How similar are the neuromuscular responses to pain with Chronic low back pain and GI pain? Join Susan and Erica in a great discussion of the role of the diaphragm and how this changes with pain and inhibiition/over-recruitment in the system. In chronic low back pain and abdominal bloating/distention the diaphragm becomes a postural control muscle which greatly limits the respiratory ability and is an ineffectual model for spine stiffness and visceral organ pusher. This is an excellent discussion following the podcast episode 185. 

1) Kolar P, Sulc J, Kyncl M, Sanda J, Cakrt O, Andel R, Kumagai K, Kobesova A. Postural function of the diaphragm in persons with and without chronic low back pain. J Orthop Sports Phys Ther. 2012 Apr;42(4):352-62. doi: 10.2519/jospt.2012.3830. Epub 2011 Dec 21. PMID: 22236541. 2) Villoria A, Azpiroz F, Burri E, Cisternas D, Soldevilla A, Malagelada JR. Abdomino-phrenic dyssynergia in patients with abdominal bloating and distension. Am J Gastroenterol. 2011 May;106(5):815-9. doi: 10.1038/ajg.2010.408. Erratum in: Am J Gastroenterol. 2011 Jul;106(7):1405. PMID: 21540894. 3) Sicilia-Gomez C, Fernández-Carnero S, Martin-Perez A, Cuenca-Zaldívar N, Naranjo-Cinto F, Pecos-Martín D, Cervera-Cano M, Nunez-Nagy S. Abdominal and Pelvic Floor Activity Related to Respiratory Diaphragmatic Activity in Subjects with and without Non-Specific Low Back Pain. Diagnostics (Basel). 2022 Oct 18;12(10):2530. doi: 10.3390/diagnostics12102530. PMID: 36292219; PMCID: PMC9600311. 

 

 

A glance at this episode:

• [0:01] Diaphragm function, GI dysfunction, and postural control

• [7:51] GI dysfunction and its impact on abdominal wall muscles and posture

• [13:39] Abdominal dysfunction and diaphragm movement in relation to chronic low back pain

• [20:36] Treating chronic low back pain through abdominal wall retraining

• [25:09] Abdominal wall deficit and diaphragm dysfunction in chronic low back pain patients

• [32:07] Treating gas and bloating through diaphragm therapy

• 36:32] Treating GI dysfunction through breathwork and positioning

Related links:

• Tough To Treat Website

• Erica’s Course: Decoding the Complex Patient

• Susan’s Pelvic Health Education Subscription

• Access the Transcript