Case Study: Breathe Better By Opening Your Hips

Not long ago, a regular client came in complaining of shortness of breath as well as her usual pain. With a history of asthma and sinus issues this wasn't super unusual, but the symptoms were becoming so pronounced my client was concerned with the possibility of a hospitalizing asthma attack. (She did not share this with me at the start of our session. Please tell your practitioners and therapists if you are concerned about a medical emergency! It serves no one to keep your health professionals in the dark.)

Having had success with opening her sinuses and easing her breathing in prior sessions, I began with her facial bone ligaments. From there I progressed to her sternum and diaphragm. The further down the body we worked, the more comfortable her breathing became.

Working with her pelvis brought the greatest change. “Wow! I can breathe so much better! That makes it easier to breathe!” she exclaimed. We were using SMRT (Spontaneous Muscle Release Technique) to address the ligaments slinging the bladder and uterus between the ischial bones.

Why did working this seemingly unrelated area provide so much relief? We released tension from the pelvic floor.

The pelvic floor and the diagram are intricately connected via function and structure. Functionally, these two muscle groups form the bottom and top of the abdominopelvic cavity, working synergistically to maintain intra abdominal pressure; as the diagram pulls down during inflation, the pelvic floor will likewise descend. This is one the reasons why breathwork can be so beneficial in reducing pelvic pain. Take deep, slow breaths with your attention focused on the areas between your sit bones or place your hand on your perineum to feel this motion. (If you have chronically tight pelvic floor muscles like the majority of people, you may feel very little or no movement as was the case with my client before our session.)

Tension in the pelvic floor caused by stress, anxiety, misalignment, or injury can disrupt this parallel movement which leads to increases in intra-abdominal pressure. Now, pressure increases of this type will happen occasionally over the course of a lifetime. We forget to exhale while lifting, go through drastic periods of change, or sustain an injury that alters our movement patterns. Our bodies are made to adjust for these situations and then return to a neutral state. It is when this tension becomes chronic that the pelvic floor begins to loose it's adaptive capabilities which interferes with its supportive functions. Higher risk of incontinence and prolapse can then result.

Structurally, fascial lines and muscle actions link the pelvic floor to the diaphragm. Fascial connections can be looked at in four avenues: via the psoas and the quadratus lumborum, via the transverse abdominals (through which the cervical fascia also connects to the pubic bones), via the thoracolumbar fascia into the sacrum, and via the lateral thoracolumbar fascia into the iliac crests. When one of these lines gets kinked, it causes imbalances up and down the chain, making it challenging for muscles to function optimally.

Disrupted fascial lines are caused by similar factors to those that cause tension in the body. However, fascial imbalance in the pelvic floor is more likely to lead the complications of misalignment and pain: hip pain, groin pain, thigh pain, low back pain, abdominal pain, sexual pain, even shoulder and neck pain. Whether functional or structural, imbalances in the pelvic floor mean that other muscles in connected chains will need to compensate to keep you moving.

When I slackened the internal ligaments and relaxed the pelvic girdle articulations, the pelvic floor was able to operate more optimally thereby increasing my client's diaphragmatic function as the corresponding compensation had no more reason to exist. Voila! Better breathing! (Of course there are nuances, but it really can feel that simple.)

For more specifics about the connections between the pelvic and respiratory diaphragms, check out these papers: Bordoni, B., & Zanier, E. (2013). Anatomic connections of the diaphragm: influence of respiration on the body system. Journal of Multidisciplinary Healthcare, 6, 281–291. http://doi.org/10.2147/JMDH.S45443 Park, H., & Han, D. (2015). The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing. Journal of Physical Therapy Science, 27(7), 2113–2115. http://doi.org/10.1589/jpts.27.2113

Park, H., Hwang, B., & Kim, Y. (2015). The impact of the pelvic floor muscles on dynamic ventilation maneuvers. Journal of Physical Therapy Science, 27(10), 3155–3157. http://doi.org/10.1589/jpts.27.3155

Think your pelvic floor and/or your diaphragm could use a little attention? Call +1 (856) 857-7535 or book your session here. Questions? Leave a comment below!

#lowbackpain #pelvicfloorhealth #pelvicfloordysfunction #pelvichealth #athsma #backpain #hippain #pain #pelvicpain #fascia #benefitsofmassage