As a pelvic floor physical therapist, "What's the best exercise for the pelvic floor?" is a question I hear all the time. When it comes to picking one pelvic floor exercise that will benefit absolutely everyone, I can tell you that it’s not yoga or pilates. It’s not a kegel. It’s not using a jade egg (sorry Gwyneth) — it’s breathing! Yes, breathing. Hear me out.
Your pelvic floor muscles and diaphragm contract and relax opposite each other to facilitate your breath. This means that, just by breathing, you can connect with — and gently move — your pelvic floor muscles.
The ability to connect with and gain control over your pelvic floor muscles is called proprioception. Proprioception is the ability to perceive the position and movement of your body in space.
Proprioception is key to improving the function of any part of the body, including your pelvic floor. And pelvic floor breathing (a.k.a. diaphragmatic breathing) is the first best step to improving your pelvic floor proprioception.
More specifically, I am talking about diaphragmatic breathing. This is when you breathe into your belly, allowing it to expand along with your lower ribs — as opposed to breathing into your chest and holding your belly tight.
Located at the bottom of your rib cage, your diaphragm is the main muscle that helps you breathe. When you inhale, it moves down into your abdominal cavity. At the same time, your pelvic floor drops and lengthens. When you exhale, your diaphragm releases and your pelvic floor shortens, moving back to its resting position. Another way to think about it is that your pelvic floor muscles and diaphragm contract and relax opposite each other like a piston while you inhale and exhale.
You may have also heard diaphragmatic breathing, or pelvic floor breathing, referred to as belly breathing. That’s because the goal of this breathing exercise is to fill the belly with air by breathing all the way into the lower lungs—and in turn activating your pelvic floor.
Chest breathing, on the other hand, is probably a feeling you’re familiar with. It’s also called vertical breathing and refers to breathing into your upper lungs and chest. When you’re chest breathing, you’ll notice that your shoulders rise and fall as you breathe as opposed to your belly and ribs expanding and your pelvic floor and diaphragm producing the piston motions I mentioned earlier.
Although you may feel like you’re breathing deeply, chest breathing does not allow for as deep and full of a breath. It’s often the result of stress or anxiety. Learning how to observe your breath and practice diaphragmatic breathing is not only a great exercise for the pelvic floor, but it also holds many other benefits including regulating your nervous system.
Diaphragmatic breathing can be done in any position and during most activities that allow you to breathe calmly.