Breathing is not only an essential component of keeping us alive, it is the backbone that supports our pelvic floor health. Our pelvic floor muscles work in sync with the diaphragm, deep abdominals (transverse abdominis), and our low back (multifidus) muscles. Furthermore, the diaphragm coordinates with the pelvic floor to control the pressure system within our abdominal cavity to help stabilize our spine and posture.

Now, let’s dive in more on how this relationship exists. The diaphragm is a dome shaped respiratory muscle that sits under our rib cage and separates our lungs from the abdomen. As we breathe in, the diaphragm moves downward and slightly outward allowing our lungs to fill up with air. This movement increases the pressure in our abdomen and down the pelvic floor causing them to relax and lengthen. As we breathe out, the diaphragm moves upward to push air out of our lungs, the pressure in our abdomen reduces, and pelvic floor muscles slightly tighten and return to their resting position.

We have two types of breathing patterns: chest (shallow) and diaphragmatic (belly) breathing. Chest breathing is when you heavily rely on using your accessory muscles of the neck and chest to breathe which are not designed to do so on a daily basis. We typically use this breathing pattern during our “fight or flight” state or emergency situations as our body is getting ready to run, fight, or feels anxious, and threatened.

How does this relate to our pelvic floor? Excellent question! As we discussed earlier the diaphragm allows the pelvic floor to lengthen and contract. Taking shallow breaths throughout the day, over time can cause the diaphragm not to be used efficiently leading to decreased pelvic floor relaxation, increased tightness, or weakness. This poor breathing pattern can ultimately cause symptoms such as pain with sexual intercourse, urinary urgency, leakage, and prolapse.

Diaphragmatic or belly breathing is when we use our diaphragm to inhale and exhale which is great for pelvic floor function. However, for some women who have a condition known as diastasis recti, a separation of the fascia that connects your abdominal wall muscles together down the center, too much of belly breathing may delay their healing as it may result in increased pressure and stress on the fascia.

You’re probably wondering now which of the two breathing patterns you should be doing.  The answer is both!  When you inhale, your chest should rise first then your belly should expand as it fills up with air.

Most pelvic floor PTs recommend 360 breathing. So, basically instead of directing the pressure towards your belly only, try to direct it to the sides of your ribcage, belly, and back. This will help distribute the pressure evenly around your belly to help relax your pelvic floor muscles more fully.

If you are still struggling to understand or apply this concept, it is best to see a pelvic floor PT who will evaluate your breathing and educate you on how to breathe better for optimal pelvic floor function.

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In summary, the pelvic floor is affected by the way we breathe. If one of the structures doesn’t function correctly due to tightness, weakness, poor posture, pain, stress, etc. the other structures would be affected as well.

Remember to always consult with your physician or pelvic floor specialist to determine the best approach for your care.

We are Pelvic Floor Rehabilitation Specialists. We can help.