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The pelvic floor is certainly a hot topic of conversation for many men and women. Specifically, people begin to focus on their pelvic floor when they are having incontinence, urgency/frequency, prolapse, or pain associated with going to the bathroom or having sex. These are all issues related to pelvic floor dysfunction. But, what many don’t realize, is that your pelvic floor is also integral in one of our most basic functions: breath.

The diaphragm, our respiratory muscle, is located at the bottom of the ribcage. At rest, the diaphragm is a domelike shape, and with inhalation the diaphragm muscle contracts and drops downward toward your pelvis. This downward motion is followed by a shifting downward of internal organs, into the pelvic bowl. The pelvic floor muscles and fascia make up the bottom of the pelvic bowl. So, with this downward force during inhalation, the pelvic floor muscles also descend or stretch slightly downward. Immediately following inhalation and pelvic floor descent, is exhalation, and similarly, the pelvic floor follows the diaphragm as it rises upward to a resting position. This synchronous rising and falling of the diaphragm and pelvic floor is often referred to as the “piston effect”.

Not to be left out, the lower abdominal muscles (transverse abdominis) also contribute to this synchronous movement pattern. Working together by relaxing and stretching with inhalation and a “belly breath”, and tightening and drawing inward slightly with exhalation. In this way, the diaphragm, abdominals, and pelvic floor make up an abdominal cylinder that modulates intra-abdominal forces and pressure changes.

When this cylinder isn’t coordinating well together, or if there is tightness or weakness within the system, we see common musculoskeletal complaints: low back pain, SIJ pain, poor stability through the back and pelvis, hip pain, pelvic pain, incontinence, urgency/frequency of urine or stool, prolapse, poor posture, balance issues, and intolerance to exercise.

Our pelvic floor physical therapists can help evaluate these movement patterns and coordination of these systems, and create a treatment approach specific to you and your individual challenges.