4 important proper breathing components

Why do pelvic floor physiotherapists focus on proper breathing so much? Telling someone that you need to teach them how to breathe better is not an easy task. I can sense some of you rolling your eyes already. You are probably thinking to yourself “ Really? Do I really need someone to tell me how to breathe?”. After all, we all do it 8-12 times every minute. You are probably also asking yourself what does this have to do with your pelvic floor (or low back, hip, neck, etc) problem. 

Hopefully, after reading this blog you will understand why good physiotherapists are obsessed with proper breathing and will be excited to start working on it yourself! 

Belly breathing vs 360-degree breathing

First, an important distinction. When we talk about a proper deep breath, we are referring to a breath that expands the belly, sides, and back, as well as lengthening the pelvic floor. So often, deep breathing education stops at: is your belly rising? This is not a proper breathing pattern.

Important components of proper breathing 

1. Belly rises more than chest – if when taking a deep breath your chest rises while your belly actually flattens- this means you are overusing your chest and neck muscles. 
2. Ribs move out to the side/laterally- if you place your hands on your sides you should feel the ribs move out to the side with a deep breath 
3. The back should expand- if you lay down flat and take a deep breath in, you should feel your back press slightly into the ground. If you actually feel your back arch that means you are laking back expansion. 
4. Pelvic floor should lengthen- when taking a deep breath in, you should feel the pelvic floor stretch slightly. 

Proper breathing and the pelvic floor 

We can think of our pelvic floor muscles as one dome shaped structure mirroring the respiratory diaphragm. During an inhale the respiratory diaphragm descends, allowing the lungs to fill, during an exhale the diaphragm reflexively recoils.

The pelvic floor muscles follow the same pattern, where they stretch and lengthen on an inhale and passively recoil to their resting state on an exhale. 

This relationship maintains the pressure in the abdominopelvic cavity. So often, this rhythm is disrupted causing pelvic floor disruption. 

What happens when we do not breathe properly?

• Tension and trigger points
  • If we are unable to get a deep enough breath, the pelvic floor doesn’t lengthen during an exhale and can develop tension and trigger points
• Incontinence and pelvic organ prolapse
  • When we cannot breathe in a 360 degree pattern, the pressure in the abdominopelvic cavity is increased, which places extra pressure on the pelvic floor. This can lead to incontinence, pelvic organ prolapse, and pain. 
• Stress and Anxiety
  • A deep breath, signals to the nervous system that we are in a relaxed state. A shallow breath signals the opposite. This creates an over activation in our nervous system which contributes to stress, anxiety, and depression. 
• Increased pain
  • Improper breathing leads to an overstimulated nervous system that creates an increased perception of pain 

Working on proper breathing

To improve our breathing technique, we need to figure out the source of our difficulty. Are the ribs mobile enough to expand? Are accessory muscles such as muscles of the neck, shoulders, and back trying to compensate? Is our posture not optimal for taking a deep breath in? Or is it simply a habit we have developed over time?

A pelvic floor physiotherapist can determine the source of the issue and provide specific exercises to address your concern!