In our latest podcast, we delve into the fascinating world of the diaphragm, that unsung hero of our body’s mechanics, which influences far more than just our breathing. With the renowned orthopaedic surgeon Dr Voracek and the experienced physiotherapist Matthias Rother on board, we discover the complex and often underestimated functions of the Musculus Diaphragma.

More than just breathing: the versatility of the diaphragm

The expertise of Dr Voracek and Mr Rother, both with over twenty years’ experience in microcurrent therapy, sheds light on the central role of the diaphragm in the human body. The diaphragm, often regarded as the primary postural muscle, is crucial for more than just breathing. It plays a key role in modulating the autonomic nervous system and influences essential organ functions, particularly in relation to cardiac activity and blood pressure regulation.

Anatomy meets function: the diaphragm at the heart of body dynamics

A particular focus of our discussion is on the anatomical positioning of the diaphragm – directly opposite the pelvic floor. This arrangement is not only important for understanding its role in breathing, but is also crucial for stabilising the structure and dynamics of the spine. Our experts explain how this interplay has far-reaching implications for our health and well-being.

In-depth insights and practical applications

The podcast offers not only deep insights into the physiological significance of the diaphragm, but also practical applications, such as how microcurrent therapy can be used to support its functions. It is a captivating discussion that sheds light on an often-overlooked yet vital part of our body.

We invite you to dive into this exciting episode and learn more about the diaphragm – a muscle that is so much more than just the centre of our breathing. Join us as we uncover the secrets of this fascinating part of our body and discover how you can optimise its functions for your wellbeing. Have a listen now!

Podcast-Diaphragma_20231129-MP3 for audio podcasting.mp3

I: A very warm welcome to a new podcast episode. Today I have two very special guests: physiotherapist Matthias Rother from Heidelberg and orthopaedic surgeon Dr Voracek from Memmingen. Today we’re talking about the diaphragm, the musculus diaphragma. I’m really looking forward to hearing what they have to say. We’ve known each other for many years – over 20, in fact. That’s about right. #00:00:24-5#

B1: Definitely. #00:00:24-5#

I: Yes. That’s about right. #00:00:24-5#

B1: If I remember correctly, we first bumped into each other in 1999 or 2000. I think it was 2000. We met in Austria (unidentified #00:01:08-1#). #00:01:07-3#

B2: What was it called? Altenhofen or Althofen. #00:01:12-3#

B1: I can’t remember. #00:01:15-1#

I: I think it was called Altenhofen. It was a clinic run by Primarius Puff. That’s an interesting name. Let’s not go into that now. I’m delighted you’re here. I’m really pleased. We’ve done lots of great seminars together over the years. They weren’t just webinars. We’ve already done podcasts together. We’ve run face-to-face seminars together. I thought last week’s event was a very, very, very, very good one. Led by Dr Schellenberg, the topic of hypnosis was discussed: hypnotherapy, hypnosis training, and the relationship between hypnosis and microcurrent. I found it to be a very successful event. Today we’re going to be talking about the diaphragm, the thoracic diaphragm. Please tell me and the listeners what’s so special about the diaphragm. What specific significance does it have when we’re talking about the musculature in general? #00:01:15-7#

B1: Shall I have the first few words? I’ll just go ahead. The diaphragm is widely underestimated in the sense that many people don’t realise it has connections along almost the entire length of the spine. This isn’t just down to the purely muscular insertions into the corresponding vertebral bodies, but also involves fascial structures extending right up into the neck and, caudally, deep into the lumbar spine. If, for whatever reason, the tension in the diaphragm is incorrect, this exerts (unv. #00:03:03-1#) tensile forces on the spine, which can – and most certainly do – affect mobility. From a purely biomechanical perspective, this then triggers a whole cascade of functional disorders. This can be verified in the extremities using relatively simple tests. Examples include external rotation of the shoulder, rotational range in the hip joint, or dorsiflexion of the feet. These are simple, superficial tests. You test neck rotation and treat the diaphragm. Once the diaphragm has been treated, you can see that these ranges of motion improve significantly. This demonstrates the potential effects of excessive tension in the diaphragm. Added to this is the fact that excessive tension in the diaphragm has a very significant effect on the nervous control of the body’s systems – the autonomic nervous system. That was my introduction. Dr Voracek will certainly have something to add as well. #00:02:23-3#

