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pelvic organ prolapse and the role of yoga

Learn All About Pelvic Organ Prolapse and the Role of Yoga in Recovery

Yoga can help manage pelvic organ prolapse, but there are also some poses, movements and breathing methods that could make the condition worse.

What is a Pelvic Organ Prolapse?

"Prolapse" refers to a descending or drooping of organs. Pelvic organ prolapse (POP) refers to the prolapse or drooping of any of the pelvic floor organs, including: the bladder, uterus, vagina, small bowel, or rectum. These organs are said to prolapse if they descend into or outside of the vaginal canal or anus.

Read our previous blog for more information on prolapse and how pelvic floor therapy can help.

Which yoga poses will help and which poses will make it worse?

Yoga has been found to help women with urinary incontinence, but will it help with prolapse?

There are hundreds of yoga poses as well as breathing exercises in the practice of yoga. Some of these poses can help manage or reduce the negative sensation felt with organ prolapse. Other poses and breathwork, however, may make the condition worse. This is due to the role of intra-abdominal pressure (IAP) on the organs and the pelvic floor. Prolapse occurs when pressure in the abdomen is greater than the strength of the pelvic floor, the connective tissue, and deep core muscles that help keep organs in their place.

It is important to note that yoga by itself will not reverse a pelvic organ prolapse. There are many factors and behaviors that contribute to prolapse. It is best to be seen by a licensed pelvic floor physical therapist for a complete examination and treatment plan for your condition.

Yoga Poses That Will Help

Yoga poses that increase pelvic and abdominal stability without significant increases intra-abdominal pressure will help with prolapse.

Mula Bandha:

In a study published in 2018 by the International Journal of Yoga, the technique of Mula Bandha may be beneficial to mild pelvic organ prolapse. Mula bandha is a technique that engages the pelvic floor muscles, along with the deep core muscles. See a yoga therapist or pelvic floor physical therapist for more instruction on proper pelvic floor muscle engagement and how to incorporate it with this exercise.

Supported poses:

  • Legs up the Wall with a block or folded blanket under the pelvis.
  • Supported Bridge pose with a yoga block under the sacrum.
  • Reclined butterfly pose with blocks under the knees.

Breathing:

Do not hold your breath when you have a prolapse, whether you are lifting a bag of groceries or practicing yoga.

Holding your breath will create extra pressure in the abdomen, which will encourage your organs to migrate further south. Practice deep breathing on a regular basis and also exhale with movement.

Exhale with Movement - Do not hold your breath while you move. Try exhaling with the following activities:

  • Transitioning from lying down to sitting up
  • Transitioning from sitting to standing
  • While lifting anything (baby, groceries)
  • While pushing anything (strollers, trash can, shoveling)
  • While bending over to empty the dishwasher, take out laundry, weeding your garden, etc.
  • Putting on your socks, shoes and pants
  • Getting out of the car
  • During exercise
  • Reaching overhead

Poses that Help with Body Alignment

  • Stand in mountain pose and find a neutral pelvis and proper postural alignment.
  • Practice chair pose with a block between the thighs, focusing on maintaining a neutral pelvic position and activation of the deep core muscles (transverse abdominus and pelvic floor).

Yoga Poses to Avoid

  1. Avoid or modify intense core exercises that increase intra-abdominal pressure (IAP) until cleared by a pelvic floor physical therapist.
  • Double Leg Lift (Modification: raise one leg only)
  • Boat Poses (Modification: raise one leg only)
  • Plank Poses, including Chaturanga dandasana
  • Uddiyana bandha (“belly lock”) – this muscular “lock” increases pressure around the prolapse and forces the organs down towards the pelvic floor
  • Deep Squats without proper bracing will increase pressure on the pelvic floor
  • Forward bends with wide legs
  • Avoid jump-backs until you learn effective bracing from a pelvic floor therapist.
  • Do not hold your breath! Breathe with movement and transitions between poses.
  • Avoid heavy lifting, straining, or “pushing”

This applies to manual work and exercise (yardwork, heavy boxes), as well as having a bowel movement.

Read our previous article about body mechanics and prolapse on more tips on how to manage a prolapse.

When to See a Pelvic Floor physical therapist

It is important to note that yoga by itself will not reverse a pelvic organ prolapse. There are many factors and behaviors that contribute to prolapse. It is best to be seen by a pelvic floor therapist for a complete examination and treatment plan for your condition.

