Why Do Pelvic Floor Therapists Care So Much About Breathing and the Diaphragm?
Your breath is the foundation of core and pelvic floor health. Learn how diaphragmatic breathing supports posture, balance, and whole-body wellness.
When your breath moves freely, so does your body.
When people think of pelvic floor therapy, they don’t usually think of breathing. But your breath—and more specifically, your diaphragm—plays a powerful role in how your pelvic floor, back, and core function.
What is the Diaphragm?
The diaphragm is a dome-shaped muscle under your ribs that separates your chest cavity from your abdominal cavity. It’s your primary breathing muscle, but it’s also a major player in posture, circulation, and core stability.
What is the Core System?
When we talk about the “core,” it’s not just about abs. The core system is a team of muscles working together to create stability and balance:
Diaphragm at the top
Abdominal muscles in the front
Paraspinal muscles along the back
Pelvic floor muscles at the bottom
Think of these muscles as forming a cylinder, or “canister.”
With an inhale, the diaphragm descends and the pelvic floor naturally lengthens. With an exhale, the diaphragm lifts and the pelvic floor gently recoils upward. In an optimally functioning core, this rhythm creates stability, circulation, and balance.
Why Breathing Matters for Your Pelvic Floor and Your Core
The way you breathe affects much more than oxygen intake:
Back pain: If the diaphragm isn’t moving well, the paraspinal muscles often overwork to create stability. This can lead to chronic tightness, tension, and pain in the back.
Core inhibition: With chronic bloating or abdominal distension, the diaphragm may not descend or ascend fully, and the abdominal wall respond as it should. This keeps the core system from functioning at its best.
Pelvic floor dysfunction: Suboptimal breathing can prevent the pelvic floor from lengthening and lifting naturally, which may worsen symptoms like heaviness with prolapse, leaking with exertion, or difficulty relaxing the pelvic floor.
Nervous system regulation: Your breath directly influences whether your body is in a stress response or a calm state—which in turn affects pain levels and muscle tension.
Circulation and lymphatic flow: The diaphragm and pelvic floor work together like pumps to support blood and lymphatic circulation throughout the abdomen and core.
What is an Optimal Breathing Pattern?
The most functional breath is often called a 360-degree breath. Instead of just belly breathing, the ribs expand front, back, and sides, while the belly and back move slightly too. This creates movement all around your ribcage, back, and abdomen with each inhale and exhale—making the most of your core system.
Breathing Practices to Support Your Core and Pelvic Floor
360-Degree Breathing: Place one hand on your ribcage and one hand on your belly. As you inhale, allow your ribs to expand in all directions—front, sides, and back—while your belly softens slightly. As you exhale, feel the ribs gently come back in and the belly naturally draw inward. This is the foundational breath for core and pelvic floor health.
Box Breathing: Inhale for 4 seconds → Hold 4 → Exhale 4 → Hold 4
Resonant Breathing: Inhale for 4 seconds → Exhale for 6
4-7-8 Breathing: Inhale for 4 → Hold for 7 → Exhale for 8
Cyclic Sighing: Inhale through the nose → Pause → Take one more small inhale → Slowly sigh all the air out through the mouth
✨ By reconnecting with your breath, you’re not just helping your lungs—you’re supporting your pelvic floor, protecting your back, and improving your overall well-being.
How to Practice 360-Degree Breathing
Step 1: Get Comfortable
Sit or lie down in a relaxed position with your shoulders soft.
Step 2: Place Your Hands
One hand on your ribcage (side or front)
One hand on your belly
Imagine your ribs expanding like an umbrella opening—front, sides, and back
Step 3: Inhale Through Your Nose
Imagine your ribs expanding like an umbrella opening—front, sides, and back
Allow your belly to soften and gently move outward
Step 4: Exhale Slowly
Feel your ribs draw back in
Notice your belly gently moving inward
Avoid forceful pulling in of the stomach—let it happen naturally
Step 5: Repeat for 5–10 Breaths
Aim for smooth, steady inhales and exhales
Try it for 1–2 minutes a few times a day
✨ Tip: Place your hands around your ribcage like a belt to really feel the side-to-side expansion.
