Lung volume intercostals relaxed

Animated online

Lung volume diaphragm relaxed

Intercostal muscles

Diaphragm muscle

Lung volume intercostal muscles contracted

Figure 2b: Contraction of intercostal muscles during inspiration

Lung volume diaphragm contracted

increased vertical height due to contraction of diaphragm

increased

lateral width due to contraction of intercostal muscles

muscles are other primary muscles of inspiration. The external intercostals (Figure 3) elevate the ribs and sternum and increase the volume of the thoracic cavity, thus helping to bring air into the lungs. The abdominal muscles (the rectus abdominus, transverse abdominus, external obliques and internal obliques) are secondary to the intercostals, with a role in forced expiration rather than the passive exhalation of a person at rest. They pull the lower ribs downward (4). Other muscles involved with breathing It is very common when forcing breath in and out during exercise for other muscles to be called into action. The use of these muscles must also be considered when addressing issues of proper control, tone and quality of breath. Activation of these muscles can also come about because of other physical factors, such as damaged lung tissue (5). The muscles include the scalenes, the pectoralis major and minor, the serratus anterior and latissimus dorsi, the iliocostalis, upper trapezius and quadratus lumborum and the levatores costarum, serratus posterior and subclavius (2).

Figure 2a: Movements of the diaphragm and lungs during inspiration

Figure 2c: Contraction of the diaphragm muscle during inspiration

move. This is an active process, in contrast to the passive process seen during the out breath. The diaphragm relaxes and moves upwards again, which in turn increases the intrathoracic pressure and expels air from the lungs (Figure 2b). The movement of the diaphragm

downwards with each inhalation gives the internal organs a gentle massage. Every breath displaces and gently moves the viscera with an ebbing and flowing motion. A change in the breathing pattern and thoracic breath (chest breathing) can result in stagnation of the organs and fascia. As well as thinking about the connective tissue that surrounds every single muscle fibre, muscle fibre bundle and muscle group, we must consider the supportive role of connective tissue in holding the organs within the abdomen and allowing constant communication between the breath and abdominal movements.

22 IS MANUAL THERAPY

The muscles of breathing The intercostals and abdominals As we have seen, the diaphragm is the major muscle in costovertebral breathing, but many other muscles come into play for respiration (Box 1). The intercostal and abdominal

TREATMENT IS AS MUCH ABOUT EDUCATION AS IT

Figure 3: The external intercostal muscles

Influence of the internal organs As well as the musculature in the torso, the organs in the abdomen affect the diaphragm. If there is reduced movement in any organ or fascial chain anywhere within the abdomen, there will be limited movement of the diaphragm and uneven pressure during inspiration (1). Organ mobility and organ function can be compromised through stress and poor posture. The slouched position that so many of us succumb to can cause chronic passive congestion in any or all of the viscera (6). As each organ is subject to its own limitation of movement, the descending diaphragm is limited a little by all of them. Therefore restriction of the organs can restrict the diaphragm, and insufficient movement of the diaphragm will in turn stagnate the organs. This reciprocal relationship is of paramount importance. The lower part of the abdominal space contains the pelvic diaphragm comprising the levator ani and coccygeus. In a true breath contraction (that is, abdominal rather than thoracic) downward movement of the diaphragm happens before the lower ribs start to move outwards (7). (Although the breathing starts with

sportEX dynamics 2010;23(Jan):21-26

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