Yoga for pelvic pain

After her endometriosis diagnosis and subsequent surgery, Meredith Koloski is paying it forward one downward dog at a time. The 42-year-old Little Silver, NJ-native, and 15-year yoga veteran began endOM Yoga, her by-appointment yoga classes and workshops, with a mission, she says, “to help women with endometriosis and autoimmune disease become less overwhelmed and more empowered advocates for their own well-being.” If you can’t book an appointment with her, don’t sweat it: Koloski says you can reap the benefit of these eight yoga poses at home, by breathing deep, stretching, relaxing to help ease chronic pain.

(photo credit: Jillian Schultz)

1. Thunderbolt or Rock Pose (Vajrasana)

Get Into It: Kneel and drop your bottom to your heels. “When you sit in Rock Pose, it places pressure on the reproductive organs and increases circulation in the pelvic area,” Koloski says. “Breathe long and deep.”

What It Does: “With the heels straight up into the buttocks, they stimulate two acupuncture pressure points. If you experience painful menstrual cramps, twisting in this pose can help to ease your pain by stretching the tissues and stimulating the liver.

2. Sat Nam Kryia: “I agree to the truth within.”

Get Into It: “Interlock all the fingers except the index fingers pointing straight up. Raise the arms straight up and rotate the upper arms inward so that they are hugging the ears. In this position, you will chant the mantra ‘Sat Naam.’ Repeat 1 to 3 minutes. At the end of the chant, inhale completely and hold in, imagining that you are sending the energy up through the top of the head. Exhale. It’s important to rest afterward to let the system regenerate.”

What It Does: “This exercise activates the parasympathetic nervous system, allowing the body time to regenerate,” says Koloski.

3. Squat (Malasana)

Get Into It: Standing with feet wider than hip-width apart, bend your knees and lower your hips, coming into a squat.

What It Does: “This pose is great for menstruation cramps, endometriosis pain, and digestive problems,” says Koloski. “It opens up your pelvic area, increases flexibility and circulation in this area.” Need to modify, or recently had surgery? Koloski advises placing a pillow under heels, leaning against a wall for support or sitting on a pillow or some blankets.

4. Pause Breath

GET INTO IT: “Inhale deeply, then pause for 5 to 10 counts,” says Koloski. “Exhale, pausing for 5 to 10 counts. Start with 3 minutes and work your way up to 8 minutes.”

WHAT IT DOES: “Meditation and breath work help to manage our stress levels and can relieve some tension. Many of us with endo have a revved up central nervous system because of years of pain, also known as central sensitization. By simply closing our eyes and bringing our gaze gently up towards our brow, we activate the pineal gland,” Meredith explains.

5. Forward Bend (Janu Sirasana)

GET INTO IT: Stand tall, then fold over, lowering your head to your knees.

WHAT IT DOES: This pose is “a life safer post-surgery,” says Koloski. “No matter how you modify it, a head-to-knee forward bend supports your reproductive and digestive system, stimulates your liver and kidney, relieves anxiety, fatigue, headaches, menstrual cramps, and can even soothe mild depression. This pose is also calming because it stimulates the bladder meridian that, according to Chinese medicine, flows down the back of your body and the backs of your legs. The urinary bladder channel has to do with our ability to cope with life and change.”

6. Three-Part Breath (Supta Baddha Konasana)

GET INTO IT: Place one hand on your heart and one on your belly. Feel your belly rise, ribs expand, and heart lift on the inhale. On the exhale, the heart moves deeper in, ribs hug around, with the belly moving gently to spine.

WHAT IT DOES: “It stimulates abdominal organs like the ovaries, bladder, and kidneys. Use these poses during times of pain, bloating, or discomfort. It all begins with our mindset. If we practice focusing on the pain as our teacher, as our messenger, we can begin to embrace what our body is trying to communicate and shift our focus onto healing, our creativity, our sensuality, our worthiness and remove the blocks to allow the energy to flow freely and heal.”

7. Sufi Grind

GET INTO IT: “Sit and put hands on knees. Begin rotating clockwise in big circles. (Flex the spine to the front, right, back and left). After one minute, move counterclockwise. Pause when you finish and notice your breath. Is it easy, shallow, deep? Can you relax your belly or do you tend to hold it in? Imagine breathing into your uterus.”

WHAT IT DOES: “It’s good for digestion, constipation, and stress relief,” says Koloski.

8. Sacral Chakra (Svadhisthana)

GET INTO IT: Simply close your eyes, and focus healing energy into your lower abdomen. Repeat a positive affirmation like, “I love and accept myself exactly as I am right here and right now.”

