Pelvic floor dysfunction is more prevalent today than ever before and impacts more than the old stereotypes. There are strengthening exercises and stretching exercises for pelvic floor dysfunction and then there are Yoga exercises to do. The question is are Yoga exercises good for pelvic floor dysfunction and if not, why! This blog will first explore:
- The anatomy of the pelvis, pelvic floor, and pelvic wall
- What symptoms of pelvic floor dysfunction are
- What treatment for pelvic floor dysfunction should be vs what it is
- And finally, if Yoga exercises are good for pelvic floor dysfunction
Anatomy of the Pelvis, Pelvic Floor, and Pelvic Wall
As stated in my Blog, ‘Are pelvic floor exercises the same as Kegels‘, “The pelvis consists of 3 bones: 2 ilium and sacrum with the 2 ilium coming together in the front to form the pubic bone. The pelvis is attached to the spine via the sacrum at the top and connected to the leg bone at the bottom to form the hip joint. In fact, in the hip joint which is a ball and socket joint, the socket is offered by the pelvis.
Pelvis bones (courtesy of https://orthoinfo.aaos.org/)
The pelvic floor muscles line the bottom and the wall of the pelvis and are more than what is along the vagina or penis. The floor itself consists of 3 layers.” Most pelvic floor treatments focus on just these 3 layers and in my opinion, is the number one reason treatment of pelvic floor dysfunction is not as comprehensive as it should be.
“On the inside, the pelvic wall consists of 2 primary muscles, the piriformis and obturator interns which are hip stabilizer muscles. When working internally on the pelvic floor, the piriformis is not accessible and the obturator internus may be reached. Frankly, with the internal manual work, the length of the examiner’s index finger determines how far and well these muscles are reached. Working on the muscles of the floor should NOT be first on the order of treatment as strengthening the pelvic floor muscles without the pelvis being strong, and without addressing the ‘influencers’ of its stability is a waste of time long term!”
What Are The Symptoms of Pelvic Floor Dysfunction?
In another Blog, “Is pelvic floor dysfunction painful”, you will find the following symptoms, not in any order of importance or prevalence listed:
- “Weak pelvic floor muscles
- Painful intercourse
- Erectile dysfunction
- Urinary incontinence
- Fecal incontinence
- Pain in the testicle
- Pain in the vulva
- Pain around the anus
- Pain in bladder
- Chronic bladder dysfunction
- Interstitial cystitis (aka painful bladder syndrome)
- Chronic UTI or urinary tract infection
- Lower back pain
- Sacroiliac pain
- Tailbone pain
- Lower mid back pain
- Hip(s) pain
- Chronic foot pain
- Chronic ankle instability or lack of proper mobility
- And bad posture”
The last 8 are easily looked at as separate, unrelated issues instead of a prelude to pelvic floor dysfunction when not treated correctly, and becoming chronic.
Holistic Treatment for Pelvic Floor Dysfunction
While most pelvic floor therapy focuses on internal manual work with some breathing coaching, hardly any attention is given to the ‘house’ that the pelvic floor is the ‘floor’ of. The most holistic approach to pelvic floor dysfunction treatment must include many other factors and the list below is my list that I apply to all pelvic floor dysfunction cases from one of my blogs:
- “Behavior modification which is always part of the solution list to all issues (your behavior about life changes how you do everything in life), is not going to correct any dysfunction fully but addresses some of the feeders of the problem.
- Postural Neurology: Movement is like a concert and the body parts are like the musicians; in that the musicians not only need to know their part but to know when to chime in and phase out. That means the pelvis and pelvic floor need to know how to ‘play’ with the rest of the body if they are to sustain their strength and integrity. This is what Postural Neurology is all about.
- Functional Movement: Common sense says that the most authentic way to move is the way babies move. After all, all babies from all over the world go through the same developmental stages of movement (Developmental Kinesiology) which means that we are hard-wired to move that way. So if the issue is movement-related or supported, then we should see how we compare to the way we moved as babies. All discrepancies are then highlighted and can be corrected through Dynamic Neuromuscular Stabilization (DNS) exercises which are baby movements.
- Kegels? There are machines like the Emsella Chair that do 400 Kegels per minute involving all of the muscles of your pelvic floor and not the ones that you hope to be engaging. Note that Kegel exercises are not for all types of incontinence and pelvic floor muscle issues.
- Breathing is what babies do automatically and that is what we need to do in order to sustain the bottom of the breathing apparatus, the pelvic floor!
- Internal manual work which ideally should be done to assess the muscles inside the pelvis BUT does not have to be done in all cases.
- Nutrition: Avoid Citrus, caffeine, soda, artificial sweeteners, spicy foods and take collagen, Vit. C, Vit. D, Omega 3, protein if no conflict with any other conditions that suggest their avoidance.
- Ergonomics: Sit on an exercise ball vs a chair, get a keyboard that is as wide as your shoulders, limit your sitting to no more than one hour and alternate with standing, make sure the middle of your monitor is at the eye level to name a few.
- Postural Awareness: It is important to pay attention to the posture and catch yourself when not standing on both feet, slouching, shifting the pelvis forward and in front of the ankles. Best to associate the increase in attention with activities done each day; for instance, when talking to someone to pay attention to the feet and pelvis positioning.
- Sleeping habits: do not sleep on the stomach and if you are a stomach sleeper, to get a body pillow to minimize that.”
What About Yoga For Pelvic Floor Dysfunction?
Yoga exercises are all good but too often the people teaching them do not know or communicate the requirements of posture and pose for each exercise. Frankly, our posture has shifted to a more flexed and forward posture where the shoulder joints are forward, the neck is forward, the shoulder blades are malpositioned, and the hips and ankles are restricted.
That means exercises such as downward dog, happy baby pose, warrior pose, and pigeon pose for instance need to be modified. Allowing the head and shoulders to dangle in the happy baby pose is no longer valid. The way it used to be taught is because most people are not in good enough shape to use that pose for relaxation and the opposite of how they are throughout the day. The happy baby pose is not about shifting side to side while holding the feet, and there is a lot more to that pose than most realize and do. To understand the principles behind movement, I suggest you visit my Youtube channel and follow us on IG.
Do not hesitate to contact me if you have any questions about your pelvic floor dysfunction.
Dr. Shakib
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