Breathing for pelvic health

For most of us the value of maintaining pelvic floor health is ignored until we start having children or face challenges like incontinence or prostate issues. However it's crucial to start looking after this part of our body long before problems arise. Just as with other aspects of our health, prevention is more effective than treatment.

We are often told for any pelvic health issue that we must strengthen the pelvic floor - do more ‘Kegels’. But just as with any muscle of the body, some of us hold too much tension in our pelvic floor muscles. It might seem counterintuitive but in any exercise, in order to more effectively contract muscles, we need to first learn to effectively relax them. Optimal functioning of any muscle requires a balance of relaxation and strengthening. So if all we do is focus on the contraction of the pelvic floor muscles, we will be making things worse. 

Before we explore a breathing exercise for the pelvic floor, let’s get a better understanding of what the pelvic floor is and look at the mechanics of breathing. 

What is the pelvic floor?
Your pelvic floor is made up of layers of muscle, nerves, tendons, blood vessels, ligaments and connective tissue. There are three layers of muscle. They stretch from the pubic bone to the tailbone and reach out to the bony parts of the pelvis that you sit on - you can visualise it as a diamond shape with the perineum at the centre. It supports the function of the bladder, bowel and, in women, the uterus, it plays a large role in our sexual health, it forms part of our ‘core’ and stabilises our back and pelvis. 

The mechanics of breathing
Your respiratory diaphragm is the main muscle responsible for breathing. When the lungs fill with air on an inhalation, it widens and moves down into your abdominal cavity. This pushes the organs below it, so your belly expands, which in turn pushes down into the pelvic bowl, widening and stretching the pelvic floor muscles. On exhale, the respiratory diaphragm returns in and up, so the belly returns in and the pelvic floor ‘condenses’ in and up.

So your pelvic floor moves with your respiratory diaphragm as you breathe. As you inhale, your pelvic floor expands downward, and the muscles relax. As you exhale, the muscles of your pelvic floor naturally contract, drawing in and up. 

We can take advantage of this natural motion to stretch, strengthen and balance our pelvic floor muscles. The key is to fully relax the muscles so that they can contract more effectively. For many of us, our pelvic floor muscles are always working, staying in a state of semi-contraction, never fully relaxed, but never fully engaged either. Without a chance to relax, the muscles become weaker over time. By taking the time to do mindful breathing exercises, we can allow our pelvic floor muscles to move through their full range of motion and let them do their job more effectively.

Let’s try this deep breathing exercise

Before beginning the breathing exercise, have a wee so that your bladder is empty.

Find a comfortable position, somewhere where you feel comfortable and relaxed. You can do this sitting - in a position where you feel centred on your sit bones and you don’t need to exert effort to keep yourself upright. Or you can try it lying down - many people find ‘constructive rest’ (lying down, knees bent) especially helpful for sensing the movement of their breath low in the belly and pelvic bowl. I find placing my hands on my belly and diaphragm also helps give valuable sensory feedback, helping me connect with the movement of my breath.

Soften your gaze or close your eyes, let out a sign or a yawn as you invite the muscles of your body relax. Release any tension that you may be holding in your pelvic floor. Begin with some gentle belly breathing. As you inhale, bring your attention to your pelvic floor muscles and start to notice the gentle expansion and relaxation of those muscles. As you exhale, notice the gentle contraction of your pelvic floor muscles. This expansion and contraction occurs without you having to exert any effort to make it happen. With each inhale, relax your muscles a little more fully, and with each exhale, as your belly moves in, notice your pelvic floor muscles also condensing in and up. 

Continue breathing in this way for five minutes or as long as you feel comfortable. You may not feel like you are doing any work at all. But by allowing your muscles to fully relax before gently contracting them, you are retraining your muscles and helping them to become stronger and more effective.

You might like to visualise the petals of a flower at the base of your pelvis, opening like the petals of a flower as you inhale and gently closing together as you exhale.

You might like to repeat the practice a few times a day. Notice where you feel more or less movement of your breath? More on the left side, or the right? More in the front or in the back? Is it different in the morning compared to the evening? Compare how it feels in a sitting position and when lying down? This is all valuable information, building up your awareness and connection to your pelvic floor.

Notes:
1. For those with pelvic organ prolapse, it can be helpful to do this breathing practice in ‘constructive rest’ pose with the hips comfortably raised on a bolster. This creates more space in the pelvic bowl so that you can sense the movement of breath there.

2. If you are a ‘reverse breather’ - meaning that when you take a deep breath, your belly moves inward rather than expands - then you would benefit from taking a front lying position, which allows for more sensation of breath in the belly and pelvic floor on inhale. Try placing a bolster along your front and letting your head and arms rest comfortably on a folded blanket.

I am running a pelvic floor yoga workshop at Yogahome on Sunday 14th July 2024, 2-4pm.  Come along and learn more simple practices to get to know and appreciate your amazing pelvis. We will explore the connections between breathing mechanics, physical alignment and our life stories in how they impact our pelvic health. To book go to ‘Workshops’ in the menu above.