Abdominophrenic Dyssynergia: Why Your Belly Bloats (Even When Nothing Is “Wrong”)
If you feel uncomfortably bloated, tight through your ribs, or like your belly pushes outward, especially after meals, stress, or exercise, but medical tests keep coming back normal, you’re not imagining it. One possible cause is abdominophrenic dyssynergia (APD) a functional breathing and muscle-coordination issue that often flies under the radar.
What Is Abdominophrenic Dyssynergia?
Abdominophrenic dyssynergia is a miscommunication between your diaphragm and abdominal wall. It also involves the diaphragm being stuck down , or in an inhalation position, pushing down on the abdominal contents causing a “pooched” belly.
Normal Breathing: The diaphragm descends during breathing, the abdominal muscles gently lengthen and support the movement.
With APD: The diaphragm descends too forcefully or inappropriately, the abdominal wall pushes outward instead of supporting inward and the rib cage may stay flared and rigid.
The result?
👉 Visible bloating
👉 Pressure and fullness
👉 A “pregnant” or distended belly feeling, even without gas
Importantly, this isn’t caused by excess food, fat, or fluid. It’s a neuromuscular patterning issue.
Common Symptoms of Abdominophrenic Dyssynergia
People with APD often report:
Bloating that worsens as the day goes on
Abdominal distension after meals (even small ones)
Rib cage tightness or flaring
Shallow or chest-dominant breathing
Difficulty “engaging the core”
Pelvic floor tension or symptoms
Digestive discomfort without clear GI findings
Many are told it’s “just IBS,” anxiety, or stress without explanation of how the body is contributing.
Why Does Abdominophrenic Dyssynergia Happen?
APD is often linked to:
Chronic stress or anxiety
History of abdominal surgery
Pregnancy and postpartum changes
Pelvic floor dysfunction
Poor breathing mechanics
Prolonged sitting or posture changes
High-level fitness without proper core coordination
Over time, the nervous system learns a protective breathing strategy that no longer serves the body.
Is Abdominophrenic Dyssynergia a Digestive Problem?
Not exactly. While APD can feel digestive, it’s primarily a diaphragm positioning, muscle coordination and nervous system issue involving:
The diaphragm
The abdominal wall
The rib cage
The pelvic floor
That’s why traditional GI treatments alone often don’t resolve the bloating.
How Is Abdominophrenic Dyssynergia Treated?
The most effective treatment is pelvic health and manual physical therapy with a focus on:
Diaphragmatic breathing retraining
Rib cage mobility
Abdominal wall coordination
Pelvic floor relaxation and timing
Nervous system regulation
Postural and movement re-education
This is not about strengthening harder, it’s about restoring proper timing and pressure management.
What Pelvic Health PT Looks Like for APD
Gentle breathing retraining (not generic “deep breaths”)
Manual therapy to the diaphragm, ribs, and abdomen
Core retraining without bracing or gripping
Education on posture, daily habits, and stress response
Functional integration into movement and exercise
Many patients notice improvements in bloating, comfort, and body awareness within weeks!
Q & A
1. Can Abdominophrenic Dyssynergia Go Away?
Yes. Because APD is a learned motor pattern, the body can relearn healthier coordination. With consistent, guided therapy, symptoms often reduce significantly or resolve entirely.
2.When Should You Seek Help?
Consider pelvic health physical therapy when bloating persists despite diet changes, tests show “nothing wrong”, symptoms worsen with stress or posture, you’ve had pelvic floor, pregnancy, or abdominal issues, or you feel disconnected from your core or breathing.
You deserve answers—and relief.
Looking for Help in Atlanta?
At Femina Physical Therapy, we specialize in pelvic health, breathing mechanics, and whole-body coordination to treat conditions like abdominophrenic dyssynergia at the source.
📍 Serving Atlanta, Buckhead, Brookhaven & surrounding areas
