Breathing and the Pelvic Floor

The pelvic floor is a fundamental part of our anatomy - quite literally. 

It forms the base of our core group of muscles. These muscles hold us up and allow us to breathe.

The core is made up of the diaphragm muscle at the top (at the bottom of the ribcage, just below the lungs), the abdominal muscles to the front and sides, the back muscles and the pelvic floor at the bottom.

The diaphragm is the main muscle of breathing. It is a sheet of muscle directly underneath your lungs attached to your lower ribs and your spine. When you breathe in, the diaphragm lowers to make more room for the lungs to expand and fill with air, moving your organs downwards. At the same time, the pelvic floor and the abdominal muscles lengthen and move down to make room for your organs and all the extra air you’ve just taken in. 

When you breathe out, the diaphragm releases, pushing the air out of your lungs, and your pelvic floor contracts. This feels like a squeezing inwards and upwards - a gentle version of a kegel exercise. 

 I’m going to say this once more, because it’s confusing. 

On an inhale, the diaphragm contracts and moves down while the pelvic floor and abdominals release and lengthen, moving down and outwards (relaxed tummy muscles).

On an exhale, the diaphragm relaxes and moves up, and the pelvic floor and abdominals contract, moving inwards and upwards, squeezing the air out of the lungs.

The conscious effort in the abdominals and the pelvic floor is on the exhale.

The diaphragm and the pelvic floor work in opposition to help air move in and out of your lungs. 

If we understand this basic principle, we can use the breath to connect to the pelvic floor and start paying attention to how it moves in our bodies when we breathe. We can use the breath to explore any areas where the pelvic floor feels stuck or weak or where there might be any pain or resistance. 

But there’s a catch.

Most people are doing it wrong. 

Breathing is so fundamental to our very existence, it’s hard to imagine that you are doing it wrong but there are loads of reasons why your breathing might be stuck in an unhelpful pattern. Emotions, habits, posture, tension and pain all impact how we breathe. 

Many people habitually use a pattern of breathing known as chest breathing.

This is what we think of when we hear the phrase ‘take a big breath’. If you imagine what this looks like, you’re probably thinking of someone taking in a big noisy breath, inflating their chest, raising their shoulders all the way up to their ears, and then holding it until they turn purple. 

It doesn’t take a professional to figure out that this kind of breathing is not going to be helpful for your pelvic floor, or many of your other bodily functions. 

Chest breathing is what it sounds like - breathing in and filling your chest and your upper lungs. A tell tale sign of chest breathing is your shoulders moving up and down as you breathe. You might feel like you’re taking a really big breath but because your core muscles are not being used fully in this type of breathing, you’re not getting as much air in as you would if your core is working freely. 

Chest breathing is often the result of stress and anxiety. 

Coordinating your breathing with how your muscles actually work is essential for maintaining a healthy pelvic floor. 

Luckily, there is a really simple fix.

Practising belly breathing allows you to connect with how your breathing and pelvic floor muscles interact and develop your proprioception (your ability to sense what your body is doing). 

It’s safe and suitable for everybody, no matter your issue. 

Being able to feel what is going on with your pelvic floor is the essential for treating any issues and improving your pelvic floor health.

Diaphragmatic breathing or belly breathing is a really simple way to reset your breathing, coordinate the muscles in your core and tune in to what your pelvic floor is doing. 

The added bonus is that belly breathing, even just for a minute or two is a relaxing reset for your entire nervous system, helping to calm you and reduce the impact of stress on the body.

Belly Breathing

1. Lie on your back on the floor with your knees bent and feet on the floor, hip width apart. Place one hand on your chest and one on your tummy, just below your ribs. The body is resting and relaxed. 
2. Breathe in. Allow your tummy muscles to relax and expand. Feel the ribs moving outwards in a 360 degree motion and the pelvic floor relax downwards. Your chest remains still and relaxed. 
3. Exhale. Feel your ribs returning to their original position and the pelvic floor moving inwards and upwards as the air is gently squeezed out of the body.

What else do you notice? Can you draw your attention to the pelvic floor and follow the motion of the breath? Do you notice any movement in your pelvis?

Pay particular attention to any holding or areas of tension - can you relax more there? 

The goal here is relaxed freedom of movement. 

Depending on what is going on with your pelvic floor, it might take some time to tune in to the sensations. As you practise, the connection between the breath and the pelvic floor will get stronger. Experiment with adding a gentle squeeze on the exhale - exaggerating this natural movement might help you connect. 

You can practise belly breathing anywhere, anytime. The more often you can remind your body to breathe this way and let go of tension, the better your pelvic floor connection will be and the more relaxed you’ll feel. 

If you want to know more about belly breathing, it’s one of the 5 Habits for a Happy Pelvic Floor that we talk about in Sheela’s FREE Guide. You’ll find it here. 

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Lastly, if there is a woman out there you think might need to hear any of this, please share. Talking about these issues is essential if we're going to help women move past them.