Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

Filtering by Tag: diaphraghm

Adventures in the Respiratory Diaphragm

Up until this year, the respiratory diaphragm was a mysterious internal object.  I did know it existed, but the specifics were never really explained to me, and as a string player, breathing mechanics was never exactly emphasized.   However, no matter your instrument or occupation, your diaphragm is "arguable the most important muscle in your body.  If it ceases to function, you will expire."  (Jill Miller, the Roll Model).  What that means is that everyone should know that they have a diaphragm, and what it does.  (PS. For meat eaters, this is a skirt steak.  You can probably see why from the image). 

Last week, I talked about misnomers in response to the word core- think less 6 pack and more abdominal sleeving.  Now, I want you to add respiratory diaphragm to that definition of core.  It's your innermost core, and definitely worth talking about.  To get started, watch this quick video which gives some good definition. 

The diaphragm is a dome shaped muscle attaching to your lower six ribs, separating your organs from your heart and lungs.  On an inhale, your diaphragm contracts and basically acts as a suction to draw air into the lungs.  On an exhale, it relaxes and pushes air up and out.  (There's also a whole thing about pressured gases, O2 and CO2, but that's more science-y).  Most importantly, your diaphragm attaches to your ribs and your lumbar spine, which means that your day to day alignment, standing, sitting, and shoe choices not only affect your spine and pelvis, but your diaphragm and therefore, your capacity to breathe.  Let me repeat that with feeling: your poor posture, your high heels, your slumpy shoulders all = restriction in the respiratory diaphragm because they affect the position of the rib cage and spine.

In this extreme example of postural decline (and a dowagers hump), you can see how breathing mechanics would be completely distorted because of postural misalignment.  There's no way for the ribs to expand or the diaphragm to move much!

In this extreme example of postural decline (and a dowagers hump), you can see how breathing mechanics would be completely distorted because of postural misalignment.  There's no way for the ribs to expand or the diaphragm to move much!

Here is a fun fact: you take about 20,000 breaths a day, so why not bring some love to this amazing muscle?  When your diaphragm is not working properly, it can affect digestion, the pelvic floor muscles, circulation, and most obviously, your stress.  When discussing the autonomic nervous system in August, I mentioned how the breath is the most powerful way to gain control of fight of flight in performance.  (If you sing or play a wind/brass instrument, this is also essential to just play your instrument). 

To get started, what can you do about this?  Notice where you breathe-inflate the belly on the inhale, and see if you can spread the ribs apart, and then on exhale, belly pulls in, ribs together.  If you tend to breathe shallowly (either from asthma or stress patterns), see if you can deepen your breath by breathing down into your abdomen.  If you regularly wear elevated heel shoes, stop doing that and notice if you capacity to breathe changes.  And lastly, if you are a slumper, you are affecting your breathing by diminishing the diaphragm's ability to expand and contract by decreasing the space in the rib cage.


Ditch the Spanx, Keep Your Viscera Where They Belong

"Live the Dream," pssh...I'd rather breathe better.

"Live the Dream," pssh...I'd rather breathe better.

I realize that the topic of Spanx may seem outside the scope of the blog (now I'm telling people about undergarments?), but I promise there's a logical explanation.  When most women prepare for a recital or fancy engagement, there are usually a few concerns: the fancy dress, the fancy shoes (usually heels, much to my chagrin), and what to wear under the dress (often spanx).  Now I've ranted at length about the perils of performing standing in heels, but did you know that those spanx aren't helping anything either?  The combination is actually a bit of a biological nightmare, especially when coupled with performing and needing to breathe.  So what's the problem?

1.  Spanx and other minimalizing garments push your viscera into your diaphraghm and belly.  Basically, your squishing your wobbly bits inside of you, or pushing in and up. 

2.  This pressure can make breathing more difficult, and depending on the undergarment, prevent diaphragmatic breathing and fully belly expansion.  In addition, the pressure compromises digestion (hello, acid reflex!) and puts extra strain on the pelvic floor.

Sara Blakely, owner of Spanx, rocking the garments and the heels.  I feel pity for her innards. 

Sara Blakely, owner of Spanx, rocking the garments and the heels.  I feel pity for her innards. 

3.  Compressing garments are like orthotics for your belly, encouraging your core muscles to just check out completely instead of supporting you in a normal engagement pattern.

4. Shapewear is entirely cosmetic and not therapeutic.  Did you know that spanx now makes garments for men?  This conversation is not just for the ladies...

5.  When women wear heels, their spine and pelvis are out of alignment as well as causing mayhem for the pelvic floor muscles.  (Neutral pelvis is best for pelvic floor strength!)  Then remember that heels also compromise your ability to use your respiratory diaphragm...which you definitely need when performing, no matter your instrument.  Couple that with an elastic corset cinching your bits, and you've got a respiratory disaster! 

My big picture takeaway is that heels alone do lots of damage, as do spanx (as well as making life less pleasant), but combining them, especially for concerts, hinders performance.  Factor in your personal response to the stress of performance, and your body just needs more air and the capacity to breathe fully, without constriction.  Most wind players know this, but for some reason, vanity reigns supreme for many other musicians.  Breathing is so important, especially when under performance stress, so consider ditching the heels and spanx to play better, breathe, and keep your food where it belongs...

*On a side note, celebrities wear spanx all the time to hide their "flaws."  This perpetuates the idea that a flawless body is the norm, not the exception, and that to wear an evening gown with visible cellulite is a grave offence.  Unfortunately, that's just not a healthy or helpful notion to be sharing with the world, especially with women.*

Human Body Mythbusters: Musicians' Edition

So I'm sure I've ranted before that musicians should take anatomy/physiology classes and learn a bit more about self-care, but more importantly, let's look at some of the most frequent myths I get to bust in lessons, classes, friendly conversations, and emails. 