WHAT IT DOES: “I finish my practice by tapping and tuning into my Sacral chakra, Svadhisthana. This chakra is located below the naval and encompasses the reproductive organs, pelvis, large intestine, the lower vertebrae, appendix and bladder (all areas often burdened by endometriosis).”

Editor’s note: Meredith Koloski will be speaking at EndoFound’s Patient Day in NYC on March 18th. You can register for the free event here.

For the past decade, I have had an on and off relationship with yoga. It has brought me both peace and frustration, but the joy and RELEASE I feel afterwards is always worth it. Because I feel so strongly about the tehrapeutic aspect of yoga for women with hormonal imbalances, I’ve asked my friend Helen from Endo Yoga to share with us her expertise on using yoga to help decrease pelvic pain in women with endometriosis. If you have pelvic pain, a hormonal disorder and are interested in using yoga as exercise and treatment, I highly recommend you check out Helen’s online course! Enjoy the post!

In 2010 I hit the rock bottom with my illness endometriosis. I´ve had it since I was 18 and had been struggling most of my life with intense pain. I had just been certified as a yoga teacher and knew how much yoga did for me, physically, emotionally and not to mention spiritually. But the yoga poses you were supposed to do if you had my kind of problems were very difficult for me. They were too painful to do with my illness. I had the advantage of being a very dedicated yogi and had felt the power of yoga so I thought there must be other yoga poses you can do to feel better. To get rid of the pain, or at least help with the pain and make you improve your overall health. I started to develop some yoga programs and tested them on myself. They were working. My approach was to make programs that women could do if they had a lot of pain. Programs that helps with pain, balances your hormones and also at the same time helps you to grow both personally and spiritually. Here are some yoga exercises for you.


Six yoga exercises you can start with

You can do these yoga exercises all together or try one or two. Remember that yoga should never be painful. It can be challenging at times but it should never hurt. So just listen to your body.

  1. The long deep breathing

The long deep breathing technique is important. Many of us tend to breathe too shallow. When you breathe long and deeply you activate the parasympathetic nervous system: relax- and rest mode. The muscles start to relax and your mind becomes calmer.

This is how you do:

Start lying on your back or sit with your spine straight. Inhale through the nostrils fill the lower part of the lungs, expanding the abdomen.

Continue to inhale and fill the middle lungs and feel that the chest is expanding and the abdomen is sinking slightly.

Continue to inhale and fill the upper lung and feel the collarbones lifting a little bit. Exhale in reverse order: first the collarbones sink down followed by the chest and at last the abdomen.

After you have exhaled wait a couple of seconds until you inhale again. Let the body decide when it´s time to inhale again. Continue to breathe long and deeply as long as you want. 5-10 minutes a day are great!

  1. Sufi grind

Sufi grind is a nice yoga pose for your hips, lower spine and digestion. It is very calming.

This is how you do:

Sit in easy pose or on a chair.

Place your hands on the knees, rotate the torso, moving from the hips. Move your body clockwise in big circles. Gradually allow the whole abdominal area to relax and release. Inhale on the rotation in front, exhale back. Stay conscious of the breath as it helps create the movement. After 1-3 minutes change direction and rotate anti-clockwise.

To end the pose, come into the center with the spine straight. Take a deep breath and relax. You can also check out this video.

  1. Squatting pose

Squatting is one of my favorite pose to do if you have pain. A lot of women have given me great feedback on this one. It works for pain.

This is how you do.

From a standing position with your legs apart, squat down and maintain that position. The toes should be straight forward and your spine as straight as possible. Pull in your chin so you get the straight line from your spine up in the neck. If you need to make any adjustment with your legs to be as comfortable as possible you can do that. Wrap your arms around your knees and breathe long and deeply. Feel so you breathe all the way down to your belly.

Sit in this pose for 1 min to 3 min. You can also sit longer if you want.

  1. Wind release pose

This is a pose I recommend if you can´t to squatting pose. Maybe your muscles are too tight in the lower back and it gives you pain. This is also very good for pelvic pain and obviously good for wind release.

This is how you do:

Lie down on you back on the floor or on the bed. Pull down your knees to your chest, with your legs wide apart and wrap your arms around your knees. Breathe long and deeply. Continue for as long as you need.

  1. Rock pose

Rock pose is another great pose if you have pain. Try this if you have menstrual cramps. It is also good for improving your digestion.

This is how you do:

Start kneeling on both knees, with the tops of the feet on the ground. Sit back on the heels.

Keep the spine straight. Breathe long and deeply for as long as you need.

