Diaphragm and Digestive Dysfunction (Heartburn/GERD/Acid Reflux/Hiatal Hernia)

I have become more and more aware that breathing is an important part of health and wellness.  I talked about the relationship with anxiety in the last post.  Anxiety is not only mental distress, but can cause muscle tension, chest pain, and digestive disorders. 

The diaphragm is a unique dome-shaped muscle controlling breathing.  It is located horizontally separating the thoracic cavity (containing lungs, heart and etc) and the abdominal cavity (stomach, liver, intestines and etc.).  The esophagus, vena cava, and aorta pass through the middle of it.

With proper breathing, the diaphragm contracts when we inhale, moving down and expanding the thoracic cavity to suck the air in, and the diaphragm completely relaxes when we exhale.  We do this about 26,000 times a day.

If we have shallow chest breathing, where the diaphragm can’t fully contract and relax, it loses the elasticity and tightens like any other muscles. The dysfunction of the diaphragm could cause adhesion with the stomach, or squeeze the esophagus, causing digestive disorders like GERD and hiatal hernia.

Here is how it happens.

Anxiety/stress ➜  Incorrect breathing (shallow breathing) ➜  Diaphragm dysfunction ➜ Stomach dysfunction ➜  Digestive disorders 

I found very helpful and comprehensive videos about understanding heartburn and GERD and an abdominal massage for hiatal hernia.  Although I never had hiatal hernia, massaging the middle of the stomach right below the breastbone and rib cage has been effective for me to relieve the pain in the upper stomach because of indigestion.

It is important to massage other abdominal muscles (will post in the future) and use the breathing exercises in order to maintain the healthy digestive functions.

Front/Back Relationship

At massage school, the relationship between front and back of the body was emphasized from the beginning.  If you have back pain, pay attention to the front; the abdomen.  If the pain is in the upper back, work on the chest.  It is an amazing concept, and it has been so true.   

When I work on clients, I never forget the front/back relationship and always work on other than painful areas, but I almost forgot to apply it to myself!  Just a few days ago, I threw up in the evening (not food poisoning or stomach flu, thankfully), and I woke up next morning with the pain all over my back (mid-back, ribs, and low back).  First, I thought I slept too long, but if that happens, pain is normally limited to a specific area, not all over my back.  I massaged every possible trigger point in the back with a tennis ball and a Body Back Buddy and used a heat pack.  It got a little bit better for a while, but the pain came back.  I knew I was not doing right.  As a massage therapist, it was frustrating not to know what to do with my own pain.

Then, I remembered that distressed internal organs could cause pain in the back, so my attention shifted from the back to the stomach.  And finally, I remembered the trigger points and referred pain of the abdominal muscle (rectus abdominis), the “six-pack.”  This muscle plays a role in childbirth, vomiting, urination and defecation.

Trigger Points

Referred Pain in the Back

I started massaging the upper trigger points just below the ribcage.  There was definitely a tender spot in the right side.  I also massaged along the muscle side to side and the lower trigger points for low back pain.  Not long after, the pain subsided, and I finally felt comfortable.

This episode is self-anecdotal, but it definitely reinforced the importance of the front/back relationship.