B2: If I take human development as my starting point, the diaphragm is special because it is the first postural muscle to begin working when a person is born. It is the very first muscle. Breathing in and out is the first thing that happens. It is therefore very important that this muscle functions properly. Before the child begins to work properly with other postural muscles – such as the musculus transversus abdominis – after the sixth week of life, the diaphragm develops its basic, postural function. This is the supportive function. If we look at how small children lie, we see that some children breathe differently when they are lying down. You can see the connection it develops with the spine. This is also due to the pelvic floor, of course, as it is an antagonist muscle, directly opposite the diaphragm. It therefore has a massive influence on the postural development of the spine. In martial arts, therefore, a great deal of attention is paid to how one breathes – ensuring one breathes correctly and that the diaphragm functions properly. The stability of the spine begins with breathing. If you breathe correctly, you have a completely different, stable spine. If the diaphragm is impaired due to any kind of damage, such as infectious diseases, the whole system fails to function properly and, apart from other problems, you cannot move correctly. You notice this when you are ill, when you have a high fever, when you have the flu, or when you have pneumonia. That is why the diaphragm is fundamentally very, very important. As Matthias said, it influences the entire spine. When I start treating patients with back problems, I often begin in the middle of the thoracic spine. That’s a crucial point. From the middle of the thoracic spine, the approach is both from above and below. If we look at the course of the musculature, it runs from the upper cranium, from the cervical spine, to the middle of the thoracic spine and from there downwards. In terms of musculature, we have two parts. Anatomically speaking, we have the cervical, thoracic and lumbar spine. But from a muscular perspective, it’s not quite like that. The diaphragm plays a very, very important role here. #00:06:42-5#

I: You’re saying that, from a functional point of view, the two areas actually merge into one another – from the lumbar spine, through the thoracic spine, into the cervical spine. #00:07:50-2#

B2: Yes. In therapy, you often have to start with breathing. Logically, many people breathe incorrectly. You know that, Matthias. They either breathe into the upper chest or only into the abdomen. Many are unable to open up the abdominal cavity and the thorax properly for thoracic breathing. They aren’t even aware of this type of breathing. You often have to start the therapy there. We’re familiar with this from Vojta, Denesse and Bobath, whose therapeutic approaches begin there. #00:08:00-2#

B1: Yes. That’s absolutely right. I see it that way too. In the classification of the reflex muscle system, the diaphragm is regarded as the most important reflex muscle, or as the one that activates first. When we experience a trauma, the first reaction is in our breathing. You pause briefly or take a deep, startled breath. This is the pathological spasm that grips the muscle. The muscle gets stuck in this state and cannot completely release itself on its own. Unless, that is, you carry out intensive self-exercises. Yoga or meditation exercises can help considerably. If you need the help of a therapist, the therapist must work on this structure in a targeted and intensive manner. That is absolutely the case. Unfortunately, many people are not aware of this. This is the key to whether a course of therapy is successful or not quite so successful when you embark on a series of treatments. It doesn’t matter what the issue is or what needs to be done. For me, this is absolutely essential. #00:08:38-4#

B1: We see this interconnection or the transmission of pathologies across a wide variety of areas. The diaphragm is the thoracic diaphragm; there is also a cranial diaphragm and a pelvic diaphragm – the pelvic arch. These systems communicate with one another solely via their existing anatomical structures. The pathologies are passed on. In a physiological state, physiological – that is, good, healthy – tension patterns and movements are transmitted. However, the same applies in a pathological situation. If one component isn’t functioning properly, this is carried forward and spreads throughout the entire body system. #00:10:35-9#

