Breathing, Posture, and Movement: Foundations of Health, Physical Function, and Quality of Life
The Relationship Between Diaphragmatic Breathing, Spinal Stability, Efficient Movement, and Physical Performance: Perspectives from Modern Science and Traditional East Asian Movement Practices
By Kyoshi Itzik Cohen Researcher and instructor of Okinawan martial arts, movement, and breathing; Head of the Teishinkan Center.
Breathing is one of the most fundamental processes essential to life. Yet its role extends far beyond supplying oxygen and removing carbon dioxide. Breathing is closely integrated with muscular activity, spinal stabilization, movement, and nervous system regulation. It influences how the body responds to both physical exertion and psychological stress.
At the center of this integrated system is the diaphragm, the primary muscle of respiration, which also contributes to the body's postural stabilization mechanisms, particularly those involving the lower back.
The relationship between breathing, posture, and movement has long been recognized in traditional Eastern movement practices. Over generations, systems integrating controlled breathing, physical movement, postural stability, and mental concentration have developed in India, China, Japan, Okinawa, and other regions of Asia. Modern research now makes it possible to examine some of these principles through physiology, biomechanics, and movement science.
Understanding this relationship is particularly important in two major areas: enhancing physical and athletic performance, and supporting health, functional capacity, and quality of life, including applications in rehabilitation and therapeutic exercise.

The Diaphragm: Much More Than a Respiratory Muscle
The diaphragm is a broad, dome-shaped muscle separating the thoracic cavity from the abdominal cavity. During inhalation, it contracts and descends, increasing the volume of the thoracic cavity and allowing air to enter the lungs. During relaxed exhalation, the diaphragm gradually relaxes, and air is expelled primarily through the elastic recoil of the lungs and chest wall.
However, the diaphragm's function extends beyond respiration.
Some of its muscle fibers attach to structures associated with the upper lumbar vertebrae, and it works in coordination with the abdominal muscles, back muscles, and pelvic floor. Together, these muscles contribute to the regulation of intra-abdominal pressure (IAP), one of the mechanisms involved in trunk stability.
Physiological studies have demonstrated that the diaphragm also participates in postural control and may become active in anticipation of limb movement. Its activity varies according to respiratory demands and the mechanical forces acting on the body during movement.
This leads to an important principle: the diaphragm performs a dual function, contributing to both respiration and postural stabilization.
Consequently, the respiratory and movement systems should not be regarded as entirely independent. They operate in coordination and influence one another.



Diaphragmatic Breathing: What Is It, and Why Is It Important?
Diaphragmatic breathing is a breathing practice that emphasizes the activity of the diaphragm and the coordinated movement of the rib cage and abdominal wall.
During comfortable inhalation, contraction of the diaphragm is accompanied by some expansion of the ribs and movement of the abdominal wall. During exhalation, these structures gradually return toward their resting positions, depending on the breathing pattern and the demands of the activity.
It is important to recognize that the diaphragm is already active during normal, healthy breathing. The purpose of diaphragmatic breathing exercises is not to activate an otherwise inactive muscle, but rather to improve respiratory control and coordination when necessary.
Diaphragmatic breathing exercises may help reduce unnecessary respiratory effort, encourage relaxation, and improve body awareness. In certain circumstances, they are also incorporated into pulmonary rehabilitation programs.
A distinction must be made between diaphragmatic breathing and deep or forceful breathing. Efficient breathing is not determined by the maximum volume of air that can be inhaled, but by how appropriately ventilation matches the body's physiological requirements.
Breathing that is excessively deep or rapid relative to metabolic demand may reduce blood carbon dioxide levels, potentially causing dizziness and other sensations of discomfort. Therefore, breathing practices intended to promote general health should emphasize comfortable, controlled breathing adapted to the individual.

