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The Ultimate Core: The Diaphragm and the Pelvic Floor Muscles

Updated: Mar 23

March 18, 2024

Erin MS Warner





We often forget that the diaphragm is a muscle, and we often forget or don’t use it more often than we should.


Aaah, to breathe. It seems too easy, so carefree, so unnecessary to think about – but we should. There’s a lot to breathing, and it can be personal and powerful. We have to talk about breathing when we discuss the pelvic floor. 


The anatomy and physiology of breathing links the diaphragm - this wide, thin muscle which looks like an umbrella at rest (just under the lungs at the ribs). When it contracts, it lowers, creating a vacuum to help pull air into the lungs. When it relaxes, it rises back to its original umbrella-shaped-state. Our abdominal muscles help with exhalation, especially the deepest of them all, the transversus abdominis, TA or TVA for short. 


What does this have to do with the pelvic floor? The pelvic floor and the diaphragm work in conjunction with each other. Naturally, as the diaphragm lowers, so should the pelvic floor. As the diaphragm retracts – or better recoils back to its resting position, so too, should the pelvic floor.


A lot easier said than done!


Pelvic floor physical therapy, or PFPT, tries to return to this natural physiology of breathing. When we work on restoring the correct function of the pelvic floor, we are also restoring the correct function of breathing, or more importantly pressure management. 


Societally for both women and men, there’s a tendency to chest breathe, to hold in the abs all day long. (would you hold a bicep curl all day long? Wouldn’t you get fatigued? Think about it.) We brace ourselves from bottom to top (like constantly “holding back pee,” or “holding a fart”). By doing this, it cinches off the natural lengthening and softening of our breathing apparati.


Our breathing is more like a bellows – you know, the old-timey fire-stoking tool? We should widen, lengthen on an inhale, and “go skinny” to exhale. PFPT looks at how to breathe efficiently, which is belly breathing - no, not deep breathing. Too much chest breathing can make you tight, increase anxiety, put strain into the jaw. “Fun” fact: pelvic floor issues are often linked with TMJ issues. (We can get into that more in another post.)


So, breathe, then check how you feel. You may be surprised what is helping, or hindering you.


Thanks for reading.


Erin MS Warner is a Physical Therapist Assistant and a Pilates Instructor and has been trying to help people feel more like themselves for the last seven years.


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