The Diaphragm and Pelvic Floor: Key Players in Breathing and Core Stability


The Right Way to Breathe:

Have you ever thought about taking a deep breath and what happens? Have you ever caught yourself holding your breath? Have you ever had a sharp bout of pain when you take a deep breath? We often forget about breathing, but have you ever thought about the anatomy and physiology of breathing? What happens when we inhale or exhale? The diaphragm is a dome-shaped muscle that separates your chest from the abdomen and sits directly below your lower ribs and plays a vital role in respiration, but also in the function of your pelvic floor. It works with the pelvic floor when you inhale and exhale. If you are limiting your breath, and not breathing deep into the base of your lungs, you may be impacting the function of both the diaphragm and pelvic floor.


The Diaphragm and Pelvic Floor

Imagine your core as a canister or a soda can. The diaphragm sits at the top, and the pelvic floor muscles at the bottom. When you take a deep breath in, the diaphragm contracts and flattens, pushing your organs down and increasing pressure in your abdomen. The pelvic floor, in response, lengthens and relaxes to accommodate this pressure change. This coordinated movement is essential for core stability, proper breathing, proper pelvic floor muscle relaxation and activation, and good function during loading activities.


When the diaphragm and pelvic floor function optimally, there are lots of benefits:

  • Improved breathing: Deep diaphragmatic breathing promotes oxygen intake and reduces stress.
  • Enhanced core stability: A strong core provides better support for your spine and pelvis, leading to improved posture and reduced back pain.
  • A healthy pelvic floor: A healthy pelvic floor helps with bladder and bowel control, preventing incontinence, reducing constipation, and improving sexual function.


Shallow breathing, chronic stress, and certain lifestyle choices can disrupt the coordination or balance between the diaphragm and pelvic floor. This can lead to:

  • Pelvic floor dysfunction: Weakened pelvic floor muscles can cause incontinence, pelvic pain, and organ prolapse. A tight pelvic floor can also cause pelvic pain and dysfunction
  • Back pain: Improper breathing patterns can strain your back muscles and cause increased stress or unnecessary weakness.
  • Reduced athletic performance: Core weakness can impact performance and increase the risk of injury.


The good news is that one can improve the diaphragm and pelvic floor coordination. Here are some tips:

  • Practice deep breathing: Lie on your back and place your hands on the outside of your ribcage. As you inhale, feel your ribcage expand, as you exhale, feel your ribcage return. You can also place your hands on your shoulders or chest to ensure that you are not breathing abnormally into your chest and shoulders; they should not move a lot during an inhale
  • Engage your pelvic floor: Imagine stopping the flow of urine midstream. This contracts your pelvic floor muscles. Practice coordinating your breath and your pelvic floor. Inhale through your nose, then exhale and think about lifting your pelvic floor in coordination with your exhale. (This does not mean just doing Kegels all day long).


If you have any questions about the function of your breath and pelvic floor, it’s time to seek professional guidance; please reach out to Dr. Mia Smyser by contacting Release Physical Therapy today and schedule your pelvic health evaluation.



Mia Smyser

Mia Smyser PT, DPT, COMT, CIDN

Dr. Mia Smyser is a native of the DMV. She received her Doctorate in Physical Therapy from the University of Miami, after receiving her Bachelors of Science in Exercise Science from the University of South Carolina. She thinks movement is of foundational importance and is dedicated to improving people’s mobility and function and helping them achieve their optimal physical well-being.

She is passionate about continuing to learn and grow in the profession. She is a Certified Orthopedic Manual Therapist (COMT), certified in Integrative Dry Needling and is continuing her coursework with Herman & Wallace as a pelvic health therapist.

Dr. Smyser previously worked at outpatient physical therapy clinics in Washington, DC and Falls Church, VA, treating a wide variety of conditions including sports medicine, pelvic health, pre/post-operative rehabilitation, and pediatrics, among others.

In her free time, she prioritizes spending time with her husband, son & dog; playing soccer and running; coaching HIIT and checking out new restaurants.