Breathing Exercises for Pelvic Floor Muscle Relaxation and Flexibility
Breathing exercises can improve your pelvic health. Learn effective breathing exercises for pelvic floor muscle relaxation and flexibility.
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Inhale, exhale. You don’t think about it. You just do it — between 20,000 and 25,000 times every day. Breathing is one of the essential functions your body handles on its own. But just because it happens automatically doesn’t mean you’re breathing in the best way to support your pelvic health.
That’s right — how you breathe can directly impact your pelvic floor muscles. And that’s why developing good breathing technique is a key component in many pelvic floor physical therapy treatment plans. By coordinating breathing with pelvic floor muscles — especially during exercise — you can help reduce bothersome symptoms while building strength and flexibility.
Read on to learn how your breathing and the pelvic floor are connected, the proper technique to practice belly breathing (or diaphragmatic breathing), and how to pair breathing with pelvic floor exercises.
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Jeni Sepe, PT, DPT
Tamara Grisales, MD
Bonnie Whiting, PT, DPT
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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 inhale, 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 pelvic, 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.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
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.
Pelvic Floor Exercises
/for-individuals →- Bridge
- Cat and Cow
- Abdominal Bracing with Heel Slide
- Hooklying Kegel
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.
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References
Cleveland Clinic. (2019). Diaphragmatic breathing exercises & techniques. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing
Harvard Health Publishing. (2016, March 10). Learning diaphragmatic breathing. Harvard Health. https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing
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
Relaxation Techniques for Health. (2021, June). NCCIH. https://www.nccih.nih.gov/health/relaxation-techniques-what-you-need-to-know
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