Diaphragm excursion in postpartum women with low back pain and its clinical implication: A narrative review

Background: Diaphragm excursion is a prevalent condition often overlooked in relation to postpartum low back pain. Diaphragmatic function plays a vital but often underrecognized role in postpartum low back pain (LBP). The diaphragm contributes to the spinal stability, intra-abdominal pressure regulation and core coordination following childbirth. This narrative review explores the relationaship between diaphragm excursion, respiratory fitness and postpartum LBP, emphasizing emerging rehabilitation strategies. Methods: This narrative review was conducted using an integrated thematic approach was used to examine studies related to respiratory mechanics, diaphragm dysfunction and musculoskeletal health in postpartum women. The relevant literature was sourced from interdisciplinary health databases (PubMed, Scopus, Web of Science, Embase, CINAHL and Google scholar) to identify clinical and theoritical patterns. Results: The impaired breathing patterns and reduced diaphragmatic excursion are consistently associated with increased pain sensititvity, decreased postural control and compromised core stability. Respiratory focused interventions, such as diaphragmatic breathing and inspiratory muscles training, have shown significant outcomes in postpartum LBP. Conclusion: Physical Therapy targeting diaphragm function within postpartum rehabilitation may enhance both pain management and recovery. A clinically integrated, breathing-centered strategy could represent a evidence-based direction in managing postpartum musculoskeletal dysfunction.