Diaphragmatic Breathing for Pelvic Health

You take 20,000 to 25,000 breaths each day. But how often do you think about how you’re breathing? After all, it’s an automatic process. As long as you’re getting the air you need, it doesn’t matter how you get it, right?

Actually, no. Turns out, good breathing technique is a critical part of your pelvic health. It’s a key component of many pelvic floor physical therapy treatment plans. Learning how to coordinate your breath to your pelvic floor can help reduce pain and build strength and flexibility.

Let’s Talk About Breath and Your Pelvic Floor

With each breath you take, your diaphragm (the muscle that sits at the bottom of your ribcage) moves. When your diaphragm moves, your pelvic floor moves. (Your pelvic floor is a group of muscles that sits at the bottom of your pelvis, connecting your pubic bone in the front to the tailbone in the back.) Think of these two as dance partners.

• When you inhale, your diaphragm moves down. This causes your pelvic floor to lower slightly, giving it a nice stretch.

• When you exhale, your diaphragm rises up, which allows your pelvic floor to move upward with a gentle contraction.

Your pelvic floor is hard at work all day supporting your organs. Slow, deep breathing allows your pelvic floor to rest periodically so your muscles remain strong and flexible. On the other hand, quick, shallow breathing prevents your pelvic floor from fully relaxing. This can cause increased tightness and weakness and, over time, lead to issues like urinary leakage and prolapse.

Let’s Practice

The following exercise is often called diaphragmatic breathing. It’s also known as belly breathing or deep breathing. Start by focusing on how you inhale.

• You can perform this exercise in any position (sitting, lying, or standing). For your first time, it’s best to start by lying on your back with your knees bent.

• Place one hand on your chest and one hand on your stomach.

• Inhale slowly for five seconds, breathing through your nose.

  • You should feel your chest and stomach expand up and out into your hands. Your stomach should rise farther than your chest, and there should be minimal movement at your head and neck.

  • As your lungs open up, your diaphragm contracts and descends down into your abdominal cavity, causing your pelvic floor to descend as well.

  • You can adjust how long you inhale to meet your comfort level.

• Practice inhaling deeply and slowly five times, or as many times as it takes to feel comfortable with this technique.

Once you feel comfortable with this method of inhaling, practice exhaling.

• Remain in the same position with one hand on your chest and the other on your stomach.

• Relax your jaw and exhale through your mouth.

• Breathe slowly, counting to five as you release your breath.

  • You should feel your chest and stomach deflate and return to their original position.

  • As your diaphragm relaxes, it ascends back up to its neutral position, which causes your pelvic floor to shift up as well.

  • You can adjust how long you exhale to meet your comfort level.

• Take a few more practice breaths (five is a good starting point), making sure to focus on your exhalation.

Let’s Put It All Together

Once you feel comfortable with your inhale and exhale, practice your diaphragmatic breathing as one cohesive exercise. It helps to be in a quiet environment so you can focus on your technique.

You can always adjust the length of your inhale and exhale as well as the frequency and number of repetitions you perform. There's no right amount, but it may be good to aim for a few minutes each day in the morning and evening, or whenever you feel stressed. Your Hinge Health physical therapist can offer personalized guidance on this exercise.

Starting Pelvic Floor Exercises

Once you’re comfortable with this breathing technique, you can pair it with additional pelvic floor exercises. Pelvic floor exercises are not just Kegels. Rather, they include a variety of moves that help strengthen and relax the muscles of your pelvic floor, which support your pelvic organs (bladder, bowels, etc.). Be sure to reach out to your Hinge Health physical therapist or coach if you’re interested in adding pelvic floor exercises to your current routine.

Key Takeaways

1. Quick, shallow breathing prevents your pelvic floor from fully relaxing, which can cause muscle tightness and weakness.

2. Diaphragmatic breathing (also known as deep breathing or belly breathing) helps promote pelvic health by keeping your pelvic floor muscles strong and flexible.

3. You can practice diaphragmatic breathing on its own or in conjunction with your exercise therapy.

References

1. Cleveland Clinic. (2019). Diaphragmatic Breathing Exercises & Techniques | Cleveland Clinic. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

2. Learning diaphragmatic breathing. (2016, March 10). Harvard Health. https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing

3. Gallup, A. (2019, October 23). Diaphragmatic breathing - Stop and Smell the Roses - Urology Austin Blog. Urology Austin. https://urologyaustin.com/stop-and-smell-the-roses