Breathing Strategies for Pelvic Floor Health

Breathing Strategies for Pelvic Floor Health

Proper breathing technique can have a big impact on pelvic floor function during movement and exercise. As physical therapists, we often recommend breathing strategies to clients to help optimize pelvic floor activity and manage intra-abdominal pressure. In this blog, we'll overview some of the main breathing techniques for pelvic floor health and how they can be applied.

Exhale on Exertion

This is the most common recommendation for breathing during physical activity. As you exert force in an exercise like a squat or deadlift, exhale at the same time. Exhaling helps trigger increased pelvic floor muscle and abdominal activation while also easing some of the intra-abdominal pressure build up from inhaling. This technique is simple and familiar for most people.

Exhale Just Before and During Exertion

Also known as "blow before you go," this technique starts the exhalation just slightly before exerting effort on a movement. Exhaling immediately prior to the exertion can help kickstart reflexive pelvic floor action. You continue exhaling as you exert. This adds an extra cue to help anchor the pelvic floor.

Exhale and Breath Hold During Rep

You can exhale first to reduce intra-abdominal pressure and then hold your breath through the exertion phase. This creates stability with slightly lower pressure compared to some other techniques. It can be a good introductory technique for those new to breath holds.

Inhale During Exertion

While less conventional, inhaling during the exertion phase has some potential benefits. It allows the pelvic floor to eccentrically lengthen under the pressure increase from inhaling. This may provide an opportunity to improve yielding capacity. We recommend only using this under low loads.

Inhale, Breath Hold, Exert

The classic Valsalva maneuver - inhale, hold breath by closing the glottis, then exert. This creates substantial intra-abdominal pressure and spinal stability for heavier lifts when executed properly. Conscious pelvic floor engagement is recommended during the hold.

Adding a Brief Exhale to Breath Hold

An advanced variation starts with a full inhale, followed by a quick exhale paired with a pelvic floor lift, then holding the remaining air during exertion. The sharp exhale helps trigger reflexive pelvic floor action before the hold. This can help fine tune pressure management.

Simply Breathe During Movement

For simpler, lower demand tasks, cueing a client to "just breathe normally" can remove overthinking about breathing mechanics. Allowing unconscious breathing regulation creates less mental demand. Habitual patterns like inhaling through tougher phases tend to emerge naturally.

Modifying Breath Rate and Volume

In exercises like yoga or running that involve sustained effort, the rate and depth of breathing becomes a key parameter. Slow deep breathing distributes oxygen efficiently without excessive pressure swings. Rapid shallow breathing replenishes oxygen faster during intense efforts. Conscious control over rate and volume provides another way to modulate pelvic floor demands.

In the end, ideal breathing mechanics are highly individual. The key is equipping clients with a variety of breathing technique tools they can apply to find what works optimally for their body and condition.