Are you Engaging your Mula Bandha Correctly?

Ruth Jones, MCSP, PhD student Southampton University UK, and Stanford University California USA, has been conducting cutting edge research on the Pelvic Floor Muscles (PFM), also know as Mula Bandha in the context of Ashtanga Vinyasa Yoga. She also happens to practice regularly at the studio where I practice so we were thrilled when she offered to contribute her latest findings! – Ed]

You will know the importance in your Yoga practice to engage your Pelvic Floor Muscles (PFM) or mula bandha, but did you know that the PFM have other functions such as contributing to spinal stability, pelvic organ support, urinary and faecal continence, sexual function and performance? What a great group of muscles to keep working well! And how do you know that you are contracting the PFM effectively when over 30% of the female population contracts incorrectly at their first attempt? We do not have the statistics for men, yet it would not be far fetched to suggest that the percentage could be higher. Or am I just biased?

Here is what I will cover with this article:

  • The basics of Pelvic Floor Muscle anatomy and physiology
  • How to correctly engage the PFM
  • How to incorporate it into and outside your Yoga and Pilates practice

Pelvic Floor Anatomy

It’s not just all about the muscles: the Pelvic Floor is actually a complex structure made up of muscle and fascia. It can be divided into three sections: the fascia, the levator ani muscles (PFM) and the superficial sphincters/perineal muscles.

The fascia gives attachment to the PFM and surrounds the muscles and pelvic organs. Sometimes there can be a tearing of this fascia and the supporting ligaments which gives rise to Pelvic Floor disorders such as incontinence. It won’t matter then if the PFM are strong and contract at the right time, someone may still have incontinence because the bladder or urethra (figure 1) is not supported in the correct anatomical position.

figure-1.gif

Figure 1. Schematic Diagram of the PFM and organs.

The levator ani is the collective name given to the PFM (figure 1 and 2) and is sometimes divided into the Pubococcygeus, Puborectalis, Pubovaginalis and Iliococcygeus. The Pubococcygeus arises from each side of the front of the pubic symphysis (midline joint), and passes around the urethra, vagina (in women) and anus to insert onto the coccyx. As you can tell from their names, the Puborectalis is the name given to those muscle fibres that loop from the pubic bone around the rectum and Pubovaginalis from the pubis around the vagina. The Iliococcygeus originates from the right or left Ilium on the pelvis and attaches to the coccyx.

figure-2.jpg

Figure 2. 3D MRI reconstruction of Female PFM
Reprinted with kind permission of Lennox Hoyte

The Superficial Perineal muscles are as their name suggests superficial or less deep than the levator Ani and are thought to have an important role in sexual activity. They all insert and meet at the perineal body, which is almost like a central tendon between the anus and scrotum in men and anus and vagina in women. The external anal sphincter encircles the anus, attaches in the front to the perineal body and behind to the coccyx.

The nerve supply to the Pelvic Floor is mainly through the Pudendal nerve originating from the 2nd to 4th sacral nerve roots. Have you ever noticed little girls or boys walking/bouncing on their tip toes when they want to go to the toilet? This is because the nerve supply to the calf muscles has a similar origin as the PFM, and by contracting the calf muscles, there is a reflex response of the PFM and the bladder contraction is quietened down. So if you ever find yourself caught short, go up and down on your toes vigorously and it’ll give you a few minutes grace. On that note, have you ever been sitting down for a long time, for example on a car journey, get up or out of the car and are suddenly desperate to go to the loo? Again, the skin at the back of your legs has been stimulated whilst you have been sitting down, and this stops the bladder from contracting too strongly. Once you stand up, that reflex inhibition is lost! So if you don’t want to be caught short gain, try contracting your PFM (see below) before you get out of the car.

The muscles of the PF have both slow (type 1) and fast (type 2) twitch muscle fibres, but since the role of the PFM is mainly to provide support over a sustained period of time, they are predominantly type 1. This is important to remember within your yoga (or Pilates) practice. Towards the end of your practice, especially if you have been contracting them too hard, they are going to be more fatigued. So if you develop awareness of these muscles, feel when they can no longer lift and hold, and perhaps call it a day with your practice…until the next time!

Guidelines for activating the PFM

These are the guidelines I use to assist people to activate their PFM (or Mula Bandha):

  • Imagine your PFM as a sling that attaches from your tail bone at the back (sacrum and coccyx) to your pubic bone at the front.
  • Now take a breath in, and as you breathe out, gently squeeze the muscles around your back passage, as if you were trying to prevent wind (gas/flatulence) escaping.
  • Bring this feeling forward (remembering the muscular sling) towards your pubic bone as if you were trying to stop yourself from urinating (having a pee).
  • Keep holding this contraction as you imagine that you are on the ground floor of an elevator, you want to lift your PFM as if you were going to the 1st, then 2nd 3rd etc floor.
  • Keep breathing as normally as you can, whilst holding onto your PFM. Aim to hold for 10 seconds, before releasing your PFM.
  • Repeat up to 10 times, breathing normally.
  • Remember to release all the way back to the ground floor, as holding on too much may be as much of a problem as not being able to hold onto them at all.