Think pelvic floor therapy is the next right step for you? Give our office a call today or fill out an appointment form and we’ll be in touch!
Why Consistency Matters in Pelvic Floor Therapy
Pelvic floor therapy is a journey, not a quick fix. Learn why consistency builds strength, confidence, and long-term healing for your body.
Consistency is where progress takes root.
Why Consistency Matters in Pelvic Floor Therapy
When it comes to your health, we often want quick fixes. But just like strengthening your muscles at the gym or building endurance for a race, pelvic floor therapy works best with consistency over time.
Your First Visit: The Starting Point
Your initial pelvic health visit is thorough. It includes:
A detailed history of your symptoms and concerns
An assessment of your movement, alignment, and breathing patterns
A pelvic floor exam (if appropriate and with your consent)
This session is like a roadmap—it shows where you’re starting and helps us design a plan specific to your body and your goals.
Why Follow-Up Visits Matter
Each follow-up visit builds on the last. Think of them as stepping stones:
Progressions: We build gradually, adding new exercises and strategies as your body adapts.
Corrections: If something feels off, we adjust your program in real time.
Reinforcement: Repetition helps your body and nervous system learn new, healthier patterns.
Without consistency, your body doesn’t get the steady input it needs to change and strengthen.
Pelvic Health Takes Time—and It’s Worth It
Many pelvic health concerns—like leakage, prolapse, pelvic pain, or core weakness—develop over months or years. It’s natural that they also take time to resolve. The good news? With consistent rehab, most people notice steady improvements in strength, control, and confidence.
Everyday Examples of Why Consistency Matters
Like brushing your teeth: You don’t prevent cavities by brushing once a month—it’s the daily consistency that keeps your teeth healthy.
Like training for a marathon: You can’t run 26 miles after a single jog. Progress comes from building mileage gradually over weeks and months.
Like learning an instrument: Playing guitar or piano takes regular practice. Skipping weeks at a time makes it hard to improve, but steady practice builds skill and confidence.
Your pelvic floor and core are no different—they need steady, repeated input to change and grow stronger.
The Long-Term Payoff
Consistency isn’t just about symptom relief. It’s about giving your body the chance to:
Restore healthy movement and breathing patterns
Rebuild core and pelvic floor coordination
Improve circulation and tissue healing
Create lasting confidence in your body
When you stay consistent, you’re investing in long-term pelvic health and overall well-being.
✨ Bottom line: Pelvic floor therapy is a process. Your first visit lays the foundation, but it’s the regular follow-ups that create lasting change. Stay the course—you and your body are worth it.
Think pelvic floor therapy is the next right step for you? Give our office a call today or fill out an appointment form and we’ll be in touch!
Pelvic Floor Dry Needling: A Powerful Tool for Pain Relief and Recovery
Discover how pelvic floor dry needling relieves pain, restores movement, and enhances recovery from pelvic, abdominal, or postpartum discomfort.
You may have heard of dry needling as a technique to relieve muscle pain, but did you know it can also be used to treat the pelvic floor and surrounding muscles?
Dry needling can be a valuable addition to pelvic floor rehabilitation, especially for symptoms such as:
Pelvic pain
Abdominal pain
Tailbone pain
Painful intercourse
Postpartum scar discomfort
Urinary urgency or frequency
What Is Dry Needling?
Dry needling is a safe and effective technique used by trained professionals to help relieve pain and improve mobility. It involves inserting very thin, sterile needles into muscles and painful points to:
Decrease muscle tension
Improve blood flow
Interrupt pain signals
Restore normal tissue function
What Is Pelvic Floor Dry Needling?
