Yoga for Urinary Incontinence | Yoga Therapy

The reason I chose to cover this issue is precisely because I am no stranger to this.  I know how it feels and how embarrassing it is, especially when it prevents
SPECIFIC ISSUE
Urinary Incontinence
Urinary-incontinence
Urinary Incontinence (UI) is the loss of bladder control, resulting in urine leakage or heightened frequency in urge to urinate. There are 4 types of UI:
  1. Urge incontinence – small leakage triggering a sudden urge to urinate
  2. Stress incontinence –  small amounts of urine with exertion, e.g. exercise, sneezing, coughing
  3. Overflow incontinence – leakage because bladder does not empty well or blockage of the urethra
    1. Functional incontinence – leakage resulting from medication/physical disability or memory problem,  making it difficult to reach a bathroom
The following yoga therapy program focusses on ‘Stress Urinary Incontinence’.
Most commonly affecting post-birth women, the main causes of SUI are:
  1. Poor alignment
  2. Weak Transversus Abdominis muscles
  3. Childbirth/Episiotomies
  4. Overweight
  5. Chronic constipation /bearing down and straining pelvic floor muscles
  6. Age
  7. Vitamin C deficiency

THE BENEFITS OF YOGA FOR THIS ISSUE (SYMPTOM CONTROL)
For this particular project, the tailored yoga therapy program is not the typical yoga poses/flow series. Applying a yoga therapists knowledge of the human anatomy, this program is designed to help improve the symptoms of stress incontinence by focussing on bringing the body back into alignment and strengthening pelvic floor muscles.
Holy Yoga therapy combines mind, body and spirit aspects to develop a healthy recipe for UI, including:
  1. training the mind  to minimise the ‘just in case’ mentality
  2. exercises to strengthen the pelvic floor muscles and bringing whole body alignment (which brings organs and systems into alignment)
  3. relieving emotional baggage, finding courage and healing of UI through spiritual growth

CONTRAINDICATIONS
1. Hypertonic -> if overly tight pelvic floor muscles. avoid Kegel exercises
2. Post-natal, especially after an episiotomy or perineal tear -> seek clearance from obstetrician on whether you can can exercise (beyond the pelvic floor exercises).
3. Urinary Tract Infection -> whilst finding alignment and yoga can help prevent UTI, it does not cure the infection or inflammation.  Get clearance from medical practitioner before engaging in this type of program during a UTI infection.

4. Functional Incontinence -> this tailored program focusses on those suffering from stress urinary incontinence and may not see any particular benefit for those suffering from incontinence resulting from medication or health issues.

15-30 MINUTE FLOW

1. Modified Cat/Cow
2. Modified Childs Pose
3. Easy seated and abdominal breathing [5 breaths]
3. Differentiated Pelvic Floor Exercise (Start with holding for 8 seconds and build up to 20 seconds over the course of practice)
     a. Engage muscles as if holding in urine (muscles around urethra)
     b. [For women] Squeeze vaginal wall muscles as if sucking from straw
     c. Squeeze anus as if preventing bowel movement
4. Chair pose, hold of 3 breaths [Repeat 2 sets]
5. Yogi Squat/Garland pose -> don’t tuck tail bone [5 breaths]
6. Lying on back,  bent leg lifts (Lift one leg at a time, not both) [Repeat 5 sets]
7. Corpse pose -> Meditation on ‘release’ and ‘God’s love for you just as your are’

SOURCES & RESEARCH

  1. http://www.continence.org.au/pages/what-is-incontinence.html
  2. https://nutritiousmovement.com/utis/
  3. http://www.yogamag.net/archives/1980/joct80/urodis.shtml
  4. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/incontinence-and-continence-problems

*Disclaimer:
These suggestions offered in the Holy Yoga With LoveJosephine yoga classes or therapy programs on www.lovejosephine.com are not intended to replace medical recommendations by your medical practitioners. It is highly recommended and, in most cases, essential that you stay compliant to the treatment advice given by a western medical professional.The suggestions and educational resource offered by Holy Yoga with LoveJosephine on www.lovejosephine.com are meant to be observed and used in conjunction with medical treatment. Neither the therapy programs nor yoga classes are designed nor recommended to replace medical treatment.
The resources offered here are intended to complement and support the medical treatment targeting the specified issue, with the goal of enhancing the well-being of the patient.
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Yoga for Diastasis Recti | Yoga Therapy

As I start to cover all these yoga therapy topics and programs on my blog, I’ve realised I’m uncovering quite a few issues that I face in my body!  I’ve never realised that there were so many issues, if I had to break them down, that I am working through, too.  And more importantly, that I am finding resolve with yoga therapy.  You’ll find in my social media posts that I love my back-bends and boats and planking.  Behind the scenes, I often struggle with ‘stopping’ the practice of backbends to allow for the recovery of my diastasis recti.  Whilst I can’t say I have a complete recovery (closed gap), yoga therapy has certainly helped me bring awareness of my need to ‘strive’.  Take this for example..I know that I need to rest and stop the back-bends to help with my DR.  At the same time, as soon as I feel like the gap is closing a little, I’m in my wheel pose.  And I wonder why I don’t have that strong core I want for my handstands…..All part of the learning.  I totally do not recommend doing what I’m doing.  At the same time, if you’re anything like me, give me a high five.  I know how you feel.
SPECIFIC ISSUE
Diastasis Recti
Diastasic Recti is the thinning of the tissue, linea alba, that connects the two rectus abdominis muscles in the core of the body.  More commonly known as the ‘separation’ or ‘gap’ (typically diagnosed with a gap of around 2.7cm or more) between the abs, occurring more frequently in women who have been through pregnancy although men and babies can also have this.
diastasis_V2_watermark
Diastasis Recti 2

