Breathing Exercise to Help with Pelvic Pain and Urinary Incontinence

If you experience pelvic pain or urinary incontinence, you are not alone. There are many people with Pulmonary Fibrosis who report these challenges. Though there are trained professionals who can help you manage and treat symptoms, it may be difficult to find them or to reach out for help. 

Fortunately, there are many ways to help with pelvic pain or incontinence. We interviewed a pelvic pain specialist, Debbie Callif (OT, BCIA-PMDB), and learned there are natural ways to help yourself heal, all from the comfort of home. For example, paying attention to the way you breathe – and changing it, if needed – can make a big difference in your quality of life. 

With that in mind, here is one exercise you can do to improve breathing. This breathing exercise is designed for people with PF and meant to be gentle. You can try it from the comfort of home to help yourself with any kind of pain or health concern – even pelvic pain and symptoms of incontinence! 

Before beginning, however, please speak with your healthcare provider to see if this activity is appropriate for you. This breathing exercise is not medical advice. 

Here are the steps:

1. Gently breathe in through your nose. Notice the cool air coming into your nose.
2. Gently exhale through your nose. Notice the warm air leaving your nose.
3. Gently breathe in through your nose and out through your nose once again. Try to breathe so slowly and lightly that anyone around you wouldn’t even hear it. 
4. Place your fingers on the front of your lower ribcage, and your thumbs on the back of your lower ribcage. Gently breathe in through your nose, and see if you can get your ribcage to expand. Then breathe out through your nose and see if you can get your ribcage to relax. 
5. Gently breathe in through your nose while counting to 2 in your head. Then gently breathe out through your nose while counting to 3 in your head. 
   1. If that feels uncomfortable, try again but this time only count to 1 when you breathe in. And then only count to 2 when you breathe out. 
   2. If it feels comfortable, try again but this time count higher. Try breathing in while counting to 3 in your head, and then breathing out while counting to 4. 

This exercise may seem simple but it has powerful results! According to Debbie Callif (OT, BCIA-PMDB), it is helpful to consider human anatomy when learning how to breathe better. The nose is the start of the respiratory system. When people breathe in through their nose, the air naturally gets humidified and filtered. This is how the body is designed and provides numerous health benefits. 

If people breathe in through their mouths instead, then they are not utilizing their body’s nasal passages. With mouth breathing, the air must pass through the tonsils and adenoids before being filtered by lymphatic tissue. This can lead to health problems. Because of this, many health professionals recommend inhaling and exhaling exclusively through the nose, or at least inhaling through the nose and exhaling through the mouth. 

Not breathing properly can affect digestion, bladder function, and more. But breathing better can help each of those too. Spending 15 minutes every night doing nasal breathing exercises can help for a variety of reasons. Here are a few:

• When you breathe like this, you are producing more carbon dioxide in your body. This triggers a natural response in your body to bring in more oxygen – which is helpful and essential for numerous bodily functions. 
• Also, this exercise promotes diaphragmatic breathing. Your breathing diaphragm is a muscle located beneath your lower-to-middle rib cage. It helps with respiration by lowering when you inhale, thereby allowing your lungs and chest to expand. Gaining control of your breathing diaphragm can help you improve coordination between your breathing diaphragm and pelvic diaphragm. Ultimately, this can reduce pelvic pain and improve issues around incontinence. 
• By making sure your inhale is shorter than your exhale, you are helping to improve heart rate variability, coordinate your pelvic and breathing diaphragms, and quiet down your sympathetic nervous system. When someone is stressed, not eating well, not sleeping well, sitting a lot, or experiencing health challenges, they can struggle with this. 
• This breathing exercise activates your vagus nerve, which quiets down your sympathetic nervous system and helps you relax or even sleep better. Your sympathetic nervous system regulates the body’s unconscious actions and drives what is known as the “fight-or-flight” response. It takes charge in response to dangerous or stressful situations, but it doesn’t automatically settle once the perceived danger has passed. Instead, help from the parasympathetic nervous system is needed in order to rest and de-stress. Exercises to help your sympathetic and parasympathetic nervous systems work together better can improve bodily functions. 

To connect with people who can relate: join our online community forum, and attend our virtual support groups on Zoom for people with or impacted by PF.