How to Return Safely to Yoga After Hysterectomy

Yoga after hysterectomy may increase the risk of pelvic floor problems for some women. Learn how some intense abdominal Yoga poses may increase the risk of some pelvic floor problems and discover how to reduce your risk of pelvic floor problems and keep Yoga after hysterectomy safe for your pelvic floor.

Are you keen to return to Yoga after hysterectomy?

Are you now concerned about your risk of pelvic floor injury?

Today’s podcast episode is all about Yoga after hysterectomy.

Please scroll down for links to further reading and transcript.

Welcome to Pelvic Exercises Podcast!

I’m really excited to bring you our first Pelvic Exercises podcast episode.

Many readers have told me that they’re busy and need a quick and convenient way to access our information so this podcast is to help those of you who are time poor and like to listen on the go.

I hope you enjoy this podcast and find it a convenient way to listen to and learn, whether it’s on your morning walk, in the gym, travelling to or from work or going about your daily chores at home.

Pelvic Exercises Podcast has been set up to help you know how to exercise safely, manage your pelvic floor and keep you fit, strong, confident and healthy.

If you have time after listening it would be great if you can leave a quick rating on the show to help other women find it too.

In this Episode

Today’s episode is all about Yoga after hysterectomy, whether it’s right for you and how keep Yoga safe for your pelvic floor.

In today’s episode I’ll be answering a great reader question from Melissa.

Melissa writes:

Hi Michelle! I had a hysterectomy 7 months ago and after reading your article on yoga poses to avoid for pelvic floor safety am wondering if this applies to me? I’m an advanced yoga student and have never had issues with my pelvic floor (surgery was for other reasons). I avoided all yoga for 6 months and am easing back into it but am missing the more advanced classes. My surgeon just said that because I kept my cervix I could do whatever I want. I’ve been doing my kegels everyday since surgery. Thanks! Melissa (Canada)

In answering Melissa’s question I’ll be discussing:

  • Is Yoga after hysterectomy safe for your pelvic floor?
  • How some Yoga poses may increase the risk of some pelvic floor problems.
  • Tips for how to keep your Yoga practice safe for your pelvic floor.
  • A couple of studies that have looked into pelvic floor problems after hysterectomy.

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Links to Further Reading – Is Yoga Safe For Your Pelvic Floor?

Links To Pelvic Floor Safe Exercise Videos And Books Inside Out Book & DVD

References

Swift, S (2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care American Journal of Obstetrics & Gynecology , Volume 183 , Issue 2 , 277 – 285

Brown, J, Sawaya G, Thom DH, Grady D. (2000) Hysterectomy and urinary incontinence: a systematic review. The Lancet , Volume 356 , Issue 9229 , 535 – 539

Full Transcript Expand to view full transcript Compress to smaller transcript view

Welcome to episode 1 of the Pelvic Exercises Podcast. My name is Michelle Kenway and I’m the Physiotherapist behind Pelvic Exercises, a website and podcast to help you exercise safely with pelvic floor problems and strengthen your pelvic floor. You can watch all our free exercise videos and read our information at www.pelvicexercises.com.au

This episode is in response to a great Yoga after hysterectomy question I received last week from Melissa.

So in today’s episode I want to talk to you about Yoga after hysterectomy and whether or not it’s safe for your pelvic floor. I’m going to teach you how some intense core abdominal Yoga poses may increase the risk of some pelvic floor problems. I want to give you some tips for how to keep Yoga safe for your pelvic floor and then briefly touch on two studies that tell us some more about pelvic floor problems after hysterectomy.

You can learn more about today’s show, get a full transcript leave your comments in our show notes at pelvicexercises.com.au/podcast/yoga-after-hysterectomy/

Here’s Melissa’s question:

Hi ...

Welcome to episode 1 of the Pelvic Exercises Podcast. My name is Michelle Kenway and I’m the Physiotherapist behind Pelvic Exercises, a website and podcast to help you exercise safely with pelvic floor problems and strengthen your pelvic floor. You can watch all our free exercise videos and read our information at www.pelvicexercises.com.au

This episode is in response to a great Yoga after hysterectomy question I received last week from Melissa.

So in today’s episode I want to talk to you about Yoga after hysterectomy and whether or not it’s safe for your pelvic floor. I’m going to teach you how some intense core abdominal Yoga poses may increase the risk of some pelvic floor problems. I want to give you some tips for how to keep Yoga safe for your pelvic floor and then briefly touch on two studies that tell us some more about pelvic floor problems after hysterectomy.

