The thoraco-abdominal pump, how important is it to the lymph system?

The 2019 #Nobel_Prize in #physiology was awarded to three scientists for their work on the effect of oxygen in #cellular_metabolism and physiological function. In an Instagram post by @MEDspiration, Nav Badesha MD (1) explains how the action of the diaphragm during breathing has the potential to improve digestive, renal, adrenal, liver, uterine, ovarian, pelvic floor, bowel and bladder function. And I can add that it is also essential to the normal functioning of the cardiovascular and lymph vessel systems.

You'd think that breathing was the most natural physical act that we perform, but many of us lose the ability to breath properly during adolescence when we start sucking in our guts to appear slim. Around about the same time we also spend a lot of time sitting to study which compresses the diaphragm, not helped by the eventual sitting jobs many of us end up in.

After a while breathing becomes more an action of the upper intercostal muscles and the diaphragm ceases to be the main muscle of breathing. If you want to see what proper, natural breathing looks like watch a toddler, its all happening in the abdomen.

But why is this important to the lymph system?

First of all let's revise our basic anatomy. The inferior vena-cava and thoracic duct both begin in the abdominal cavity, pass through the aperture in the diaphragm and between them bring all the fluids that are returning from the lower body back up to the heart.

As the diaphragm flattens it pushes down on the abdominal contents increasing the pressure in the abdomino-pelvic cavity. At the same time the height of the thoracic cavity increases and the air is sucked in from the outside through your nose.

This variation in pressure between the body cavities also affects the fluids that are in the main veins and lymph vessels, its like squeezing on the abdominal parts of the vessels while you are sucking on the thoracic parts, whatever is in these vessels will be moved up into the thoracic sections.

But its even more than that for the cardiovascular system, the expansion of the thoracic cavity expands the heart too and the fluid that is in the last past of the superior and inferior vena-cavas is literally sucked into the right auricle of the heart. You can see how much this affects the inferior vena-cava and the heart in this YouTube video.

Put this all together, and remembering that everything that helps the lymph system helps the venous system and visa-versa, and it becomes obvious that deep abdominal breathing supports the normal function of both systems. I have had many people affected by lymphoedema tell me how much learning proper deep breathing helps them, and the first paper to be published on this by Amanda Moseley and Neil Piller (2) has been cited over 100 times

1: read the @MEDinspiration post here

2: Moseley AL, Piller, N.B., Carati, C.J. The effect of gentle arm exercise and deep breathing on secondary arm lymphedema. Lymphology. 2005;38(3):136-45.