If you are plagued by pain or discomfort down there, these exploratory tools and yoga sequences (no, we're not talking Kegels) can help you either tone or release tension. You won’t believe the benefits—from better sex to walking through the world with more freedom.
As girls, we are exposed to relentless conditioning. We will be told to walk, sit, stand, move, and behave in ways that are appropriate, sexy, ladylike, and motherly. We will even be told which bathroom to use. By adulthood, each of us will carry these ways of being women throughout our body, but we will feel them particularly in the pelvic region, the part of our bodies most deeply associated with our gender. The pelvic region becomes a complex, multilayered storage unit—I call it the original 1-800-MINI-STORAGE—the place where we store the things we can’t let go of but don’t want to deal with right now.
This can lead to health issues that are both emotional and physical in nature. We need to explore and liberate this terrain and take charge of ourselves—openly acknowledge and understand our issues—and skillfully tune in to the healing power of our own bodies. I believe it’s time to liberate your pelvis.
Every Pelvis Has a Story
“Every pelvis has a story” is what I tell my students. My story is this: In 2005, I had already been a yoga teacher for 20 years, so I thought I knew the anatomy and mechanics of “down there” fairly well. But around that time, I began to experience pain and discomfort in this nether region. And then as I worked to figure out why, I realized that much of my knowledge about the pelvic area was abstract, generic, and derived mostly from anatomy books. I didn’t understand the specifics—the muscles housed within it and that entire region’s relationship to the rest of my body, mind, and life history.
I began experimenting with yoga poses and breathing practices to familiarize myself with, and ultimately explore, the many layers of trauma, held emotion, and pain that lay hidden between my hip bones. The more I understood how the intricacies of my pelvis intersected with personal history, cultural conditioning, sexism, anatomy, and symptoms of ill health, the more I began to see how my pelvis was tied to my general well-being—physically, emotionally, and spiritually. It turned out that my pelvic floor muscles were way too tight, but I had no idea why or how that had happened. My exploration turned into an investigation of the factors that shaped me, such as my postural, sexual, and medical histories; my struggles with body image; and the influence of relationships, family, advertising, media, and movies. Bringing the story of my pelvis to light became a key component of my evolution as a human being. From there, I eventually developed a yoga protocol that formed the cornerstone of the pelvic-floor workshops I now teach around the world.
Many people with pelvic issues attend my workshops after having tried a number of different approaches to deal with them, often consulting first with their general practitioner, then a gynecologist, then a urologist. They may have tried Kegels, other muscle-building exercises, or even antidepressants. Some have reached a point where they are considering surgery. Let’s look at this scenario: A woman in her mid-40s starts feeling pain during intercourse. Her doctor recommends using more lubricant, but that doesn’t help. She visits a gynecologist who can’t diagnose a reason for her painful intercourse. She starts to read about the issue on the Internet, which offers exercises that may solve the problem. She does the exercises but they don’t help. She starts to wonder if her symptoms are psychosomatic and seeks a psychotherapist . . . The list goes on.
Each of the approaches above (allopathic medicine, exercise, counseling) has its merits. But for many women, yoga is the last resort. I’ve worked as a pelvic-floor yoga teacher for over 12 years, so I say this with absolute certainty: Yoga should be the first resort. Here’s why. Practicing yoga cultivates self-awareness and sensitivity toward your body; it isn’t just another set of exercises you do. Yoga fosters subtle observation and awareness of your body’s mechanics and energetics. It gives you experiential insight into the unique form and shape of your individual embodiment. It allows you to understand what is happening as it is happening, and it gives you the tools to adjust your practice to constantly fluctuating conditions, moment by moment. It is one thing to have a general conceptual understanding of the anatomy of muscles; it’s something else to be able to locate, sense, and work with the individual muscles in your own body.
Body awareness is key to properly diagnosing ailments. No doctor in the world will be able to tell you what it’s like for you to feel pain or tension or relief or any other sensation; this is information only you can access. This type of insight is critical to making a proper diagnosis. Yoga combines external conceptual knowledge with the internal experiential understanding that only you can access. Yoga is empowering. It empowers you to take an active role in your own healing rather than handing over responsibility to a doctor or someone else. It encourages and supports you to see for yourself. After all, it is your body, and you should not blindly give up control. You hold primary authority over your body, and you need to exercise that authority by exploring, observing, and learning about yourself. Yoga helps you shed your self-imposed states and empowers you to emerge, to mature, and to take responsibility for yourself.
