The Role of Yoga in Pelvic Floor Rehabilitation
Yoga has long been known for its healing and therapeutic benefits. It has been adopted as a form of rehabilitative medicine in many different areas of practice, including stroke rehab, cardiac rehab, pulmonary rehab, oncology, and psychology. More recently, yoga as an adjunct to treatment in pelvic floor rehabilitation has grown in popularity. The pelvic floor is one of the four components of our inner core unit, along with the multifidi, diaphragm, and transversus abdominis muscles. The muscles of the inner core work together to regulate our breathing and stabilize our spine, among other vital functions.
Common forms of pelvic floor dysfunction include pelvic pain, low back pain, and dysmenorrhea (intensely painful menstrual cycles). Pelvic floor therapy treats these conditions conservatively through manual therapy, pelvic floor training, posture and breath training, lifestyle modification, dietary changes, home exercise, stress management, and self-care. Yoga presents itself as a unique adjunct to therapy in pelvic floor rehabilitation because it combines different aspects of these treatments into one session, including posture, pranayama, sequencing, inner core training, mobility, and meditation.
In a study that assessed the impact of yoga on primary dysmenorrhea, participants demonstrated a significant improvement in menstrual pain, physical fitness, and quality of life (Yonglitthipagon et al., 2017). These benefits were seen with just two 30-minute yoga sessions per week for 12 weeks. With respect to low back pain, the role of yoga in the management of non-specific low back pain has been well-described in the literature. Low back pain has been linked to delayed inner core unit activation, poor trunk stability, and pelvic floor dysfunction, which yoga has been shown to help improve (Sorosky et al., 2008).
“Yoga presents itself as a unique adjunct to therapy in pelvic floor rehabilitation because it combines different aspects of these treatments into one session, including posture, pranayama, sequencing, inner core training, mobility, and meditation.”
Another study evaluated the efficacy of a 6-week yoga program on chronic pelvic pain. The program consisted of two 90-minute group sessions and one 60-minute self-practice at home each week. Many of the participants had co-existing conditions like endometriosis, uterine fibroids, and urinary incontinence. Participants showed a significant decrease in the severity of their pelvic pain as well as an improvement in sexual function, including reduced pain with intercourse. In addition to these benefits, 75% of the participants felt that it would be moderately easy to continue practicing this yoga program to self-manage their pelvic pain (Huang et al., 2017).
The role of yoga in helping to treat these common pelvic floor conditions can be attributed to its therapeutic effects on the mind and the body, including whole-body neuromuscular training, improved coordination and timing of muscle activation, improved physiological range of the muscles and joints, and an increased relaxation response. Practicing pelvic health clinicians with appropriate yoga training may utilize yoga as an adjunct to treatment in pelvic floor rehabilitation to assist in the management of chronic pelvic pain, low back pain, menstrual pain, and dyspareunia. Additional benefits for the use of yoga clinically includes helping to improve sense of well-being, sexual function, quality of life, and physical fitness.
References
Alison J. Huang, MD, MAS, Tami S. Rowen, MD, Priscilla Abercrombie, RN, NP, PhD, Leslee L. Subak, MD, Michael Schembri, BS, Traci Plaut, BS, Maria T. Chao, DrPH, Development and Feasibility of a Group-Based Therapeutic Yoga Program for Women with Chronic Pelvic Pain, Pain Medicine, Volume 18, Issue 10, October 2017, Pages 1864–1872, https://doi-org.myaccess.library.utoronto.ca/10.1093/pm/pnw306
Sorosky, S., Stilp, S. & Akuthota, V. Yoga and pilates in the management of low back pain. Curr Rev Musculoskelet Med 1, 39–47 (2008). https://doi-org.myaccess.library.utoronto.ca/10.1007/s12178-007-9004-1
Yonglitthipagon P, Muansiangsai S, Wongkhumngern W, et al. Effect of yoga on the menstrual pain, physical fitness, and quality of life of young women with primary dysmenorrhea. Journal of Bodywork and Movement Therapies. 2017;21(4):840-846. doi:10.1016/j.jbmt.2017.01.014.
