Core Connection: The Relationship Between the Pelvic Floor & the Breath

“Breathe into your belly” is a common instruction in yoga classes. While it may seem like a convenient metaphor for active and engaged breathing, the breath does literally affect the muscles of the abdomen and the pelvic floor. A deep breath that goes into the abdomen benefits the pelvic floor in many ways.

First, let’s look at the anatomy of the pelvic floor. It’s made up of three layers of muscles (a total of 16 individual muscles) that attach to the left and right sitting bones, the pubic bone in the front, and the tailbone (coccyx) in the back. These four points are the diamond-shaped frame of the pelvic floor.  

The layers of muscles “hang” like a sling in the base of the pelvis, holding the organs.

Every breath you take

Proper breathing is incredibly important for healthy pelvic floor function. Our primary breathing muscle is the diaphragm, a dome-shaped muscle which operates like a parachute. It connects to the lower part of the ribcage. The intercostals, little muscles that fit between your ribs, also play a primary role in breathing. Then there are the secondary breathing muscles: the scalenes in front of the neck, the pectoralis in the chest, the sternocleidomastoid from behind the ear to the sternum, and the upper trapezius.

Let’s take another look at the diaphragm. When we bring in air from the mouth or the nose, the lungs expand and the diaphragm muscle moves down towards the pelvic floor. So on the inhalation, the diaphragm pushes down our organs, which fit in a sack called the peritoneum. And where does that sack of muscles get pushed? To the pelvic floor.

This is why breath is such an important part of pelvic floor work. When we breathe in, the pelvic floor is receiving the breath and the downward-moving organs. As we exhale, the breath goes up and out. The organs also move up. A healthy pelvic floor stretches as we breathe in and contracts slightly as the breath goes up and out.

Connecting the dots 

We’ve looked at the connection between the diaphragm and the pelvic floor. But there’s another key player in the healthy function of the pelvic floor: Our abdominals.

Particularly important is the transverse abdominus, the deepest abdominal muscle, which is like a corset that goes all the way around the lower torso, attaching at the bottom ribs. The fibers of the transverse abdominus are horizontal, which means when they’re contracted, they pull in the diameter of the abdomen (think of the image of tightening a belt). These muscles also serve a purpose in exhaling the breath.

If we have “poor” posture or spend a lot of time sitting in chairs, our transverse abdominus muscles will be weak. This, in turn, can be linked to pelvic floor problems. For example, if we collapse our chest while sitting, we end up with a “C-curve” in the spine. This makes it challenging to take a deep breath, and as a consequence, the muscles of the pelvic floor don’t receive the gentle ‘exercise’ they need, stretching and contracting with every breath in and out.

In short, if our posture is not good and we’re not taking in deep breaths to the abdomen, our pelvic floor is most definitely suffering. Everything is connected, and deep belly breathing is the most efficient way to take care of the pelvic floor.

It’s not easy to change breathing habits and patterns, and the key is to never force. But to get you started on deepening the breath, here’s a little exercise you can try.

Deepening the Breath

  1. Lie on your back with your knees bent, the feet hip width apart.

  2. To begin, take a few minutes to tune in to your body. Notice how you’re feeling, notice where there are areas of tension or tightness. Notice the movement of the breath, not judging or trying to change anything, just observing.

  3. Put one hand on your lower belly below the navel, the other on your chest. Allow yourself to feel the breath move under your hands for a couple of minutes.

  4. Then, as you exhale, gently contract the lower abdomen, moving the navel toward the spine. Repeat a few times, each time emptying out the air more fully. As you inhale, let the belly relax and be soft. Allow the air to fill you lungs as the belly naturally inflates. Repeat 3 to 5 breaths, then just relax and return to your normal breath. Rest.

  5. For round two, again draw the navel towards the spine as you exhale. Add a slight sighing sound on the exhale by constricting the back of your throat gently. As you get used to adding the sighing sound on the exhale, begin to add it on a small inhale as well. This will challenge the diaphragm and make the movement of the breath slightly deeper. It also adds a meditative quality to the flow of breath.

Repeat this breath 8 to 10 times or as long as comfortable, then again, relax and return to your normal breath.

Doing this simple breath exercise a couple of times a day or at the start of your yoga practice will go long way towards strengthening and engaging the diaphragm and in turn, slowly deepen your breath over time.

Yoga for Pelvic Floor Health a course by Jessica RealePT and Patty Schmidt for YogaUOnline Education

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