You may know conscious breath work, or pranayama, can help manage pelvic pain. But how?

Pain is processed by the autonomic nervous system. The three arms of the autonomic nervous system are sympathetic, parasympathetic, and enteric (facilitates the gastrointestinal system). Think of the sympathetic and parasympathetic as the gas and the brake.

If we are experiencing pain, our sympathetic nervous system (fight-flight-freeze response) acts as the gas. The fight-flight-freeze response reacts to real or perceived danger, releasing adrenaline, cortisol, and other stress hormones. This increased your heart rate and blood pressure but decreased the immune response and digestive system.

The parasympathetic nervous system (rest and digest) acts as the brake and decreases the body’s stress response.

Using your breath consciously asks the nervous system to shift the balance from fight-flight-freeze to rest and digest.

Studies show that conscious breathwork decreases heart rate and decreases blood pressure. This is one of the reasons why pranayama is beneficial for people experiencing persistent pain.

Pelvic floor movement with breath

Another reason why breathing is helpful for people experiencing pelvic pain is the relationship between the diaphragm and the pelvic floor.

When we inhale, the diaphragm and the pelvic floor descend toward our feet. When we exhale, they both ascend toward our head.

This helps provide a sump pump-like motion in the abdominal and pelvic cavities, and offers mechanical support to the low back and pelvis

Go for expansion

When we are stressed or experience persistent pelvic pain, your nervous system could be on high alert and you might tend to breathe more shallow. With shallow breathing, your belly doesn’t expand on inhalation or allow the ribs to glide outwards away from midline of the body.

Try pranayama at home

Here are some breathing exercises and tips you might find helpful to try at home.

Cues

·      When you inhale, feel your belly expand

·      When you inhale, imagine your sitz bones separating.

·      When you inhale, feel your ribs expanding out to the side. First start by feeling your lower ribs expand. Work your way up feeling the expansion all the way up into the armpits.

·      Try and breathe into the diagonal back corners of the rib cage. This is often where we grip our back and offering breath and rib expansion can combat stiffness 

Feedback for diaphragmatic breathing

Lay down on your back with a heavy book on your belly. Feel your abdomen rise up towards the ceiling as you inhale. You’ll see the book lifting as well. No need to push the book, just allow it to offer some feedback into the diaphragm.

Lightly wrap a resistance band around your ribs. As you inhale, you’ll feel some resistance to the outward glide of your ribs on inhalation. The band will offer you resistance and tactile feedback.

Pair the breath with movement

In addition to using the breath consciously while in different body positions, you can use your breath consciously as you move, stretch, or practice yoga. It offers a lovely way to mindfully connect.

Pranayama breath exercises

1) Dirga

Dirga is the three part breath. We inhale into the belly, then the outer ribs, then allow the collarbones to float up

2) Ujjayi

Ujjayi breath, also known as the ocean-sounding breath, creates a calm cooling and cleansing vibe. It’s counter-intuitive to evoke the leader of the dark side for a calming breath, but you know you are doing it right when you sound like Darth Vader.

3) Letting Go Breath

Letting Go Breath is a lovely breath that can be performed quietly or audibly, creating a big sigh of tension out of the body.

4) Nadi Shodhana

Also known as alternate nostril breathing, nadi shodhana is an easy was to feel centered and calm your nervous system.

You can use the second fingers of your right and left hands, or shape your right hand in Vishnu mudra (4th and 5th fingers bend halfway and keep first three fingers straight).

·      Close off your right nostril gently with your thumb

·      Exhale, then inhale through the left nostril.

·      Switch the nostril plug to the left side with your 4th finger

·      Exhale and inhale through the right nostril.

·      Switch the nostril plug to the right side using your thumb

·      Continue for 10 breaths or as desired.

Keep your breath smooth, long, meditative, and gentle to balance the hemispheres of the brain, sooth the nervous system, and quiet the mind.

Blog post written by Dr. Laura Finnern, PT, DPT, CDN, CYI