Breathing- yes, it really is your FIRST exercise for pelvic floor issues!
Here at Recharged PT, we talk all about how important breathing is – and doing it properly – for pelvic health. This is particularly true during pregnancy or in the postpartum period. We have talked before about the benefits of diaphragmatic breathing before. But it is time to dive back in and level up our breathing.
But first a review!
There are three diaphragms in the body: the epiglottis in the throat, the respiratory diaphragm, and the pelvic floor. The respiratory diaphragm helps with pressure creation and management in the abdomine (including the pelvic floor). The liver helps hold up the right side of the diaphragm in a relative half dome, making the right side more efficient for respiration than the left. When we inhale, the diaphragm contracts and expands downward – allowing for more air to move into the chest cavity. When we exhale, the diaphragm relaxes and moves upward, decreasing the amount of air.
A healthy pelvic floor will move in the same pattern as the diaphragm when we breathe.
Although the respiratory diaphragm is the primary mover for breathing, muscles that sit between the ribs (intercostals) help as well. Secondary muscles for respiration may kick in with hard effort (think labor, running, heavy exercise) – particularly true for muscles closer to the upper chest and neck.
In traditional diaphragmatic breathing, people are often taught to belly breathe: put one hand on your belly and the other on your chest. Try to move your abdomen as much as possible while keeping the hand on your chest (mostly) still. This is a great first step to engaging the diaphragm more and to decrease accessory muscle use (e.g., breathing through the upper chest and shoulders). However… deep breathing is NOT the same as belly breathing. In fact, belly breathing only really emphasizes expansion in the front of the abdomen – and this is where the secret ingredient to leveling up our breathing comes in!
In order to truly have a deep breath and get the diaphragm to work properly, we need to have good rib cage expansion in all directions: front, back and side in a 360 degree fashion – like an umbrella. Because of postural deviations, people very commonly have limited expansion in one or more of these directions. It is also common for expansion to be limited more on pne side than the other (right vs left side).
Check for how well you are breathing:
You or a friend (or your pelvic floor PT) can assess rib mobility by checking right versus left side expansion in the front, back and sides of your rib cage in the upper, middle and lower areas as you inhale and exhale. This will give you a good baseline of where to start – and may correspond with areas of tightness or tension.
Start improving how you breathe:
A good way to start working on this 360 expansion is with “ha” breathing. You start by letting your belly relax and round through your back. With hands on your ribs (in those tight spots assessed above), think about making a “ha” sound as you exhale, pressure your hands on those tight areas and press in with slight overpressure for 5 seconds. Inhale into your thumbs for 5 seconds and repeat 4-5 times.
If you have trouble with finding that expansion, you can try laying face down on a stability ball with your trunk bent forward slightly (or over the side of the bed.. but bloodflow to the head is a thing) to get into the back tension. You can also perform laying flat on the floor or in child’s pose. This may be one of the best exercises postpartum to work on breathing. It is all about playing with the positions that best work for you to feel that “umbrella” expanding.
Breathing well often tends to be forgotten as a key element during pregnancy or postpartum & can have significant effects on our bodies. Other factors that may affect diaphragm expansion include poor abdominal tone, a tense or tight pelvic floor, poor posture, and habitual shallow breathing. This is where a qualified pelvic floor PT (that’s us!) can help by assessing your specific needs and developing an individualized treatment plan. It can never hurt to at least get assessed! Breathing is one of our primal needs – and doing it well will always pay off!
<3 The Recharged Performance Team
www.rechargedperformancetherapy.com
References
Duvall, Sarah (2025). Breathing. Pregnancy and Postpartum Corrective Exercise Specialist 3.0. https://www.coreexercisesolutions.com/pces/
Duvall, Sarah (2025). Posture. Pregnancy and Postpartum Corrective Exercise Specialist 3.0. https://www.coreexercisesolutions.com/pces/
Duvall, Sarah (2025). Anatomy. Pregnancy and Postpartum Corrective Exercise Specialist 3.0. https://www.coreexercisesolutions.com/pces/
https://www.health.harvard.edu/healthbeat/learning-diaphragmatic-breathing