The Relationship Between the Diaphragm, Lower Back, and Posture
The lower back must support mechanical loads and maintain stability during everyday activities such as standing, walking, sitting, carrying objects, and lifting.
Stability is not produced by a single muscle. Rather, it emerges from the coordinated activity of muscles, connective tissues, and neural control mechanisms.
The diaphragm contributes to this system alongside the transversus abdominis, the abdominal oblique muscles, the back muscles, and the pelvic floor.
When these muscles operate in coordination, they can contribute to the regulation of intra-abdominal pressure and establish mechanical conditions that support spinal stabilization.
Research by Hodges and colleagues demonstrated that the diaphragm is active not only during breathing but also when the body must respond to postural disturbances generated by limb movement. Additional studies identified relationships between diaphragmatic activity and changes in intra-abdominal pressure during movement.
These findings provide a scientific basis for understanding the relationship between breathing and lower-back stability.
However, an important distinction must be made between two concepts: stability and rigidity.
Good posture does not require continuous, forceful contraction of the abdominal and back muscles. On the contrary, efficient movement requires an adaptable balance between stability and freedom of movement.
Lifting a heavy load requires a different stabilization strategy from relaxed walking, balance training, or rapidly changing direction.
Increased muscular contraction may be beneficial for certain tasks. However, unnecessary muscular tension can increase energy expenditure and restrict movement.
The objective, therefore, is not to maintain constant muscular contraction, but to develop a system capable of stabilizing the body according to the demands of a particular activity.
These principles are discussed in greater detail in The Science and Tradition of Breathing and are integrated into the Integrated Respiratory Regulation Model (IRRM), which provides a framework for adapting breathing regulation to the individual, the situation, and the intended purpose.

Can Diaphragmatic Breathing Improve Posture?
Diaphragmatic breathing may play a role in training postural control and body awareness, particularly when combined with movement and stabilization exercises.
Appropriate practice can help individuals recognize breathing patterns associated with unnecessary muscular effort, improve coordination between movements of the rib cage and abdomen, and learn to adapt breathing to physical activity.
For example, an individual who excessively recruits the neck and shoulder muscles during relaxed breathing may benefit from exercises encouraging a more comfortable breathing pattern while reducing unnecessary muscular effort.
Nevertheless, diaphragmatic breathing should not be regarded as an independent method for correcting every postural deviation. Posture is also influenced by muscular strength, flexibility, coordination, movement habits, and individual anatomical characteristics.
The principal value of diaphragmatic breathing lies in its integration into healthy breathing habits and a broader movement-training approach.

Diaphragmatic Breathing and Lower Back Pain
The relationship between diaphragmatic function and lower-back stability has also attracted considerable interest in therapeutic and rehabilitation settings.
Studies have identified changes in the function of stabilizing muscles and breathing patterns in some individuals experiencing chronic lower back pain. However, these findings do not establish dysfunctional breathing as the cause of pain. Lower back pain is a complex condition influenced by physical, neurological, psychological, and environmental factors.
A systematic review and meta-analysis published in 2026 examined 17 studies involving 633 participants with chronic nonspecific low back pain. The review reported favorable outcomes associated with breathing exercises, including reductions in pain and improvements in physical function.
However, the researchers emphasized considerable variation among the studies and assessed the certainty of the evidence as low to very low.
There is currently insufficient evidence to conclude that diaphragmatic breathing alone can prevent lower back pain or address all of its underlying causes.
The practical conclusion is that breathing exercises may serve as a complementary component of rehabilitation programs, alongside physical activity, strengthening, motor-control exercises, and appropriate professional treatment.

Breathing and Movement in Sports: Stability, Strength, and Performance
In sports, coordination between breathing and muscular activity becomes particularly important.
During physical exertion, the body's demand for oxygen and the removal of carbon dioxide increases. The respiratory system responds by adjusting breathing frequency and depth according to exercise intensity.
At the same time, athletes must maintain stability, transmit forces between different body segments, and execute precisely coordinated movements.