If it is uncomfortable you can:

Tuck in a pillow between your legs close to the hollow of your knees. You can also put a pillow under your feet or knees. Try different ways to support until you have found it comfortable.

  1. Cobra pose

Cobra pose is a great pose especially for your lower back but also to open up in your pelvis. If you can´t to the cobra pose you can do the modified version instead.

This is how you do it:

Lie on your belly and place your hands under your shoulders with your elbows by your side. Inhale as you lift your head and shoulders, pressing your hips into the floor and tightening your buttock muscles. Using your hands as support, arch your back up, keeping your feet as close together as possible. Gently stretch your neck and focus on your third eye point. Breathe long and deeply for 1- 3 minutes.

Modified version

Set your elbows under your shoulders and your forearms on the floor parallel to each other. Inhale and lift your upper torso and head away from the floor into a mild backbend.

To end: Inhale and hold the breath. Exhale and carefully come down on your belly again and rest.

Helen Kaselov is a yoga teacher and yoga therapist and the founder of Yoga for Endometriosis & Pelvic pain. Helen has a history of severe endometriosis and is today helping women with endometriosis, PCOS, uterine fibroids and other pelvic pain online, with yoga, nutrition and other lifestyle changes. Using yoga both as a tool in different kinds of healing programs, pain management, yoga has become the foundation in her work. “Yoga can help you in so many ways: Physically, mentally, spiritually and as a personal development tool. Yoga has totally changed my life in so many ways!” Visit www.endoyoga.com to learn more.

Raise your hand if you rolled your eyes after seeing the title to this column. It’s OK, because usually I roll my eyes whenever I see endometriosis and yoga in the same sentence, too. After my endometriosis diagnosis, I felt like a hostage to my own body. I felt weak, betrayed, and powerless. I did not believe anything would help me find comfort or relief. The everyday pain felt as though it was beyond repair.

If I had to guess, many of you reading this have felt that way, too. These are typical feelings you will experience as a response to having a chronic illness. And it is not wrong to feel like this. However, it is vital that we do not let ourselves become stuck in a rut. Whenever I saw posts about yoga, I would laugh and think how that would never help me. Pain and fatigue would set in and yoga would always be the last thing on my mind. But the more I brushed things off, the more of a rut I fell into.

Yoga

I started to become more open to trying natural remedies to help me feel better. Sure enough, yoga ended up being No. 1 on my list. I learned quickly that yoga did not just involve being flexible and practicing difficult moves for hours on end. In fact, yoga offers many poses, stretches, and variations. Yoga has helped me feel alive again. I am certainly not cured and will always have to deal with a bad day, but yoga has taught me to love myself, how to breathe, take a step back, and just take it one day at a time.

3 of my favorite poses for a chronic illness day

Kimberli enjoys Malasana when she has pelvic pain. (Courtesy of Kimberli Davino)

1. Malasana-garland pose

This pose is great when I am experiencing pelvic pain and feeling dizzy. Garland pose opens up the pelvic area and helps ease pain and increase circulation. To practice this pose, stand at the top of your mat with your arms at your side. Move your feet so they are about as wide as your mat. Bend your knees slowly and come into a squat. Keep your thighs separated and a little wider than your torso. Lean forward slightly, with your heels still touching the ground. Bring your elbows along the inside of your knees and palms in prayer position. Shift your weight onto your heels, and keep your spine straight and shoulders relaxed. Breathe and hold for five minutes.

Modify: If you are having trouble balancing or feel pain in the knees, put a soft yoga block beneath you to rest your bottom on.

Kimberli enjoys Balasana for migraines. (Courtesy of Kimberli Davino)

2. Balasana-child’s pose

This pose opens my back and hips and even helps with my migraines. This pose is known to help relieve cramping, soothe anxiety, and release tension. It also helps when I am feeling fatigued or dizzy.

To practice this pose, start on your hands and knees. Spread your knees apart while keeping your big toes touching one another. Sit up straight and begin to slowly bow forward. Your chest will rest on your thighs and your forehead will touch the floor. You can keep your arms extended in front of you or you can put them alongside your body. Breathe and hold for five minutes.

Modify: If you cannot get your head all the way to the floor, put a soft yoga block in front of you. You can rest your forehead on the block. Resting your forehead on the block also helps with migraines.