Is Your Pelvic Floor Hypertonic or Hypotonic?
These are two conditions that can cause a fair amount of pelvic pain and discomfort. To assess if you are dealing with either, here are some informal diagnostic tools.
A little sitting-bone massage is an ideal way to develop greater awareness of this area. In any seated position, lean onto your left buttock so that the right sitting bone is easily accessible (you can also do this lying on your side). With one hand, find the tip of your right ischial tuberosity, a.k.a. sitting bone. Using the sitting bone as your landmark, begin to massage the muscles just on the inner edge of the sitting bone, toward the vulva. Massage a little toward the front and a little toward the back. Are there are any tender or tight spots in the corridor between your vulva and the bone? Is there any pain? Take note of the density of the muscle around the bone. Is it firm, hard, squishy, tense? Does the area have any “give”? Continue for one full minute.
Now sit back on both sitting bones and observe the difference between the right and the left sides.
• Has anything changed as a result of releasing muscular tension on one side?
• Does the right sitting bone feel lower on the seat? Is there a sense of more space around the bone?
Now take a few deep breaths and shift your attention to breathing sensations.
• Does the right side of your body feel more spacious as you inhale?
Repeat on the left side and notice any differences.
Where you notice tightness and soreness is where you might be hypertonic.
Basic symptoms of a hypertonic Pelvic floor
• Pelvic pain
• Urge incontinence: strong immediate feelings of needing to urinate, without leakage
Basic symptoms of a hypotonic Pelvic floor
• Stress incontinence: leakage that often happens without any forewarning
Both a hypertonic and hypotonic pelvic floor can often be effectively remedied with yoga.
Yoga provides a complex and nuanced set of tools you can fine-tune to address your specific circumstances in a noninvasive, holistic way. As you practice the poses on the following pages, I encourage you to pay attention to the specific energy each of them carries. Poses are often experienced as calming, invigorating, focusing, heating, cooling, and so on. When you understand the energy of different poses and how they affect you, you can use this knowledge to energize, balance, and calm your life; to challenge yourself; to cultivate greater sensitivity and compassion; or to simply enjoy a richer and much more complex range of sensations and emotions.
Some of the poses in the sequences build strength and help you find and contract muscles. Some lengthen muscles, while others soften muscles. Some focus on the breath. I have separated the poses into two categories to address hypertonicity and hypotonicity. The poses are presented from easiest to more challenging, but not in a specific sequence for a particular symptom. Hopefully you have done some exploration and you know whether you need to do the poses for a hypertonic or hypotonic pelvic floor. Remember, if you are a combination of both hyper- and hypotonic, you need to address the tight muscles first. Getting chronically tight muscles to let go can sometimes happen rather quickly or in some cases may take up to a year (that is how long it took mine to let go).
Practicing alone and in a quiet space can open you up to continual inquiry: What am I feeling? How is my breath? Where do I feel movement created by the breath in each pose? Remember that some yoga postures are more difficult to maintain than others. Be patient with yourself. If you are feeling tired after practicing some of the more challenging postures, switch to practicing supported Viparita Karani (Legs-Up-the-Wall Pose) or supported Supta Baddha Konasana (Reclining Bound Angle Pose) for 10 minutes. With practice, you should find it easier and more relaxing to assume and maintain all of these postures. The heart of practicing yoga postures is to train your nervous system to be calmer, even in a physically challenging pose. Your breath will always let you know if you are doing too much.
Hypertonic Pelvic-Floor Sequence
After a week, gradually add these poses
See also Understanding Your Sacroiliac Joint
Hypotonic Pelvic-Floor Sequence
After a week, gradually add these poses
See also Understanding Your Tailbone
About the Author
Teacher and writer Leslie Howard is an internationally acclaimed yoga educator who pioneered the growing field of yoga for pelvic health. Sonima.com named her one of the top 50 yoga instructors in the United States. University of California–San Francisco medical studies have scientifically demonstrated the effectiveness of Leslie’s techniques for improving women’s pelvic health. Learn more at lesliehowardyoga.com. Model Lenore Kitani is an Iyengar Yoga teacher and physical therapist in Boulder, Colorado.