B2: What do patients with slipped discs or back pain do? Their breathing is incorrect. They are often unable to take a deep breath at all because it causes pain. This is where we need to start, so that people learn to breathe properly and more relaxed. It’s about all the other functions that are also linked to the mind. When we feel stress or anxiety, we breathe very differently. We can express a great deal through our breathing. If that isn’t working, we have a problem that manifests structurally. When I consider that I have a diaphragm that isn’t functioning properly and is misaligned in relation to the pelvic floor, I cannot exert the correct pressure. I lose that pressure. The spine and the ligamentous structures are subjected to enormous strain. This leads to secondary damage. When dealing with a spinal issue in the lumbar region, I always have to ask myself how the diaphragm is positioned and how the patient is breathing. It’s also a question of the abdominal and back muscles. You have to show the patient that they can help themselves a great deal through their breathing. #00:11:20-8#

B1: Absolutely. What we’ve just discussed is largely about biomechanics. You’ve just explained the biochemical effects it has. You mentioned the diaphragm and the pelvic floor. When these function properly from a physiological point of view, every breath acts as a kind of self-massage for the organs and the organ systems. This has a significant influence on organ function. It’s about biochemistry, metabolism and the proper nourishment of the body’s cells, as well as effective detoxification, elimination and relief. That is the next major factor which always has latent adverse effects in the context of pathology. It is impaired breathing. If breathing is not good, we do not receive adequate oxygen or are unable to exhale CO₂ adequately. #00:12:36-5#

B2: If you move upwards from the abdominal cavity into the thoracic region, you’ll see that blood pressure rises or cardiac function is compromised. When blood pressure is elevated, we observe poor breathing in patients. I believe that I am missing a key therapeutic element in a treatment programme – one that, from an orthopaedic perspective, is linked to bilateral shoulder problems, the spine or the hip joints – if I am not aware of how the patient moves. I find it more difficult to help the patient. #00:13:47-7#

B1: Absolutely. For me, these effects are clear. You know how I’ve been working for decades. This is a absolutely central component for me. You can separate it from manual treatment techniques, whatever form they may take. You can certainly incorporate it into training and exercises. That’s what I’ve done. Over the last few months, I’ve treated some very, very young athletes who had problems in this regard. I looked at what wasn’t working there. It became apparent that there was no economy in their movement patterns. There was no link between their movement patterns and economical, efficient breathing. To be honest, I was quite appalled. You know one of them. She’s a young tennis player who was under your care. She’s now with me, as she lives in the area. She’s 13 years old. I’m treating a 15-year-old rower and a top-level runner who’s in the national squad and is 17 and a half years old. All three have static deficits. They lack stability. None of them are able to perform even the simplest exercises efficiently and economically whilst coordinating their breathing. I asked whether the athletic trainers do this sort of thing with them. They don’t. They can’t perform even the simplest exercises. They’ve shown me all sorts of things. They do the most complicated, impressive exercises from training manuals they’ve been given by their athletic trainers. These training plans aren’t bad in themselves. However, they aren’t being properly guided. They’re only delivering quantity in their training, but not quality. #00:15:30-0#

B2: They’ve often compensated for this quite well through their musculature, as they’re trained. However, if this goes on for a long time, it doesn’t work. I know this from ice hockey. Ice hockey players usually have a very good, complex musculature from their legs right up to the cervical spine. They’re in good shape. Yet you often come across ice hockey players who suffer from back pain. They’ve got six-pack abs, but you can see they can’t breathe properly. As a result, they put too much strain on their spine and develop back problems. The training isn’t about working out with them and building more muscle; rather, you have to teach them to breathe properly and to breathe deeply and in a relaxed manner. We saw last weekend at the hypnosis course that breathing is absolutely, absolutely vital. Many of these people cannot relax. Just as they cannot relax all their muscles, they cannot relax through their breathing either. It’s a huge problem. #00:18:16-2#

