by Shelly Prosko, PT, PYT, CPI [bio]
Over the past few years, mindfulness practises have gained popularity in the media. Perhaps it is because of the growing body of research supporting the health benefits of mindfulness or perhaps it is simply because those that practice mindfulness are personally experiencing the value of being present and mindful throughout the day.
Jon Kabat-Zinn, scientist, author, meditation teacher and founder of the popular Mindfulness Based Stress Reduction (MBSR) Clinic and Center for Mindfulness in Medicine, Health Care and Society, defines mindfulness as “the awareness that emerges through paying attention on purpose, in the present moment, and non-judgmentally to the unfolding of experience moment by moment.” There is even preliminary research suggesting the positive and promising effects of MBSR on pelvic health conditions such as urinary urge incontinence (Baker et al 2014), chronic pelvic pain (Crisp et al 2016), and specifically, interstitial cystitis and bladder pain syndrome (Kanter et al 2016). We talk about mindfulness during many activities such as driving, walking, exercising, eating, socializing, etc; so why not also be mindful while going to the bathroom? Yes, mindful toileting!
Being fully present and aware of our body, breath, mind and emotions can potentially help relax the pelvic floor muscles (PFMs) when we perform our toilet duties, resulting in successfully completing our task. We often times are in a hurry and rushing with the attitude of ‘hurry up and just get it over with, I have something important waiting’ or our minds are elsewhere as we are texting or reading, which can be distracting from our present intention of the moment: to empty and eliminate!
These poor toileting habits could contribute to problems associated with not fully emptying the bowel or bladder, or to issues related to a non-relaxing pelvic floor, where the PFMs are over-recruited and not fully relaxing or releasing as they should during voiding. This may potentially lead to or exacerbate a variety of pelvic health issues like irritable voiding symptoms, incontinence, chronic constipation, chronic pelvic pain and low back pain (Faubion et al 2012).
It was knowledge of this information, combined with my training and experience of integrating medical therapeutic yoga with my physical therapy practice and working with patients suffering from pelvic floor dysfunctions who had difficulty relaxing during voiding, that I was inspired to create this brief ‘Toilet Meditation’.
Patients, yoga students and pelvic health practitioners that I have shared this with have seemed to really enjoy it, find it easy to practice and teach, and report its usefulness! It involves 6 stages, using the acronym “AIRBAG” to help you remember!
If you are sitting on the toilet, it is a good idea to place your feet up on some blocks so that your knees are slightly higher than your hips. This position can help enhance your PFMs to relax and allow for proper elimination, particularly for bowel movements. If you are standing during urination, these toilet meditation stages of “AIRBAG” can still be performed:
A = Awareness: become present and connected to your body as best as you can. A brief body scan from head to toe simply observing sensations that you may be experiencing, without judgement, both internally (interoceptive awareness) and externally (such as the sensations at the soles of the feet weight bearing on the supporting surface, or sensations at the thighs as they weight bear on the toilet seat, or how you are holding your arms, or any tension in the jaw or shoulders). You may include awareness of thoughts and emotions, without elaborating on a story or analyzing.
I = Imagination: use your visualization skills to imagine your pelvic floor and the general area of attachments of the PFMs to the inside of the front, sides and back of the pelvis, the tailbone and sacrum. Visualize where the bladder and bowel are positioned and imagine them emptying and that the PFMs spanning across the pelvic floor are healthy and functioning optimally.
R = Release & Relax: let go of any tension in the PFMs as best as you can. Releasing and relaxing these muscles can sometimes be difficult for a variety of reasons. Sometimes ‘trying too hard’ to relax and let go creates even more tension. Be patient and compassionate towards yourself if you have trouble with this. Letting go often takes courage, trust, concentration and practise.
B = Breathe: allow your natural breath pattern to emerge. Sometimes when we try to breathe, we create more tension that results in unnatural patterns that do not serve a relaxed state. As you quietly inhale, the belly will naturally protrude outwards or forward and the pelvic floor will descend. As you exhale, the belly and PFMs will return to their resting positions. During toileting, see if you can simply allow the quiet rhythm of the abdomino-pelvic diaphragmatic breath to happen on its own without trying to change it.
A = Allow: this ‘allowing’ stage is a little more than just releasing and relaxing or allowing the breath to happen on its own. See if you can really give yourself permission to trust that your body knows what to do and when to do it. Perhaps you feel the need to push gently (do not strain) or you feel like you want to take a deep breath, sigh out loud, lean forward, or place your feet in a different position. The more refined your awareness skills are, the more you can trust what feels right, and not always what you think you should do.
G = Gratitude: I think it is a healthy practice to not only be completely present and mindful when toileting, but to also honour this sophisticated and truly complex function that our body does for us on a daily basis without us even asking it to. So each time you complete your toileting event, I invite you to send a little gratitude to your body and all its incredibly phenomenal parts to end your toilet meditation !
There is a FREE bonus feature of the full guided Toilet Meditation (with music and breathtaking cinematography) included along with the “Creating Pelvic Floor Health with PhysioYoga” practice sessions which consist of a combination of physical therapy based exercises and yoga methods targeted to optimize pelvic floor health. I also have a free brief segment of the meditation on my YouTube channel.
**This article and any video links are not meant to diagnose, treat, or act as medical advice. Please consult your health care provider for clearance and guidance before following or participating in these activities.**
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Shelly Prosko, Physical Therapist, Professional Yoga Therapist, and Pilates instructor, is a highly respected pioneer in the area of PhysioYoga Therapy, a combination of Physical Therapy & Medical Therapeutic Yoga. She received her Physical Therapy degree at the University of Saskatchewan, Canada, her Medical Therapeutic Yoga training through Professional Yoga Therapy Institute, and her Pain Care Yoga training through Life is Now.
Since 1998, Shelly has been integrating yoga into her physical therapy treatments in order to promote optimal healing for people suffering from a variety of conditions including pelvic health issues and persistent pain conditions. She is also passionate about helping health practitioners prevent burnout and compassion fatigue by cultivating compassionate care for themselves and their patients through yoga methods and philosophy.
Shelly’s PhysioYoga courses have been well received by physical therapists and other healthcare providers, yoga therapists/teachers, and students of all levels. Her mission is to educate, inspire and empower people to create and sustain health by authentically sharing her work as she travels internationally offering courses, teaching at medical colleges and yoga therapy schools, and presenting at numerous conferences.
Shelly has a unique ability of sharing her passion of integrating the art and science of yoga and physical therapy in an engaging and valuable way. Participants of her offerings express feeling inspired and empowered with a sense of joy, gratitude, love and authenticity.
For more information please visit www.physioyoga.ca