You can learn more about today’s show, get a full transcript leave your comments in our show notes at pelvicexercises.com.au/podcast/yoga-after-hysterectomy/

Here’s Melissa’s question:

Hi Michelle! I had a hysterectomy 7 months ago and after reading your article on yoga poses to avoid for pelvic floor safety am wondering if this applies to me? I’m an advanced yoga student and have never had issues with my pelvic floor (surgery was for other reasons). I avoided all yoga for 6 months and am easing back into it but am missing the more advanced classes. My surgeon just said that because I kept my cervix I could do whatever I want. I’ve been doing my kegels everyday since surgery. Thanks! Melissa

Hi Melissa

Thank you for posting your question about Yoga after hysterectomy, this is definitely one of those frequently asked questions.

Melissa it’s great that you’re thinking about the long term safety of your pelvic floor with Yoga after hysterectomy. It’s also great to hear that you’ve been doing your Kegels daily, this is a really good starting point.

Before answering your question I want to mention I personally enjoy Yoga and I’m a big supporter of appropriate Yoga poses matched to individual ability. This information is really to help women like you continue to enjoy your Yoga practice safely.

Yes I think you’re right to ask this question Melissa as there are some potential risks with some Yoga poses for some women after hysterectomy. We’re talking about the risk of two main pelvic floor problems after hysterectomy:

  • Pelvic organ prolapse; and
  • Bladder incontinence.

Problems With Intense Core Abdominal Yoga Poses

Melissa we know that some intense core abdominal exercises can increase the risk of pelvic floor problems such as prolapse or incontinence. You will know that there are a number of intense core abdominal Yoga poses from your own practice.

The problem for the pelvic floor is that when your abdominal muscles contract they create pressure inside your body. This pressure pushes down on your pelvic floor.

Pelvic floor problems can occur when the pressure pushing down on your pelvic floor is too strong for your pelvic floor to withstand.

It’s a little like squeezing a tube of toothpaste. Imagine that the sides of the toothpaste tube are your abdominal muscles and the lid of the tube is your pelvic floor. If you strongly squeeze the sides of the tube the toothpaste comes out. This is the same as when your abdominals contract strongly (like squeezing the sides of the tube) your pelvic floor is forced downwards. If you do this repeatedly or intensely, your pelvic floor can become weak and pelvic floor problems can develop.

This is how pelvic floor problems can potentially result from some of the intense core Yoga poses.

Melissa being a regular student of Yoga you’ll know the types of Yoga poses that involve intense core abdominal contractions for example The Plank (and therefore Chaturanga), V sit and Garland pose all require strong abdominal contractions. There is a list of some of these Yoga poses to be mindful of in the further reading.

The big question for you now that you’ve had your surgery is whether your pelvic floor is strong and supportive enough to withstand this kind of pressure? Especially with repeated pressure on your pelvic floor. Let’s talk about this now in some tips I have for you.

Tips To Keep Yoga After Hysterectomy Pelvic Floor Friendly

So here are a number of tips to help your Yoga exercise after hysterectomy.

Tip 1

First of all know whether your pelvic floor is at risk of injury* this is a key point. Every woman is different when it comes to her individual risks, there’s definitely no one rule fits all women. What are some of the risk factors that make your pelvic floor more vulnerable to injury? We know that previous pelvic floor surgery is a risk factor for future pelvic floor problems so you do have one potential risk factor. Other factors come into play too and I don’t know these details about you especially factors such as how well your pelvic floor is working. It’s fantastic that you’ve been doing your Kegels, keep this up. You also consider your other risk factors such as chronic constipation, being overweight, increasing age, chronic coughing, your childbirth history including the number of vaginal deliveries you’ve had and whether you’ve had any instrumental deliveries such as forceps. All these factors can combine to increase your total risk.

Tip 2

Keep doing your Kegels (pelvic floor exercises) every day. For the benefit of other listeners, if you’re not sure about how well your pelvic floor is working or how to do your Kegels then make it a priority to see a Pelvic Floor Physical Therapist.

Tip 3

Return to Yoga gradually as you’ve been doing. This will allow you to strengthen gradually and change your practice if you do notice any pelvic floor symptoms such as abdominal heaviness, bladder leakage or bulging within your vagina.

