Diaphragmatic Breathing for Pelvic Health: A Somatic Pelvic PT’s Guide

Authored by Bodyful PT and Wellness

Are you confused about what true diaphragmatic breathing is?

Do you want to understand the difference between diaphragmatic breathing and belly breathing?
Do you want to know why diaphragmatic breathing matters for pelvic health, pelvic floor relaxation exercises, the core, and the nervous system?

You are in the right place. At Bodyful Physical Therapy and Wellness, we value diaphragmatic breathing as a foundation for somatic pelvic therapy, trauma-informed pelvic physical therapy, and sustainable movement integration. Keep reading to learn why.

Why diaphragmatic breathing matters for pelvic health

The body has many diaphragms. The pelvic floor itself is a diaphragm—often called the pelvic diaphragm. When we talk about breathing, the diaphragm under your ribcage is the respiratory diaphragm.

These two diaphragms relate to each other as the top and bottom of a closed pressure system—your true core. This system is designed to absorb shock, manage pressure, and offload the spine. Forget “six-pack abs.” A healthy core is adaptable, responsive, and efficient.

When pressure changes anywhere in this system, all parts respond—including the pelvic floor. That pressure change happens through true diaphragmatic breathing.

Diaphragmatic breathing vs. belly breathing

Diaphragmatic breathing is not always the same as belly breathing.

Yes, the belly may respond to breathing—but it is not the driver. The respiratory diaphragm lives under the ribcage, not in the belly. To engage it fully, let the ribcage expand—to the sides and even into the back of your body. Most diaphragm fibers live there.

A helpful image: remember parachutes from gym class? When the parachute expanded, it also moved downward.
That’s what happens on an inhale—the diaphragm expands and descends, creating space for the lungs. On the exhale, it recoils elastically and returns upward with minimal effort.

Pause for a moment. Place your hands on your ribcage. Breathe. What do you notice?

How diaphragmatic breathing strengthens the pelvic floor

Because the respiratory diaphragm is the top of the system and the pelvic floor is the bottom, when the diaphragm descends on an inhale, pressure increases. A healthy pelvic floor responds by gently expanding and yielding.

This is pelvic floor eccentric movement, and is a strengthening practice.

Restoring this rhythm supports:

• Pelvic floor strengthening exercises without strain

• Improved blood flow and tissue health

• Relative nerve glide within the pelvic floor

• Reduced stiffness and guarding often seen in trauma PT and persistent pain

When assessed and guided by a trained pelvic floor physical therapist, diaphragmatic breathing can create meaningful, lasting change.

How somatic pelvic therapists teach diaphragmatic breathing

At Bodyful, our pelvic floor physical therapists use a somatic approach—prioritizing felt experience over performance.

We often begin with imagery and gentle tactile cues so you can feel the breath, not just direct it cognitively. From there, we integrate breathing into posture and meaningful movement—especially movements that have been painful, too effortful, or avoided.

As somatic movement therapists, we go slow. We leave room for curiosity. Everyone experiences their body differently—and that difference matters. Let compassionate curiosity guide the practice.

Step-by-step diaphragmatic breathing (somatic pelvic PT version)

Step 1: Ground and find safety. Choose a restful, supported position for at least 5 minutes.
Step 2: Hands on ribs. Place your hands on the sides of your ribcage (or use a strap).
Step 3: Inhale through the nose. Feel the ribs widen. Let the belly follow softly. Sense the pelvic floor gently yield to the pressure.
Step 4: Gentle exhale. Allow a quiet, unforced recoil of ribs and respiratory diaphragm.
Step 5: Repeat 5–10 breaths. Teach your nervous system this option.
Step 6: Add movement. Try this breath with small movements—lifting a limb, sit-to-stand, or walking. You don’t need to breathe this way all the time—just give your body a helpful choice.

10 benefits of diaphragmatic breathing

• Decreased pelvic floor strain and pelvic pain

• Improved core coordination and strength (remember: tight ≠ strong)

• Less breath holding during stress or effort

• Nervous system resourcing via vagal nerve support and longer exhales

• Easier movement transitions during daily tasks

• Improved lymph movement (via the cisterna chyli pump)

• Better blood flow to muscles and nerves

• Reduced GERD symptoms by improving diaphragmatic strength

• Improved digestion and less bloating (including abdomino-phrenic dysynergia patterns)

• Decreased back pain through restored diaphragm mobility and core function

The respiratory diaphragm does far more than “just breathing.”

When to use diaphragmatic breathing

• Before or after pelvic floor exercises or manual therapy

• During pregnancy, labor prep, and postpartum recovery

• When noticing pelvic tension, guarding, or stress

• As a daily somatic check-in to reinforce nervous system safety

Work with a pelvic floor PT

Want your breathing patterns assessed by a pelvic floor expert? We offer skilled pelvic floor physical therapy and somatic wellness sessions—in person in Oakland or via telehealth.

Bodyful Physical Therapy and Wellness specializes in somatic pelvic therapy, trauma-informed pelvic physical therapy, and movement-based care that honors your nervous system and lived experience.

If you’re ready to explore pelvic floor relaxation exercises with guidance and care, we’re here.