Updated: Sep 24, 2022
Breath has become quite the popular topic these days, especially among pelvic floor therapists. At the same token, it is easy to glance over breath topics and recommendations because it may seem redundant. The reality is, we live in a world that can feel quite stressful and most of us spend the day holding our breath and/or not paying attention to our breathing habits. Becoming aware of your breathing patterns can impact so much of your overall physiology and well-being, so it is worth going into more detail and explain why we frequently educate our patients on breath. Below you will find 4 things that you probably didn’t know about your breath.
Breath affects your nervous system.
Your whole body is controlled by your nervous system. We can break down the nervous system (think brain, spinal cord, nerves that innervate your body) into your somatic and autonomic nervous system. Your somatic nervous system is under your conscious control. Examples would include using your legs to get up from a chair or reaching for something with your hand. Your autonomic nervous system controls the parts of your body not usually in our conscious awareness, such as your heart rate, digestion, organ function, etc.
Your autonomic nervous system can further be broken down into your sympathetic and parasympathetic nervous system. To keep it very simple, your sympathetic nervous system (SNS) is more active in times of stress. Most people know the SNS as the “fight or flight” response to a stressful situation. Your parasympathetic nervous system is our “rest and digest” system and is more active during relaxation. You can imagine how these systems can be imbalanced in today’s world. Whereas our ancestors may have been stressed at work, they usually had a reprieve once they left that environment. The level of connectedness we have in today’s world via technology has some great benefits but also some serious downsides to our biology. We are not meant to be in a constant state of stress.
Let’s bring it back to breath. Having an awareness of your breath at certain points of your day can help to reorganize and relax your overall body. Taking deep breaths can slow your heart rate, lower your blood pressure, help with digestion, lower anxiety, and help you create a better balance of sympathetic vs parasympathetic activity in your body. While the autonomic nervous system is generally not operating under our conscious control, the breath is an amazing hack to create a little more control for your stress response and body overall.
Breath impacts your core function.
Our respiratory diaphragm is the main muscle we think of in terms of breathing. But, the diaphragm is also the top of our “core canister”. Most people think of their core as their 6 pack abs, but in actuality it is more akin to a deep canister, shaped like a soda can. The boundaries include the diaphragm at the top, the pelvic floor on the bottom, the anterior abdominal wall and muscles in your back wrapping around. The respiratory diaphragm and the pelvic floor, oftentimes called the pelvic diaphragm, should mirror each other with breath and talking (voice blog coming soon!). As you breathe in, both diaphragms should drop down slightly to allow the lungs to fill. As you breathe out, the diaphragms will rise slightly and the anterior wall should draw in as the lungs empty.
We work on the diaphragm and breath a lot with our patients, especially our pregnant and postpartum moms, because the coordination of the action mentioned above impacts the ability of the core to manage pressure under load. All sides of the canister need to be operating efficiently to generate force, safely, with a heavy load. For example, if you are picking up a carseat without thinking about your core stabilizing and working together, there is a good chance your system “leaks” and creates too much strain through your back. Many people want to correct their ab separation by doing abdominal exercises, however, coordinating respiratory and pelvic diaphragms is crucial to healing a diastasis, as well.
There are different breath techniques used for different outcomes.
We like to get hung up on teaching “the right way” to breathe. The reality is there are MANY breath techniques used for different results. We won’t go into all of them in this space, but we will go over the most common we use with our pelvic health patients.
The first is a 360 breath. The focus here is expanding the lower ribcage in all directions as we INHALE. Many of us present with an inverted breathing pattern (or apical breathing pattern), which basically looks like your abdominal wall is sucking in as you inhale. This can often be associated with chronic pain or stress where we have grown accustomed to taking short, shallow breaths. Chest breathing requires much more effect from the upper trapezius and neck muscles to physically lift the rib cage to get air in. The goal here is to feel expansion through the abdominal wall, lower rib cage and finally the upper rib cage. I will often also cue my patients to focus on trying to feel that expansion into their pelvic floor as well. This breath is great at tapping into the autonomic nervous system mentioned above.
Another breath technique we teach often is called a hypopressive breath. This type of breathing pattern has been shown in the literature to improve diastasis recti and low grade prolapse. There are plenty of youtube videos to search if you want to see a visual, but the basic technique includes: taking a full inhale, taking a full exhale (really try to get as much air out of your lungs as possible), hold that out for a few seconds, and then close your glottis to create a vacuum as you suck in. I will often tell my patients to try to create a vacuum like we did when we were kids trying to show our ribs. This creates a closed system from our mouth to our pelvic floor and allows some tractioning upwards of the lower organs. A few repetitions of this per day can be very effective at reducing downward pressure on your lower core and pelvic floor, and can also help to gain awareness of this tissue. Important tip: Make sure you do this on an empty stomach if you are going to attempt.
Nasal breathing is important.
Nasal breathing has become a buzz topic in recent years, and for some very important reasons. Our nasal cavity filters the air more effectively than our mouth. Our nose has receptors in it that help to engage our parasympathetic activity to help mitigate our stress response. Mouth breathing, especially at night when many of us are unaware we are even doing it, has many negative health consequences. It can dry out your mouth and change the oral microbiome which can impact your teeth health. It can also make you more susceptible to snoring, allergies, and a host of other problems. If you know you are a mouth breather, you can try using mouth tape to keep the lips closed to force nasal breathing. Again, even if done for a short period of time, can help bring a greater awareness to some unconscious patterns your body is operating under during the day and while you sleep.
This is not meant to be an exhaustive list. If you have found this blog to be interesting/intriguing, check out Breath by James Nester. If you have any questions or would like to see if your breath is impacting your pelvic floor, feel free to reach out and connect with us! Remember you can always locate a pelvic health provider near you using www.pelvicrehab.com
Health & Happiness,
Dr. Carly and Dr. Katie