Breath & the Pelvic Floor: Basic 360 Breath

Breathing is an essential task for living, however, many individuals display non-optimal breathing patterns which affect digestion, stress, pelvic floor function, and our overall deep stability system/ core. Our breath can be restricted for many reasons including the obvious respiratory issues like asthma, bronchitis or even chronic stress or anxiety. A history of pain or trauma can also influence our breathing strategies as when we are in pain or have injured ourselves, we reduce the depth of our breath to limit movement that could cause pain, as well as to provide stability by gripping our diaphragm (one of our main central stability and core muscles). Overtime and with layering injuries, our breath patterning can be limited in ways that we don’t even notice as it doesn’t necessarily show up as an inability to breath or get the basic oxygen requirements of daily life.

However, in working with people with core dysfunction, including pelvic floor, abdominal wall, hernias, back or hip pain, as well as chronic or persistent pain, I always get pulled back to the thorax, ribcage and the breath to some degree. So in knowing the breath is integral and important to the optimal function of the core, whatever the complaint or symptom is, it makes sense to enhance that as best we can to optimize reflexive systemic control.

Inhalation & Exhalation

During inhalation, the diaphragm contracts and descends into the abdomen, pulling the lungs downward which in turn, creates negative pressure in the thorax (ribcage) drawing more air into the lungs through the glottis/ throat. This then pushes the visceral organs downward, massaging the digestive system, aiding in digestive activity. As this happens, the pelvic floor lengthens to accommodate changes in pressure from above.

During exhalation, the diaphragm recoils up, drawing the organs back up, and the pelvic floor and transverse abdominis (deepest abdominal wall muscles, part of the core) reflexively contract to assist the emptying of the breath and upward direction of depressurization.

Belly Breathing: Pitfalls

Many individuals practice diaphragmatic breathing by puffing their belly expanding just the anterior line – this increases abdominal and anterior pelvic pressure (hello bladder;)). Now if you cough or sneeze or lift with the same strategies, you may leak urine or loose stability in the pelvis or abdominal wall because things are not balanced, thus limiting the reflexive activation of the central stability system.

True Diaphragmatic Breathing: Expand the Ribs!

Ideally diaphragmatic expansion should occur in a multi-planar direction, moving front, back, sideways and upward. Imagine your bottom 5 ribs (to which the diaphragm attaches) like bucket handles each side coming up and out on the inhale to allow for more optimal excursion of the diaphragm. This not only draws more air into all lobes of the lungs, but also massages the organs to a greater degree, as well as balances abdominal and pelvic pressures throughout the abdominopelvic canister. This in turn allows for more optimal reflexive activation of the deep stability system.

Factors that may be impeding true diaphragmatic breathing:

  1. Tight fitting clothing (think spanx, ill-fitted bras)
  2. Sitting at a desk (reducing the ability of the abdomen to expand with poor posture)
  3. Sucking in your tummies in (let your tummy relax)
  4. Pregnancy (baby takes up a lot of room)
  5. Stress (shoulders do a lot of work to get breath in during times of stress)

Check out how you can optimize your true diaphragmatic breath to optimize pressures and reflexive deep core activation. Important for anyone with pelvic floor dysfunction, hernias, back/ pelvic/ hip/ shoulder/ etc pain and if you breathe (i.e. for everyone). Episode 1 of 8 below:)

Andrea Plitz Physiotherapist

Written by Andrea Plitz, Physiotherapist and Yoga Teacher. Andrea has a clinical focus in women’s health including applied pelvic health, complex orthopedics and concussion rehab. She currently lives and works in Ottawa, Ontario, Canada.

Disclaimer – Everything shared is for informative purposes only. It is not intended for assessment, diagnosis or treatment purposes. If you feel there needs to be further investigation, please seek out a qualified health care professional for a proper assessment.

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