What should you know about diaphragm manual therapy?

The diaphragm sits beneath the lungs and works with the ribs, abdominal wall and muscles around the spine. A physiotherapist may observe breathing, feel rib movement and assess tension in the chest wall, upper abdomen or back. Treatment can involve light pressure, guided breathing, rib movement and posture work.

The aim is usually to improve comfortable movement and reduce guarding in related tissues, not to force the diaphragm or replace assessment of heart, lung or abdominal symptoms. Hands-on care may be included within a broader plan for neck or back pain, including symptoms associated with cervical spondylosis, myofascial pain syndrome, sacroiliac joint dysfunction or whiplash.

Wear clothing that allows the therapist to see and gently access the rib cage and upper abdomen. Tell them about recent surgery, pregnancy, osteoporosis, reflux, breathing problems, abdominal pain, bruising, medicines that affect bleeding, and any discomfort with touch or lying flat.

During treatment, describe pressure, pain, dizziness or breathlessness as soon as they occur. A useful plan may also include relaxed breathing, thoracic mobility, posture changes and strengthening matched to your examination. Do not press deeply into the abdomen yourself without professional instruction.

Stop the session and seek urgent care for new or severe breathlessness, chest pressure, fainting, blue lips, coughing blood, severe abdominal pain, vomiting blood or sudden neurological symptoms. These problems need medical assessment rather than manual treatment.

Ask what is causing your symptoms, whether hands-on work is suitable with your medical history, which area will be treated, what sensations are expected, and how progress will be measured alongside exercise.