B1: That was the core problem with the three examples I’ve just mentioned. They can’t perform even the simplest exercises. I guided them through them. They’re actually silly, simple exercises. There are only a few of them. They’re making progress with these. All three have a weakness in the central axis, that is, in the core. One patient has problems at the front of the symphysis, whilst the rower and the runner have lumbar problems. In one case, there is also a psychosocial factor. I don’t want to talk about that now. It’s quite clear and obvious. In the case of the tennis player, the athletic trainers questioned this. They asked why I was doing such things with her and altering her movement patterns. They claimed that tennis requires a different, sport-specific movement. She came back to me feeling confused. I told her that was true and that I was aware of it. She needs to disconnect from that so that she can stabilise her central axis. Fortunately, she understands me. She’s been able to fully grasp what I want from her and what I’m doing with her. She realises she’s making progress. After nine months, she’s finally back on the tennis court. It’s simple things. We’ve practised all sorts of breathing exercises. We’ve worked a lot on her breathing. It took a long time before she really dared to breathe in a way that was adapted to the movement, after I’d cleared everything out so that it could work in the first place. #00:18:16-6#

B2: We carried out an MRI scan and saw how breathing works when you have blockages in the spine and when you have a slipped disc. The upward movement of the diaphragm as it contracts and relaxes is very different. I’ve got this on video. I demonstrated it as part of another story. You can see that the diaphragm is practically rigid. It isn’t working properly at all. #00:20:09-1#

B1: You have to bear one thing in mind. When the diaphragm moves upwards in a cranial direction, it has to relax. This isn’t an active upward movement of the diaphragm. It has to relax, after all. It has to let go during exhalation and contract during inhalation. #00:21:07-4#

B2: It moves downwards. It moves down nicely. It contracts. It creates a static negative pressure. With a spasm, your lung capacity is significantly reduced. #00:21:08-7#

B1: You can’t draw in air anymore. That’s absolutely right. Something else has just occurred to me. There’s a component moving upwards towards the cranium. If we look at the tension patterns there / #00:21:21-2#

B2: People are naturally tense when they breathe from the upper chest. They have constant tension. Those (unint. #00:21:45-1#) are tense. The entire neck musculature is tense. This has a massive impact on shoulder function. #00:21:39-4#

B1: That’s perfectly clear. To me, however, these are almost the superficial aspects. It goes one level higher still. If we extend these tension patterns into the skull – and this carries over into pathology – the cranium no longer functions properly. The osteopaths amongst the audience will know immediately what I’m talking about. This pulsation of the cranial system – which is primary respiration – is also impaired as a result. In principle, we already have an impairment of the body’s fundamental control mechanisms stemming from there. Everything suddenly plummets to rock bottom. We must constantly remind ourselves of this. People tend to view it in simplistic terms. ‘I’ve got diaphragmatic breathing, yes, I do that.’ Many people are unaware of this significant interconnectedness. They do not apply it adequately, or with the necessary mental focus, either as therapists or when conveying this to the people they care for and treat. #00:22:04-4#

