Stretch and Strengthen: Yoga for Pelvic Floor Health

The best yoga poses for the pelvic floor actually depend upon what your pelvic floor needs. Sure, a strong pelvic floor is essential for many reasons, but did you know you need to be able to relax the pelvic floor muscles too? Just like any other muscle in the body, the pelvic floor muscles need strength, flexibility, and rest.

What is Your Pelvic Floor?

The pelvic floor is a group of muscles, and fascia, that runs from the pubis at the front of the pelvis to the coccyx (tail bone) and ischial tuberosities (sit bones). The muscles literally create a bowl or floor for the body. The pelvic floor muscles include muscle bands (sphincters) around the urethra, anus, and vagina. When the pelvic floor muscles are contracted, the organs are lifted up, and the muscle bands squeeze together. The pelvic floor muscles also synergize with the diaphragm and the transverse abdominis muscles to help with posture and spine protection. The pelvic floor is essential for core stability, balance, and movement.

What is a Healthy Pelvic Floor?

When the pelvic floor muscles are strong, we have control of our bowel and bladder release. Even when we sneeze, laugh, run, practice yoga, etc., a healthy pelvic floor engages and prevents any leakage. The pelvic floor muscles and fascia keep the pelvic organs, the bladder, rectum, vagina, and uterus, in the right place while allowing for some movement with breathing. This prevents pain and pressure in the pelvic region and prolapse or dropping of the organs. Aging, pregnancy, and vaginal birth are common causes of issues with pelvic floor strength.

Healthy pelvic floor muscles can relax, which allows us to empty the bladder and bowel completely. Also, the relaxation of the pelvic floor allows for enjoyable sex and the ability to insert tampons. 

Lower back or pelvic pain and a more constant urge to pee are associated with hypertonic or constantly contracted pelvic floor.  A tight pelvic floor can be caused by holding back the urge to urinate or defecate for long periods, engaging the muscles without relaxing, or as estrogen decreases during menopause. 

It is possible to have a weak and tight pelvic floor at the same time, too, as if one wasn’t enough to contend with. There are breathing practices, and yoga poses to help with both pelvic floor strength and relaxation.

Healthy Breathing: Yoga for the Pelvic Floor

Most yoga practices encourage diaphragmatic breathing. This is essential, as the pelvic floor works synergistically with the diaphragm. When we inhale, the pelvic floor relaxes so diaphragmatic breathing can help relax the pelvic floor. Remember, relaxing and resting is just as important as strengthening and stretching. No muscle in the body can be constantly contracted and not accumulate metabolic waste and lose efficacy. There are many ways to train diaphragmatic breathing in yoga for healthy pelvic floor function. The following is a simple and effective method and an excellent way to begin a yoga practice:

1. It is easier to do this lying down as, ideally, the diaphragm and pelvic floor are parallel to each other. Think of the diaphragm as the roof and the pelvic floor as the body’s floor. Keep the roof above the floor.
2. Place your right hand over your chest and the left one over your belly below your ribcage. Feel your chest and belly rise with your breath.
3. Take a deep breath in, hold for three seconds, and then exhale for four. The chest and belly relax and lower with the exhale.

Strengthen: Yoga Poses for the Pelvic Floor

Many people have heard of Kegels exercises, which are very similar to engaging Root Lock (Mula Bandha) in yoga for the pelvic floor. This is excellent news for yogis as long as we engage the pelvic floor. A simple way to engage the pelvic floor is:

1. Start lying on your back with your knees bent and feet on the floor, as if you were coming into Bridge Pose (Setu Bandha Sarvangasana).
2. Place your hands on the front of your hip bones with fingertips pressing into the abdomen.
3. Gradually lift and squeeze your pelvic floor muscles as if you were stopping the flow of urine, stopping gas from escaping, or both. If you feel something activate under your fingertips, that’s a good indicator the pelvic floor is contracting. 
4. Release gently and slowly, and make sure to relax fully. You should feel it release under your fingertips when you relax again.
5. When you know you can lift and let go, then try to hold. Breathe normally, hold the lift, and squeeze firmly for 5 seconds, building up to 10. Release slowly. Repeat up to 10 times. Relax for 5 to 10 seconds between each one.
6. Perform quick, short, firm squeeze and lift. Repeat 10 times. Again, make sure you can release fully each time.

Mula Bandha is a simple technique to learn and to teach. Once you understand the feeling of engaging the pelvic floor, Mula Bandha can be added to many yoga poses to continue strengthening the pelvic floor and improve the pose’s expression. Try engaging Mula Bandha with the following poses:

• Mountain Pose (Tadasana)
• Downward Facing Dog Pose (Adho Mukha Svanasana) 
• Inversions such as Headstand Pose (Sirsasana) 
• Warrior Pose I, II, and III (Virabhadrasana I, II, and III) 
• Jump throughs and Jump forwards

Stretch: Yoga Poses for the Pelvic Floor

You may wonder how on Earth we can stretch the pelvic floor. Fortunately, there are a lot of muscles connected to the pelvic floor. That means we can access the pelvic floor with yoga poses for other areas. The adductors of the inner thigh and abdominal muscles converge with the pelvic floor at the pubis. Through the fascial network, the pelvic floor is also connected to the lower back, the piriformis, and the psoas, so yoga poses that stretch these muscles help the pelvic floor. Try:

Happy Baby Pose (Ananda Balasana)

1. Lie on your back and bring your knees up toward your chest. Keep them wide apart.
2. Raise your feet so your ankles are above your knees. Support your legs with your arms if you need to.
3. Hold this position and gently rock from side to side without going all the way over.

Child’s Pose (Balasana)

1. Start on your hands and knees, and then spread your knees as far apart as you can and keep your big toes touching.
2. Stretch out your arms on the floor in front of you, move your hips toward your heels, and your head and chest toward the floor. 
3. Stay here for 5 to 10 deep breaths.

Reclined Bound Angle Pose (Supta Baddha Konasana) 

1. Lie flat on your back and bring your feet toward you.
2. Spread your knees out to the sides and place the soles of your feet together. You can add a block or support on each side of your leg if needed.
3. Relax here and take 5 to 10 deep breaths. 
4. Then lift your legs up and rest with the soles of your feet on the floor, hips-width apart.

Reclined Figure 4 Pose (Supta Ardha Padmasana)

1. Lie on your back and bend your knees with your feet on the floor.
2. Place your right ankle across your thigh, just below the left knee to form the figure “4.”
3. Thread your right hand through the opening behind the right calf. Interlace the fingers of both hands around the back of your right thigh, and draw your left thigh toward your chest.
4. Take 5 to 10 deep breaths, relaxing into the position.
5. Switch to the other side.

Reclined Big Toe Pose (Supta Padangusthasana)

1. Lie on your back. Ground your left leg and bring the right knee toward the chest.
2. Loop a strap around your right foot and extend the right leg toward the sky.
3. Keep the pelvis neutral. There should be a slight arch in the lower back, as you continue to ground the left leg as much as possible.
4. Draw the right leg toward the body while keeping the pelvis neutral. Resist the temptation to tuck the tail and go for the hamstring stretch.
5. Take 5 to 10 deep breaths in this position.
6. Release the pose and rest for a few breaths to check in with your legs. Do the right and left legs feel different from each other?
7. Repeat the pose on the other side.