Diaphragmatic Breathing for a Happier Pelvic Floor

If you’ve been told your pelvic floor needs help, your first thought might be “I guess I need to do more Kegels.” But here’s the thing: sometimes what your pelvic floor really needs is not more work, but more ease.

One of my favorite ways to help patients find that ease is diaphragmatic breathing (also called belly breathing). It’s simple, free, and you can do it almost anywhere. And yes, there’s actual science behind it!

When you inhale, your diaphragm (that big dome-shaped muscle under your ribs) drops down. Your pelvic floor responds by gently lengthening. On the exhale, your diaphragm rises and your pelvic floor naturally recoils and lifts. This teamwork between your breathing muscles and your pelvic floor is built into your body’s design. When they’re in sync, you get better bladder control, more core stability, less tension, and often less pain.¹ ² ³

What the research says

I love when something so simple has such strong science behind it. Here’s what studies have found:

• They’re built to work together. Imaging and EMG studies show that the diaphragm, pelvic floor, and deep abdominals are a coordinated system. When you breathe in, all three respond together to manage pressure and posture.¹ ²

• Breathing can improve pelvic floor symptoms. A 2022 clinical trial compared diaphragmatic breathing to traditional pelvic floor exercises for people with urinary incontinence. Both groups improved, but those who combined breathing with pelvic floor muscle training had better outcomes than breathing alone.³

• It helps more than just the pelvic floor. Research shows diaphragmatic breathing can also lower stress hormones, improve core stability, and even help manage chronic pain—all of which can indirectly benefit pelvic floor health.⁵

The fascial connection: why your breath affects more than you think

Your diaphragm and pelvic floor aren’t just teammates, they’re literally connected through layers of fascia and connective tissue that run along the entire “core canister.” Think of fascia as a web of soft tissue that wraps and links your muscles, bones, and organs. When your diaphragm moves, that motion and pressure change travel through this fascial network all the way to your pelvic floor (and beyond).

This means that if your diaphragm is tight, restricted, or not moving well (maybe because of shallow breathing, stress, or old injuries) it can create extra tension or poor coordination in the pelvic floor.

The opposite is true too: restoring the diaphragm’s natural mobility can improve the pelvic floor’s ability to lengthen and contract without strain. This is one reason pelvic floor therapists love breath work—it treats the system, not just one muscle group.

Why it matters for pelvic floor health

• Eases tension: If your pelvic floor is overactive or “grippy,” diaphragmatic breathing can help it learn to let go.

• Supports bladder & bowel control: Coordinating your breath with your pelvic floor can help you respond better to sneezes, coughs, and lifting.

• Improves core stability: That fascial connection helps your breath create balanced, 360-degree support for your spine and pelvis.

• Calms your nervous system: Slow, intentional breathing cues your body’s “rest and digest” mode, which helps muscles relax and lets you feel more at home in your body.

How to try it right now

1. Get comfy. Lie on your back with your knees bent and feet on the floor, or sit with your feet supported. Rest one hand on your chest and one on your lower belly.

2. Breathe in through your nose. Let your lower ribs expand and your belly gently rise under your bottom hand. Your chest hand should stay relatively still.

3. Exhale slowly. Exhale slowly through your nose or lightly pursed lips, letting your ribs soften and your belly fall. Picture your pelvic floor gently rising, like a hammock naturally drawing upward. The key is not to squeeze or intentionally contract. Just observe the movement that happens on its own with your breath. If it takes time to feel it, that’s completely normal.

4. Repeat 5–10 times. Go slowly. This isn’t a workout—it’s about noticing and allowing.

   
   

A few tips:

• If you feel lightheaded, shorten your breaths and rest.

• If you have pelvic pain or feel a lot of tension, skip any “lifting” or “squeezing” and just focus on the gentle drop with your inhale.

• Try it for a couple of minutes in the morning, at night, or whenever your body feels tense.

• You can practice lying down, sitting, standing, or even in a supported deep squat once you get the hang of it. Honestly, try it while standing in line at the grocery store!

The takeaway

You don’t need fancy equipment or a gym to start improving your pelvic floor health. Just your breath, a little awareness, and a few minutes a day. And because of the fascial connections between your breathing diaphragm, your pelvic floor, and your deep core, you’re not just helping one muscle, you’re improving the whole support system.

If you’re curious about what else might help (especially if you have pelvic pain, bladder leakage, constipation, or core instability) this is something we can build into a bigger plan together.

I invite you to schedule a session and experience what it feels like to come home to your root

References:

1. Hodges PW. Postural and respiratory functions of the pelvic floor muscles. Neurourol Urodyn. 2007.

2. Sapsford RR, et al. Contraction of the pelvic floor muscles during abdominal muscle contractions. Arch Phys Med Rehabil. 2001.

3. Toprak N, et al. Diaphragmatic breathing vs pelvic floor muscle training for urinary incontinence. Physiother Theory Pract. 2022.

4. American Physical Therapy Association, Section on Pelvic Health. Diaphragmatic Breathing in Pelvic Floor Rehab. 2023.

5. Jerath R, et al. Physiology of long pranayamic breathing. Med Hypotheses. 2006.