In both of these moves below, you should be able to maintain your breathing pattern as you move the legs without any tensing of the neck & back muscles or gripping at the ribcage.

It takes practice to UNDO tensions.  Our tension patterns are so hard-wired.  Healing DR, UI and POP requires integration of the core system: head and neck, ribcage, diaphragm, abdominals, pelvic floor AND re-establishing new connection to our nervous system.
Try this right now:
Sit for a moment and notice your breathing. 
Now start to nod your head up and down as if you are saying yes, or lift your arm up and down. 
Did you hold your breath?   
It is a simple move, and yet more than likely, you held your breath. We should be able to move and breathe at the same time. 
​When we hold our breath we are tensing muscles and increasing pressure into our body wall.  This load to the tissue adds up over time.   Doesn't this make you curious how often you might be holding your breath all day long? One of the keystones to healing the pelvic floor and the abdominal wall is to connect to our breath, allow the abdominals and pelvic floor to move, decrease the tensions in the neck, shoulder girdle, ribcage and lower back.  

Last week City Weekly released their BEST OF UTAH Body & Mind  February 2018 edition.  Susan McLaughlin, of ALIGN Integration | Movement was recognized among health and wellness practitioners as  Best Physical Therapist.
I am completely blown away, and incredibly grateful to the reader's of City Weekly.  Thank you!  Thank you! Thank you! 

• Skeletal System

The bones are in a position for appropriate loading to stimulate bone growth, and to position the muscles for optimal resting length tesnion.  From a sideview, the Standing plumbline markers for alignment are the earlobe, midpoint of joints: shoulder, hip, knee and ankle.  The ribcage is stacked over the pelvis, and the pelvis is stacked over the ankles.  

• Muscle System

The muscles are able to shorten and lengthen through full range of motion.   Optimal positioning of the skeletal system allows the muscles to be in a better position to move and generate force.

• ​Pressure System

Ability to generate appropriate intra-abdominal pressure.  Normalize pressures: Increased resting muscle tension can create abnormal pressures.  Pushing type strategies (bearing down) for strength and movement increase downward pressures into the abdominal wall and pelvis.

• Nervous System

Regulation of the peripheral and autonomic nervous systems.  Dysregulated autonomic nervous systems increase resting muscle tension (among other things).

Due to the resting tension in the upper abdominals there is more pressure into the lower abdominals and pelvis.  When the muscles are activated in a shortened contraction, even more pressure is created into the lower abdomen.  This constant downward pressure can have an impact on the health of the pelvic organs, abdominal wall and pelvic floor.  
Changing the pressure and muscle activation pattern is essential to recovery.  Typically, this person has no problem breathing low into the belly, but may have a hard time filling the entire abdomino-pelvic canister evenly on the inhale (generation of appropriate intra-abdominal pressure, evenly distributed 360 degrees). Home practice will require breathing practices to connect with the movement of the lower ribcage, side and back body, and then bring this new awareness and pattern into movement and daily activities.

• Lie down on the floor with your legs out straight
• Bring your legs together
• Keep your knees straight and lift both legs off of the floor about thirty degrees.
• Notice: what happens to your abs?  Did they bulge outward?  What does your back do?  Does it arch?  What does your neck do?  Does it tense?

​How did you do?  In my experience, 95% of my clients use a pushing strategy: holding breath, pushing out into abdominal wall and pelvis, arching back and tensing or lifting the neck. Outside of pilates, or working out, this strategy gets carried over into daily tasks such as: getting out of bed, bending and lifting tasks, pushing open a heavy door, etc.   ​

The first step is to become aware of the day to day habits that interfere with optimal breathing:

• shallow breathing into chest and neck
• holding breath
• holding abs
• locking down ribcage or gripping shoulder blades back and down
• lifting shoulders to breathe (over activation of the scalenes, upper trapezius, levator scapulae)
• squeezing butt cheeks (tightens the pelvic floor muscles)
• ribcage and pelvic positions

The second step is to practice breathing.  During quiet respiration there should be movement in the intercostals (the muscles between the ribs), the diaphragm, the abdominals and the pelvic floor.  In order to have strength in the muscles, they need to move through full range of motion: lengthening and shortening. In this video, I talk about diaphragmatic breathing and core function.  Practice lying down, sitting and standing.  Each position places a different demand on the body. 
​Have fun and explore!

The third step is to begin to challenge the system.  Can you maintain the breath as you add a new skill or a new load?  Are you able to get movement into all areas of the thoracolumbar pelvic canister?  Quite often I observe tension and stiffness surrounding the ribcage.  Below I share a breathing drill to get mobility at the lower ribcage and diaphragm and a link from Dr Evan Osar on Three Dimensional Breathing. 

​Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.