An Exploration of Diaphragm, Glottis, and Pelvic Floor Connection

Breathing is a fundamental process that sustains life, but its significance extends beyond mere respiration. In the realm of pelvic physiotherapy, breathing techniques play a vital role in optimizing pelvic floor function and promoting overall pelvic health. This article delves into the intricate connection between the diaphragm, glottis, and pelvic floor, elucidating the anatomy of these structures and highlighting how breathing techniques can be utilized to enhance pelvic physiotherapy outcomes.

Understanding the Anatomy of the Diaphragm, Glottis, and Pelvic Floor

1. The Diaphragm: The diaphragm is a dome-shaped muscle located beneath the lungs, separating the thoracic and abdominal cavities. It serves as the primary muscle responsible for breathing. When it contracts, it flattens and descends, creating negative pressure in the chest cavity and allowing the lungs to expand with air. The diaphragm attaches to the lower ribcage, the sternum, and the spine, forming a muscular barrier at the base of the thoracic cavity.
2. The Glottis: The glottis refers to the opening between the vocal cords in the larynx, which controls airflow during breathing, swallowing, and speaking. It consists of the vocal folds, which are elastic bands of tissue that vibrate to produce sound. The glottis opens during inhalation to allow air to enter the respiratory system and closes during swallowing to prevent food or liquid from entering the airway.
3. The Pelvic Floor: The pelvic floor refers to a group of muscles, ligaments, and connective tissues that span the bottom of the pelvis. It acts as a hammock-shaped structure, providing support to the pelvic organs, including the bladder, uterus, and rectum. The pelvic floor muscles play a crucial role in urinary and fecal continence, sexual function, and stabilizing the pelvic region. These muscles can be divided into three layers: superficial, middle, and deep, each with specific functions and connections to other anatomical structures.

The Connection between Breathing and the Pelvic Floor

Breathing and the pelvic floor are intricately connected through the coordination of the diaphragm, glottis, and pelvic floor muscles. When you inhale, the diaphragm contracts and descends, causing the abdominal contents to be pushed downward and the pelvic floor to relax. This coordination creates an optimal environment for efficient diaphragmatic breathing and proper pelvic floor function.

The Importance of Diaphragmatic Breathing

Diaphragmatic breathing, also known as belly breathing or deep breathing, refers to the practice of engaging the diaphragm fully during the inhalation and exhalation process. This technique is crucial in pelvic physiotherapy for several reasons:

1. Pelvic Floor Activation: Diaphragmatic breathing promotes the engagement and coordination of the pelvic floor muscles. As the diaphragm descends during inhalation, the pelvic floor muscles naturally relax, allowing for optimal expansion of the abdominal cavity. On exhalation, the diaphragm ascends, and the pelvic floor muscles contract, providing support to the pelvic organs.
2. Improved Diaphragm Mobility: Deep breathing exercises help improve the mobility and excursion of the diaphragm. This enhanced mobility allows for better ventilation and oxygenation of the lungs, reducing respiratory inefficiencies and promoting overall lung health.
3. Stress and Tension Reduction: Diaphragmatic breathing activates the body's relaxation response, promoting a sense of calm and reducing stress levels. This can be particularly beneficial for individuals with pelvic floor dysfunction, as stress and tension can contribute to pelvic pain, muscle tightness, and other pelvic floor disorders. By incorporating diaphragmatic breathing into pelvic physiotherapy, individuals can effectively manage stress and alleviate tension in the pelvic region.

Techniques for Incorporating Diaphragmatic Breathing in Pelvic Physiotherapy

1. Mindful Breathing: Begin by finding a comfortable position, either sitting or lying down. Place one hand on your chest and the other on your abdomen. Take slow, deep breaths, focusing on filling your abdomen with air as you inhale. Feel your abdomen rise and fall with each breath. This technique promotes diaphragmatic engagement and relaxation of the pelvic floor.
2. Breathing with Pelvic Floor Muscle Activation: Combine diaphragmatic breathing with pelvic floor muscle activation to enhance coordination. As you inhale, relax your pelvic floor muscles, allowing them to naturally descend with the diaphragm. On exhalation, gently contract the pelvic floor muscles, lifting them back up. This synchronized movement strengthens the connection between the diaphragm and the pelvic floor.
3. Yoga and Pilates-Based Breathing Exercises: Yoga and Pilates incorporate various breathing techniques that can be beneficial for pelvic health. Techniques such as "Ujjayi" breath or "Pilates Breathing" emphasize deep, controlled breathing, engaging the diaphragm and promoting relaxation and coordination with the pelvic floor muscles.
4. Integrated Breathing during Exercises: During pelvic floor exercises or other therapeutic movements, it is essential to maintain proper breathing. Coordinate your breath with the movements, ensuring that inhalation aligns with relaxation and lengthening of the pelvic floor, while exhalation corresponds with contraction and engagement of the pelvic floor.

