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Exercise & bladder symptoms

Published on 13th Octover 2020

No, exercise is not a miraculous cure for everything, and doing 10 yoga triangle poses a day will not solve all your problems. But yoga does other useful tools to keep your pelvic floor and bladder healthy.
After being diagnosed, did you jump on a computer or phone to search ‘MS symptoms’? I certainly did. That was 20 years ago, and there wasn’t as much info available then but there was still enough to scare me.
I remember, for example, reading that about 80% of people living with MS will at one stage experience bladder problems. At the time, I was regularly standing in front of an audience, lecturing or doing presentations, and started to imagine all possible catastrophic scenarios.
Fortunately, there are a whole range of treatments available, from medication to nerve stimulation or biofeedback. Most hospitals now offer continence advisory services to help you choose.

What about yoga?
I often work with clients who experience urinary problems, and I would be misleading you if I were to say that yoga solves them all. It doesn’t, but – as research shows – yoga can be safely and effectively used as an additional care, and it can help maintain a healthy bladder.
The key yogic practises to master are ashwini mudra (horse gesture), vajroli mudra(thunderbold attitude) and moola bandha (root lock). If practised regularly, they help to tone the pelvic floor – which supports the bladder and bowel, and uterus in women- and to engage the key muscles when needed.  
According to Moola Bandha: The Master Key, ‘By regular practise of moola bandha the area in the brain associated with the perineum will develop so that one may gain complete control over such processes as urination, defecation and sexual intercourse.’ (1)
The challenge is twofold:
– to become aware of the key muscles 
– to control them.

The perineum
Even though you might not be a fan of anatomy, having a clear picture in your mind of the basic structure of the perineum is really helpful. The perineum is a group of muscles which extends the entire length of the pelvic floor. It is divided into two groups:
– those of the anal region, at the end of the gastrointestinal tract
– those of the urogenital region, around the urinary and sexual organs.
The same way as the third and fourth tows are joined by fibrous tissue, the two groups of muscles in the perineum are also interrelated. This means that it is difficult to move one without moving the other. That is what moola bandha practise will help you achieve!

Practising moola bandha
At the physical level, practising moola bandha means activating and engaging the perineum muscles and the space between the genitals and the anus. The best is to really give it a try now. Are you ready?  Let’s take it one step at a time! I recommend you read one step, do it, and then move to the next one. There are 5 steps.

1: Sit tall in a comfortable position either cross-legged or on a chair. Close your eyes and gently breathe in and out through the nose for 2 minutes. 
2:  Draw your attention to the lower pelvic region, and as you breathe in, contract the whole pelvic floor: the urinary system, genitals and anus. There should be no tension in any other part of the body. Hold for 5-10 seconds and as you breathe out, relax. Repeat for 5 rounds.
3: As for step 2 but this time only contract the anal sphincter, as if to stop passing gas. This is ashwini mudra. Repeat for 5 rounds.
4: As for the previous two steps but this time, only contract the urethra, as if to stop the stream of your pee. This is called vajroli mudra but you might know it as kegel exercise. Repeat for 5 rounds.
5: As for steps 2 to 4, but this time, as you exhale, gently lift the space between the genitals and the anus. This is moola bandha. Repeat for 5 rounds

At the beginning, it is very difficult to fully control the various muscles separately. It doesn’t matter. Just keep drawing your awareness to each specific area and keep practising. Slowly build up until you can repeat 25 rounds. Once you become more familiar with this practise, you can also start integrating it into your yoga practise (2). This will help you find strength and stability. For those of you attending a yoga class, I would highly recommend you talk with your yoga teacher too.

Don’t give up!
There’s no secret: you won’t notice a difference unless you practise regularly. In one of the research projects showing the benefits of yoga for bladder dysfunction (3), participants practised 2 hours a day for 21 days, including some breathing exercise, moola bandha and deep relaxation!
I can hear you say: ‘I can’t spend two hours a day doing this!’  So, what about joining me for Moola bandha tea breaks? 
Yes, you got it. Once you’re familiar with it, you can secretly practise moola bandhaduring the day, for instance each time you make a cup of tea, even in the office. Nobody will notice!
Please don’t hesitate to contact me if you have any questions!

(1) Swami Buddhananda, Moola Bandha: The Master Key. Bihar: Yoga Publications Trust, p.17. Note that there are other physical but also emotional benefits to practising moola bandha
(2) Especially when doing Tadasana (mountain pose), Utkatasana (chair pose), Trikonasana (triangle pose), Malasana (squat pose), Viparita Karani Variation (legs up the wall pose), and Savasana (corpse pose). 
(3) The results showed a significant improvement in post void residual urine (62%) – which is the amount of urine retained in the bladder after urinating-, as well as urinary frequency (25%), incontinence impact (33%).

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