Just Breathe: The Link Between the Pelvic Floor and the Diaphragm

By Dr Chloe Sandberg – CC’s Staff

Just Breathe: The Link Between the Pelvic Floor and the Diaphragm

Let’s chat about the link between the pelvic floor and the diaphragm. Your diaphragm is a domed muscle that separates your chest cavity from your abdomen. When you take a deep breath in, the diaphragm contracts and flattens, inversely when you exhale this muscle relaxes back into the dome shape. The mirror of the diaphragm is the pelvic floor on the bottom end of the abdomen. Your pelvic floor is a basket of muscles that sit on the inside of your pelvis and help support organs and either hold or void bowel and bladder. The pelvic floor works inversely of the diaphragm. That means when you breath in the pelvic floor relaxes while the diaphragm contracts and when you breath out the pelvic floor contracts while the diaphragm relaxes. You can think of these muscles working together as the top and bottom of an elevator going up and down together… or at least they should.

Sometimes this coordination can be impaired by several different things such as tightness or weakness in the pelvic floor, impaired breathing patterns, constipation, etc. When we do not have the coordination of the pelvic floor muscles to contract and relax we can experience things like urinary or fecal incontinence, pelvic pain, feelings of pelvic pressure or heaviness, etc. So, let’s walk through how to breathe and contract your pelvic floor. 

How to breath:

1. Begin lying on your back with your knees bent. Now I want you to place one hand on your chest and the other on your abdomen. Now take a big breath in and take notes of what happens to your hands. Did your hand on your chest move a lot and your other hand not so much? This is more common than you would think.
2. So let’s focus on diaphragmatic breathing. With your hands in the same place I want you to breathe in and think of pushing your abdomen into your hand. You should notice more movement throughout your abdomen. Your chest will still rise but it should not be the only movement. Try this 5 more times. We don’t just want our abdomen rising to the ceiling in isolation.
3. Now, I want you to move your hands to your ribs. This time I want you to fill your abdomen on the next breath and also think of pushing your ribs into your hands as well. This should look more like a 360 degree expansion. Now you’ve got it! 

Not only is this great to get your pelvic floor and breathing coordinated but an added benefit is stress relief by stimulating the vagus nerve. Perform this exercise daily for 3-5 minutes. 

Now let’s talk about how to contract your pelvic floor. This exercise is to bring awareness to the coordination of your pelvic floor through full relaxation and contraction, but should not be used as a primary exercise to strengthen the pelvic floor. There are exercises that are much more effective at doing so than purely a pelvic floor contraction… more to come on that! For this exercise I want you to think of a house. The attic is when the pelvic floor is contracted, first floor is the muscles at rest, and the basement would be when bearing down the muscles are on a stretch. 

This exercise can be performed in a variety of different positions but I am going to teach you how to do so in sitting so that you can feel the contraction a little bit better. If you still don’t feel like you can feel the contraction and relaxation, you can use a mirror while laying on your back to see the tissues moving. 

How to contract my pelvic floor:

1. To start you are going to roll up a small towel and sit on the towel with direct pressure on the vaginal tissues.
2. Next, I want you to think of moving to the attic, pull the tissues up and away from the towel. You may notice you contract through your glutes 
3. or your inner thighs. Try to contract the pelvic floor without the help of these other muscles.
4. Now relax the tissues back to the ground level. Push your tissues into
   the towel like you are bearing down. The only time we should be bearing down is when having a baby but for the sake of this exercise it helps provide information on pelvic floor awareness and range of motion of the tissues.
5. Now you can go through the diaphragmatic breathing and feel your pelvic floor go through all the different floors of the house with the breathing. 

If you need help figuring out how to do so or are experiencing any of the symptoms listed above please reach out. You do not have to live with these symptoms. They are not normal or a part of aging or having a baby or another excuse you have heard before. There are so many ways that pelvic floor physical therapy can help!

See how to use your diaphragmatic breathing by following our video here!