5 Misconceptions About Using Yoga to Navigate Vaginismus
Just a few years ago, when I was starting my own exploration into vaginismus, there wasn’t nearly as much information about pelvic health in the public realm. Since then, an explosion of pelvic floor related content has emerged on the internet, including how yoga can alleviate vaginismus and other pelvic floor concerns. While much of it is helpful, it’s important to keep in mind that we all have specific needs that might not be addressed with generalized content, and that practices can go much deeper than what can be shown in a 30 second clip. With that, here are five things that might be overlooked if you are thinking about using yoga as an approach to vaginismus.
The postures that might help your pelvic floor the most might not be the postures you commonly see on Instagram or YouTube.
When I first began physical therapy to support my vaginismus, I also started a journey down the pelvic floor PT internet rabbit hole. The postures that my internet sleuthing revealed would support my pelvic floor all had one thing in common: hip opening. Malasana (squat), ananda balasana (happy baby), utkata konasana (goddess pose), ardha kapotasana (half pigeon) and other hip opening postures are popularly touted as yoga’s answer to how to support the pelvic floor. These postures can be helpful in opening the hips and inner thighs, which may be contributing to pelvic floor dysfunction, but they aren’t the only support available. Many of these postures close off the pelvic diamond, or the space between the pubic bone, coccyx (tailbone), and sits bones. This is a space that many of us with pelvic floor dysfunction close off through clenching or improper glute engagement. If this is our case, we may actually need postures that keep that space open and support the outer hips vs. the hip openers that commonly grace our screens. Virasana (hero’s pose) is an easy place to start. Parighasana uttanasana (gate pose with a forward fold, also known as half child’s pose) is another option that can simultaneously open the inner and outer thighs while keeping the pelvic diamond open.
Similarly, if you’re anything like me, a tight psoas might have been impacting your alignment, restricting your breathing and impacting your pelvic floor, so working on postures and techniques to alleviate that tension could be key. You might also have chest, throat, or jaw pain that is correlating to pelvic tension, and working on releasing those spaces can support what’s going on lower on your chain. Conversely, you might have tension in your feet or misalignment in your ankles or knees, causing your pelvic floor to do the work of those foundational spaces.
Working with a PT or experienced yoga teacher to explore the specific needs of your body can be helpful in determining which postures might be right for you.
Yoga postures are not always about flexibility.
I started in-person pelvic floor physical therapy very confused. To be fair, I think my first PT was a little confused by me too. A lot of the typical exercises initially given to people with a hypertonic (tight) pelvic floor are stretches for the glutes and inner thighs. The problem here? I had been a dancer in my youth, then an active yoga practitioner. Stretching for flexibility and relaxing into those postures was not an issue for me. That is, until I realized my focus in each position needed to shift not to my glutes or inner thighs or hip flexors, but to my pelvic floor. Because I mostly felt so much comfort and ease in these positions, I never thought too much about them in my yoga practice. I instead had to see them more akin to the challenging standing or balancing postures I would encounter in a yoga class like anjaneyasana (crescent lunge) or garudasana (eagle)— my drishti (gaze, focus) in a standing balancing posture had to be strong in order for me to keep my balance, maintain the posture, and reap its benefits. In postures where we are lying down or seated, our drishti can turn inward because our need for stability by orienting ourselves externally is lowered. Instead, in each of the postures I was prescribed, I needed to strengthen my gaze toward my intention— that meant initially focusing on relaxing my pelvic floor, breathing into my lower back, and later adapting my pelvic floor to my breath.
This concept was emphasized by an occupational therapist I later worked with. She made the keen observation that if pelvic floor dysfunction was based solely on flexibility, a lot more folks would have issues with it, given the average fitness and flexibility level of the population. Additionally, due to shifts in how I currently exercise and care for my body, my flexibility is at an all time personal low, yet my pelvic floor is probably the healthiest its ever been.
Interested in yoga practices that can support vaginismus and other pelvic floor dysfunction? Check out Yoga for Vaginismus on YouTube.
Sometimes using yoga for pelvic health is about building strength.