Kimberli enjoys this pose for leg cramps. (Courtesy of Kimberli Davino)

3. Viparita Karani-legs up the wall pose

This pose helps when I have pain in my legs or period cramps. It is known to improve the flow of blood to the pelvic region, refresh tired legs, and calm you. To practice this pose, lay on your back facing a wall. Gently walk your feet up the wall until your legs are resting on the wall. Be sure your bottom is as close to the wall as you can get it. Rest your hands on your stomach or out to your sides. Close your eyes, breathe, and hold for five minutes.

Modify: Place a pillow or towel under your lower back to relieve additional strain. You can also place a pillow or mat for support under your head. Use a strap around your thighs and knees to help hold legs in place. This helps take pressure off the lower back and pelvis.

You can follow more of my journey at: http://www.myendojourney.org

***

Note: Endometriosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Endometriosis News or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to endometriosis.

Hi, my name is Kimberli. I am 29 years old and was diagnosed with endometriosis in March 2017. I am a yoga lover, blogger, and writer. My passion is to raise awareness for other women suffering out there with endometriosis. × Hi, my name is Kimberli. I am 29 years old and was diagnosed with endometriosis in March 2017. I am a yoga lover, blogger, and writer. My passion is to raise awareness for other women suffering out there with endometriosis.

Yoga Poses to Ease Pelvic Pain and Endometriosis Pain

It’s Endometriosis Awareness Month

1 in 10 women have endometriosis and experience different forms of pain—pain with urination, pain with bowel movements, painful periods, pelvic pain, ovulation pain, painful sex, abdominal pain, and nerve pain. The Office on Women’s Health of the U.S. Department of Health and Human Services estimates 5 million American women are affected by endometriosis.

As we covered in a previous blog post, endometriosis is a condition where endometrial-like tissue grows outside of the uterus (endometrial tissue is tissue that usually tissu grows inside of the uterus). Endometrial-like tissue can implant on the surface of organs and structures including the ovaries, bladder, rectum, and along the walls of the abdomen and pelvis. These tissues can cause inflammation and pain to develop throughout the abdomen and pelvic cavity.

As a pelvic floor therapist and a registered yoga teacher, I have seen the power of gentle yoga poses to help stretch and lengthen the muscles and tissues in the abdomen, pelvis, low back, and hips during painful flareups.

Yoga poses to try if you are dealing with endo-related pain

What you will need:

  • Pants you can stretch in
  • An empty wall
  • Yoga mat or folded blanket, rug, etc. for padding
  • A pillow or bolster

1. Deep Breathing

Dealing with chronic pain often leads to the development of short and shallow breathing. Short and shallow breathing adds tension to the diaphragm, abdomen, and pelvic floor. Relearning how to breathe deeply is a profound way to start unraveling the tension inside the body, often held in between the ribs, in the low back, neck, shoulders, belly, and pelvic floor. Studies, such as this one by Roditi and Robinson (2011), also show that diaphragmatic breathing can help the body break the pain cycle, thereby reducing pain and chronic pain.

Deep breathing can be practiced anywhere: stuck in a traffic jam, waiting in line at the grocery store, or at night before you go to bed. Below are instructions for breathing on your back.

Instructions:
  • Lay on your back. Knees can be bent with feet flat on the floor, or knees can be propped up on a pillow or bolster.
  • Place one hand over the heart and one over the belly button.
  • Inhale through the nose and feel both hands rise with the in-breath. Ribs are expanding, belly is also expanding, even the back of the body expands into the mat.
  • Exhale gently and slowly, either through pursed lips or the nose. The air is slowly escaping as if you poked a hole in a tire with a needle and the air slowly passes out. The goal is to elongate the exhale, so that it is longer than the inhale.
  • When the breath has been fully exhaled, pause for a second or two before beginning the breath cycle again, with another inhale. After you have exhaled wait a couple of seconds until you inhale again. Continue to breathing for 5-10 minutes.

2. Hamstring Stretch at the Wall

  • Lay down comfortably on floor with both legs against the wall, feet towards the sky.
  • Keep knees straight and pull toes down towards face
  • Relax low back/pelvic and shoulders.
  • Keep knee soft, NOT Locked.
  • Keep your glutes and low back flat on floor.
  • Breathe deeply throughout the stretch.

3. Adductor Stretch at the Wall

  • Lay down comfortably on floor or bed with both legs on wall, as in the hamstring stretch (above).
  • Rotate toes and hips outward and gently allow legs to slide out into a “V” shape.
  • Relax low back and shoulders.
  • Keep knee soft, NOT Locked.
  • Keep your glutes and low back flat on floor.
  • Breathe deeply throughout the stretch.

