First off, I’d like to introduce myself. I am Megan Fosko and the newest physical therapist here at Hudson Valley Physical Therapy. In addition to being a PT, I earned my 200 hour yoga teacher certification in 2015. I enjoy incorporating principles from yoga into my physical therapy treatment style and taking the alignment and knowledge of anatomy from physical therapy and bringing that into yoga classes I teach.
As a yoga instructor and a student (because you never really ever stop learning anything in life), I could talk your ear off about why I love yoga. Personally, yoga helps me take all the thoughts floating inside my brain and quiet them, yoga has helped me change the way I breathe, and it challenges muscles that I didn’t even know I could feel. As a physical therapist in the pelvic health world, I acknowledge the role of yoga in enhancing treatment of various pelvic floor dysfunctions.

But don’t just take my word for it.

A prospective study conducted in 2015 followed a group of women with urinary incontinence that completed an eight week program of both pelvic floor strengthening and yoga. Results showed improvements in pelvic muscle strength and incontinence at the end of eight weeks (Kim et. al, 2015). A randomized control trial (RCT) from 2017 looked at the sole effect of yoga on chronic pelvic pain and found statistically significant improvement in quality of life measures and a decrease in pain after eight weeks (Saxena et. al, 2017). Individuals living with endometriosis experienced a decrease in pain and improvement in quality of life when compared to a control group after practicing yoga twice a week for eight weeks (Goncalves, Barros, & Bahamondes, 2017). This is just a small sampling of the research out there on pelvic floor dysfunction and yoga.

So what is it about yoga that complements pelvic floor rehab?

The breathing:
Pranayama or breath control is at the center of any strong yoga practice. Living in the Northeast, life is fast paced and stressful. How do you breathe through all that stress? Yoga teaches you how to breathe using your diaphragm and link that breathing to movement. All too often we see patients come breathing through their chest and using accessory muscles while their diaphragm is underutilized. Diaphragmatic breathing is fundamental to initiating proper pelvic floor exercise in rehab sessions.

Savasana and meditation:
“Just don’t think about it.” You’ve probably heard this from countless people in your life; especially if you are in pain. Yes, relaxing would help with pain, stress, or anxiety, but it is very difficult and can feel next to impossible to relax when you’re in significant discomfort physically or mentally. Meditation is not easy, but there are many formats of guided meditation that help train your mind to quiet. Savasana is the final relaxation following the end of physical yoga practice. Savasana similarly provides time for the body to rest after yoga and the mind to rest.
At Hudson Valley Physical Therapy, we look at patients from a full body approach. Tight and/ or painful pelvic floor muscles require down training or relaxation, and that down training starts with the mind.
Flexibility:
Ask any 5 year old what they think yoga is, and from personal experience, they will tell you that yoga is stretching. While not entirely true, there is an improving flexibility component to many yoga practices. Going back to the full body approach, the pelvic floor muscles are not isolated. A tight pelvic floor likely means tight muscles attaching to the pelvis which can impact the pelvic floor’s ability to function optimally.

Strengthening:
Yoga wakes up those muscles that you may not even know you have. While many of our patients require pelvic floor down training, we see many individuals who benefit from strengthening. Building strength through yoga asanas (poses) can complement the exercises performed in pelvic floor physical therapy.

At Hudson Valley Physical Therapy, we know that there is no one “standard” treatment for our patients. Similarly, yoga is not one size fits all. When it comes to pelvic floor dysfunction, it is important to talk to your therapist and evaluate what you need in a yoga practice to best complement your rehab.

-Megan Fosko PT, DPT

Gonçalves, A., Barros, N., & Bahamondes, L. (2017). The Practice of Hatha Yoga for the
Treatment of Pain Associated with Endometriosis. Journal of alternative and complementary medicine., 23(1), 45–52. doi:10.1089/acm.2015.0343

Kim, G. S., Kim, E. G., Shin, K. Y., Choo, H. J. and Kim, M. J. (2015), Combined pelvic muscle
exercise and yoga. Japan Journal of Nursing Science, 12: 330-339. doi:10.1111/jjns.12072

Saxena, R., Gupta, M., Shankar, N., Jain, S., & Saxena, A. (2017). Effects of yogic intervention on
pain scores and quality of life in females with chronic pelvic pain. International Journal of Yoga, 10(1), 9–15. http://doi.org/10.4103/0973-6131.186155