Even though my inner thighs and glutes seemed to be doing okay on the flexibility front, I often felt like my hamstrings and hip flexors were tight and needed to be stretched. Sometimes my lower back would feel strained, too. I would try lunges and forward folds, but even though I might feel immediate relief, nothing seemed to help long term. Through PT, additional yoga trainings, experimentation, and some googling, I realized the strain I was feeling in my hip flexors and hamstrings wasn’t due to lack of flexibility, it was due to lack of strength. I relied on other muscle groups to do the work of these areas, and actually needed to ease up on the stretching. This was all having an impact on my pelvic floor function— I was clenching and tightening certain muscle groups to maintain stability because the parts of my body that were supposed to be doing that work weren’t doing their job.
For me, that meant focusing more on outer glute and outer thigh engagement in postures like lunges and warrior series. That often meant shortening my stance in split leg standing positions so I could focus on stability and strength rather than deepening my lunges to stretch my hip flexors. I also had to stop going into my deepest stretch when it came to hamstrings, taking a more yin-style approach to relaxing and softening into postures rather than striving for flexibility.
Interested in yoga practices that can support vaginismus and other pelvic floor dysfunction? Check out Yoga for Vaginismus on YouTube.
Yoga isn’t just about physical poses.
After plateauing in my progress with PT, I ended up taking a break from a physical approach to vaginismus. First I focused on therapy, then during the pandemic, went on a journey of all things self-help— from journaling and self reflection to the science of behavior change and manifestation, to energy healing practices like Reiki and chakra work, to super intense breath work practices that left me exhausted. You name it, and short of psychedelics, I probably tried it. It wasn’t until much later that I realized that the concepts that were most helpful in unraveling the patterns that were keeping me tense in my body or prohibiting me from taking action on my health were concepts that are at the forefront of yoga philosophy, I just hadn’t been paying attention. Those patterns are known as samskaras, or the mental loops or habitual patterns we develop over our lives. Identifying and deconstructing them was key to freeing up tension in my body and removing roadblocks to positive habits. Examples of this include moving from frustration and anger at my body and myself to a place of patience and love— this is present in ahimsa, the concept of non-harming; learning to speak up and be honest with partners, medical providers, or frankly, any human I encountered in my daily life is satya, or truthfulness; being present and not spiraling about my past or future is santosha, or contentment; learning to focus on myself and my own needs, and letting go of others expectations or my own expectations of other people or situations is aparigraha, or non-possessiveness. The list goes on.
Practicing yoga doesn’t mean you must forgo Western medical advice or procedures.
I’ve definitely been through my own journey of being that girl who wants to take a more natural approach to my health and avoids Western medicine all together. Now, I’m in a more balanced place. I’ve learned to take advantage of the gifts of modern medicine and to listen to my body to know when a treatment being suggested feels truly wrong for me vs. uncomfortable or scary but something I should move forward with.
We see a more intense version of this journey mirrored in the Baghavad Gita, a super old Hindu scripture that explores different paths of yoga. In the Gita, our hero Arjuna is put in quite a predicament. A peaceful fellow, he is forced into the decision of whether to go to war against family and members of his community after violence has erupted in his land. The Gita is his story of navigating his principals to make the decisions that are aligned to his responsibility to himself and his people, in conversation with his charioteer, who spoiler alert, turns out to be God. He has to make some tough calls, some of which go against who he thinks he is. It’s an allegory for navigating the challenges of putting our principals into action in the context of the external world, and helps us to realize that sometimes the hard decisions, or the ones our egos don’t want to make because of who we think we are or how we identify, are the right ones for the situation.
I’ve heard plenty of stories from women who were against Western medical practices, had strong notions of how they wanted to navigate a health situation, and ended up in an emergency situation where they had to rely on Western medicine to make it through. Conversely, I’ve heard stories about an over reliance on Western medicine, and how health issues only went away after some hard lessons had to be learned about self care. These stories are different sides of the same coin; the answers to what, where, when, and how to go about making decisions for ourselves often lie somewhere in between rather than on the edges, and that is what yoga philosophy can help us navigate.
The teachings and benefits of yoga span the physical, mental, emotional, and spiritual, making it an excellent tool for those for whom vaginismus needs a more holistic approach.
If you’re struggling to navigate vaginismus through exercise and dilating alone, and interested in learning more about how yoga asana and philosophy can support you as you navigate vaginismus, sign up for my newsletter through the form below.