Also, you may have noticed that your abdominal muscles were also engaged as you pulled in your PFM. This is perfectly normal as long as you do not tilt your pelvis or hold your breath as you do so. In yoga the abdominal muscles activating is part of the Uddiyana Bandha (the abdominal lock), and the Mula Bandha is almost always activated at the same time as that lock.

As I said earlier, many people do not activate their PFM correctly when first asked to do so. Without being examined, we cannot tell for sure whether you’ve got it “right”. Having said that, below are some tips to make sure that you are not activating too much of the incorrect muscle groups:

  • Many people bear or push down when they try to activate their PFM, as if they were straining to go to the toilet. Remember to squeeze and lift, as described above, rather than pushing down.
  • Keep your buttock cheeks (bottom muscles/butt), inner thigh, and leg muscles relaxed.
  • There should be no movement of your spine or pelvis as you engage your PF or abdominal muscles.

Timing of Contraction: It seems that the timing of contraction is as important as strength of PFM contraction. In women who do not have a Pelvic Floor Dysfunction, there is a small PFM contraction before they cough, or raise their intra abdominal pressure. It appears that this pre-contraction is lost in women who have Stress Urinary Incontinence. It maybe the case that this loss of pre-contraction is also lost in other women with prolapse of the pelvic organs, so encouraging them to also do a pre-contraction seems logical. There also seems to be a correlation between Pelvic Floor disorders and back pain, although we have a good idea why this is. So if you get back pain, or if you have noticed that your PFM are not as they used to be, whether due to childbirth, high impact sports such as trampolining, or just aging, its a good habit to contract your PFM just before you cough or sneeze, lift anything heavy, or even just bending over, as well as contracting your PFM as described above twice a day.

Tips from the clinic to bring your PFM into your Yoga practice

As I have previously said, it’s not all about strength: letting go fully, timing of contraction, endurance and anatomical position of your pelvic organs are all important aspects of good PFM function. So what to do in your Yoga practice? From what we know about PFM physiology to date, these muscles are mainly designed for endurance. There is evidence that the end of a workout, these muscles are as fatigued as the rest of your body. So, if you contract them too hard, they are going to tire and it will be difficult to maintain throughout your practice, potentially leaving your spine and pelvic organs vulnerable to strain. We don’t know how quickly they recover either, so just after your practice, especially if you know that you have a PFM disorder, it maybe well worth contracting your muscles before you lift or bend over, as extra protection.

Back to your practice, as a good rule of thumb, I would suggest contracting around a quarter of your maximum effort. Try this now. Contract your PFM, as detailed above, as hard as you can. Let go of that contraction by half, then by half again. You should still be able to feel the lift, but be able to breathe easily from your diaphragm. Frequently people find it hard to do both!

Over time your awareness, the endurance, coordination and strength of your PFM will improve, allowing you to work harder for longer…should you wish! Yoga is a great way to maintain and improve the health of your Pelvic Floor. Imagine looking and feeling as good on the inside as you do on the out!

Ruth Jones February 2008

21 Comments »

  1. stroumfaki said,

    February 11, 2008 at 7:10 am

    I don’t look or feel so hot on the outside.
    Should I stop working on my PFM before it penetrates inside?

  2. adarsh said,

    February 11, 2008 at 5:39 pm

    Great article! Very useful tips in finding and activating the pelvic floor.

    I found the suggestion to contract the pelvic floor at about a “quarter of maximum effort” to be especially helpful-this will help reduce the “bulging bandhas” that we occasionally see around the shala!

  3. Joy Nieda said,

    February 22, 2008 at 11:35 am

    Anyone know why the images from this article are no longer displayed? Images from other postings do appear.

  4. Joy Nieda said,

    February 22, 2008 at 11:36 am

    Images just now appeared! Still puzzled, however, as to why they disappear and reappear.

  5. Free Day, First List « driste said,

    February 29, 2008 at 8:51 am

    [...] and voila. Instant floatage. Well, not completely. But much more controlled than before reading this article. Everything seems easier, from standing poses to jumpbacks. And I can jump into a handstand before [...]

  6. dan said,

    December 17, 2008 at 12:32 pm

    does anyone have Ruth Jones email? I would like to get in contact with her

  7. ruth lovegrove/jones said,

    December 18, 2008 at 3:28 am

    Ruth here

    My email is ruthlovegrove@gmail.com

  8. rocio said,

    January 26, 2009 at 4:04 pm

    thanks a lot, it was really usefull!

  9. ellie said,

    May 20, 2009 at 1:04 am

    Hi, just read this article as I’m trying to find my way around piriformis muscle pain that came on through anxiety. The Master Practice healing system suggests the root lock as a way of relieving stress related back region pain. I am off now to a yoga class for the first time in 10 years and on a journey of stress reduction. This is the best article I have read describing how to do pelvic floor exercises. The inclusion of diagrams shows they are not the mythical process described in Pilates!