4. Hip & Buttock Stretch

  • Lay down comfortably on floor or bed with both legs on wall, as in the hamstring stretch (above).
  • Place one ankle on opposite thigh.
  • Slide opposite foot down wall until stretch is felt in hip/glute.
  • Place gentle pressure with hand on knee (as seen in picture)
  • Breathe deeply throughout the stretch.

5. Groin Stretch/Pelvic Floor Relax Position

  • Start in hamstring stretch position, bring knees to chest, feet flat on the wall.
  • Do deep breathing and allow the pelvic floor muscles to sink into the mat, relaxing the muscles.
  • You can rest here for 60 seconds, and focus on your deep breathing and pelvic floor relaxation.

6. Hip Flexor Stretch/Runner’s Lunge

  • Start in a kneeling position on a mat (you can have a towel or blanket under the knees)
  • Step one foot forwards.
  • Lean hip points forward, feeling a stretch down your quad in into the hip flexor.
  • Maintain a neutral pelvic position.
  • If you are feeling balanced, reach both arms towards the sky, spreading the collarbones towards the ceiling.
  • You can rest here for 60 seconds, and focus on your deep breathing and pelvic floor relaxation.

7. Cobra Pose

  • Lie on your belly and spread your hands under the shoulders. Elbows hug in towards the body, in line with the nipples.
  • Press the tops of the feet and thighs and the pelvis into the floor.
  • On an inhalation, use arms to support you as you lift the chest off the floor. Do not go too high, 4-10 inches.
  • Firm the glute muscles, without clenching the cheeks together. Bring the belly button to spine, engaging the low belly to support the low back.
  • Breathe long and deeply for 1 minute.

8. Child’s Pose

  • Start on a quadraped (hands and knees) position
  • Sit back on your heels and curl forwards bringing your forehead to the mat
  • Reach your arms forward on the mat
  • Try this position with a pillow or a bolster supporting the glutes and/or chest
  • You can rest here for 60 seconds, and focus on your deep breathing and pelvic floor relaxation

**This information is for educational purposes only and is not intended to replace the advice of your doctor.**

Relieving Pelvic Pain

Pelvic pain affects 25% of women and 11% of men. Often, those who are experiencing pain feel more alone than the statistics reveal because pelvic pain is not as readily spoken about as other parts of the body, like the back or hip.

Pelvic pain can disrupt bowel, bladder, digestive, and sexual function. Men and women who experience pelvic pain often have at least one other systemic concern (called co-morbidities).

For example, a woman with interstitial cystitis might feel her pain getting worse if she is constipated or flaring during certain times in her menstrual cycle. (Co-morbidities of pelvic floor dysfunction are not always painful.)

Let’s categorize what you or your loved one might be experiencing.

Urinary

  • Interstitial cystitis (also referred to as painful bladder syndrome or bladder pain syndrome)
  • Urinary urgency
  • Urinary frequency
  • Urinary incontinence
  • Urinary hesitancy

Gastrointestinal

  • Constipation
  • Irritable Bowel Syndrome
  • Fecal (or gas) incontinence
  • Abdominal pain

Musculoskeletal

  • Fibromyalgia
  • Pudendal neuralgia
  • Coccydynia
  • Back pain
  • Hip pain
  • Sacroiliac joint pain
  • Pelvic floor muscle spasm aka overactivity aka levator ani syndrome

Cis women

  • Endometriosis
  • Vulvodynia (also referred to as vulvar pain)
  • Vestibulodynia
  • Dysmenorrhea

Cis men

  • Chronic non-bacterial prostatitis

How is it treated?

Appropriate diagnosis

If you are looking for a second opinion from a provider who has a specialization in pelvic pain, the International Pelvic Pain Society is an excellent resource.

Your provider will be able to create a treatment plan that might include pelvic health physical therapy, medication, acupuncture, nerve blocks, therapeutic exercise, dietary tips, yoga, and mindfulness.

Avoid constipation

If you and your provider suspect diet might play a role in your symptoms, being properly hydrated, increasing fiber intake and avoiding irritants may provide relief.

You might also have pelvic floor muscle tightness or incoordination that might be making bowel movements sluggish, incomplete, or painful.

Some techniques to try while defecating include:

  • elevating your feet on a Squatty Potty (or stool),
  • working with the pelvic floor muscles (lengthen or strengthen), and
  • abdominal massage.

Stool consistency is a self-assessment tool you can communicate to your provider.

Mobilize

Movement that feels safe in your body is critical to feeling like your best self. This is why so many people love using yoga as an adjunct treatment modality to decrease pain and increase function.

Yoga offers the opportunity for slow, mindful movements with breath work and inner reflection. Relaxing, developing awareness, and integrating breath into your movement increases flexibility of the body and the mind.

