Strengthening the connections
As a yoga teacher and pelvic floor physical therapist, I love blending the two disciplines together as part of a holistic model of care. What are the connections between the pelvic floor, incontinence, urinary urgency, and yoga?
The breath, core, and pelvic floor work together for optimal pelvic health. Pelvic floor muscles can have different conditions: weak, tight, asymmetrical, or difficulty firing. Yoga increases strength, flexibility, and improves balance. For instance, as you inhale, the pelvic floor muscles naturally lengthen out and down.
Yoga also improves the mind-body connection and decreases the sympathetic nervous system activation (fight-or-flight reaction). Urinary urgency responds when the nervous system is balanced.
Yoga is not the only exercise option for incontinence. Traditional physical therapy exercises are wonderful and pilates is also a great option. The key is finding what works for you and what you will be motivated to continue practicing.
How is yoga helpful for incontinence?
One of the benefits of practicing yoga is retraining breathing patterns. The diaphragm is a key player in the role of lumbopelvic stability, which is necessary for optimal continence.
Yoga addresses the balance of the nervous system.
Urinary urgency is associated with heightened sympathetic nervous system (fight or flight) and yoga has proven in clinical trial to decrease the sympathetic override.
Additionally, the practice of yoga improves muscle coordination, flexibility, strength, and balance.
Where is the evidence? Huang et al. conducted a randomized control study presented at the 34th Annual Scientific Meeting of the American Urogynecological Society. Highlights of the study:
- All 19 participants were women over 40 with at least 7 incontinent episodes/week.
- Control group (N=9) was educated on behavioral techniques they could implement on their own.
- Intervention group (N=10) included two Iyengar style yoga classes and one home practice per week for 6 weeks.
There was over 50% decrease in urinary incontinence episodes with yoga intervention (P=0.05).
Will yoga cure UI?
Yoga is not a panacea. For optimal results, it is important to be evaluated to ensure that you are performing a pelvic floor muscle contraction correctly (without substitution and able to activate on both sides) and you are able to release the contraction appropriately.