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What to Know About a Tight Diaphragm

Medically Reviewed by Dan Brennan, MD on June 12, 2021

The diaphragm is an important respiratory muscle. It’s large, dome-shaped, and found below the lungs, around your lower-to-middle rib cage. When you inhale, your diaphragm lowers and helps your lungs expand so you can take in air. When you breathe out, it goes back to its original position.

Causes of a Tight Diaphragm

If you love working out, you may experience a tight diaphragm. When this happens, you feel a sharp pain on your side that interferes with your breathing. It’s referred to as a diaphragm spasm. Deal with it by taking a break until the cramp stops.

Like most people, you may resort to chest breathing when you are stressed. This causes some tension in your diaphragm, which results in tight muscles around your shoulders and neck and may lead to headaches.

Other causes include pregnancy, anxiety, hiatal hernia, trauma from an accident, problems with your bladder, and nerve damage.

Symptoms of a Tight Diaphragm

Symptoms depend on the cause and may be severe or mild. You diaphragm may be tight when you have:

How to Treat a Tight Diaphragm

Unless you have a ruptured diaphragm or hurt yourself through an accident, treating diaphragm pain is easy.

Use proper breathing techniques. According to Northwest Medicine Doctors, if your diaphragm tightness results from working out, deep belly breathing should offer you some relief. Belly breathing refers to using your stomach instead of your chest to breathe.

Deep breathing or diaphragm breathing strengthens your diaphragm, uses less effort, and decreases oxygen demand. Lie down on your back and place pillows below your knees to raise them. Put one hand on your chest and the other on your lower rib cage so you feel your diaphragm.

Breathe in slowly so that your stomach moves up while the hand on your chest remains as still as possible. Once you master diaphragm breathing while lying down, practice it while standing up.

Watch how you work out. Warm up properly before any vigorous activity to reduce the chances of getting diaphragm spasms during workouts. If you get a tight diaphragm while running, stop, take a deep breath and slowly breathe out, making sure all the air leaves your lungs. As you breathe out, drop your shoulders, shake your arms and legs, and relax.

Treat hiccups.Hiccups are repeated diaphragm spasms. They happen when your diaphragm pulls down when you breathe in, but the glottis (space between your vocal cords) closes, stopping more air from coming in. That’s why you have a "hic" sound.

Treat hiccups by drinking a lot of water quickly, holding your breath, sticking your finger down your throat, or pulling your tongue gently. If your hiccups stay for more than two days, see a doctor.

Treat hiatal hernia.Hiatal hernia is when your stomach pushes itself up against an opening in your diaphragm into your chest, pinching your stomach and causing acid reflux (stomach acid backup). It’s usually a result of coughing, vomiting, pregnancy, obesity, strained bowel movements, or sudden physical movement.

Treatment usually depends on your age, health, and symptoms. If it’s severe, a doctor may recommend medicines to weaken and neutralize the stomach. You may also get medication to make your esophageal sphincter, the muscles above the esophagus, stronger, so it stops stomach acid from backing up into your esophagus.

Change your lifestyle. This includes avoiding foods that cause heartburn, eating smaller portions, working out, improving your posture, and losing weight if you’re obese. Always warm up and stretch before working out.

Learning to cope with stress by balancing your work and home, connecting with supportive people, meditating, and doing yoga also help reduce diaphragm tightness and painful neck and shoulders.

When to See a Doctor

Visit a doctor right away if you get into an accident or undergo trauma. You should also see a doctor when the diaphragm tightness persists and comes along with nausea, vomiting, and respiratory distress.

Treating diaphragm pain depends on its cause. If it’s because of working out, you'll feel relief as soon as you rest. It will take longer to get relief if the reason is trauma. Medication will help when dealing with illnesses such as hiatal hernias. Ultimately, changing your lifestyle may be the best medication.

Show Sources

SOURCES: 

American Family Physician: “Pleuritic Chest Pain: Sorting Through the Differential Diagnosis.”

BioMed Research International: “Effect of Different Head-Neck Postures on the Respiratory Function in Healthy Males.”

British Journal of General Practice: “Hiccups: a common problem with some unusual causes and cures.”

CHEST JOURNAL: “Treatment for Idiopathic Diaphragm Flutter.”

Cureus: “Symptomatology Correlations Between the Diaphragm and Irritable Bowel Syndrome.”

Harvard Health Publishing: “Learning diaphragmatic breathing.”

Integrative Physiological and Behavioral Science: the official journal of the Pavlovian Society: “Diaphragmatic spasm: a neglected cause of dyspnea and chest pain.”

International Journal of Yoga: “Positive Effects of Yoga on Physical and Respiratory Functions in Healthy Inactive Middle-Aged People.”

JOURNAL OF APPLIED PHYSIOLOGY: “Action of the diaphragm on the rib cage.”

Journal of Exercise Rehabilitation: “The effect of warm-ups with stretching on the isokinetic moments of collegiate men.”

Journal of Neurogastroenterology and Motility: “Hiccup: Mystery, Nature and Treatment.”

Journal of Sports Science & Medicine: “Repeated Abdominal Exercises Induces Respiratory Muscle Fatigue.”

MEDICINE PHARMACY REPORTS: “The management of hiatal hernia: an update on diagnosis and treatment.”

Medicines: “Effects of Diaphragmatic Breathing on Health: A Narrative Review.”

Northwestern Medicine: “4 Breathing Techniques for Better Health,” “Causes and Diagnoses of Disorders of the Diaphragm.”

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