A lovely small image from Gray's Anatomy.

A lovely small image from Gray's Anatomy.

1. Your rotator cuff is one giant muscle, and you can tear it.  Well, yes, you can, but the rotator cuff actually refers to four muscles that assist in the movement of your arm and scapula.  If someone tells me they hurt their shoulder and "tore my rotator," I always ask them which one, which they inevitably can never answer. ( At least figure out what range of motion hurts, and then remember which muscle you hurt.  "Everything hurts" is not helpful.)

2. Your core refers to your abdominals exclusively.  I despite this misunderstanding, perpetuated by the fitness realm of "burn," "shred," "melt," and "tone," your abs.  Your core, refers to the entire muscular sheathing of your viscera and spine, which includes your abdominals (6 pack, obliques, transverse), back muscles, diaphraghm, psoas, and more, depending on your definition.  Some folks define core as include hip musculature too, so that's open for debate.  Either way, your 6 pack is not your core, although it is part of it, and doing sit-ups will not invariably cure back pain although strengthening the whole core might help.

Image courtesy of

Image courtesy of

3.  Your fingers start at your knuckles.  Nope.  While this is not intuitive, the bones that make up your metacarpals and phalanges originate at your wrist.  Your wrist position while playing your instrument directly affects your ability to use your fingers, and when you think of fingers articulating, they begin their articulation from the wrist.  In addition, your have minimal musculature in the hand, but instead the bulk of your musculature in your forearms.

4.  Your respiratory diaphraghm cannot be stretched.  So your diaphraghm is a muscle, which means that it can be tight, loose, weak, and strong, in various degrees.  Your diaphraghm is also a muscle nestled within your rib cage which helps your lungs to inflate and deflate. In addition, the muscles around your ribs can also be tight, loose, weak, and/or strong, which also affects your respiration.  There are interesting ways to stretch your diaphraghm (for another day-ooh la la!) as well as open up the muscles on the sides of the ribs, which can help your breathe more easily and more fully (good for most musicians and people at large).  PS.  The narrator in this video has a hilarious accent.

Amazing and interesting!

Amazing and interesting!

5.  The tongue is one big muscle.  Your tongue, ladies and gentleman, is a structure composed of eight separate muscles, attaching at various bones including the hyoid bone, mandible, and styoid process.  Without dwelling on the anatomy too much, take a look at this picture and be amazed!

6.  Standing with my feet turned out is natural.  Nope.  I've had a chat about this before, especially in relation to violin pedagogy, but here are a few thoughts.  Just because everyone does something, doesn't mean it's natural.  Everyone currently sits 6-8 hours a day, but that's not biologically natural.  Just because everyone turns out their feet doesn't mean that's natural either.  The more you turn out your feet and legs, the more likely you hyperextend your knees and flatten your pelvic/low back curves.  When your feet face parallel (or close), you walk in a manner that is more biomechanically sound for feet, knees, and hips, and can help change your pain patterning.

BONUS!  (Just thought of a few more to add as of 5 PM today.)

7. Sitting, standing, and playing with poor posture won't affect my long term body health.  Nope.  I've talked about this a lot, and I'm sure it gets boring to read about, but the way you move affects your tissues!

8.  Wearing High Heels Regularly Won't Affect My Body.  This is a biggie.  If you only wear them to sit in, then sure, you might be ok.  Walking and standing in them regularly will affect your alignment, your back, your knees, and possibly cause you bunions.  Save them for super special occasions and don't regularly concertize or audition in them.

9. Many of the great players had ridiculous setups and strange posture.  They didn't hurt -why can't I play that way?  In regards to string technique, much has changed in the last fifty years.  We no longer teach to learn how to play, but we teach folks (hopefully) in a way that not only imparts knowledge of how to play an instrument, but how to play it sustainably for a long time.  I can't know if famous musicians of the twentieth century were ever in physical pain from playing.  My guess is, yes, they were in pain sometimes, and no, there weren't an abundance of tools at their disposal for improving their setup.  My friend Molly Gebrian said this quite eloquently last week: "Great players played well not because of their (idiosyncratic) technique, but in spite of it."  That means you don't necessarily want or need the setup of famous 1940's violinists.

10.  If I just take an anti-inflammatory drug, all of my wrist/arm/shoulder/back pain will go away.  So if you just treat the symptom (pain/discomfort/tingling) and don't address the cause (misalignment, tension, overuse, too much playing, poor sleeping/standing/sitting alignment, etc.) the pain will most likely be chronic.  NSAID's can be important sometimes in treating serious inflammation and wounds, but we often medicate without thinking of the obvious thing: our body has an inflammatory response to treat tissue damage for a biological reason.  

"Overuse of the muscles causes cells to break down, releasing waste products, which produces pain and inflammation.  Cleanup crews in the form of white bloods cells called macrophages carry away the cellular debris. If you take anti-inflammatory drugs at this time, the natural inflammation process is disrupted and instead of being cleansed away in the blood stream, the trash settles into scar tissue." - Dr Emil Pascarelli

Maybe reconsider the next time you reach for the Advil, and instead ask, "why do I hurt?" and "Is there any other way I can treat this right now?"

While the body is a complex and interesting structure, many of our bodily misconceptions have affected how we play and how teach.  If one of these concepts resonated with you (pun intended), think of how it can help your students and your own practice!

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