How does breathing affect leaking?

This week we’re bouncing back to the pelvic floor and diving more specifically into some of the topics within this realm. If this is a topic that interests you, or you feel you’re in need of some work here, we’d love to see you at one of our upcoming workshops! We unpack the pelvic floor, its function, and its potential dysfunction; as well as what we can do about it. As these evolve, we’ll dive deeper into specific aspects; so, if you’ve been to one already, keep your eyes peeled for something fresh!

At a pelvic floor workshop last week, we talked a lot about incontinence. Particularly stress incontinence (leakage with things like coughing, sneezing, lifting, jumping, etc.). Something that is SO relevant to many! This one can be a tricky thing to manage because we need to know exactly what is going on in YOUR body, not that of the person next to you. HOWEVER, there are some general concepts surrounding breathing and pressure management that can go a long way; so that’s what we’ll talk about today!

Incontinence, as well as many other symptoms of pelvic floor dysfunction, is impacted greatly by the pressure we create – and manage – through the abdomen and pelvic floor. Think of the area from your ribs to pelvis like a cylinder, or a pop can… do you say pop? Anyway, this cylinder is formed by the diaphragm on the top, pelvic floor muscles on bottom, and abdominal muscles/spinal muscles all around the outside. When we do things with exertion – sneeze, jump, run, cough, etc. – we create increased pressure through this cylinder. This in and of itself is not a bad thing – it helps us to move STRONGER and brace better. The problem comes when an aspect of that pop can can’t withstand the pressure created. This is often the pelvic floor, and this can result in leakage during activity.
 
Strength can be an issue here, but it seems to more commonly be increased tension or over-activity through the pelvic floor. One thing we can work on to address this is breathing. Through our breath, our pelvic floor is meant to stretch upon inhalation, and return from this stretch on exhalation. This is caused by a synchronistic movement with the diaphragm; when we breath in, the diaphragm and pelvic floor both lower, when we breathe out, they raise. If we don’t utilize the diaphragm as we should, this synchronistic lowering doesn’t happen, and the pelvic floor remains tense. This is fairly common because many of us breathe primarily through our chest for a variety of reasons. This can be because of anxiety or feeling stressed; but also, because we try to keep our abdomen tight and belly sucked in. Regardless of the reason, when we don’t get adequate belly movement during breathing, we have inadequate diaphragm and pelvic floor movement.
 
The first step in this is to work on breathing more into your belly and toward your pelvic floor. You can start by simply lying on your back when you’re hanging out in the evening or getting into bed. Place a hand on your belly, and as you breathe, send your breath toward your hand so that it raises as you breathe in, and lowers as you breath out. At the same time, you can think about sending that breath lower toward the pelvic floor, and feeling a gentle flare of your sit bones as you breathe in.
 
This is a super simple movement, but it can go a long way in the journey of addressing incontinence! It’s important to note that this alone will not likely have a large effect on leakage during activity – laying down on your back is much different than jumping rope after all! These breathing and bracing strategies need to be progressed to functional movements for ultimate success; and need to be part of a plan that tackles mobility, strength, and coordination! That being said, it is a great place to start, and to assess what your natural breathing pattern is.
 
Try it out, reach out with questions, and keep your eyes open for next week’s newsletter!
 
If you’re interested in learning more about the pelvic floor, or how to help yours, hit ''Talk with a PT' up top for to register for a free discovery call!

Cheers! 
Dr. Elle Carlson, PT, DPT