The diaphragm — More than an inspired design

摘要

There is arguably no other muscle in the human body that is so central literally and figuratively to our physical, biochemical and emotional health as the diaphragm. From its most obvious role in respiration, to its less obvious roles in postural stability, spinal decompression, fluid dynamics, visceral health and emotional regulation, the diaphragm has a repertoire of function that is broad by any muscle's standards. In this editorial, the two accompanying papers by Montes et al. (2017) and by McCoss et al. (2017) provide new insights into the diaphragm's interconnected role with trunk stability and, via a somato-somatic reflex, the effects of the diaphragm release on nociception in the neck, respectively. The diaphragm has long been considered a key part of the trunk's stability mechanism by Strength & Conditioning Coaches (Chek, 1994) and Rehabilitation specialists (Lee, 1998) alike; it is considered frequently underactive by specialists in breathing rehabilitation (Chaitow, 2014); it is found to be a key muscle in those therapists working with somato-emotional release (Manheim and Lavett, 1989); and is considered a metaphorical and literal transitional point between the reptilian functions of the body and the mammalian limbic-emotional functions of the body. Osteopaths have long considered the respiratory diaphragm part of a multi-diaphragm system for regulating pressure within body compartments (starting with cranial dura, then sequentially the suboccipi-tal group; the supra-hyoid group, muscles of the nasopharynx, glottis and sphenoid-ethmoid palate; the pleural dome and cervi-cothoracic fascia (Paoletti, 2015); the diaphragm proper; and the pelvic floor (Keleman, 1989)).