Trunk Stabilization and Force Production
Activities such as weightlifting, running, jumping, pushing, and performing martial arts techniques require coordination between the muscles of the trunk and limbs.
Regulation of intra-abdominal pressure, abdominal muscle activity, and diaphragmatic function may contribute to the stability necessary for effective performance.
However, it is important to distinguish between force and power. Adequate stability can support force transmission, but rapid force production also requires precise timing, coordination, rapid muscular recruitment, and technical skill.
Furthermore, no single breathing rule applies to every physical activity. Exhaling during exertion may be appropriate for certain tasks, whereas maximal strength efforts sometimes involve brief increases in intra-abdominal pressure accompanied by breath-holding.
Such techniques, particularly the Valsalva maneuver, can produce substantial changes in blood pressure. Their use should therefore be adapted to the demands of the exercise, the athlete's technical proficiency, and individual health considerations.

Respiratory Muscle Training
Research has examined the effects of respiratory muscle training (RMT) on athletic performance.
Systematic reviews have reported improvements in respiratory muscle strength and certain measures of endurance and physical performance.
A review published in 2025, encompassing 25 studies and 522 athletes, reported positive effects on measures of respiratory muscle strength, together with some improvements in respiratory function and athletic performance. Nevertheless, the researchers noted that the certainty of the evidence was low to very low.
An important distinction should also be made between respiratory muscle training performed with specific resistance or loading and relaxed diaphragmatic breathing exercises. These are not equivalent methods, and they should not necessarily be expected to produce the same outcomes.
For athletes, breathing exercises should therefore be selected according to their training objectives: endurance, stabilization, force production, recovery, or regulation of physiological and psychological arousal.

Breathing, the Nervous System, and Stress Regulation
The relationship between breathing and health extends beyond the muscular system.
Breathing interacts closely with the autonomic nervous system, which participates in regulating heart rate, blood pressure, and the body's responses to physical exertion and rest.
Unlike many autonomic functions, breathing can also be consciously controlled. This makes it a potential means of influencing certain physiological processes associated with arousal and stress regulation.
Slow, comfortable breathing may influence interactions between respiratory rhythm, cardiovascular activity, and blood-pressure control mechanisms, including the baroreflex.
A systematic review and meta-analysis published in 2022 found that voluntary slow breathing influences heart rate variability (HRV), a measure reflecting certain aspects of autonomic regulation of cardiac activity.
However, not every change in HRV necessarily indicates improved health, nor does every slow-breathing technique produce a desirable state of relaxation. The effects depend on breathing rate, comfort, individual physiological characteristics, and the circumstances in which the technique is practiced.
For individuals experiencing everyday stress, comfortable, controlled breathing may serve as a useful tool for relaxation. By contrast, an athlete or martial artist preparing for a task requiring heightened alertness needs appropriate arousal regulation rather than necessarily achieving maximal relaxation.

reathing and Movement for Health and Quality of LifeB
For the general population, combining breathing and movement may contribute to maintaining physical and psychological function.
Movement practices incorporating conscious attention to breathing can encourage body awareness, motor coordination, and better adjustment of physical effort to individual capabilities.
In certain circumstances, these practices may be incorporated into programs intended to reduce stress, improve movement control, or help individuals manage functional limitations.
The World Health Organization (WHO) emphasizes that regular physical activity contributes to cardiovascular health, metabolic health, physical function, and mental well-being.
Combining breathing with movement should therefore not replace sufficient physical activity. Rather, it may add a dimension of awareness, coordination, and effort regulation.
For older adults, as well as individuals experiencing movement limitations or chronic health conditions, it is particularly important to adapt the exercises to their medical circumstances and functional abilities.

