Is there anyone out there, ‘cause it’s getting harder and harder to breathe (Pelvic Floor Function 101, part 2)
If CrossFit teaches us anything, it’s that failure to manage your breathing patterns during one million thrusters or a lifetime supply of burpees is futile. Understanding how and when to breathe during high intensity exercises — not just during heavy lifts — helps to not only regulate your heart rate and achieve the intended workout stimulus, but it properly manages the pressure that builds in your abdomen (called “intra-abdominal pressure”) — creating core stability to keep you safe while you’re exerting yourself.
If you follow us on the interwebs, you know that our love for Dr. Aaron Horschig over at Squat University is loud and proud. In his article, How to Breathe When Squatting, Dr. Horschig elaborates on a lot of great points about core stability vs. strength — and I particularly loved this:
“Core stability is the synchronous action of the abdominal muscles along with the muscles of the back, hip, pelvic girdle, diaphragm and surrounding fascia. When working together they keep the spine in a safe and stable position while we move. Therefore, core stability has nothing to do with how many crunches you perform or hypers off the glute-ham machine. The essence of stability is based on two things: timing and coordinated recruitment. In order to recruit our core muscles prior to the squat the cue to “brace for a punch” is recommended.”
But, he goes on, it’s not enough to only brace when we squat (or deadlift, or clean, or snatch), if we want to move weight safely we must also learn how to breathe. Check out his article for a more in-depth outline of how to do just that.
So why am I talking so much about breathing — aren’t we supposed to be talking about pelvic floors and peeing? Well, symptoms of a weak pelvic floor can be exacerbated by improper intra-abdominal pressure management.
So how do I properly manage my intra-abdominal pressure?
There are many schools of thought for how to breathe/manage intra-abdominal pressure during movement — especially as a pregnant and postpartum person — but at the end of the day it’s all about mind-muscle connection, and appropriate timing of your breath. And if you’re a person who is pregnant or postpartum and symptomatic, this pressure management piece is critical in protecting — and even strengthening — your pelvic floor. If you’re experiencing major symptoms (leaking, prolapse, pain of any kind), or within 8 weeks of having a baby, then stop what you’re reading and go see a Pelvic Floor Physical Therapist over at Sullivan Physical Therapy. We can take the website abandonment.
For continuity’s sake, let’s take the squat. While Dr. Horschig would advise an athlete in good health with a functioning midline and pelvic floor to “brace for a punch” before their squat, the demand that a braced core (or simply — a held breath) places on the pelvic floor after having a baby can be tremendous. The intra-abdominal pressure created during the “brace” naturally bears down on the pelvic floor. This is not ideal for someone experiencing pelvic floor weakness, or recovering from diastasis recti (abdominal separation), as that bear-down pressure then adds more stress on those weakened areas. Instead, we need to consider distributing the pressure created with our breath throughout our diaphragm, throughout the duration of a movement.
Over at the Pregnant and Postpartum Athlete, Brianna Battles touches on this concept in her article, How Do I Change My Breathing During Pregnancy and Postpartum:
“When you inhale, your belly should expand/give way (making room for the diaphragm to go down), this reduces tension in the pelvic floor and abdominal wall. When you exhale, the diaphragm travels back up, and the pelvic floor gently recoils/contracts following the diaphragms lead. The transverse abdominals, creates a “force” across the midline. This does not “close” your abs, but it does help create tension in the linea alba from the intentional contraction. The tension generated helps with generating strength and adaptation to the system.
This connection between your breath and the base of your core, aka your pelvic floor, and your abs matter. The breath helps facilitate coordination, intention, and awareness of tendencies. It’s not the end-all-be-all of healing and rehab, but it is a foundation to be in tune with because it’s how we add movement, improve/manage symptoms and overall familiarity with our postpartum body.”
In relation to the squat, we want to inhale as described at the top, and then exhale as we move through the concentric and eccentric portions of the movement; controlling our exhale and allowing our transverse abdominals to create that “force” across our midline to help stabilize our core as we work our way through the squat. Or, from Brianna:
“While standing, shift your body weight so that it’s evenly distributed across your feet. Let your belly and glutes let go of any tension they are holding in standing, Inhale (feeling the expansion into your rib cage and stomach) and then gently exhale (feeling the gentle support from the bottom and around your center) and then begin to squat down.
Try to exhale through the full range of motion to generate the most support. When you return to standing, inhale and give your body a chance to reset, relaxing at the top. You do not need to squat low, and avoid your pelvis tipping under (referred to as butt wink), and squat to a controlled depth. When you stand up, finish in a neutral position, there’s no need to squeeze your glutes at the end range/top.”
If you’re struggling to feel the connection, check out her article, Your First 6 Weeks Postpartum, for more movement ideas, or that other article I linked up there for some more varied physical cues.
The more we can learn and apply appropriate breathing patterns and core control to our training, the better we can manage our symptoms and tendencies as they relate to our pelvic floor health — aiding in a better, safer, maybe even faster, postpartum recovery process.
I think two is probably enough in this highly-anticipated blog series — but if you want more information about this topic, I’d love to chat! Let’s set up a time to meet and work through some strategies and exercises to ensure you’re taking care of that amazing body before, during, and after baby. Hit me up: [email protected].