woman blowing confetti out of hands

The pelvic floor connection: breathing is better than kegels

Proper breathing turns isolated exercise into dynamic movement.

Melanie Connell PT

Everything is Connected

Are you trying to remember to do your kegels but left wondering if it is even accomplishing anything?

You aren’t alone.

There is no one size fits all exercise! In the case of pelvic floor dysfunction, the issue may lie somewhere in the kinetic chain and not in those specific muscles at all. Pelvic floor dysfunctional symptoms include tightness or weakness, poor control with leakage, SIJ pain, hip flexor tightness, weak gluteal muscles, neck pain, back pain, and tight hips. Kegels alone will not fix the root cause of these symptoms. What you need is not more isolated exercises, but a better connection. Isolated exercises aren’t functional. Humans move dynamically so in the case of retraining your pelvic floor it makes much more sense to train the connection and the timing of the muscles with daily activities. This is the reason that kegels in isolation don’t accomplish much.

In order to train your pelvic floor muscles you need to connect to them first. You can’t train what your brain can’t connect to. Without the brain we have no movement. The neuromuscular response causes the muscles to initiate and control the movement. So if you aren’t able to efficiently contract your pelvic floor or lower abdomen then continuing to add more repetitions still won’t get you there. You have to make the connection.

The connection starts with your breath.

You need to learn to connect your breath with your core. Watch this video to learn how.

The Connected Breath


Train the breath through movement

In order to train your pelvic floor muscles try timing your inhale and exhale during a squat. Most people don’t realize that even the phonation of our voice during activity affects our abdominal and pelvic floor pressure and engagement. A squat is a dynamic movement in and of itself but even more so when you add a breath connection. Stand up and squat and check in with your body. Did you hold your breath on the way down or up? Holding your breath changes the abdominal pressure which can cause more pressure on the pelvic floor.

Try this breathing exercise while you squat:

  1. Squat and inhale on the way down this will increase hip range and open up the pelvic floor
  2. Exhale as you return to standing and engage the pelvic floor and lower abdominals.
  3. The exhale should be medium strength, not just flat air. This will allow the abdomen to engage better. Do not grunt or create a hard forced breath. Do not bare down as this will cause you to hold your breath.
  4. Try it the other way around and see if you notice a difference. Some people may do better with the exhale down and the inhale up. The point is to connect with your body and breathe through the movement.
  5. Do not practice this with added weight until you get connected with your body and make sure there is no prolapse or leakage during the squat.
  6. If you find that you hold your breath. Try blowing out before you begin the movement this prepares the core to engage before the movement.
  7. Repeat for one minute
  8. Practice 1-2 x/day




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