Recently, I attended a yoga class facilitated by an experienced senior yoga teacher. It was a well-rounded class, complete with asana, pranayama and meditation practices. However, there was a key ingredient missing. Lately, I am finding this missing ingredient all too common when I attend yoga classes. The teacher gave no cues to engage Mula Bandha nor the pelvic floor muscles during the core-activating postures and breathing techniques.

Superficially, this point may not have seemed important to many of the students in the class. Although in a predominantly female class, the fact that these cues were missed is extremely relevant to everyone, especially women. It didn’t escape my attention, because I personally know I need all the cueing and awareness I can get to ensure my own personal pelvic floor safety. Despite being a yoga student and yoga teacher with a physiotherapy degree and 27 years of experience in women’s health, I’m still hopeful that my own practice is being safe-guarded and shepherded by my teachers.

These three factors place me, and so many others, in the higher risk population for pelvic floor dysfunction. The fact that I am of perimenopausal age - this being the journey from 35 to 55 years of age in which hormones mount a steady challenge to prepare the body for menopause resulting in a lowering of collagen levels and tissue integrity. The fact that I am employed in a manual profession (physiotherapy and yoga teaching are both manual professions as are jobs that have us working on our feet like nursing, factory working and labouring). The fact that I am a survivor of two traumatic childbirths. Others at higher risk include those with a history of anxiety, obesity, chronic chest conditions and scoliosis.

Pelvic floor dysfunction, according to the International Continence Society, affects up to 50% of the population aged under 60. Rates rise to 60% in over 60s. The International Continence Society also estimates that 38% of the population have incontinence and predict that this is likely to be an under-estimate. As high as 70% of those with incontinence symptoms do not seek help according to the Australian & New Zealand Continence Journal. Hence the under-estimate.

So why is it so risky to engage in core-strengthening practices without our pelvic floor muscles being consciously integrated?

First, let’s explore the Sanskrit term Mula Bandha which is derived from the word Mula meaning root, base, beginning or foundation, origin or cause and source (Yogapedia). Bandha means bondage, fetter, joining together or catching hold of’. Hence, Mula Bandha could be translated as a practice in which one ‘catches hold of source energy.’ 

Iyengar defined Mula Bandha as a posture where the body from the anus to the navel is contracted and lifted up towards the spine. It involves a contraction of the muscles at the base of the pelvis and the lower abdominals or transversus abdominis. In the western scientific sense, the pelvic floor muscles are a sling shaped group
of muscles that run from the pubic bone at the front, to the tailbone at the back of the body. There are 16 muscles in the deep and superficial layers of the pelvis, held within connective tissue and fascial connections. One of the major muscles, pubo-coccygeus, or ‘PC’ our new best friend, contains the urethra, the vagina and the anus in women’s bodies. Hence PC supports the bladder, uterus and bowel and plays an important role in creating stability at the base of the pelvis. PC partners with transversus abdominis for a true Iyengar definition of Mula Bandha.

Mula Bhanda is also referred to as ‘the root lock’, an energetic seal that locks prana (energy) into the body and prevents it from leaking out at the base of the body. Mula Bhanda is also said to move prana up the central channel of the body. (source: http://en.wikipedia. org/wiki/Mula_Bandha).

In other words, Mula Bandha could be considered both an energetic phenomenon, whereby an energy seal is created at the base of the body in order to preserve and capture vital life-force energy - as well as a physical phenomenon, whereby the pelvic floor and lower abdominal muscles are drawn into a contraction that ensures stability, steadiness and safety to the lower back and base of the body.

 Omitting the active, conscious engagement of Mula Bhanda is problematic as it means that any downward and/or inward forces that are placed upon the torso by the respiratory diaphragm or upper abdominal muscles will have the effect of pressing the abdominal organs towards the base of the body, without adequate counter-balance from the pelvic floor and lower abdominals. Put simply, this can be as disastrous as squeezing a tube of toothpaste with the lid not properly sealed. The strain this pressure places on the pelvic floor and base of the body can create weakness leading to incontinence and lower back strain. For some women, this pressure imbalance also means a downward descent of the bladder, bowel or uterus, also known as pelvic organ prolapse (POP) through the vaginal canal (hence the toothpaste tube metaphor). The tendency for this distressing risk to be overlooked may be linked to the fact that many yoga practices were originally taught and designed for the male body, and not bodies with vaginas.

