Breathing and the Pelvic Floor
Breathing seems like such an automatic process. Most people don’t spend much time thinking about their breathing. How does breathing actually work? Or how should it work? And what does breathing have to do with my pelvic floor?? Well, let’s talk about the connections.
Normal resting breathing should be a fairly quiet and passive action. Signals from our brain move through the spinal cord and cause a contraction of the breathing diaphragm (a dome-shaped muscle sitting under the lower part of our ribcage). The contraction of the diaphragm moves the muscle down toward the pelvis and the lungs expand to fill with air (inhale), then as the diaphragm slowly returns to it’s dome-like shape the air is pushed from the lungs (exhale). Repeat. The diaphragm should be the primary muscle involved in the action of breathing. There are also some additional muscles that assist in breathing. They are located between the ribs and assist in moving the ribs upward and outward as the lungs fill with air.
What could go wrong here? Well, if you are sprinting across a football field, you are going to need a little more air moving in/out, or at least moving faster to get air in/out of the lungs to keep up with the demands of oxygen needed. So, to assist with this requirement, additional muscles around the upper back, neck, and chest will help out to meet those demands. While it is necessary in a situation like running across a football field for those muscles to be active in breathing, it is not necessary for those muscles to be involved when you are sitting at your desk. When our body senses that we are under “stress” such as physical exertion we switch into this “chest breathing.” As you can imagine, chest breathing is necessary….at times. In our fast-paced lives though, often our body is creating high levels of cortisol (hormone released when our body is under stress of any kind) which can leave our body sensing “stress” and shifting our breathing into more of a chest-based breathing pattern.
So, what’s wrong with that? If we start overusing the chest muscles to breath, rather than our diaphragm, then we can see the problems show up further down the chain. Remember how we said that the diaphragm moves down during an inhale? Well, if we keep following the muscles connected below the diaphragm you will see the pelvic floor muscles at the bottom of the core. When things are moving as they normally should be, the pelvic floor muscles actually move together in synergy with the breathing diaphragm. On a natural inhale, the pelvic floor moves slightly downward and on a natural exhale, the pelvic floor moves slightly upward. If we stop moving the diaphragm due to chest breathing, we can also experience a decrease in pelvic floor movement which can start to show up as pelvic floor symptoms.
Chronic chest breathing can lead to tightness of the pelvic floor muscles which can show up as pelvic pain, pain during intercourse or penetration for pelvic exams, constipation, urinary urgency or even urinary incontinence. So, it is not uncommon for your pelvic floor physical therapist to watch how you are breathing and provide some exercises to help you move into better diaphragmatic breathing patterns as a starting point for your pelvic floor symptoms.
If you notice that you are constantly experiencing stress, or noticing pelvic floor symptoms, they might actually be related! Take a deep breath (into your belly and lower ribs!) and reach out to Shift Physical Therapy to help you get back to feeling well again.
Written by: Renee Hancock, Pelvic Floor Physical Therapist
