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Foundation Breath with Prolapse: “I Feel Hesitant to Let Go”

March 19, 2017


With the launch of the Made for Women Workout Series this week, we’ve received some great questions and we’ll go over them in separate blog posts. One of the questions was this: 


“In the Foundation Series, why is it that when we inhale, we have to let go of our pelvic floor? I feel a bit hesitant to let go when I know there is an increase in pressure during that time. “


This is such a great question and what’s important to realize is that there is more to Foundation Breathing than meets the eye.


First off, when we discuss the relationship between the diaphragm and pelvic floor, it has been demonstrated consistently through EMG and ultrasound studies that when the diaphragm descends, so does the pelvic floor. Now, this pelvic floor descent can be interpreted in a couple of ways:


  1. The pelvic floor is letting go

  2. The pelvic floor is lengthening



What actually happens though is more of a combination of those two things. The pelvic floor is letting go but it is letting go gradually. As it does this, it lengthens. The important word here is “gradually”. In order for a muscle to let go gradually, it means it is exhibiting some level of control over that motion, which therefore means it is still in a contracted state. A similar example is a biceps curl. The biceps muscle doesn’t fully release when we lower our arm back down, but it gradually controls the descent of the arm while the biceps lengthens.



Going back to the pelvic floor - diaphragm rhythm, when we inhale, there is a slight increase in intra-abdominal pressure, and since the abdomen is a closed canister, this pressure is directed down to the abdominal organs which subsequently presses down on the pelvic organs and then finally to the pelvic floor. Hence, the pelvic floor descends as a result of that rise in pressure from above. It has to ease up on it’s resting tone to enable a dynamic response to pressures being placed on it. As an example, think of placing a 1 pound weight on a hammock. The hammock will

naturally give in to that weight but it will still support it.



The above example reflects the body in a normal state. Women with prolapse might have connective tissue that has lost some of its supportive ability, so as pressure travels through the abdomen and pelvis, the laxity may present as points of weakness and pressure might have more of an impact there. In these cases, women may become more aware of their prolapse descending during rises in intra-abdominal pressure. It’s like the same hammock now has areas where the weaving of threads isn’t as strong or as tough, so the weight is still held up, but it might be sitting a little bit lower.


It is understandable why someone with prolapse may not want to let go. However, the pelvic floor can’t be held in a shortened, contracted state all of the time, and so, if we are going to train the body to lengthen and release the pelvic floor, isn’t it better to do it in a way that mimics how the body naturally operates? If we don’t ever let go of the pelvic floor, the hammock becomes a thin piece of wood. Now, we have taken away all of the pelvic floor’s ability to be reactive to pressures and this in turn can make the core rigid and ineffective at dynamic support. Being held in contraction for the whole duration of your workout has the potential to slow you down and the potential to make exercising harder for you, not to mention the inevitable pelvic floor fatigue which doesn’t help prolapse either.




Practical Tips:


  • When you are just beginning to practice the coordination between your pelvic floor and diaphragm, it is often easier to learn how to let go first. Once you are comfortable with that, then you can practice “picking the blueberry up” and then “let it fall back down gradually but not letting it fall out”.  Practice this when you are not exercising and then you can practice it during exercise.


  • The Foundation Breath is not a hard and fast rule. It will work great for most exercises. In some exercises, like the squat, you can breathe out and contract on the way down and on the way up. Once you are up, let go, and repeat again.


  • Exhale with effort, that is, when you are doing the heaviest part of the exercise. But breathe easy. Make it easy for the air to blow out. Also, direct it up to your mouth, not down to the pelvic floor.




* filmed at Bosnar Centre for Health



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