Tip 4

Avoid intense core poses and potentially compromising poses such as deep wide squats. It’s really a risk versus benefit kind of decision here for how far you choose to push your body. Just be mindful that your risk of pelvic floor injury may be increased with your surgery and some exercises.

Tip 5

Manage your pelvic floor lifestyle risk factors by managing your body weight, not smoking, avoiding high impact exercises, avoiding constipation and never straining to empty your bowels.

Tip 6

Know the potentially unsafe Yoga poses that might increase your risks of pelvic floor problems. You can read more about Yoga poses to avoid in the further reading.

Tip 7

Stop any Yoga poses that cause you to experience pelvic floor symptoms and avoid or modify these intense core abdominal poses if you’re tired, unwell or especially if you’re not entirely confident in how well your pelvic floor is working.

What Studies Tell Us About Prolapse And Incontinence After Hysterectomy

Now I don’t want to bore you with lengthy study details here but I’d like to briefly mention what a couple of studies tell us about possible pelvic floor problems after hysterectomy. This is because debate still exists about whether hysterectomy can cause pelvic floor problems.

Studies to date have shown that previous pelvic surgery increases the risk of prolapse but when it comes to prolapse after hysterectomy the evidence is not as clear. One study by Swift (2000) revealed that prolapse was more likely in women with a history of previous prolapse or hysterectomy surgery.

In relation to bladder problems, a review by Brown et al (2000) found that hysterectomy is associated with increased bladder incontinence problems in women 60 years and older and the authors suggest that women should be advised of this risk before their surgery.

Key Points Discussed

So we’ve discussed a number of key points and I’d just like to re emphasise a couple of these main points.

  • The main point is that every woman has her own individual level of risk when it comes to the safety of Yoga after hysterectomy.
  • Some intense core abdominal poses in Yoga can potentially increase the risk of pelvic floor problems in some women and it’s important that women are aware of this.
  • I think it’s vital that when returning to Yoga, you avoid intense core abdominal poses and then progress very gradually matching the intensity of your exercises to how well your pelvic floor is working.
  • Make sure you do your pelvic floor exercises or Kegels every day because when your pelvic floor is working well, you can feel a whole lot more confident in what you can do safely during your Yoga practice.
  • And last but not least see a Pelvic Floor Physical Therapist if you’re not sure how well your pelvic floor is working after your hysterectomy.

Well Melissa I hope this answers your questions and helps you continue to enjoy your Yoga practice.

Thank you so much for listening today. If you’d like to receive this weekly podcast you can subscribe on iTunes or Stitcher. You can find today’s show notes at pelvicexercises.com.au/podcasts/1/ where there’s a full transcript and links to further reading and exercise videos.

Have you had problems returning to Yoga after hysterectomy? Have you had positive experiences returning to your Yoga practice? Have you had any pelvic floor problems with any particular Yoga poses? I’d love to hear your comments on today’s show if you have time to leave them. You can find comments by scrolling down to the end of the transcript in the show notes.

Next week in episode 2 we’ll be talking about prolapse and exercise.

I hope you have an active and healthy week and I look forward to chatting with you then.

We Welcome Your Comments

Comments

  1. Can I ask you?

    I am prolapse (hopefully uterine only) waiting urogynae diagnosis. Stopped yoga, joined YMCA to do cycling like you show! What can I do safely in the gym other than cycling. Upper body etc without pushing pelvic floor in wrong direction.

    I am only doing gentle cycling and some hiking at moment.

    • Michelle Kenway Physiotherapist says:

      Hi Jacqui

      You can do a lot in the gym – start by listening to the podcast on exercise with prolapse after childbirth https://www.pelvicexercises.com.au/podcast/safe-postpartum-exercises/ The same information applies to you and you will see further reading links too. Upper body biceps/ triceps weights need to be manageable weight and preferably done seated. Low dumbbell row is great too. Lags need to be modified mini squat or lunges and bridging with weights is a great pelvic floor safe glute strength exercise. You can also see more here on gym exercises to avoid using this link all the best for getting started

  2. Melissa says:

    Hi Michelle. Thanks for answering my questions! I’m looking forward to getting back to yoga safely thanks to your advice :) Melissa

    • Michelle Kenway Physiotherapist says:

      My pleasure Melissa, I hope you’re doing really well and that you can now enjoy your Yoga practice with confidence, Michelle