What makes the omission even more distressing is the number of stories I have heard from women during my pelvic floor workshops. Some have shared openly with the class and others have shared with me privately. About the time that they were engaging in an asana class (usually a deep squat or double-leg lift such as navasana) only to experience a spontaneous prolapse. About the worsening incontinence that they were suffering as a result of not being aware of how important daily strengthening to the pelvic floor muscles is, or how to engage Mula Bandha accurately. Or about how the acute or chronic pelvic pain that they have been experiencing due to over-activation of the muscles without an awareness of the importance of release and relaxation to these muscles.

The trauma to women’s bodies, that is ironically and sometimes even unconsciously being experienced every day in yoga studios and gyms world-wide, cannot be under-estimated. For some women, the signs and symptoms will be gradual, and not linked to the fact that engagement of the pelvic floor muscles has not been a habitual part of their activity or daily life. For some women, an irrefutable and acute link is made the hard way, after a chaturanga in which the pelvic floor was not engaged adequately on the exhalation and worsening prolapse symptoms and pain are immediately felt.

Are these points relevant to male bodies, seeing as they won’t be experiencing vaginal prolapse? Absolutely, because men still experience urinary and/or faecal incontinence associated with weak or tight pelvic floor muscles, including the sphincter muscles. Men are also prone to erectile dysfunction, which may respond positively to pelvic muscle strengthening and awareness. Men may also experience rectal prolapse if adequate care is not given.

So how do we ensure that Mula Bandha is being engaged at the right time and place? At the risk of over-simplifying a complex discourse that needs to be applied on a case-by-case basis here is a generalization that may be helpful, That is, we ensure that transversus abdominis and pubo-coccygeus are working in a healthy synergistic partnership with one another. As Iyengar says, the body from the anus to the navel is contracted and lifted up towards the spine. A transversus abdominis contraction can be both isolated and cued as an active drawing of the navel towards the spine. However, this must not occur without synergistically partnering this muscular contraction with a contraction of pubo-coccygeus, which is where the ‘anus (or tail-bone) to the pubic bone area is lifted up towards the spine. And this phenomenon and partnership must consciously happen whenever we are required to ‘switch on the core.’ This includes and is not limited to plank, chaturanga, navasana, deep squats, double leg lifts (from the supine position), uddiyana bandha (belly lock), forward bends with wide legs and strong upper limb weight bearing postures such as crow pose. However, these postures are highly risky in cases where prolapse is already present and must either be eliminated or heavily modified.

It’s also important to note that in the overactive high toned pelvic floor, which is said to be present in 30% of pelvic floor dysfunction, postures that consciously soften and relax the pelvic floor such as reclined baddha konasana, abdominal and yogic breathing and savasana, are equally as important as postures that activate and contract these muscles.

It’s also worth now revisiting the understanding Mula Bandha as a practice that is both physical and energetic for its transformational benefits. A Hindu term used to name the Divine Mother, kundalini shakti is the active and dynamic principle of divine feminine power that lies coiled at the base of the spine. Several yogic practices are available to gracefully awaken this sacred force within, but pelvic floor awareness is a great starting point. As Jivamukti founder David Life so eloquently describes in his article, ‘Mula Bandha: Your Ticket To Infinity and Beyond!’ Mula Bandha is ‘said to cut through brahma granthi, the energetic knot of our resistance to change. He writes, ‘On an energetic level, Mula Bandha allows us to feel, restrain, and then direct our energies toward enlightenment.’ ( https://www.yogajournal.com/practice/to-infinity-and-beyond ).

           If enlightenment is the goal then we are fortunate to have practices to move us closer to this luxury. However, if our goal is to maintain our continence levels as we age, then the pathway to this more humble form of enlightenment is the same. Whether they’re top down or bottom up practices, they lead us to the same destination in the end.