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.


The Connected Breath

I have an upcoming online course called, The Connected Breath where I teach all about this connection and how it can unlock posture, reduce pain, and engage your core. The diaphragm is one of our main core muscles. It contributes to stability and strength of the core as well as aids in our postural control during movement.

If you are experiencing any of the above mentioned pelvic floor symptoms, the first place you should start is to connect with your breath. Then you connect your breath with your pelvic floor. This will improve upon the intra-abdominal pressure and create better balance among the diaphragm, the pelvic floor, and the lower abdominals.

Try this first. Purse your lips and exhale like you are blowing out a candle. What do you feel in your abdomen? It should contract to help you get a stronger exhale. Now try to blow out the candle again and see if you can purposefully contract the pelvic floor muscles during the exhale. It will feel like you are stopping your urine flow. Do not hold your breath! Do not squeeze your buttocks! Do not use your adductor muscles to bring your legs together! These are all common compensation patterns.

Now inhale through the rib cage and relax the pelvic floor. Picture your pelvic floor muscles opening and relaxing. The relaxation is just as important as the contraction.  Don’t force the positions: breathe and move gently through each one.

As you begin to practice this breathing pattern, check in with your body.

Inhale – what area of your body expands? Chest, ribs, belly? 

Exhale- what area of your abdomen contracts? Upper rib cage? Middle of the belly? Lower abdomen? 

Can you engage your core and still breathe? This is important !!!!

Inhalation means mobility of your entire rib cage with abdomen relaxed. (Not upper chest or belly breathing)

Exhalation means engaging your deep core muscles to create stability and strength in the trunk. (Not belly bulging or doming or clenching). Breathing properly with your diaphragm will improve the mobility/stability ratio. Remember consistency is the key to any new movement pattern.


Practice breathing through movement

So if you really want 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



Share this post

Share on facebook
Share on twitter
Share on linkedin