This is often a difficult question to answer, as everyone’s needs are different. Some people have tightness in their pelvic floor muscles, whereas others have weakness in the pelvic floor muscles.

Having said that, the most common pelvic floor exercise that we work on in pelvic floor physical therapy is breathing. Of course you know how to breathe, you are alive right? Well yes, but as pelvic floor therapists, we are really looking at how well does your diaphragm help you breathe?

Your diaphragm is the main muscle that helps you breathe. It sits underneath the bottom ribs and is positioned sort of like an umbrella. On inhale your diaphragm moves down, and through pressure, pushes your pelvic floor down into a more relaxed state. On exhale your diaphragm contracts up, and through pressure, lifts the pelvic floor up.

Besides moving your pelvic floor through pressure, using your diaphragm also stimulates a nerve called the Vagus nerve. This nerve is the main brach of our parasympathetic nervous system (or our calming nervous system). Therefore, by using our diaphragm, we are making ourselves calmer which helps to ease tension/tightness in the pelvic floor muscles.

Since the diaphragm plays such a vital role in how the pelvic floor moves, this relationship is a crucial part of pelvic floor treatment. Through habits like always sucking in our belly, or prolonged shallow breathing during chronic stress, or poor sitting posture, the movement of our diaphragm could be compromised. This in turn, affects how our pelvic floor is functioning.

Therefore, the top thing that we need to ensure that is happening with all of our patients is that their diaphragm is moving as they are breathing. Usually the first exercise that we give patients is an exercise to help get their diaphragms moving better. This includes teaching them that on inhale, their belly should expand and on exhale, it should gently draw in.

The diaphragm moves 360 degrees, so diaphragmatic mobility exercises will vary from person to person, depending on where we find limitations. However, for simplicity’s sake, in general, moving the diaphragm through deep breathing is the best exercise that you can do for your pelvic floor.