B1: Our presenter is silent and watching us. #00:23:02-5#

I: No. He’s not silent; he’s writing. I’m taking loads of notes. That’s why I’m relatively quiet. That’s also why, on camera, I’m leaning slightly to one side. I’ve jotted down some very useful key points. I need to keep the marketing aspect in mind. I don’t really need slogans for our social media channels such as Instagram, Facebook, Twitter – and YouTube. These are our core channels. We have nearly 3,000 followers on Instagram. We have over 1,000 followers on YouTube. I want to offer our viewers something of value and am trying to jot down some key points. You’re sharing a great deal of knowledge – it’s a wealth of extremely valuable expertise. I need to be able to convey that somehow. The podcast is one thing. I’d like to try to share and summarise the whole thing as best I can. That’s why I’m taking notes. These are two of the three pages I’ve already described. I’d like to mention a story in this context. I’ve jotted down a few notes. The topic of training was mentioned. I’ve jotted down ‘detoxification’ as a key point. I’ve learnt that the diaphragm, through exhalation and the breakdown of CO₂ in the body, is extremely important for detoxification, deacidification and acid-base balance. That’s what was said. I’ve still got a few questions before we get round to my main topic. What tips could you offer here on the podcast regarding stretching exercises? We’ve heard a lot about breathing. Is there a basic tip on what one can do? Do I lie on my back with my stomach stretched out and take a deep breath? Please give a specific tip. How can I influence diaphragmatic breathing and stretching? #00:24:43-8#

B1: That’s tricky. I’m not sure whether lying on your back and breathing actually helps. #00:25:22-5#

I: That was an ironic prompt for an idea. #00:25:31-5#

B2: I advise people to lie on their backs, place their hands on either side of their chest and try to breathe in against their hands. The chest expands outwards, to the right and to the left. This is a form of self-therapy. There are, of course, other therapies, such as Vojtak and Denesse, designed to stimulate breathing and encourage deep breathing. As part of self-therapy, I tell people to try this whilst lying down. All you need to do is concentrate on your breathing. Press your hands against the sides of your chest and try to breathe in and out deeply. Apply gentle pressure with your hands against your chest so that you can feel how it moves on the right and left. Focus on your abdomen and try to breathe into it, pushing against your hands. You can also tell people to breathe into their right and left lungs. That works. You need to train your awareness of how you breathe. Many people breathe completely subconsciously. They aren’t aware of their breathing at all. I start with this method before people sit down and practise it whilst seated. In the final stage, they do it whilst standing. They need to pay attention to how they stand. I explain that to them. They start by lying down. #00:27:18-0#

B1: That’s absolutely not the wrong approach. I don’t know much about yoga. I know a few poses and exercises. They’re lovely. Even someone who isn’t very athletic or flexible can do them. I don’t know what they’re called. #00:27:40-1#

I: The crane? #00:27:40-1#

B1: I don’t know what the Crane looks like. There are some lovely exercises that are quite intense in terms of stretching the diaphragm. I’ve just thought of an exercise that I used to do myself many years ago in a (unidentified #00:28:15-1#). You move around and breathe exclusively through your nose. We were jogging on the beach back then. You had to adjust your pace so that you could always breathe properly through your nose without any strain. Of course, this also works during a brisk walk, depending on how fit you are. The effect of this is that breathing through the nose forces you to breathe efficiently. You learn to let go as you breathe out and to engage your diaphragm as you breathe in. In this way, you teach the diaphragm to relax more and more effectively over time. It’s a lovely exercise. It’s wonderful. Once you’ve worked your way up to it, it’s a very relaxed and pleasant sensation of movement. Afterwards, you’ll find it easy to breathe and feel very supple and flexible in the chest area. It’s a lovely exercise that anyone can do. If you’re not able to jog for 20 minutes, go for a brisk walk or a walk uphill. You’ll end up slightly out of breath. If you adjust your pace so that you can manage this whilst breathing through your nose without feeling as though you’re suffocating, you’ll achieve precisely this tension-regulating effect in the diaphragm. Anyone can actually do this. That’s what comes to mind. #00:28:52-8#

I: I’d be interested in the topic of the autonomic nervous system. We talk a lot these days about stress and chronic fatigue syndrome, which can be a problem related to the autonomic nervous system. It’s quite straightforward. What specific influence does the diaphragm have on the autonomic nervous system, and why? #00:29:56-9#