Because the pelvic floor is made up of muscles, it can also develop tightness or tender points - just like your neck, shoulders, or back. Dry needles can be inserted into these pelvic muscles to help:
Reduce pain
Improve circulation
Support better muscle relaxation and contraction
Enhance overall pelvic floor function
This can be done by carefully inserting the needles externally through the pelvis to reach specific pelvic floor muscles. Don’t worry, it’s not what you were thinking 😉
What to Expect During a Session
Your first session will include a thorough evaluation, including a detailed history of your symptoms and medical background, assessment of posture, breathing, movement patterns and pelvic floor function.
If dry needling is appropriate for you, it may be included as part of a comprehensive treatment plan, always with your informed consent. Of course, dry needling is always optional, and your comfort is our top priority! Your plan may also include:
Hands-on (manual) therapy
Breathing and core exercises
Lifestyle and movement education
Other targeted exercises to support healing
What to Expect After Dry Needling
It’s common to feel mild soreness in the treated area for 24–48 hours. This is similar to the feeling after a good workout. Gentle movement, walking, or light exercise can help ease the soreness and support recovery.
Final Thoughts
Pelvic floor dry needling is just one tool in a broader, holistic approach to pelvic health. When combined with other physical therapy strategies, it can help you move more comfortably, reduce pain, and feel more in control of your body again.
If you’re curious whether pelvic floor dry needling could be helpful for you, book an appointment today!
Leaking with Sneezing, Coughing, and Exercising? Is It Just Pelvic Floor Weakness?
Leaking with sneezing, coughing, or exercise? It’s not just weakness. Learn how pelvic floor therapy restores balance, coordination, and confidence.
Have you ever sneezed, coughed, or jumped during a workout only to feel a small leak of urine? You’re not alone. Stress urinary incontinence (leaking with pressure or impact) is common, but it’s not something you just have to live with. It’s also not always about having a “weak” pelvic floor.
Why Does Leaking Happen?
Leaking with activity is a sign that your core system isn’t working together optimally. The pelvic floor, diaphragm, abdominal muscles, and back muscles form a team that should coordinate with your breathing and movement. When this system is off, leaks can happen.
Here are a few reasons why you might be leaking:
Core muscle coordination is off
The timing between your breath, pelvic floor, and abdominal muscles may not be in sync.Too much tension in the system
A tight pelvic floor doesn’t always mean a strong one. Overactive muscles can’t generate power effectively, which can lead to leaks.Muscle or connective tissue weakness
Pregnancy, birth, surgery, or chronic strain (hello constipation!) can reduce the support structures of the pelvic floor and surrounding core.Compensation from other muscles
Sometimes the glutes, inner thighs, or abdominals aren’t functioning optimally. This makes the pelvic floor overwork, leading to fatigue and leaking.
How Can Pelvic Floor PT Help?
A pelvic floor physical therapist looks beyond just “strength.” At your evaluation, we’ll assess:
How your pelvic floor contracts and relaxes
Your breathing pattern and core coordination
Muscle tension or restrictions in the hips, back, or abdominals
Posture, alignment, and movement strategies during daily activities and exercise
From there, treatment may include:
Teaching you how to coordinate your breath with movement
Relaxation techniques for an overactive pelvic floor
Targeted strengthening where it’s actually needed
Hands-on techniques to reduce tightness in the hips, back, or abdomen
Pelvic floor dry needling to decrease muscle tension, improve blood flow, and help muscles activate more effectively
Functional retraining so you can cough, sneeze, and exercise without leaks
The Bottom line: Leaking is common, but it is not normal and it doesn’t always mean you just need Kegels. Pelvic floor PT takes a whole-body approach including tools like breath training, manual therapy, and dry needling to restore coordination, strength, and balance so you can move confidently - without worrying about leaks.
Think pelvic floor therapy is the next right step for you? Give our office a call today or fill out an appointment form and we’ll be in touch!