happens to practically everyone. I often bring it up in my classes just to show women that it is so common."
Prevalent as occasional incontinence is, however, it's only one aspect of pelvic floor dysfunction, the umbrella term for disorders of the pelvic floor muscles. In the case of urinary incontinence, the muscles in the area may have grown weak, or hypotonic, usually due to the kind of overstretching that can happen in childbirth. When the muscles are overly tight, or hypertonic, other conditions can result, such as urinary frequency and urgency, interstitial cystitis, irritable bowel syndrome, painful intercourse, lower-back pain, and—in men—prostate problems.
A little "pee-pee problem" probably is related to hypotonic muscles that need strengthening, says Lizanne Pastore, a physical therapist based in the San Francisco Bay Area who specializes in dealing with pelvic floor dysfunction. But it might also be caused by hypertonic muscles that have been tensed to the point of fatigue and give out at just the wrong time.
Since it's often hard to know which condition is at the root of a pelvic floor disorder, Pastore says that there isn't a one-size-fits-all exercise solution. The Kegel gospel of squeeze, squeeze, squeeze to strengthen the pelvic muscles has been presented to women for 6o years as the answer to everything. But it addresses only half of the equation. To strengthen the pelvic floor, you also need to relax the pelvic floor, Pastore says, and not everyone can do that.
STEADY HAMMOCK If you're suffering from urinary incontinence and aren't sure whether your problem stems from muscle laxity or hypertonicity (aphysical therapist oryoga therapist can make that diagnosis), it pays to find a holistic way of working with the pelvic floor that will benefit those at both ends of the spectrum. Step one is simply building awareness of the muscles in the region. "For many people, the pelvic floor is like a dead zone," Pastore notes. "They don't even know they have it."
Yogis have a bit of a leg up, in that we talk about the pelvic floor in relation to pelvic floor balancing
Yoga can help you strengthen weak pelvic floor muscles and relax tight ones. Vlnlyoga, which coordinates slow movements with the breath, is particularly well suited to this kind of work. The Viniyoga seguence below, developed by physical and yoga therapist Emily Large, emphasizes both the contraction and the release of the hip adductors, pelvic floor, and transversus abdominis, which helps create pelvic stability. Practice daily until you notice an improvement.
Lie on your back with your knees bent, feet slightly apart. Place a yoga block (at its narrowest width) between your knees. Inhale deeply. Exhale, and seguentlally begin sgueezing your knees into the block with your hip adductors, lifting the pelvic floor up, and pulling the transversus abdominis toward your spine. Keep your feet and back on the floor; the lumbar curve may flatten slightly. On an inhalation, seguentially relax the transversus abdominis, and release the pelvic floor and hip adductors without dropping the block. Repeat 8 times.
Supta Baddha Konasana (Reclining Bound Angle Pose)
Start in the same position, but this time with your feet together. As you inhale, relax the pelvic floor, transversus abdominis, and hip adductors and let your knees drop open to the sides. Exhale and bring your knees up to the starting position while lifting the pelvic floor and pulling the transversus abdominis in. At the end of the exhalation, briefly accentuate the muscular contraction. Repeat 8 times.
(Two-Footed Pose) Place your feet hip-width apart and close to your buttocks. As you inhale, push down through your feet and lift your hips, keeping the transversus abdominis and pelvic floor relaxed and soft. Exhale and slowly lower your hips back to the starting position while you lift the pelvic floor and pull the transversus abdominis firmly inward. Repeat 8 times.
(Reclining Wide-Legged Hand-to-Big-Toe Pose), variation Lie perpendicular to a wall with your legs raised and your buttocks against the wall. Inhale and open your legs wide as you relax the transversus abdominis and then the pelvic floor. As you exhale, lift the pelvic floor, contract the transversus abdominis, and bring your legs together, sgueezing your knees together at the end of the breath. Repeat 8 times.
(Legs-up-the-Wall Pose) Still at the wall, place a bolster under your buttocks and let your upper back and shoulders drape onto the floor. (Scoot back from the wall If your knees want to bend. If your legs are rolling outward, use a strap just above your knees to keep them stable and aligned.) Relax all effort and allow the transversus abdominis to soften and the pelvic floor to release completely. Simply observe your breath and the Interplay between diaphragm and pelvic floor.
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