Far Eastern Traditions: Practical Experience and Scientific Perspectives
The relationship between breathing, posture, and movement occupies an important place in various traditional Asian practices and movement systems.
These traditions include exercises that integrate controlled breathing, postural organization, movement, and focused attention.
Practices such as Daoyin (Dǎoyǐn), Qigong, and Taijiquan (Tai Chi), as well as traditional martial arts including Aikido, Kyudo, Okinawan Karate, and other disciplines, place considerable importance—although in different ways—on coordinating breathing, the body's center, force transmission, and balance.
In Okinawan Karate, for example, breathing methods vary according to tradition, training method, and intended purpose. Some emphasize short, precisely timed exhalations, while others incorporate prolonged breathing, controlled muscular activity, and trunk stabilization.
Practical experience suggests that skilled performance is not determined solely by the intensity of breathing or movement, but also by timing, muscular control, and the ability to adapt an action to the body's functional requirements.
Nevertheless, traditional concepts such as Tanden in Japanese practice and Dantian in Chinese traditions should not automatically be equated with a single anatomical structure or a specific physiological mechanism.
Functional parallels between traditional practices and modern movement science can be explored, but such parallels do not establish that the underlying conceptual systems are identical.
The value of these traditions lies, in part, in the accumulated experience of training, observation, and skill development. Modern scientific research, in turn, provides methods for investigating physiological mechanisms, measuring outcomes, and identifying the limitations of existing knowledge.
A meaningful integration of these perspectives requires recognition of the value of practical experience, together with a critical evaluation of physiological and health-related claims.

What Characterizes High-Quality Breathing and Movement Practice?
The quality of breathing and movement practice should not be judged solely by breathing intensity, air volume, or the degree of physical effort involved.
Rather, it should be evaluated according to how effectively it serves a defined purpose, such as improving movement, supporting posture, preparing for exertion, facilitating recovery, or regulating stress.
An individual exercising to improve general health does not necessarily require the same breathing methods as a competitive athlete. Similarly, a technique suitable for relaxation may not be appropriate for maximal force production.
The essential principles are individual adaptation, gradual progression, respiratory comfort, and coordination between breathing and physical activity.
When breathing and movement exercises are used for rehabilitation or in the presence of medical conditions, they should be practiced within an appropriate framework and under the guidance of qualified professionals.

Conclusion: Breathe Efficiently, Move More Effectively
Breathing, posture, and movement are interconnected through anatomical, physiological, and neural mechanisms.
The diaphragm plays a central role in this system. It serves as the primary muscle of respiration while also contributing to the stabilization mechanisms of the trunk and lower back.
Understanding this dual function provides a broader perspective on physical training, rehabilitation, and health maintenance.
For athletes, this knowledge may contribute to more effective training strategies and better coordination between breathing, stabilization, and physical exertion. For the general population, appropriately adapted breathing and movement practices may support stress regulation, body awareness, and functional improvement as part of an active and healthy lifestyle.
The accumulated experience of traditional Far Eastern movement practices, together with the findings of modern science, offers a valuable foundation for understanding these relationships.
The objective is not to breathe more deeply in every situation, but to breathe efficiently and according to physiological needs; not to create rigid posture, but to develop stability that supports free, precise, and economical movement.
A professional approach integrates knowledge of physiology, biomechanics, and movement science with practical experience, skilled instruction, and individual adaptation. In this way, breathing and movement can become valuable tools for supporting physical function, health, and quality of life.

About the Author
Kyoshi Itzik Cohen, 7th Dan in Okinawan Karate, is the Head of Teishinkan, a center dedicated to Okinawan martial arts and Ryukyu culture. He is the official representative of Kyudokan Kobayashi Shorin-ryu in Israel, a member of Ryukyu Kobudo Shimbukan, and an Honorary Director of the World Kyudokan Organization.
He is a martial arts researcher, instructor, and author with extensive experience in teaching and developing physical and mental capabilities. His publications examine the historical development of karate, its practical applications, and the relationship between traditional breathing practices and modern physiology. His books include The Science and Tradition of Breathing: East Asian Methods, Modern Physiology, and the Integrated Respiratory Regulation Model (IRRM).

Disclaimer: This article is intended for educational and informational purposes. It does not constitute medical diagnosis or replace appropriate medical care, physiotherapy, or professional rehabilitation services.

15/10/2026

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