B1: This is due to the anatomy. In the thoracic spine region, the autonomic nerve ganglia are located in the border zone; these innervate and control the organs. If this is irritated by pressure resulting from an unphysiological state of tension or tone in the diaphragm, our autonomic nervous system becomes disrupted. That is one mechanism. I’ve just mentioned the second mechanism. We can experience irritation at the brainstem level when the pressure extends towards the skull and the cranial region. This affects central control and the physiological, homogeneous regulation of the system. Those are the two points that spring to mind. I’m sure you’ve got something to say on this too, knowing you as I do. #00:31:02-8#

B2: Relatively little. It’s always a complex whole. Breathing and the diaphragm have a reciprocal effect on the nerve pathways. I’d say that if I breathe properly, I can avoid all these negative, pathological problems. Anatomically speaking, it does have an influence – you’re right about that. However, I don’t see this aspect as the main issue here. With people, though, everything is always complex. #00:32:14-1#

B1: Things are interlinked at every level – in physiology as well as in pathology. You certainly have to weigh things up differently depending on the context. As the saying goes: simply breathe the stress away. #00:32:48-9#

B2: There’s some truth in that. #00:32:48-9#

I: That’s true. The topic of martial arts was briefly mentioned earlier in relation to breathing. I’m familiar with that. I practised martial arts for many years and also taught them for a while. I know how important it is. I don’t want to go into too much detail, but I’d like to mention the keyword ‘meditation’. We’ve mentioned the topic of hypnosis. Breathing actually plays a crucial role in that. The diaphragm is fundamentally involved. Another question has occurred to me. It’s been said in the field of developmental physiology of the diaphragm that it is the first postural muscle. I’d be interested to know which movements in babies are linked to their physiological – and therefore healthy – development? I’d be interested to know that. Have any studies been carried out on this? #00:32:57-1#

B2: You can see this in children with spasticity. Children with spasticity have a very different chest shape. When they try to sit up, they brace themselves. Their development is, of course, significantly delayed. You can see that the ribcage is shaped quite differently. This means they don’t breathe properly either. In children who suffer perinatal brain damage, breathing and hip development are affected. The spine is positioned differently. As a result, their breathing is inevitably incorrect. When you begin therapy with these patients – and I’m referring to Reuter here – you place the children in a specific position. This changes their breathing. You can see that the children begin to breathe a little more deeply. You can see that their breathing changes, and this is followed by the activation of the muscles. Breathing always begins first. Particularly when working with children with spasticity, you always notice immediately that their breathing changes before you trigger this reflex movement whilst they’re lying on their stomach or in the side-lying position. We’ve produced plenty of videos and studies on this. A friend of mine from Prague is very knowledgeable in this area. He’s analysed the whole thing. You can see from the videos he presents how the chest position is completely different in these children with spasticity. Your motor development is completely different if you cannot breathe properly. #00:36:08-5#

I: My question was slightly aimed at that. You spoke about children with spasticity. On the one hand, that is a pathological condition. Can one actually deduce from certain movement patterns in babies and toddlers that potential predispositions might arise from them? #00:36:08-6#

B2: You see the developmental delay. You know that a newborn baby should be able to do certain things by the sixth week. You know what they should be able to do at three, six and nine months. There are stages. You always have to take breathing as your guide. If you see that, in the sixth week, the child is lying on their back on the floor and only making these uncoordinated movements, their breathing is functioning, but the child has not yet established a ‘punctum fixum’. Only when the child establishes a ‘punctum fixum’ through stable breathing does the next muscle come into play. This is the musculus transversus. It is the second muscle to begin functioning in the child. It enables the child, whilst lying on their stomach, to generate a certain amount of resistance against the surface they are lying on. This enables the child to begin turning their head at least to the right or left before lifting it upwards. If breathing is poor, the child may achieve this function much later, or not at all. That is why we should start working with and treating these children, who have suffered perinatal damage, at a very early stage, in order to significantly reduce the developmental delay that would otherwise occur. #00:38:04-8#

B1: Does Pavel focus a lot on the neck as part of the preliminary treatment? If we’re talking about the innovation, it’s the innovation relating to the diaphragm at C4, the phrenic nerve. #00:38:26-7#

