Why you should care about how you breathe
This is SO IMPORTANT that I spend time teaching this to almost every single one of my pelvic floor and low back pain patients!! Don’t underestimate the importance of breathing!
The diaphragm and your pelvic floor work together like a piston. When you inhale, air fills your lungs and your diaphragm descends, increasing your intraabdominal pressure and allowing your pelvic floor muscles to lengthen/relax slightly. When you exhale, your pelvic floor returns to its normal resting state, and if you exhale all the air in your lungs, it can help your pelvic floor lift a little (not quite a full contraction or kegel).
“Diaphragmatic breathing” is when we allow the diaphragm to fully descend downwards and outwards (like a big umbrella opening). I prefer calling it “360 breathing” because I want you to send your breath all around your belly AND your low back, not just to your belly.
360 breathing can help with: decreasing stress, pelvic floor muscle relaxation, decreasing neck and jaw tension, improving pelvic and intestinal blood flow, digestion, and improving lymphatic flow in the abdomen and pelvis.
In times of high stress or chronic pain, we tend to switch from 360 breathing to chest breathing. This causes us to lose out on all the benefits of diaphragmatic breathing and actually perpetuates our pain/stress cycle. Scroll down to re-learn how to do 360 breathing correctly.
360 Breathing
(Passive, relaxing breathing to ease pelvic floor tension)
Watch this short video to learn how to do and then follow these simple steps to practice
1. You can try this sitting or laying on your back with your legs bent or straight, whichever is most comfortable.
2. Relax your jaw by placing your tongue on the roof of your mouth and keeping your teeth slightly apart.
3. Place one hand on your belly and the other on your chest.
4. Take a deep breath in through your nose, letting your rib cage widen and your abdomen and low back expand. It’s common for your low back or belly to feel tight and for this to be challenging at first (psst: that means you’ve probably been chest breathing and you really need this!)
5. When you inhale, you should feel your hand on your belly rise first and more than your hand on your chest.
6. Keep your upper chest, neck, jaw, and shoulders relaxed as you breathe in.
7. As you breathe out through your open mouth, allow your abdomen to relax. Exhale completely.
8. Breathe slowly. Do not force your breathing. Practice this for a few minutes, or however long feels right for you.
How do you feel after practicing this? Do you feel more relaxed? You should! Super nerdy fact: as the diaphragm descends downwards, it strokes the Vagus Nerve, which is the nerve that controls your body’s rest/digest system. This means that by practicing 360 breathing, you are literally stimulating your body to relax. How cool is that?!
Piston Breathing –
(More active exhaling to engage and encourage pelvic floor contraction/activation) Watch this video on how to do Piston Breathing and follow these simple steps
1. Once you have conquered the ability to fully relax the pelvic floor with 360 breathing, you can consider practicing 360 breathing with contracting your pelvic floor. Make sure you have fully conquered 360 breathing before moving on to this step. It can often take weeks to learn to learn 360 breathing and to coordinate fully relaxing the pelvic floor.
2. Relax your jaw by placing your tongue on the roof of your mouth and keeping your teeth slightly apart.
3. Place one hand on the lower part of your abdomen and the other on your chest.
4. Take a deep breath in through your nose, letting your rib cage widen and your abdomen expand.
5. You should feel your hand on your abdomen rise first and more than your hand on your chest.
6. Keep your upper chest, neck and shoulders relaxed as you breathe in.
7. As you breathe out through your mouth, blow out like you are blowing air through a straw. Allow your abdomen to relax and exhale completely.
8. Now focus on the relationship between your breathing, diaphragm, and the pelvic floor muscles.
9. As you breathe in, allow your pelvic floor to relax and lengthen.
10. As you exhale, close and lift the pelvic floor up (Kegel), as if the pelvic muscles are helping the air leave your lungs.
11. Continue to do your diaphragmatic breathing, working on coordinating your inhale with pelvic floor relaxation/lengthening and your exhale with pelvic floor close and lift.
12. Breathe slowly. Do not force your breathing. Practice this for a few minutes, or however long feels right for you.
Make sure to return to 360 breathing for a few breaths afterwards to return the pelvic floor to a relaxed length-tension relationship afterwards!
Quick pelvic floor contractions
• Relax your body and breathe during your exercises. Coordinate your breathing with your pelvic floor contraction by blowing out or exhaling while you contract your pelvic floor muscles. You may lightly place your hands on your lower abdomen, one on either side, to monitor for a gentle abdominal contraction.
• Avoid straining, holding your breath, or using buttock or leg muscles while you exercise the pelvic floor muscles. You can try counting out loud to avoid straining.
POSITION FOR THE EXERCISE:
• You may find it easier to start performing the exercises lying down. Once you’ve gained awareness and can feel the muscles contracting, you can perform them sitting or standing. You can even incorporate them into your daily activities, such as at mealtime or while brushing your teeth.
QUICK CONTRACTIONS •
Contract your pelvic floor muscles off/on/off/on as fast as you can, but *make sure to fully relax between contractions* • Perform 10-15x and repeat for 2-3 sets every day! Make sure to fully relax by doing a couple 360 breaths after these kegels!
Endurance contractions
- Pull your pelvic floor muscles up and in and hold for 5-10 seconds.
- Relax for 10 seconds, or two deep 360 breaths
- Count out loud while you are holding the contraction to make sure that you are breathing throughout the exercise and not straining.
- Repeat this 10 times.
- Do these endurance contractions once a day.
- Progress to holding for 10 seconds, relax for 10 seconds, repeat 10 times.
- End with a few 360 breaths after doing these kegels to fully relax your pelvic floor afterwards!