Falling Bladder (April 2005)

ORIGINAL QUESTION:

From Sue Chadwick, Ananda Dallas

A female yoga student has had 2 surgeries over the years to lift her bladder. She is practicing some Kegel exercises recommended by her doctor in which one contracts the entire lower area, holds for 10 seconds & releases. She is feeling physical pressure indicating that the bladder is falling & would like to avoid surgery again! She is asking if there are any asanas or yogic practices known to help strengthen the area to keep the bladder lifted.

ANSWERS:

From Beth Hamilton, AYTT Aug 2002 (born and raised in Dallas!)

Dear Sue,

Number 34 - Stomach Exercises of the Energization Exercises came to mind immediately when you mentioned falling bladder.  Also, Cat-Cow warm-up and Setubandasana come to mind.  However, I do not have research to prove that these would help with this specific issue. It seems that strengthening the muscles in the area would be quite beneficial.

Namaste',
Beth

From Susan Hayes, AYTT 1999

Dear Sue

This is Susan Hayes, AYTT 1999, e-mail: susan@mountaintopyoga.com.  I recommend an article (with photos) by Shari Frederickson in last month's Yoga International on exercises to strengthen the pelvis.  It is a good one. We do it every Friday at my studio.  If you can't find it, let me know and I'll send it to you.

Susan

From Clara L. Morgan (AYTT graduate of August 2003)

Dear Sue,

my name is Clara L. Morgan (AYTT graduate of August 2003) and my suggestion is not strictly about yoga postures but something else that can help.

It is the Maya Abdominal Massage that she can receive from a professionally trained physical therapist or massage therapist. She will also learn how to practice the Maya massage on her own abdomen. To learn more about it and to locate a trained health care practitioner in her area, she can go to www.arvigomassage.com(Often, and it would be helpful to find out if it is her case, the uterus is prolapsed too).

The Maya abdominal massage is a very safe and non-invasive way to bring naturally the lower abdominal organs back in place. I do recommend it because it is very easy and effective, I have learned it myself. The physical therapist from whom I learned the Maya massage, said that the Downward-facing dog pose (Adho Mukha Shvanasana) may help. She also recommended not only to contract the pelvic floor muscles during the Kegel exercises, but also to draw them inward and upward.

From Rosemarie Stabback

Sue,

I suggest that you encourage your student to engage Mula bandha (pelvic lock) before entering most poses. I advise my students to aim for a 20 - 25 % engagement, lightly lifting not trying to make a fist. If you contact me at rosemarie_stabback@hotmail.com I will be happy to let you have a copy of the 1-page handout I give new students on the bandhas; it is not comprehensive but is informative.

I hope this helps.

Regards

Rosemarie

From Stuart Moody

These are fascinating responses.  I am wondering whether any of our health professionals are familiar with the use of yoga for this condition.  Since none of them have responded, I turned to a couple of my yoga texts for some hints.

Stella Weller's "Yoga Therapy" (London:  Torsions Press, 1995) lists many disorders and potentially helpful practices, but falling bladder does not get listed.  For urinary incontinence -- a condition of course related to the bladder -- Weller (a registered nurse in the UK) recommends a number of moves that stretch the pelvic region:  Butterfly, Squatting posture (like the deep version of Utkatasana), Spread-leg Forward Bend, and Ustrasana.   She also suggests twisting poses:  Lying Twist (a feet-on-the-floor, both-knees-bent version of Jathara Parivartanasana), and the Seated Twist (Vakrasana -- a one-knee-bent version of Ardha Matsyendrasana).  Inversions are also recommended: Half or Full Shoulder stand.

We might speculate that the stretches and twists would help in a very general way via the principle of stimulating circulation and restoring sensory-motor awareness in this region.  Inversions might provide temporary relief, and give the body the reminder of where the bladder is meant to be.   An additional pose from Weller's book, the mountain pose (Parvatanasana), might help.  Weller comments that it "improves muscular support of the viscera."  Could Uddiyana Bandha have a similar effect?  As Rosemarie suggests, the specific application of Mula Bandha may also extend the effect of the more generalized Kegel routine that has been recommended to your student.

Eleanor Criswell, in "How Yoga Works:  An Introduction to Somatic Yoga," comments that Matsyasana "slows down abdominal and sexual system degeneration."  Could Cat-Cow and Setu Bandhasana (mentioned by Beth) have a similar effect?

BKS Iyengar, a champion of therapeutic yoga asanas, like Weller, has an index of ailments in the back of his classic "Light on Yoga" (New York: Schocken Books, 1979).  Like Weller, too, he does not list bladder per se, but has a section on "Urine (Dribbling or excessive)".  Perhaps not surprisingly, he makes similar recommendations for this disorder:  the Shoulder stand, Matsyasana, the Butterfly (Baddha Konasana), and Uddiyana.   In addition, he recommends Mahamudra, the Lion, and Nadi Shodana with retention at inhalation and exhalation.  The latter two must work indirectly -- through stimulating the nadis? -- If they truly have an effect.  The Iyengar Institute in India does lots of yoga therapy, and may have much more updated recommendations, specifically geared for your student's condition.

Whether any of these poses can really remedy a falling bladder appears to be still a matter of speculation.  It would be lovely if it were so!  Part of the joy of yoga is being able to do things for ourselves, with our own minds and muscles.  Given the sensory-motor havoc wrought by surgeries, it could be well worth a few months' personal study (steady, intentional practice with careful observation of changes) to see what can be accomplished by the use of consciousness in motion.  In this light, affirmations, as another expression of consciousness, would no doubt assist the process -- uplifting her mood at least, if not her bladder.

Massage may work in a similar manner.  Given the number of conditions that research has shown to respond favorably to deep tissue massage (e.g., decreasing pain, ameliorating fibromyalgia, reducing post-traumatic stress, improving alertness, normalizing blood sugar levels), there may be many more wonderful outcomes of specifically targeted massage such as the Maya Abdominal treatment.

As you can see, we all wish blessings on your student!

Stuart Moody, San Rafael, CA (AYT, Nov 03)