Controlling Incontinence

I am a 29-year-old woman with incontinence. Are there any poses that can help manage this problem?

By Jaki Nett

—via e-mail

Jaki Nett's reply:
The two most common types of incontinence are stress incontinence and urgency incontinence. Stress incontinence occurs when a small amount of urine leaks out after internal pressure quickly builds, such as when one sneezes, coughs, laughs, or lifts a heavy weight. Urgency incontinence happens when the body signals its immediate need to release urine without the usual build-up warning.

Although urination is somewhat voluntary, the actual act of urination is a reflex action. When the bladder signals its need to void, the urinary sphincter relaxes and the muscles in the walls of the bladder contract, forcing out its contents. One of the best ways I know of to help alleviate incontinence is to improve the voluntary control of your urinary sphincter. You can accomplish this by increasing your conscious awareness in this area of your body.

Here's an example of how to do this using Utkatasana (Chair Pose). Stand in Tadasana (Mountain Pose) with your feet together. Align the center of your legs and bring them together as though they were zipped to each other. Align the pelvis and the torso so the center of your head is in line with the center of your pelvic floor. On an inhalation, raise your arms into Urdhva Hastasana (Upward Salute) in line with your ears, palms facing each other.

Keeping the arms straight, interlace the fingers; on an exhalation, turn the palms to the ceiling and fully extend through the arms. Soften the lower back ribs and take several breaths. Keep lifting the arms and torso upward, and on an exhalation, slowly bend the legs deeply. The heels should be grounded and the feet, knees, and inner thighs together. As the legs are bending, soften the back ribs more and open the lower spine. Then slowly rotate the pelvis backward. Stop the movement of the pelvis when you feel a soft contraction in the pelvic floor.

Remain in this position and direct your attention to the lower abdominals, right above the pubic bone; softly pull them toward the back of the pelvic bowl. Now try to softly contract the urinary sphincter as if you're trying to stop a urine flow. Hold for several breaths, then release. Repeat several times, stopping at the onset of fatigue in the pelvic-floor muscles. Practice this regularly and you should gradually gain awareness and conscious control. From personal experience, I am happy to report that regained voluntary control is a wonderful thing.

Jaki Nett is a certified Iyengar Yoga instructor in St. Helena, California, and a faculty member of the Iyengar Yoga Institute of San Francisco. She teaches public classes in the San Francisco Bay Area and leads workshops in the United States and Europe, including specialty workshops on female issues.

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