At Femina Physical Therapy, we offer personalized, one-on-one yoga therapy sessions that are geared towards your interests, body type, and condition. If you are in need of this therapy and have a little one at home that makes it difficult, many patients over the years have chosen to bring their babies with them to the session. We are proud to be a baby-friendly office and increase access to our services by making it easier for new moms to attend. Contact us to get started on your healing path.

 

Resources

Huang AJ, Jenny HE, Chesney MA, Schembri M, Subak LL. A Group-Based Yoga Therapy Intervention for Urinary Incontinence in Women: A Pilot Randomized Trial. Female pelvic medicine & reconstructive surgery. 2014;20(3):147-154. doi:10.1097/SPV.0000000000000072.

Prosko, S. Organ Prolapse and Yoga. https://www.yogauonline.com/yoga-for-pelvic-floor-health/organ-prolapse-and-yoga

Sweta K, Godbole A, Awasthi H, Pandey U. Effect of Mula Bandha Yoga in Mild Grade Pelvic Organ Prolapse: A Randomized Controlled Trial. International Journal of Yoga. 2018;11(2):116-121. doi:10.4103/ijoy.IJOY_32_17.

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

 

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Before I was referred to Heather Jeffcoat I was living in a nightmare. I had been married to my husband for three years and I was suffering from Vaginismus. That all changed when I visited my OBGYN and she said she knew of someone with a great success rate. To be honest I was hesitant at first because my first doctor had already told me that all I needed to do was order dilators from the internet and I should overcome my problem. She was wrong because I had followed the book on how to use the dilators with absolutely no advancements in my condition. However, that all changed when I went in for my first visit and Heather took the time to explain my condition and how we were going to work together to overcome it.

I remember leaving her office with a glimmer of hope that I could live a normal life. As my sessions continued I began to see immediate results. With only four sessions and a strict dedication to my home programs I was cured of Vaginismus. In the beginning of this process I was made aware that my health insurance company might not cover the costs, which was disappointing but today I can say one hundred percent that it was the best money I ever spent. Now thanks to Heather I am finally enjoying my life to the fullest with my husband. Thank you Heather, I can’t begin to tell you how much I appreciate all that you have done for me. I will never forget it. Those who are suffering from these types of conditions don’t be afraid because she makes you feel so comfortable and the end result is worth it. Good luck to you all and I hope you experience the success I have.
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I was hopeful but frankly skeptical when the doctor treating me for Interstitial Cystitis recommended that I go to Heather for physical therapy. Medication and diet helped control my IC symptoms, but I had never heard of physical therapy being used to treat IC. The education and treatment I received from Heather was a revelation. She explained that the pain I experienced with IC had helped create a cycle of muscle guarding which affected the entire pelvic area. I had no idea of the amount of tension being held there. No wonder my husband and I had not been able to have sexual intercourse for years!

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I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

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Heather has affected my life in the MOST POSITIVE way and I am forever grateful. My husband refers to her as the "sex doctor" so you can only imagine how happy he is with my therapy outcome.

After the birth of my son I suffered from "Vaginismus", however, at the time I just thought I was broken. My "broken vagina" affected me physically but it was an emotional struggle as well. Many women in my life also suffered with pain from sex after their babies were born so I knew I wasn't alone. They told me they "just got used to it" but I couldn't see myself living that way.

Sex wasn't just painful, it was literally impossible - IT DIDNT FIT!

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Heather is without exaggerating AMAZING! After years of trouble with a certain part of my body, in no time, she made everything change back to equilibrium and to what would be considered normal. She explains everything in detail and therefore gives you a better understanding of why things are the way they are, and how you can work towards turning things around. I would highly recommend Heather for any type of Physical Therapy. She has created her own "Method/Therapy" through years of studying (with some of the greatest practitioners), practice and breaking down the issues of her past patients, enabling her to fine tune her own system. I'm so thankful to have found her, and I'm especially grateful for the quick recovery I've achieved, after years of distress. If you cannot afford her, I recommend you purchase her book. Although it may not be Heather in person, it can still help you to get on the right path to recovery!

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My last appointment with Heather was over 6 years ago but I still think of her every day. I don’t take for granted that I can easily get out of bed, care for my two active and busy young boys, run, play tennis, clean my house, or sit at a desk for several hours at a time. None of these tasks were easy for me before meeting Heather. Eight years ago my car was struck from behind by a tractor trailer that was estimated to have been speeding. I spent 3 years working with different PTs and Drs trying to heal and move on with my life. When I became pregnant and the hormone relaxin that “relaxes” all the joints of the body and the additional weight gain erased all my progress and I was suddenly in a lot of pain again. My OB sent me to Heather for one last try.

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