Yoga helps control the release of compounds in your body: serotonin (the feel-good neurotransmitter) and cortisol (the stress hormone). The majority of serotonin, the feel-good neurotransmitter, is produced in the gut. Strengthening the parasympathetic nervous system response via pranayama, meditation, and gentle movement can be helpful in the balance of cortisol and serotonin.

Breathe

Conscious breathwork, or pranayama is another non-invasive tool to decrease pain and increase confidence that you have control over the pain by targeting the nervous system. See the pranayama section below for a continued discussion.

Aspects of a yoga practice

Eight limbs

The Indian sage Patanjali outlined “eight limbs of yoga” in the Yoga Sutras.

You may be familiar with asanas (physical postures) and pranayama (breathwork), but these are only two of the “eight limbs of yoga” as outlined by the Indian sage Patanjali in the Yoga Sutras.

Meditation, compassion, and other concepts and practices of yoga can be applied in the holistic model of healing the pelvis and general wellness.

Pranayama

Iyengar describes pranayama as “extension of breath and its control.” Pranayama can be practiced alone or in coordination with asana. Mindful pranayama encourages the student to explore diaphragmatic breathing without gripping and holding tension in the chest and ribcage.

To learn more about the relationship of the breath and the pelvic floor, check out this video of pelvic floor movement with the breath. If you wish to gain knowledge about different types of pranayama, read my blogs about dirga, ujjayi and letting go breath.

Asana

Asanas are the most widely known aspect of yoga. Prior to asanas, warm-ups are an ideal way to introduce movement. Gentle and slow movements combined with conscious breathing, act to warm up muscles, lubricate joints, and direct the focus of the student inward to the mind-body-spirit connection.

×

Note: As with any exercise program, please consult the appropriate medical provider. Some precautions and contraindications to specific yoga postures include uncontrolled high or low blood pressure, second and third trimester of pregnancy, recent surgery, etc.

Medical Therapeutic Yoga for Pelvic Pain and Better Sex

Posted August 15, 2019| by katherine SHARE

Medical therapeutic yoga uses physical therapy in the context of yoga as medicine to treat many types of conditions including pelvic pain. Releasing tight pelvic floor muscles not only helps manage pain, but can also lead to improved physical health, including better sex and better movement of the whole body.

What are Pelvic Pain Symptoms?

Pelvic pain can manifest as many different symptoms. Pelvic pain symptoms can include pain with sitting, pain with sex, painful urination or pain with bowel movements. Pain can be felt in the pelvis but also can be referred to the abdomen and other areas of the body like the hips and back.

Symptoms can arise from various sources, but often could be due to overly tight (hypertonic) or sometimes weak (hypotonic) pelvic floor muscles.

Pelvic Pain Treatment

Treatment for pelvic pain often has people seeking care with a primary care doctor, orthopedist, OB/GYN, urologist, or even a GI doctor. While the many of the treatments offered by these clinicians are necessary, yoga can be very effective to manage pelvic floor muscle tightness and pain.

Why does the pelvic floor get tight in the first place?

Yoga therapist Leslie Howard shared a clever analogy of the pelvis. We know physiologically that the pelvis is a hub of activity in the body for things like reproduction, digestion and elimination just to name a few.

Howard likens the pelvis to a storage unit. Human beings are exposed to stress and conditioning throughout a lifetime. Our pelvis is like a multi-layered storage unit for this conditioning. It’s often a place where we put things that we can’t let go. The pelvis is a place where we can leave the baggage when we don’t want to deal with it at the moment.

We take that conditioning and stress and carry it in the body specifically in the pelvis. The problem is that sometimes the accumulation of this stress can manifest as a variety of symptoms when our body has reached its limit. That limit might be met when we are overextended by too much stress, when we are depleted in sleep, low in nutritional support, or when we are limited in certain types of movement.

How can Medical Therapeutic Yoga help?

So we can understand why the pelvic floor might get tight since it’s sitting at the bottom of this hub of activity and storage in the body but why use yoga and physical therapy as a first line to treat pelvic pain?

Yoga cultivates self awareness of the body, particularly when its practice is under the guidance of a professional who has a medical understanding of pelvic floor muscles. Medical therapeutic yoga can increase awareness of the tight pelvic muscles and help you to understand triggers that cause muscles to get tight in the first place.

Medical therapeutic yoga attempts to provide a person with self empowerment skills to take charge of their own health— to understand that much of health is within his/her control when self awareness is practiced. It helps individuals to understand that treatment is more than a medication, procedure or a stretch that we may use to treat the pain. It’s the way we eat, the way that we breathe, the way that we hold stress, the way we move and the way that we choose to react to our unique life situations.