Photo source: http://www.belliesinc.com/mummy-tummy-2/

THE BENEFITS OF YOGA FOR THIS ISSUE (SYMPTOM CONTROL)

For this particular project, there are a number of commonly taught yoga poses that should be avoided to avoid worsening Diastasis Recti (DR).   For the purposes of this project, it isn’t so much about how yoga is beneficial to DR because there exercises discussed in this project are not typical yoga poses.  More importantly, it is the understanding  of the biomechanics of the body that will help us realise which yoga poses or body movements to refrain from doing.
Modern research shows that exercises that activate the transversus abdominis (TVA) muscles is of most benefit to ‘closing of the gap’.  However, in more severe cases of DR, medical practitioners may advise surgery to prevent or treat other more serious forms of dysfunctions resulting from the DR, such as hernia.  When translating this into a yoga therapy program, it would consist of deep breathing with targeted TVA-focussed exercise while drawing awareness to the navel and body’s midline.
Yoga poses to avoid are the ones which stretches of places stress on the rectus abdominis muscles.  Generally speaking, they are poses that require:
  1. back-bending which stretches the midline, e.g. bow, cobra, up dog, camel, wheel and bridge
  2. the head and shoulders lifted off the ground in a back lying position which prevents engagement of the TVA and with increased intensity, causes the belly to protrude, e.g. boat pose
  3. being on all fours with the navel and knees lifted off the ground, which causes the organs to press down into weak abdominal muscles and slows down healing, e.g. downward dog, plank pose, and bear pose
  4. rotating and forward/laterally stretching the upper body and having the arms extended away from midline, which makes it impossible to engage the TVA, e.g. revolved side angle, triangle, low-lunge, half-moon.

CONTRAINDICATIONS
1. Cat pose is one that requires modification to reap benefits for DR and should be carried out with the assistance of a yoga therapist.
2. Lifting and carrying heavy objects is not advisable and applies to yoga with weights.

3. Some practitioners may advise on avoiding abdominal breathing but for the purposes of this project, it is recommended to partake in this breathing technique on the basis that the benefits outweigh the detriments (if any at all).

15-30 MINUTE FLOW

1. Abdominal breathing with each hand placed on respective side of abdominal muscles. Feel the navel expand on an inhale.  Exhale and bring belly button in towards spine on exhale. [Repeat 5 times, drawing awareness to the navel]
2. Seated lateral shifts – In easy seated position, have sitting bones rooted into the ground. Place each hand on respective side of abdominal muscles.  Keeping shoulders and ribcage square and level, shift the upper body laterally to the left on an exhale at the same time pulling belly button into spine.  Inhale and bring upper body back to centre (neutral).  Repeat on the right.  [Repeat for 5 sets]
3. Chair pose – observing spinal alignment and don’t tuck tailbone. Hold for 3 sets of breath and rest.  [Repeat for 3 sets]

4. Belly button pulsing – On inhalation, expand the belly.  Exhale and draw belly button in toward the spine, and then pulse the belly button into spine 5 times.  Rest for 1 belly breath. [Repeat for 3 sets]

SOURCES & RESEARCH

  1. http://breakingmuscle.com/womens-fitness/12-weeks-of-workouts-to-rebuild-after-diastasis-recti
  2. https://fit2b.us/how-to-check-for-diastasis-hd/
  3. http://happyyoganewcastle.com/yoga-for-diastasis-recti-split-abs/
  4. http://www.anadavis.com/ana-davis-blog/entry/postnatal-yoga-and-diastasis-recti
  5. http://www.webmd.com/baby/guide/abdominal-separation-diastasis-recti
  6. http://www.befitmom.com/diastasis-recti.php
  7. http://www.mamanurture.ca/diastasis-recti-yoga-for-abdominal-separation/
  8. https://fit2b.us/how-to-check-for-diastasis-hd/
  9. https://en.wikipedia.org/wiki/Diastasis_recti
  10. http://inspiredrd.com/2013/11/5-exercises-to-heal-diastasis/ 
*Disclaimer:
These suggestions offered in the Holy Yoga With LoveJosephine yoga classes or therapy programs on www.lovejosephine.com are not intended to replace medical recommendations by your medical practitioners. It is highly recommended and, in most cases, essential that you stay compliant to the treatment advice given by a western medical professional.The suggestions and educational resource offered by Holy Yoga with LoveJosephine on www.lovejosephine.com are meant to be observed and used in conjunction with medical treatment. Neither the therapy programs nor yoga classes are designed nor recommended to replace medical treatment.
The resources offered here are intended to complement and support the medical treatment targeting the specified issue, with the goal of enhancing the well-being of the patient.