Breathing Exercises for Pelvic Floor Muscle Relaxation and Flexibility

Key Takeaways: 

1. Shallow breathing, stress, and holding in urine or bowel movements can lead to tightness and problems in the pelvic floor muscles.

2. Slow, deep breathing helps relax your pelvic floor and can ease tension and discomfort.

3. Practicing breathing exercises alongside simple pelvic floor movements can support relaxation and flexibility (see videos below).

Hinge Health offers virtual physical therapy and more to help you improve pelvic health. Learn more.

Inhala, exhala. No piensas en ello. Simplemente hazlo, entre 20.000 y 25.000 veces al día. La respiración es una de las funciones esenciales que tu cuerpo maneja por sí mismo. Pero el hecho de que ocurra automáticamente no significa que estés respirando de la mejor manera para favorecer tu salud pélvica.

Así es, la forma en que respiras puede afectar directamente los músculos del piso pélvico . Y es por eso que desarrollar una buena técnica de respiración es un componente clave en muchos planes de tratamiento de terapia de ejercicio de piso pélvico . Al coordinar la respiración con los músculos del piso pélvico , especialmente durante el ejercicio, puede ayudar a reducir los síntomas molestos mientras desarrolla fuerza y flexibilidad. 

Sigue leyendo para saber cómo están conectadas tu respiración y el piso pélvico, la técnica adecuada para practicar la respiración abdominal (o respiración diafragmática) y cómo combinar la respiración con los ejercicios del piso pélvico.

Breathing and Your Pelvic Floor

First, a quick anatomy lesson: Your pelvic floor is a group of muscles and tissues shaped like a bowl at the bottom of your pelvis. It stretches from your pubic bone in front to your tailbone in the back. Your diaphragm is the muscle that sits on top of your rib cage. Think of these two as dance partners that move together with each breath.

• When you inhale, your diaphragm moves down. This causes your pelvic floor to drop slightly and lengthen, giving it a nice stretch. Breathing in stretches your pelvic floor.

• When you exhale, your diaphragm rises up, which allows your pelvic floor to move upward with a gentle contraction. Breathing out contracts your pelvic floor.

Your pelvic floor is like the foundation of a house. It works hard all day to help support your abdominal and pelvic organs, such as your bladder and bowel. 

Slow, deep breathing allows your pelvic floor to relax and stretch, which helps the muscles remain strong and flexible. Quick, shallow breathing (like you might do when you’re stressed) prevents your pelvic floor from fully relaxing. This can cause tightness and weakness and, over time, may lead to issues like urinary incontinence (or leakage), fecal incontinence, pelvic pain, prolapse, and other pelvic symptoms.

Belly Breathing: How to Do It

Also known as diaphragmatic or deep breathing, belly breathing is good for your pelvic floor. It encourages your core muscles to relax and contract in a way that supports pelvic floor health. Breathing movements and sensations are subtle. They’re not like a bicep curl where you can easily see and feel your arm moving. It can take practice to identify the sensations that go along with proper belly breathing. 

Start by lying on your back with your knees bent. Place one hand on your chest and one hand on your stomach. (Belly breathing can also be practiced while sitting or standing.)

To inhale:

• Breathe in slowly through your nose, counting to five as you inhale.

• You should feel your chest and stomach expand up and out into your hands. Your stomach should rise farther than your chest and there should be minimal movement at your head and neck.

• As your lungs expand, your diaphragm contracts and descends down into your abdominal cavity, causing your pelvic floor to descend and relax.

• You can adjust how long you inhale to meet your comfort level.

To exhale:

• Relax your jaw and breathe out through your mouth.

• Exhale slowly, counting to five as you release your breath.

• You should feel your chest and stomach deflate and return to their original position.

• As your diaphragm relaxes, it rises back up to its neutral position, which causes your pelvic floor to shift up as well.

• You can adjust how long you exhale to meet your comfort level.

Practice inhaling and exhaling deeply and slowly five times or as many times as it takes to feel comfortable with this technique.

A pelvic floor physical therapist (PT) can offer personalized guidance on this exercise. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

Pelvic Floor Benefits of Belly Breathing

Just like other muscles in your body, your pelvic floor muscles can get tight or tense. They may stay contracted or have difficulty relaxing. Many different factors can contribute to pelvic floor tightness, such as holding stress and tension in your pelvic floor muscles or frequently delaying urination and bowel movements. An overly tight, or hypertonic, pelvic floor can lead to pelvic pain, urinary and bowel symptoms, and painful sex. Belly breathing can help lengthen and relax tense pelvic floor muscles to relieve symptoms. It can also coordinate muscle contractions to strengthen the pelvic floor, which may help reduce or prevent urinary or fecal incontinence and improve pelvic floor function. More benefits of belly breathing: It helps lower your body’s level cortisol, a stress hormone, and reduces your heart rate and blood pressure.

There's no right amount of diaphragmatic breathing you need to do, but it may be good to aim for a few minutes each day in the morning and evening, or whenever you feel stressed. Over time, diaphragmatic breathing can become second nature, leading to better pelvic (and overall) health. 

Breathing During Pelvic Floor Exercises

Pelvic floor physical therapists often include belly breathing exercises as part of their treatment programs. Pelvic floor exercises are more than just Kegels. They include a variety of movements that help strengthen and relax the muscles of your pelvic floor. Coordinating your breathing with particular movements during exercises can help make them more effective. 

General rules for breathing with pelvic floor exercises:

• Exhale with exertion, or during the “hardest” part of the exercise when the muscle is contracting.

• Inhale during the “rest” portion.

The following exercises recommended by Hinge Health pelvic floor physical therapists are a great way to keep your pelvic floor muscles strong and flexible. Here’s how to coordinate them with your breathing.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Breathing Takes Practice

“I can’t say enough about the power of diaphragmatic breathing to help manage pelvic pain and symptoms,” says Jeni Sepe, PT, DPT, a Hinge Health pelvic floor physical therapist. “It’s not a flashy or complicated exercise. It just takes time and intentional focus to target the areas of tightness and pain.”

How Hinge Health Can Help You

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Cleveland Clinic. (2019). Diaphragmatic breathing exercises & techniques. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

2. Harvard Health Publishing. (2016, March 10). Learning diaphragmatic breathing. Harvard Health. https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing

3. Park, H., & Han, D. (2015). The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing. Journal of Physical Therapy Science, 27(7), 2113–2115. doi:10.1589/jpts.27.2113

4. Relaxation Techniques for Health. (2021, June). NCCIH. https://www.nccih.nih.gov/health/relaxation-techniques-what-you-need-to-know

5. Toprak, N., Sen, S., & Yigit, B. (2021). The role of diaphragmatic breathing exercise on urinary incontinence treatment: A pilot study. Journal of Bodywork and Movement Therapies, 29. doi:10.1016/j.jbmt.2021.10.002