B2: Yes. You check whether the child has any blockages. They often have cranial blockages. I’ve unblocked young children many times and their motor development has shot up. It’s this combination in their development. You really have to work on it and be aware of it. Physiotherapists who practise the Vojta, Denesse or Bobath methods pay attention to things like that. #00:38:48-0#

I: That’s quite fascinating. I couldn’t keep up with taking notes that quickly. That’s not really relevant. To wrap up, I’d be interested to know the following. I’m a developer of medical products. I develop microcurrent devices that can be used in a medical context, within the framework of medical authorisation, for physiotherapeutic treatment of chronic and acute pain, as well as neurological conditions. You’ve been using microcurrent therapy for many years. What exactly can microcurrent therapy and light therapy do in relation to the diaphragm? #00:39:27-2#

B1: You know how I work. I use light to treat the diaphragm. That’s how I’ve achieved the best results. In the past, when it was still authorised, we used rod electrodes. We achieved excellent results very quickly. I don’t specifically treat the diaphragm with adhesive electrodes. I tried that once ages ago to see what results it would produce. It does produce results. However, it takes too long for my liking. For me, it’s embedded within a manual treatment approach in the broadest sense. This means that I need to see a result relatively quickly – within one to three minutes – so that I can move forward in my sequence of treatments. The light heads are the method of choice for the devices currently available on the market. It’s excellent for initial treatment, pre-treatment and manual follow-up. You can reach deeper if you pre-treat with light. For me, it’s a fantastic tool to work with. I make good progress with it. #00:41:16-6#

B2: However, treating the diaphragm on its own is usually not enough. #00:41:46-7#

B1: Yes, that’s clear. #00:41:53-3#

B2: Of course, someone might have a spasm in a muscle. But treating the diaphragm on its own is almost pointless. It therefore needs to be treated systemically. I see better results with a systemic approach. Sometimes you can help yourself with one channel or another, if you have the means to apply it. You basically have to look at the spine. If the spine is functioning well, you have good conditions for breathing. Often, unless the dysfunction is spastic in nature, restricted breathing or impaired diaphragmatic function is a manifestation of other pathologies present in the body. It is rarely a primary pathology. Unless, that is, there is a hernia in the diaphragm, which can restrict its function. It is often a manifestation of other problems, and one must view it within the patient’s overall context. #00:41:55-2#

I: I’ve now reached the end of my notes. I’ve covered all my points in full. The fundamental questions that many people are interested in have been addressed. Matthias, we recently did a podcast on the piriformis muscle. The download and subscriber figures have gone through the roof. That gave me the idea to discuss the topic of specific muscles. A friend of mine, Burkhard Hock, who has been teaching the Hock pain therapy method for many years, refers to his specific muscles as the Seven Dwarfs and Snow White. There’s the ‘Snow White’ muscle and the ‘Seven Dwarfs’ – the seven muscles associated with it. It’s a very interesting concept. It worked very well with the piriformis. That’s where today’s podcast topic comes from. That’s why Dr Voracek is joining us; he’s extremely well-versed in developmental physiology and the relevant studies. The session was packed with a great deal of information. I’m not yet sure how I’ll convey all this knowledge. I think it will take two episodes, as there’s simply too much content. In my view, the whole thing deserves a certain level of appreciation. We show our listeners our appreciation by delivering high-quality content. It’s always important to me that we try to convey and present this content as well as we possibly can. I think these are two things that go hand in hand. The knowledge might be brilliant, but it doesn’t come across well if it’s conveyed poorly. Would you like to add anything, Matthias? #00:43:53-0#

B1: We touched on this topic in our last podcast about the piriformis. I remarked back then that it’s difficult to focus on a single muscle. It’s just a tiny keyhole through which you toss little tidbits. Not to bribe anyone, but to convey what you might or should be thinking about. It’s always a whole network. It’s far too limited to focus solely on the diaphragm during treatment; it only makes limited sense. You must always consider it within the context of the overall problem. #00:45:22-1#

