Postnatal Yoga – Yoga for Prolapse

20 Apr 2017

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GUEST POST: ANA DAVIS

What a prolapse is and how the right kind of yoga can support a woman’s recovery from this condition.

A prolapse occurs when the organs in the pelvis (uterus, bladder and/or bowel) drop down into the vagina instead of sitting in their normal position. This can cause a heaviness, dragging or aching type of feeling in the vaginal area, which often feels worse at the end of the day, and better in the morning or after lying down. Some women also notice lower abdominal aching and backache due to having a prolapse. A bulge in the vaginal area may also be felt, and sometimes this bulge may actually be felt outside of the vaginal opening. Many women describe the feeling of having a prolapse as “that it feels like everything is going to fall out”.

Depending on what kind of prolapse it is (ie: which organ is prolapsed), a woman may experience incontinence, constipation or an inability to control bowel movements, or sexual dysfunction.

According to a study in the Journal of Prenatal Medicine, pregnancy and vaginal childbirth are the main causes for prolapse: “..carrying the weight of a baby as it drops lower into the pelvic region; labouring to bring the baby through the birth canal, and pushing the baby into the world. All of these combine to weaken the pelvic floor and create conditions for a prolapsed uterus,” says this report. Not only is the pelvic floor weakened, there are other connective tissue structures like fascia and ligaments that help hold all of our pelvic organs in their respective space and place which are also compromised.

A study in the Journal of Reproductive Medicine claims that at least half the women who have had more than one child have some degree of genital prolapse (although only 10-20% complain of symptoms).

The symptoms of prolapse may not exhibit for many women until they are older and postmenopausal. Even though the condition is most common in postmenopausal women who have had children, it can also occur in younger women and women who have not had children.   In addition to the changes in the pelvic floor caused by pregnancy, childbirth and menopause, some of the other causes for prolapse can be a general weakness in the pelvic floor, chronic coughing, obesity and straining to lift heavy objects.

Lisa Fitzpatrick, resident Bliss Baby Senior Lecturer and Physiotherapist offers the following advice: “Managing and healing a prolapse is an opportunity for women to become more in tune with the importance of their pelvic floor and the profound role it plays in supporting continence and core stability in the body. It’s a very common condition and many women suffer from prolapse without even realising, as it can be symptom-free”, states Lisa. A Physiotherapist specialising in women’s health, your GP or a specialist continence nurse are experts at diagnosing prolapse which is more common after vaginal births. A program of exercise and treatment of this condition is essential. Addressing or preventing this condition early on during the postnatal period reduces the risk of it worsening and also supports a woman’s postnatal recovery.”

How can yoga help?

In addition to seeking specialised treatment from her healthcare provider, as Lisa recommends, a woman can also support her recovery from prolapse with the right kind of yoga.

First and foremost it is important to work on gently strengthening the pelvic floor with Kegel exercises and in yoga this means mindfully practicing the pelvic floor lock or Mulha Bandha. Emphasis should be placed on both the subtle drawing up as well as the release and relaxation of the pelvic floor. Try squeezing a block between your upper thighs in Tadasana (Mountain Pose) and other standing postures which helps access the pelvic floor as you focus on drawing the pelvic floor up towards the cervix.

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Practices such as gentle Uddiyana Bandha, the Abdominal Lock, combined with Mulha Bandha, for example in Dandasana (Seated Staff Pose)

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and Janu Sirsasana (One legged Seated Forward Bend) are beneficial. Done correctly these practices promote improved support for the pelvic organs. The abdominal activation in this exercise must be gentle; if forceful it may have the capacity to force the pelvic floor and prolapse downwards.

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Gentle inversions such as Viparita Karani (legs up the wall) and half-shoulderstand, are very good for returning the uterus (and other internal organs) to its correct position.

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Finally, avoid postures that cause a bearing down effect on the pelvic floor which will weaken rather than repair the pelvic floor. For example, the Squat Pose (malasana), Boat Pose (navasana), Plank (modify by weight bearing through knees rather than through feet) and strong forward bends with wide legs – (avoid or modify wide leg forward bends which increase downward pressure in a vulnerable wide leg position).


Ana Davis is Director of Bliss Baby Yoga a specialised Yoga Teacher Training organisation that offers prenatal, postnatal, fertility, women’s yoga and restorative yoga teacher training courses. Find out more here.

 

References

“Postpartum pelvic floor changes”, The Journal of Prenatal Medicine < http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279110/ >

“Genital Prolapse Fact Sheet”, Queensland Women’s Health < http://www.womhealth.org.au/conditions-and-treatments/210-genital-prolapse >

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