  10. cera said,

    October 10, 2009 at 12:16 pm

    Great article! I am confused though about the perineum. Most yoga teachers say you should contract the perineum and don’t mention the levator ani. Am I correct in thinking the perineum just the more superficial muscle to the levator ani, and we should contract both of them in Mula Bandha?

  11. Ruth Lovegrove Jones said,

    October 11, 2009 at 3:59 am

    Thankyou. Yes exactly right, the levator ani are the muscles you “should” be trying to engage. Indeed you should see/ feel a lift of the perineum when you engage your Levator ani muscles correctly. The perineum is part of the superficial neuro-muscular unit of the pelvic floor.
    Hope that helps :-)

  12. Dianne said,

    March 22, 2010 at 1:32 pm

    Does anyone have any exercies they can recommend to avoid having tailbone extraction surgery?

  13. ann said,

    October 28, 2010 at 11:30 am

    I have been practicing yoga for 12 Years and stiil can’t do the root lock.
    tired so many times. You think I should buy the kegal excercise device to find these musles.

  14. neil keleher said,

    September 22, 2011 at 4:33 pm

    Hi, nicely written. Like the fact that you talk about resting too.

    For myself I was thinking that the main muscle to focus on is the pubococygeous.

    Since it attaches between the coccyx and the pubic bone its really easy (or relatively easy) to think of a it directly connecting the two. And since the sacrum (to which the coccyx attaches) can move a little with respect to the pelvis, another way of activating might be to focus on pulling the coccyx towards the pubic bone.

    Since you are pulling in line with the muscle fibers, this will have the same affect as “lifting” but it might also be easier to mentally grasp.

    If you pull the coccyx towards the pubic bone you can think of this action causing the sacrum to tilt back relative to the pelvis, perhaps “wedging it in place.”

  15. Ruth Lovegrove said,

    September 23, 2011 at 1:11 am

    Hi Neil

    Now you can have a technical answer and a practical answer :-)
    Throughout the literature, there still remains lack of consensus regarding the description and terminology of the Pelvic Floor Muscles (PFM). A recent review of the literature revealed over 16 different overlapping terms for different parts of the muscle, (yet the anatomy was found
    to be very consistent amongst different studies). Pubococcygeus itself actually only comprises a small proportion of the levator complex, although clinicians have often referred to the entire pubovisceral muscle as pubococcygeus.

    So if you just concentrate on the coccyx to pubic component, it maybe more tricky to engage the whole muscle and perhaps wont engage the displacement forwards and up. A physio on a recent course I was teaching came up with a great analogy that has been helpful for some of her patients in the way of thinking as the displacement of the PFM like an escalator, …so your starting point could be the coccyx (or back passage) imagine then that PFM contraction starting at the bottom of the escalator, then as you contract the muscle, the pubic bone would be the top of the escalator. The journey between the two positions is one of forwards and up. Try it…see what you think! But yes, really really important to let go too & breathe….

    If youre interested theres a technical (academic) book coming out next month that I’ve co-edited with Leon Chaitow and theres fab section on the PFM….the book is called Chronic Pelvic Pain and Dysfunction: Practical Physical Medicine (Elseveier)

    Thanks for your interest

    Ruth

  16. SPIROS CHRIS said,

    August 31, 2012 at 11:26 am

    Hi!
    my problem is the timing. During Ashtanga practice when is the appropriate time in breathing to engage mula bandha? Inhalation or exhalation?

    Thank you in advance!

  17. ruth said,

    September 11, 2012 at 6:14 am

    Hi Chris
    Sorry for the delay….Change in email address!
    Clinically I get people to contract the pelvic floor on the out breath ie get them to breathe in, breathe out, not breathe then contract the PF then continue to breathe normally (or as long as there is some diaphragmatic movement). This in my experience minimises cheating ie using inappropriate muscle substitutions. Hope that helps

  18. Kathleen Summers MD PhD said,

    September 11, 2012 at 9:04 am

    Great article! For sure, the terminology on this is confusing – even the experts can’t agree.

    I’ve written about mulabandha’s wonderful effects on health here:

    http://theyogadr.com/mula-bandha/

    In the article, I take a look at the original textual sources of this technique in the Yoga literature – there’s confusion there, too! Some yogis think it is one thing and others describe it as something else!

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  20. yisforyogini.com | friday the 13th + freaky, strange, odd yoga { wtf yoga } said,

    May 5, 2013 at 4:14 pm

    [...] See photo above for Inappropriate Yoga Adjustment. Creeper! Do you suppose he told them this was the best way to engage their Mula Bandha? [...]

  21. yisforyogini.com | primal power { 40-day kundalini meditation } said,

    May 6, 2013 at 3:18 pm

    [...] slowly. At the top of the inhale, contract your Mula Bandha (rectum + sex organs). Pull in your navel center. Hold for a [...]

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