Breathing and Pelvic Floor: Are You Doing it Wrong?


First, let’s consider breathing in its broadest terms as the expansion and recoil of the chest and abdomen.

Now, if your lungs don’t even reach to the bottom of your rib cage, then why does your abdomen expand when you inhale instead of just your chest where the lungs are?

Singers and yogis will be very familiar with the idea of “belly breathing.” Those of us under chronic stress might not remember that it’s possible to expand through the abdomen as you breathe.

The key is understanding that your entire trunk is a pressure system designed to keep you upright, yet flexible. When you inhale, your diaphragm actively draws downward in `your chest. This decreases the pressure above your diaphragm, creating a vacuum in your lungs for air to rush in, while simultaneously increasing the pressure below your diaphragm and causing your abdomen to expand.

This is where the pelvic floor comes in. It, too, lowers and lengthens under the increased pressure when you inhale. It moves with the diaphragm like a piston, giving rise to the term “piston breathing.” Pelvic floor muscles are constantly working to hold in urine, provide stability to the pelvis, and a multitude of other functions. So this slight lengthening facilitated by your breathing is a welcomed “micro-break” that keeps the muscles from becoming too tight as they stay active throughout the day. Something called high-tone pelvic floor is a common pelvic condition among men and women where the muscles are unable to relax, leading to pain and sometimes a variety of other symptoms like increased bladder urgency.

Poor posture can cause inadequate abdominal and pelvic floor expansion during breathing since compressing the abdominal region will restrict this natural pressure dynamic.

When you exhale, your diaphragm recoils upward to push the air out of your lungs, and this reduces the pressure in your abdomen. A dysfunctional exhale involves the chest remaining expanded so that the abdomen never gets relief from the increased pressure. This is a pattern often seen in those under chronic stress who take shallower breaths. The pelvic floor can respond to this constantly higher pressure in one of two ways—either staying lengthened and letting the leaks happen, or fighting back with the high-tone situation described above. It’s also possible to experience a combination of the two.

So, what is the “right” way to breathe to promote the health of your pelvic floor? Ensure that your chest and abdomen expand and recoil together with minimal effort.

“Piston breathing” uses the analogy that an entire piston moves up and down as a unit, the same way the diaphragm and pelvic floor move together. Understanding how your diaphragm works is the key to understanding how your pelvic floor responds to your breathing.

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