Benefits of Incorporating Breathing Techniques in Pelvic Physiotherapy

1. Enhanced Pelvic Floor Function: By incorporating diaphragmatic breathing, individuals can optimize the coordination between the diaphragm and the pelvic floor, improving muscle tone, relaxation, and overall function.
2. Stress and Pain Reduction: Diaphragmatic breathing activates the parasympathetic nervous system, reducing stress levels and promoting relaxation. This can help alleviate pelvic pain, muscle tension, and other symptoms associated with pelvic floor dysfunction.
   
3. Mind-Body Connection: Breathing techniques foster a deeper mind-body connection, allowing individuals to be more in tune with their pelvic floor muscles and body sensations. This increased awareness can lead to better control, coordination, and self-management of pelvic health.

Incorporating Breathing Techniques into Daily Life

Apart from incorporating breathing techniques during specific pelvic physiotherapy sessions, it is beneficial to integrate them into daily life. Practicing diaphragmatic breathing during activities such as sitting, standing, or exercising can support pelvic floor health and overall well-being. Mindful breathing exercises, relaxation techniques, and stress management practices can be valuable tools for maintaining pelvic health beyond formal therapy sessions.

Breathing techniques, particularly diaphragmatic breathing, play a crucial role in pelvic physiotherapy by optimizing the coordination between the diaphragm, glottis, and pelvic floor muscles. By engaging in deep breathing exercises, individuals can enhance pelvic floor function, promote relaxation, improve circulation, and reduce stress levels. Incorporating breathing techniques into pelvic physiotherapy interventions and daily life can lead to better pelvic health, improved overall well-being, and a stronger mind-body connection. Embrace the power of your breath and unlock the potential for optimal pelvic health.

Pain that is nagging or debilitating and not going away? Have you tried just about everything (physio, massage, chiro, acupuncture) and it’s still not reducing or going away? The brain might be involved. By NO means are we saying the pain is in your head.

Research indicates most tissue healing should take place by the 3 month mark and beyond this the spinal cord and brain (nervous system) may get involved. Well, what the heck does that mean?

Everything in the body is connected. We have small nerves in tissue that send the brain signals, and the brain can send signals back down. Think of it as this way. You are walking around doing your normal daily things at home and then you notice a paper cut on your finger. OH!!! All of a sudden, you are so acutely aware of the irritating cut on your finger. When did it happen? How long was it there for? Why didn’t you feel it right when it happened? Because of…the brain! The brain is constantly assessing what is harmful in your environment and what is not. If it didn’t think the paper cut was that important, it let it go but then it was brought to its attention when you visually saw it and perhaps got worried about it = pain. For some, discomfort. For others, like me, I better go lie down and nurse myself. My pain tolerance is very low.

While pelvic pain by no means is like a paper cut, similar concepts can apply. Depending on the exact location of pain and if all the tissues have healed and there is no nerve, muscle, connective tissue, bone damage, the brain can indeed become involved.

A specific example can be pain with sex. If someone had an experience where there was pain, the brain MAY pick up on this for the next time around. It wonders “is this going to hurt again? Well we don’t want that, so we better stop this activity from happening” and this can lead to anticipation of pain, tightening of muscles, holding of the breath and then the pain is recreated. This reinforces the pain and the brain can become more and more involved over time.

So, what does all of this mean?! This means that all of the therapy you have done previously may have been done with good intentions and have been appropriate at that time, but perhaps a change in treatment is needed with targeting the brain. The brain is plastic and using this neuroplasticity can help to change it in positive ways for our health and wellbeing.

Your pelvic floor physiotherapist and other care providers should be able to provide you with specific brain training techniques for the symptoms you are having.

Questions? Comment below, e-mail us at hello@kaaiaa.co or book a free phone consult.

Known medically as diastasis recti, abdominal separation is a condition that affects men and women of all ages. What is abdominal separation? The abdominal muscles have a slip of connective tissue/glue joining them together and we can see this most often in persons with a six-pack when they have a line down the middle. When there is too much pressure, leading to thinning of the connective tissue, this can lead to what is traditionally known as abdominal separation. However, just because there is a gap, doesn’t mean you have the separation. Primarily known as something that can be caused by childbirth, there are common signs and symptoms to be aware of to know if you are experiencing this:

-abdominal bulging in any position or  commonly with ab exercises

-weakness in the core

-feeling like it is difficult to lose weight in the middle area

-feeling you have lost weight elsewhere but in the stomach region

-feeling your stomach is bigger end of day versus at the beginning of the day

-feeling you are still pregnant

Pelvic Floor Physiotherapists are trained to assess the abdominal muscles for their strength and also assess the gap. Traditionally a two finger width gap or more was a diagnosis for diastasis recti, but we look at this differently these days. The physiotherapist will assess your muscle strength, your ability to contract and tighten the muscles in different positions and what happens to the middle connective tissue area when you are doing a crunch or sit up. Based on this, they would prescribe you exercises to do at home that will help reduce the symptoms you are feeling.

Along with the abdomen, your physiotherapist may also check your back, hips and pelvic floor muscles because this what you core actually consists of! A lot of people think the core = abs but there is MUCH more to this. A full assessment can identify the things that will help you recover faster.

Questions? Comment below, e-mail us at hello@kaaiaa.co, or book a free phone consult.