B2: Assessing the function of the diaphragm is relatively straightforward. You can already see, anatomically, how a patient breathes when they are standing or lying down. The diaphragm is a very, very important factor in diagnosis and treatment. It can be assessed relatively easily from the outside, without the need for any equipment. #00:46:08-6#

B1: That’s right. You have to observe it and be able to draw conclusions from it. That’s the big picture. #00:46:32-8#

I: It’s clearly described throughout the podcast and in my latest book that it’s not about making isolated observations. I’ve listed the reflex muscles and, in particular, the diaphragm. It’s not about making a single observation. Earlier, the phrase ‘secondary and primary injury’ was mentioned. It’s about deriving this analysis and keeping the pathogenesis in mind. There are a great many key points here that doctors and therapists should consider. #00:47:08-4#

B1: If you get stuck in your therapy and aren’t making progress, you might want to consider something like this. The ultimate restoration of mobility, in whatever structure, may be held back by the diaphragm. I observe this time and again. It also sometimes comes up in the seminars we organise. Some people aren’t aware of this. I go to the diaphragm and (unint. #00:47:40-1#) release it. #00:47:45-2#

B2: I’m not sure if I can demonstrate anything here. I have a video of a child with cerebral palsy – I’m not sure if I can show you something or if I can do it here – I’ve got a video here of a child with cerebral palsy. You can see how the child moves. You can see how they breathe and how their diaphragm moves. #00:47:54-3#

I: You can share your screen. #00:48:07-0#

B2: In the video, you can see this little child. On the left-hand side, we see a child with normal development, moving in a normal way. They crawl differently. Their chest is normally developed. When the child tries to stand up, you can see how the abdominal muscles engage to provide stability. With this child, you can see from the chest that the abdominal muscles aren’t working at all. When the child tries to stand up, we see that the movement comes entirely from the back. Can you see this instability? The child can’t breathe at all. #00:48:40-4#

B1: It’s clearly visible. #00:48:40-4#

B2: Did you see how that rib cage is sticking out? The child can’t properly engage their diaphragm for stability. #00:49:08-4#

I: We’ve come to the end of the main content. Your presentation is brilliant. I’ve seen that there’s even more content on the diaphragm in the video. That might provide material for another podcast or webinar, where we could discuss the topic and take participants’ questions live. That would certainly be an exciting idea. I’ve got a webinar with Matthias next Thursday on combining microcurrent and LED light. Why this topic in general? The diaphragm is a very good application for it. #00:49:25-9#

B1: It’s bound to come up. #00:50:11-7#

I: I certainly think so. Yes. We should keep things within reasonable limits here. We don’t want to overwhelm the audience. I have to produce the transcripts, descriptions and images, and edit the video we’ve recorded. We’ll publish it on YouTube and all the podcast platforms. That’s important for our listeners. It doesn’t matter where you listen to us. You can listen to our podcast on Spotify, Apple Podcasts, Google, Amazon and Amazon Alexa. Tell Alexa she can give us five stars. She can do something for a change. She can do more than just read out the weather and tell you when to use an umbrella; she can give our podcast five stars. That would be great. With that in mind, I’d like to take this opportunity to thank Dr Voracek very much for these excellent explanations. I’d like to thank Matthias Rother for his explanations, and especially for providing that handy link. I’m really looking forward to our webinar this Thursday. Thank you very much for your time. Thank you very much for all the input you’ve provided. I’m looking forward to future podcasts on other muscles and other topics. I think this session invites us to go beyond microcurrent and LED light therapy to explore other areas and share them with the world. #00:51:42-6#

B1: Thank you. #00:51:45-4#

B2: Thank you. #00:51:45-4#

I: See you soon. #00:51:45-9#