What You Can Tell by Laying a Hand on the Belly

When I examine, I lay a hand on the belly and stay still for a while.

I am neither pressing nor rubbing, so many people look as though they cannot tell what I am doing. What I am doing then is following the breath.

When you breathe in, the pressure inside the abdomen rises

When you breathe in, the diaphragm that runs across below the chest goes down. The chest side widens, the pressure there drops, and air comes in.

But below, the opposite thing happens. The diaphragm that has come down presses on the organs inside the belly, so the pressure inside the abdomen rises. That is why the belly comes out when you breathe in.

And that pressure helps with breathing out

This is the centre of the story.

The pressure that rose while breathing in does not simply disappear. To the extent that the wall of the belly and the diaphragm have been stretched, tension is stored. When you breathe out, that stored tension comes back and pushes the diaphragm up.

In easy breathing, breathing out takes almost no effort. It is because what was pressed down while breathing in is being taken back and used. The belly is not a load that gets in the way of breathing but the place holding one side of the breath.

So if the belly is stiff, or only one side of it moves well, half of the breath goes stiff.

The same pressure holds the back as well

Intra-abdominal pressure is not used for breathing alone.

You will know how the body holds its breath by itself when lifting something heavy. It is pressing the inside of the abdomen to make it firm and so hold the back. In material that was measured, when intra-abdominal pressure was raised the trunk grew 21% to 42% stiffer in the direction of bending forward. It was the same when leaning to the side.

The diaphragm is not a muscle for breathing alone either. In a study looking in with ultrasound, while lifting something heavy the diaphragm moved downward and the tension of the abdominal wall rose along with it. The work of breathing and the work of supporting the body are held by the same muscle together.

So when the belly cannot do its work, the back is used instead. Among people whose back comes back before long however much it is released, there are cases where it is caught here.

What the hand is looking at

What I look at with a hand laid on the belly is four things.

How it moves along with the breath. I look at where the belly swells from first when breathing in, and where it sinks from first when breathing out.

The push back. If I press lightly in time with the grain of the belly's movement, the push back comes to the hand. I look at whether that force is even, and at which point it breaks off abruptly.

The difference left to right. There are many cases where left and right move differently on the same breath. I compare both the movement of the muscle and the pressure left against right.

The state of what is inside. I look at whether it has the feel of fluid pooled, at what the sounds are like, and at whether movement has dropped away with only tension left.

I do not press hard. Press hard and the original movement disappears, pressed down under that force. It has to be laid on lightly to be seen.

Where this story continues

The case where the belly swells excessively and pushes the diaphragm up I have written down separately. (When a Full Belly Makes Your Chest Tight and Your Heart Race)

If that piece is the situation where the belly gets in the way of the breath, this one is a story about the original work in which the belly helps the breath. It amounts to looking at the same place from the other side.

How far the organs in the abdomen actually ride up and down with that breath I have written separately in The Organs in Your Abdomen Ride Up and Down with Your Breath.

How the body works out its posture I have written down in Your Back Hurts, and I Look at Your Foot. If the foot is the side sending information up, the belly is the side that holds the body with that information.

When to see a doctor first

If the belly suddenly goes hard and hurts, if it hurts more when you release after pressing, if a fever comes with it, if weight is dropping, or if the belly is swelling up more and more — before a story like this, examination and testing come first.

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Sources

• A study measuring that raising the pressure inside the abdomen makes the trunk 21–42% stiffer in the direction of bending — European Spine Journal, 1999
• A study confirming with ultrasound that the diaphragm holds not only the work of breathing but the work of supporting the body as well — PLOS ONE, 2022

Written by Dr. Heo Ji-young (Ph.D. in Korean Medicine Pathology, Kyung Hee University · former Research Professor of Herbology, Kyung Hee University)