Diaphragmatic Breathing and the Pelvic Floor
Dr. Hannah Williams, PT
Pelvic Health Specialist
“Just breathe” – A common sentiment we hear throughout our lives, whether at yoga, in our therapist office or on a nice decorative sign at Hobby Lobby. It may often seem trite but the truth is, many of us could be breathing in a way that is inefficient at best and beyond that highly dysfunctional with rippling impacts.
Before we dive in, let me briefly introduce myself! I’m Dr. Hannah, Physical Therapist at Peak Health and Performance. I specialize in post-operative, sports, tactical, and pelvic health rehabilitation and training. I am certified in trigger point dry needling and Neufit ESTIM, (aka: direct current neurotherapy) both of which are profound tools on the road to recovery and enhancing performance. Now, let’s get back to breathing.
A common breathing pattern many of our clients demonstrate can be described as “chest breathing.” When you breathe like this, your chest and shoulders rise and fall instead of your abdomen expanding and falling back with each breath. It commonly occurs in times of stress and anxiety because we resort to shorter and shallow breathing patterns. This is normal and nothing to panic about in these moments (Mayo Clinic Staff, 2022). It’s also a common breathing pattern in peri-natal patients due to the widening of the rib cage that occurs during pregnancy and the general compression of all their internal organs/thoracic cavity pressing up on their lungs. You really can run out of breathing room! Upper chest breathing negatively impacts the muscle activity in our shoulder and neck muscles and the natural kinematic coordination of our core and pelvic floor.
Let’s try it. Take a large deep breath wherever you are right now and see what happens with your chest and shoulders. Did they expand and lift upwards? What happened to your abdomen? Did it suck in with your inhale? If so, that’s upper chest breathing. When clients demonstrate upper chest breathing, we learn about proper breathing and the impact on all our function and movement.
At Peak Health and Performance we deeply believe the breath is part of all movement. All of our clients will tell you about exercises focused on the inhale and exhale; sometimes even more than the movement it’s paired with. Breath can be one of the most powerful tools to create space and change within the body in addition to all the incredible impacts on your nervous system, whether it’s ramping you up or calming you down. But let’s dive into more of what “proper breathing” looks like.
If you’ve been in the health and fitness world, you will likely hear the term “belly breathing” or Diaphragmatic Breath. It sounds obvious now but if we don’t want our chest to primarily rise and expand with inhale, then we need our abdomen to. Our body is full of pressure regulation systems (National Library of Medicine, 2021). Thankfully the breath is one pressure system we can exercise a significant amount of voluntary control over. We’ll start by breaking down the diaphragmatic breath.
The Diaphragmatic Breath
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Start with lying down in a comfortable position free of distraction
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Often on your back with legs supported or side-lying in the fetal position
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Place one hand on your chest and one on your belly
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Inhale through your nose and fill your abdomen with air
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You should feel your ribs and back expand as well, think a balloon
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Exhale through your mouth and allow all the air to leave your abdomen.
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The hand on your chest should stay still while the hand on your abdomen gently rises and falls
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Take your time and try to clear your mind of clutter for 2-5 minutes
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Try in another comfortable position such as Child’s Pose. You will notice differences as your body is able to relax and expand/contract with breath.
Deep breathing has a slew of benefits both physiological and psychological, including but nowhere near limited to:
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Increasing blood oxygen levels
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Improving muscle function during exercise by reducing strain
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Promotes HR and blood pressure reduction
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Decreasing stress and anxiety (fight or flight response)
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Promotes proper body and respiratory mechanics
But wait, there’s more! We’ve covered what the outside of your body is doing while diaphragmatic breathing. But what about the inside? It is named after the diaphragm after all. This is where Dr. Hannah gets to share some pelvic health insight!
The Diaphragm and The Pelvic Floor
The diaphragm is the respiratory muscle just below our lungs but above our internal abdominal organs. In between you have the abdominal cavity full of lots of important organs that we like to keep happy and healthy and mostly not compressed (Unless you’re pregnant and then we have to make room for a baby, or two!) Then, at the bottom, are our pelvic floor muscles. These sit at the base of the abdominal cavity and aid in many functions regarding support, stability, sphincteric, and sexual capabilities. For more on this check out our other blog posts or come in and chat with Dr. Hannah!
The pelvic floor mechanics during breath are often one of the most overlooked components of our movement patterns (American Physical Therapy Association [APTA], n.d.). You know how much we love movement patterns at Peak Health and Performance! When our pelvic floor isn’t properly functioning, this will almost always cause compensation – around the core, lower back, lower extremities, and vice versa. Ideally, and for optimal function, our diaphragm and pelvic floor should be working in cooperation with each other. But when we are utilizing the upper chest breathing pattern (shallow breathing) this cannot occur. What should happen is as we inhale, our diaphragm descends, and our pelvic floor lengthens. Then, as we exhale our diaphragm rises and our pelvic floor gently lifts. This is an optimal movement pattern during breathing for your pelvic floor.
If we can optimize our internal balance and pelvic floor function with something as simple as breath, think of the possibilities to affect other movement patterns and the rest of our body!
Curious how breathing mechanics and breath work can affect your performance and wellbeing? Then it’s time to book a session with Dr. Hannah. We can’t wait to work with you to achieve your performance and wellness goals.
References
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American Physical Therapy Association [APTA]. (n.d.). Pelvic Health Physical Therapy.https://
aptapelvichealth.org/ -
Mayo Clinic Staff. (2022). Diaphragmatic breathing for better health. Mayo Clinic. https://www.mayoclinic.org/
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National Library of Medicine. (2021). The effect of diaphragmatic breathing on core stability and pelvic floor function. https://pubmed.ncbi.nlm.nih.
gov/
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Hannah Williams, PT, DPT
Movement Performance Coach
Things Dr. Hannah treats:
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Exercise through all stages of life for all pelvic floor presentations
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Incorporation of pelvic floor stability and appropriate activation in athletes
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Fine-tuning your movement patterns with an emphasis on pelvic floor coordination
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Guidance for prenatal, pregnancy, and postpartum
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Pelvic pain
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Bladder and/or bowel incontinence
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Adjustments to make during menopause or perimenopause
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Dyspareunia and sexual health
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Endometriosis care
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Post-operative abdominal care
As always, our physical therapy clinic does participate in most insurance plans, including Tricare Select, Tricare Prime, and Tricare For Life for military active duty, military retirees, and their dependents. As military families ourselves, we at PHaP are excited to continue to serve our nation’s guardians and their families.
References
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American Physical Therapy Association. (n.d.). Pelvic Health Physical Therapy.https://
aptapelvichealth.org/ -
Bø, K., & Hilde, G. (2013). Does it work in the long term?—A systematic review on pelvic floor muscle training for female stress urinary incontinence. Neurourology and Urodynamics, 32(3), 215–223. https://doi.org/10.1002/nau.
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Dumoulin, C., Hay-Smith, J., & Habée-Séguin, G. M. (2014). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, (5), CD005654. https://doi.org/10.1002/
14651858.CD005654.pub3 In health,
Dr. Hannah Williams, PT, MPC
Pelvic Health Specialist
Movement Performance Coach
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