What is pelvic floor dysfunction & how can yoga help?

WHAT IS THE PELVIC FLOOR?

The pelvic floor (PF for short) is composed of multiple muscles in multiple layers that blend together to create a sling of sorts that supports the pelvic organs and helps to keep the pelvic bones in alignment. The female and male pelvic floor are fairly different, so this short article will focus on the ways in which they are similar and is intended as a brief introduction to the Pelvic Floor and its anatomy and function.

It is beyond the scope of this post to go into a detailed overview of all the PF muscles, but it is worth noting that there are multiple layers of muscle, and that these muscles are divided front to back into what we call the anterior and posterior triangles. The anterior (front) triangle stretches from the pubic bones in front out to the 2 sit bones (ischial tuberosities). The posterior (back) triangle connects from these same 2 sit bones to the tailbone in back. These pelvic floor triangles also blend seamlessly into the transverse abdominal muscles in front, and into some of the deep hip stabilizing muscles in back and up into deep stabilizing muscles of the spine. Because of its placement in the body and the connection into the spine in back and the deep core in front, the PF is commonly referred to as one of the muscles of the intrinsic core. This core set of muscles is essential to how our bodies stabilize the relationship between the spine and pelvis during movement and breathing.

THE PELVIC FLOOR AND BREATH

Speaking of breathing, did you know that the PF is also a breathing muscle? As part of its essential inner core work, the PF works in tandem with the diaphragm (your other main breathing muscle) and moves to some degree with each breath. How much movement depends on the strength/tone of the muscles, and the effort involved in whatever you might be doing, but generally speaking, whenever we inhale, the diaphragm and pelvic floor both descend, and on the exhale, they both lift back to their starting positions. Ideally, when we do things that require more core strength, the PF should be able to tone more as well to support an even pressure within the abdomen.

Take coughing for example. When we cough, the abdominal muscles contract quickly and strongly. This increases pressure in the abdomen to force air quickly out of the lungs (try it now to see how it feels!). If we try to cough and the pelvic floor doesn’t engage enough, then there will be some pressure moving air out, and more pressure down in the pelvis and not as effective of a cough. If this happens with a full or even partly full bladder, we may leak a small (or sometimes large) amount of urine. Or we may suffer a low back injury while lifting something heavy if we are not also engaging the pelvic floor enough to match the needs of the other inner core muscles.

Due to its complex makeup (multiple muscles), and its many responsibilities as a breathing muscle and foundational stabilizer, there can also be a multitude of ways we might experience symptoms when the PF gets out of balance. These muscles can become too tight, too loose, too weak, or a combination of all three. To list all the possible symptoms of pelvic floor dysfunction is again, way beyond the scope of this short article, but some very common ones might include incontinence (urinary or bowel), low back pain, and pelvic pain (including pain at hips, tailbone, or pubic bones). For women, these possible symptoms expand to include difficulties with menstruation, fertility, postpartum recovery, and possible challenges with prolapse, especially as we age and enter menopause.

YOGA FOR PELVIC FLOOR DYSFUNCTION

Enter Yoga (victorious trumpets blare)! Yoga provides us with many essential tools for healing dysfunction and maintaining health at every level of being. How can yoga help? In so many ways! Yoga poses can help stretch tight pelvic floor muscles and strengthen weak ones. Yoga practice can help build a new awareness of breathing that can integrate the pelvic floor more intentionally for ongoing health. Through practice over time, we can build the strength of other postural muscles and gain an awareness of our own spine and posture that supports optimum PF engagement. Yoga practice can also help us build the skills to manage stress more intentionally, and to relax the pelvic floor when needed. And MOST importantly, Yoga is a practice of deepening and focusing awareness of the inner body and its more subtle functions, so we become better able to sense what is occurring in the PF, spine, and core, and adapt to the changing needs of the moment.

SUMMARY

This is just a brief overview on some of the ways yoga can help. A general hatha yoga practice can help do many of these things over time, but if you are suffering from acute symptoms, do take the time to find either a specialized workshop, a pelvic floor physical therapist, or a yoga therapist who can work with you one on one to develop a practice that will tend to your unique needs and support optimum healing. As the foundation for movement, breath, and posture, your pelvic floor will thank you! We highly encourage you to start your yoga practice before you start experiencing pain, and to proactively strengthen your pelvic floor. Book your first class today!