The Diaphragm, the Core, & the Pelvic Floor: Intrinsically Connected

The physical act of respiration is dynamic. It’s a rhythmic dance involving simultaneous coordinated synergy across multiple muscular structures. What most know to believe about respiration is focused on the inside the ribcage, our lungs and the dome-shaped thoracic diaphragm, the primary inspiratory muscle. However, respiration in a complex multi-structural system that goes well beyond the ribcage. To start, we actually have four diaphragms in our bodies, and they are all involved in the physical act of respiration.

• The cranial diaphragm moves during respiration to regulate the cerebral fluid flow.

• The cervical diaphragm includes the tongue, floor of the mouth, hyoid musculature, and is effected by the trachea pull during respiration.

• The thoracic diaphragm (as described above) descends when contracted to inhale, making room for air in the lungs.

• The pelvic diaphragm or pelvic floor musculature (PFM) forms a basket at the bottom of the abdominal cavity. It descends downwards with the contraction of the thoracic diaphragm on the inhale.

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Although the thoracic diaphragm (the primary diaphragm) impacts the behavior of the others, all four move symbiotically with each breath cycle and are responsible for the movement of fluid throughout the body during respiration.

This video by Roger Fiammetti beautifully illustrates the relationship between this structures.

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Understanding that respiration is a whole body experience. Let’s narrow our lens to the inner core.

Imagine that your abdominal cavity is a house: the diaphragm is the roof and the pelvic floor musculature is the floor. The transversus abdominis (TA), the deepest abdominal muscle layer, are the walls that enclose the house and the multifidus, postural muscles along the spine, are the studs of the walls. All players work together to keep a solid base for the rest of the abdominal cavity.

In a functional breathing pattern the deepest abdominal layer is an active participant. The diaphragm and PFM work symbiotically descending with inspiration and lifting with exhalation. Meanwhile, the TA expands on the inhale and contracts on the exhale.

These systems work together- expanding and contracting, ascending and descending- during respiration. They function most efficiently with full range of motion and in-coordination with one another.

So why is developing a functional breathing pattern utterly crucial in pelvic floor and core recovery?

The deep symbiotic connection between of the thoracic diaphragm and the pelvic floor!

When one works effectively, the other is encouraged to as well. On the other hand, dysfunction in one is likely to affect the other.

Ready to give it a try?

Diaphragmatic Breathing 101: Getting Started

1. Sit in on a comfortable surface—finding stacking posture principles (head over heart over hips). Relax shoulders away from your ears

2. Place hands on rib cage with four fingers around the front of ribs and thumb wrapping around the back

3. Inhale slowly, breathing into your hands. Feel the ribs gently press against your hands—in all directions (front, side, and back ribs). Belly expands like a balloon filling up with air. Gently drop the pelvic floor to the feet as if you were releasing urine or gas.

4. Exhale, feeling the contraction of the ribs. Belly contracts like a deflating balloon. Lift pelvic floor like you were holding in urine or gas.

5. Work towards a sense of smoothness, steadiness, consistency in your breath

Having trouble piecing everything together? Go back to the breath. Only focus on smooth even breaths in and out, pressing ribcage to hands on the inhale and the ribcage shrinking away from the hands on the exhale. Then add on from there.

Diaphragmatic Breathing 101: Benefits

• Connection to the inner core musculature

• Enables automatic core activation a.k.a. improves core muscle stability

• Capitalizes on the parasympathetic nervous system

  a. lowers cortisol levels (stress hormone)

  b. lowers blood pressure

  c. slows rate of breathing

  d. reduces acute stress

• Allows you to be more present in the moment, improved sense of mindfulness

Respiration is a beautifully fluid integrated system. We don’t learn to connect with our breath because breathing happens automatically. Most assume there’s no need to fix a wheel that turns. However, when a piece of the system isn’t working smoothly with the rest, it’s an opportunity to explore, to reset and reconnect, so that we understand our bodies at a deeper level.

References:

Emerich Gordon, K. A., & Reed, O. (2018). The Role of the Pelvic Floor in Respiration: A Multidisciplinary Literature Review. Journal of Voice.