When people come to me with pelvic floor issues, one of the first things I ask them to do is breathe.
Not deep, effortful, Instagram-worthy breathing. Just breathe — naturally, into their belly, without forcing anything. And what I notice, more often than not, is that they can't. Their chest rises, their shoulders creep up, their belly stays perfectly still. Their whole torso is braced.
This matters more than most people realize.
The pelvic floor and the breath are connected
Your diaphragm — the dome-shaped muscle at the base of your ribcage — and your pelvic floor move together in a coordinated rhythm every time you breathe. On an inhale, your diaphragm descends, your belly expands, and your pelvic floor gently lengthens and drops. On an exhale, everything recoils back up.
When that rhythm is disrupted — when we breathe shallowly, hold our breath, or chronically brace our core — the pelvic floor loses that natural release. Over time, it can become stuck in a state of tension. And a pelvic floor that can't let go is often at the root of pain, urgency, and dysfunction.
What's driving the tension?
Stress. Trauma. A busy, overstimulated nervous system. Years of being told to "suck in your stomach" or "hold it together." All of these things can quietly train the body to stay contracted, guarded, protected.
This is why I incorporate breathwork and nervous system regulation into almost every session. Not because it's trendy, but because it works — and because it gives my patients a tool they can use anywhere, anytime.
A simple practice to try
Find a comfortable position lying on your back with your knees bent. Place one hand on your chest and one on your belly. Take a slow inhale through your nose and see if you can let your belly rise first, before your chest. On the exhale, let everything soften — jaw, shoulders, belly, pelvic floor. Do this for five breaths. Notice what happens.
Many of my patients tell me they feel their pelvic floor for the first time during this exercise. Not because it suddenly appeared — but because they finally stopped clenching long enough to feel it.
Where to go from here
If you're dealing with pelvic pain, urgency, or tension and you've never been taught to breathe into your pelvic floor — this is often where we start. It's not a fix-all, but it's a foundation. And sometimes, the most powerful thing we can do is simply learn to let go.