Yoga Poses to Release Tight Pelvic Floor Muscles

Here are two yoga poses that we use at Rebalance as a part of medical therapeutic yoga treatment to help release tight pelvic floor muscles. It’s important to emphasize that the benefits of these poses are not only in the position of the stretch (or asana in yogic language) but what you do while you are practicing these poses.

Give attention to how you are performing the pose:

  • Are you forcing a stretch or allowing the body to relax while you are moving into the position?
  • Are you using enough support?
  • Can you maintain a relaxed breathing pattern or do you start to hold your breath when you are performing the pose?

If you are using enough support, you should be able to fully relax and breath with ease.

1. Hamstring Insertion and Pelvic Floor Stretch

  • –Use a yoga strap or belt to draw one leg up toward the ceiling.
  • –Lengthen the SIT bone away from your head and shoulders.
  • –Maintain the natural curve in your spine and avoid over extending the leg when you pull it up.
  • –You can bend the knee a little bit if your hamstrings are on the tighter side.
  • –Uncurl the tailbone because the pelvic floor attaches to the sitting bone and the tailbone.
  • –Allow you SIT bones to move toward the floor.
  • –Keep the femur over the hip socket and bend the knee if needed.
  • –Start with 3-5 slow breaths in/out and work up to 5-10 breaths as you are able.

2. Reclined Angle Pose supported with blocks and bolsters

  • –Recline to a comfortable angle where you can maintain the natural curve of your back. You should not feel over arched or curled up.
  • –Bend your knees and allow the knees to fall outward so you feel a stretch in your inner thighs but you can still maintain the position of your back. Keep your feet wide to start.
  • –Support your knees with yoga blocks, cushions or pillows so you can maintain a position that fully relaxed and pain free.
  • –Start with 3-5 breaths and evaluate how you are feeling. You can stay in this position for up to a few minutes at a time, breathing slowly and evenly but work up to this over a few attempts.

Yoga Benefits Off the Mat

If you choose to practice one or both of these, consider how the benefits of yoga practice go beyond the mat. Take what you do with your breathing in each pose and use that to help you breathe more calmly when you are dealing with a stressful situation.

If you’re interested in learning more about how medical therapeutic yoga can help treat your pelvic pain, click here to schedule a complimentary phone consultation with our physical therapists.

The Yoga Poses That Have Helped With My Endometriosis

If you are reading this, you most likely rolled your eyes after reading the title. It’s OK, because that is something I used to do also whenever I would see endometriosis and yoga in the same sentence.

After my endometriosis diagnosis, I felt like a hostage in my own body. I felt weak, betrayed and powerless. I did not believe anything would help me find comfort or relief. The pain I was experiencing felt as though it was beyond repair.

I am sure many of you have felt like this also. These are feelings you will experience as a response to having a chronic illness. And it is not wrong to feel like this. However, it is vital that we do not let ourselves become stuck in a rut.

Whenever I saw posts about yoga, I would laugh and think how that would never help me. I was in too much pain and too tired to try and be flexible. But I began to realize that the more I brushed trying things off to help me, the more of a rut I was getting stuck in.

As I began to become more open to trying natural remedies to feel better, yoga was number one on my list. I learned quickly that yoga did not just involve being flexible and practicing difficult moves for hours. In fact, yoga offers many poses, stretches and variations.

Yoga has given me the opportunity to feel alive again. I may not be cured and will always have bad days, but yoga has taught me to love myself, breathe, take a step back and just take it one day at a time.

Here are three of my favorite poses I use when I am having a rough chronic illness day:

1. Malasana – Garland Pose

This pose is great when I am having pelvic pain and feeling dizzy. Garland pose opens up the pelvic area, helps ease pain and increase circulation.

To practice this pose, stand at the top of your mat with your arms at your side. Step your feet so that they are about as wide as your mat. Bend your knees slowly and come into a squat. Keep your thighs separated and a little wider than your torso. Lean forward slightly, with your heels still touching the ground. Bring your elbows along the inside of your knees and palms in prayer position. Shift your weight into your heels, keep spine straight and shoulders relaxed. Breath and hold for five minutes.

Modify: If you are having trouble balancing or pain in the knees, put a soft yoga block under you to rest your bottom on.

2. Balasana – Child’s Pose

This pose opens my back, hips and even helps with my migraines. This pose is known to help relieve cramping, soothe anxiety and release tension. It also helps when I am feeling fatigue or dizzy.

