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.
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