress on the spine, especially the lumbar region (24)
- https://movement-as-medicine.com/why-and-how-we-program-breathing-exercises/
Thoracoabdominal Pump
- When people breathe in, the diaphragm descends, which decreases the intrathoracic pressure and improves the intra-abdominal pressure. This compresses the blood in the inferior vena cava (IVC) and forces it upward into the right atrium and helps to fill the heart. When abdominal lymph vessels are also compressed, its passage upward within the thoracic duct is aided by the negative intrathoracic pressure. Furthermore, valves in the thoracic duct prevent the backflow of the lymph in the thoracic duct. (5)
Trunk stability
- 2 types of spinal instability: gross: obvious radiographic displacement of the vertebra associated with neurologic deficit and deformity.
- Functional/ clinical instability: "clinical instability as the loss of the spine's ability to maintain its patterns of displacement under physiologic loads so there is no initial or additional neurologic deficit, no major deformity, and no incapacitating pain“(25)
- •Core strength provides proximal truncal stability for distal mobility. Hence most of our exercises will focus on mobility of extremities along with core/ lumbar stabilization with deep breathing techniques. • Training of the core is a coordination of both sensory and motor inputs, comprising of Neuromuscular control, Passive structural components (osseous and ligamentous elements) and Active mobile components (29 pairs of muscular elements).
Overview on Muscle systems
•Local muscle system and global muscle system: Local muscle system are slow twitch muscles, deep layer, controls intersegmental movements. Respond to changes in posture and extrinsic loads. Key local muscles include transversus abdominus, multifidi, internal oblique, deep transversospinalis, and the pelvic floor muscles.
•Global muscle system: fast twitch, long and possess large lever arm, produces torque and gross movements. Key global muscles include erector spinae, external oblique, rectus abdominis muscles, and quadratus lumborum
References
23. Coexistence of stability and mobility in postural control: evidence from postural compensation for respiration.,Hodges PW, Gurfinkel VS, Brumagne S, Smith TC, Cordo PC. Exp Brain Res. 2002 Jun; 144(3):293-302
24. Michael S, Erik S, Udo S: Thieme-Atlas of Anatomy, New York: THieme Stuttgart, 2006, pp 130–137. Support CenterSupport Center
5. McCool FD, Manzoor K, Minami T. Disorders of the Diaphragm. Clin. Chest Med. 2018 Jun;39(2):345-360
25.Panjabi, M.M. Clinical spinal instability and low back pain. J. Electromyogr. Kinesiol. 13:371-379, 2003.