To practice this pose, start on your hands and knees. Spread your knees apart while keeping your big toes touching one another. Sit up straight and begin to slowly bow forward. Your chest will rest on your thighs and forehead will touch the floor. You can keep your arms extended in front of you or you can put them along side your body. Breath and hold for five minutes.

Modify: If you cannot get your head all the way to the floor, put a soft yoga block in front of you. Here, you can rest your forehead on the block. Resting your forehead on the block also helps with migraines.

3. Viparita Karani – Legs Up the Wall Pose

This pose helps when I have pain in my legs or period cramps. It is known to improve flow of blood to the pelvic region, refresh tired legs and calm you.

To practice this pose lay on your back facing a wall. Gently walk your feet up the wall until your legs are resting on the wall. Be sure your bottom is as close as you can get it to the wall. Rest your hands on your stomach or out to your sides. Close your eyes, breathe and hold for five minutes.

Modify: Place a pillow or towel under your lower back to relieve additional strain. You can also place a pillow or mat for support under your head. Use a strap around your thighs and knees to help hold legs in place. This helps take pressure off the lower back and pelvis.

You can follow more of my journey over at My Endo Journey.

We want to hear your story. Become a Mighty contributor here.

Mind-Body Practices

Mind-body practices are techniques and therapies that aim to connect the body with the mind to help reduce stress and provide other health benefits. Individuals who practice and teach mind-body therapies believe in the mind-body connection. The mind-body connection refers to the mind’s ability to potentially impact the body’s wellbeing and experiences, positively and negatively. The mind, in this case, is more than just the brain. It refers to the thoughts, feelings, and mentality that an individual has toward themselves, their personal experiences, and the world around them. Stress is known to play a role in the development and progression of many different physical and mental health-related conditions, and decreasing it may improve overall health.1-3

How might mind-body practices help women with endometriosis?

According to the mind-body connection theory, connecting an individual’s mind and body, and focusing on having a positive, relaxed attitude and outlook toward a situation may improve physical outcomes. Alternatively, having a negative outlook and believing in poor outcomes with the mind, may negatively impact the body. In this sense, a positive, relaxed outlook may decrease stress, and therefore, improve an individual’s mental, emotional, and physical health. Some experts believe that pain, including endometriosis-related pain, exists in a cycle with an individual’s mental health. For example, endometriosis-related pelvic pain may lead to anxiety or depression. Anxiety and depression, in turn, can increase an individual’s physical pain. This cycle can continue to loop, and both pain and feelings of anxiety or depression can keep escalating. Intervening in this cycle and using mind-body practices may help break this loop.1-4

Improving an individual’s outlook on life may also help them better cope with additional symptoms that arise. Furthermore, some mind-body practices involve mindful movement, such as yoga and tai chi. Not only do these help to reduce stress, they also help relax an individual’s muscles, potentially adding to improvements in pain. Few studies have investigated the impact of mind-body practices on endometriosis-related symptoms, and results have trended positively. Much more research needs to be done to further classify this potential relationship, however, outcomes thus far have indicated that mind-body practices may improve a woman’s overall quality of life.5-7

Examples of mind-body practices

Mind-body practices can take on a variety of forms. Common examples of mind-body practices include, but are not limited to:

  • Meditation: A practice that involves focusing the mind. Many forms of meditation involve sitting quietly and alone. Meditation can also occur during prayer, and although it is used regularly in some religions, it does not have to be a religious practice. Meditation may also take the form of using guided imagery. Guided imagery relies on the imagination to picture different relaxing situations or locations. The guiding can come from an in-person guide, tapes, or videos.
  • Mindfulness: Mindfulness is often considered a type of meditation; however, it doesn’t always have to take place alone or in one place. Mindfulness can happen at any time or anywhere, and involves being aware and present in each moment. The mind can go on autopilot during routine events, such as driving to work or watching TV. Making an effort in these moments to be aware and present, and taking special care to notice the things that are going on around you is considered practicing mindfulness.
  • Yoga, tai chi, and qigong: These practices involve tapping into the mind-body connection via physical movement, and are sometimes called mindful movement. They can each take on varying forms and intensities, making them accessible to many individuals. Mindful movement therapies can be performed at a studio or on your own at home with the help of self-guided videos or recordings.
  • Hypnosis: Hypnosis can be performed by a trained professional on an individual in order to induce a trance-like state of deep focus. This focus is generally directed at one thought, idea, task, or object, and it causes the individual experiencing it to have no other distractions. Hypnosis can also be self-guided in some situations.2,8

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *