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Pelvic + Sexual Health

The 1 Pelvic Floor Exercise Everyone Should Do (It's Not a Kegel)

Nov 09, 2021Dr. Ashley Rawlins, PT, DPT4 MINS
A woman lying down, doing a pelvic floor exercise

If you want to know the secret to the best exercise you can do for your pelvic floor, look no further! As a pelvic floor physical therapist, I can tell you that it’s not yoga or pilates. It’s not a Kegel. It’s not using a jade egg (sorry Gwyneth) — it’s breathing! Yes, breathing. Hear me out. 

Your pelvic floor muscles, along with your diaphragm, contract and relax opposite of each other to facilitate your breath. Just by breathing, you can gently move and connect with your pelvic floor muscles, which is a first step everyone can take to improve their pelvic health.

Diaphragmatic Breathing 101

More specifically, I am talking about diaphragmatic breathing. This is when you breathe into your belly, allowing it to expand along with your lower ribs — as opposed to breathing into your chest and holding your belly tight. 

Located at the bottom of your rib cage, your diaphragm is the main muscle that helps you breathe. When you inhale, it moves down into your abdominal cavity. At the same time, your pelvic floor drops and lengthens. When you exhale, your diaphragm releases and your pelvic floor shortens, moving back to its resting position. Another way to think about it is that your pelvic floor muscles and diaphragm contract and relax opposite each other like a piston while you inhale and exhale.

Diaphragmatic breathing can be done in any position and during most activities that allow you to breathe calmly.

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The Power of Your Breath

So why is this the ideal exercise for your pelvic floor? Because the first step to taking care of your pelvic floor is connecting with these muscles and familiarizing yourself with the way they move and function for you. Diaphragmatic breathing is the best way to do this. Also, everyone needs to breathe, so it’s already part of your daily routine. It’s gentle and safe for everyone to do, and it gives you A LOT of information about your body, your pelvic floor, and your tension holding patterns.

Most importantly, unlike Kegels, diaphragmatic breathing is beneficial for everyone’s pelvic floor muscles. Kegels are a strengthening exercises, which means they're only helpful if your pelvic floor muscles are weak and lack adequate tension. Many people experience pelvic floor dysfunction because there is too much  tension in their pelvic floor muscles, and they need to release it. Others need to work on coordinating their pelvic floor muscles. Or you might need all of the above.

Mastering the Move

It may seem easy and natural, but it’s worth spending the time to make sure you are using this breathing technique properly to get the most benefit for your pelvic floor. Follow these simple steps:

1. Start by lying on your back with your knees bent, feet hips width apart, and your body at rest. Place one hand on your chest, and your other at the top of your abdomen, by the bottom of your rib cage. (Pro Tip: let the fingers of the abdominal hand open a bit so that you can feel your bottom ribs and your abdomen at the same time).  

2. Take a few normal breaths in and out — don’t think about it too much at first. On your next inhale, allow the air to fill your belly, low back, and all the way into your pelvic floor. On your exhale, everything should settle back to its resting position. Try this again. You should not feel the hand on your chest moving, but with your other hand, you should feel your abdomen expanding and filling with air. You may even feel the bottom of your ribs expanding away from each other, and up towards the ceiling along with your abdomen. 

3. Continue to breathe in and out in this way. On each inhale, you should feel the air lengthen and expand your belly, back, and pelvic floor. As your breath reaches your pelvic floor, try to gently allow your pelvic floor to expand downward (towards your feet) and outward (towards your sit bones). With each exhale, you should feel your pelvic floor muscles moving back to their normal position. 

Depending on what's happening with your pelvic floor, you may or may not be able to feel any movement at first. Be patient and continue to practice and tune into your body. Before long, your connection to your pelvic floor will get stronger.

Want more guidance on connecting with your pelvic floor or having symptoms that you think could be pelvic floor dysfunction? Don't hesitate to connect with a pelvic floor PT. We're here to help!

Dr. Ashley Rawlins, PT, DPT
Dr. Ashley Rawlins, PT, DPT

Dr. Rawlins is a physical therapist at Origin who specializes in the treatment of pelvic floor muscle dysfunctions including pelvic pain, sexual dysfunction, pregnancy related pain, postpartum recovery, and bowel and bladder dysfunction. In addition to being a practicing clinician, she is a passionate educator and author.

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