(646) 355-8777

Herman & Wallace Blog

Yoga as Treatment for Urinary Incontinence

Dustienne Miller MSPT, WCS, CYT is a Herman & Wallace faculty member, owner of Your Pace Yoga, and the author of the course Yoga for Pelvic Pain. Join her in Columbus, OH this April 27-28, to learn how yoga can be used to treat interstitial cystitis/painful bladder syndrome, vulvar pain, coccydynia, hip pain, and pudendal neuralgia. The course is also coming to Manchester, NH September 7-8, 2019, and Buffalo, NY on October 5-6, 2019.

How does a yoga program compare to a strength and stretching program for women with urinary incontinence? Dr. Allison Huang1 et al have published another research study, after publishing a pilot study2 on using group-based yoga programs to decrease urinary incontinence. Well-known yoga teachers Judith Hanson Lasater, PhD, and Leslie Howard created the yoga class and home program structure for this research study and the 2014 pilot study. The yoga program was primarily based on Iyengar yoga, which uses props to modify postures, a slower tempo to increase mindfulness, and pays special attention to alignment.

To be chosen for this study, women had to be able to walk more than 2 blocks, transfer from supine to standing independently, be at least 50 years of age, and experience stress, urge, or mixed urinary incontinence at least once daily. Participants had to be new to yoga and holding off on clinical treatment for urinary incontinence, including pelvic health occupational and physical therapy.

28 women were assigned to the yoga intervention group and 28 women were assigned to the control group. The mean age was 65.4 with the age range of 55-83 years of age.

The control group received bi-weekly group class and home program instruction on stretching and strengthening without pelvic floor muscle cuing or relaxation training.

The yoga program met for group class twice a week for 90 minutes each and practiced at home one hour per week. The control group met twice a week for 90 minutes with a one-hour home program every week. Both groups met for 12 weeks.

Both groups received bladder behavioral retraining informational handouts. The information sheets contained education about urinary incontinence, pelvic floor muscle strengthening exercises, urge suppression strategies, and instructions on timed voiding.

The yoga program included 15 yoga postures: Parsvokonasana (side angle pose), Parsvottasana (intense side stretch pose), Tadasana (mountain pose) Trikonasana (triangle pose), Utkatasana (chair pose), Virabhadrasana 2 (warrior 2 pose), Baddha Konasana (bounded angle pose), Bharadvajasana (seated twist pose), Malasana (squat pose), Salamba Set Bandhasana (supported bridge pose), Supta Baddha Konasana (reclined cobbler’s pose), Supta Padagushthasana (reclined big toe pose), Savasana (corpse pose), Viparita Karani Variation (legs up the wall pose), and Salabhasana (locust pose).

Women in the yoga intervention group reported more than 76% average improvement in total incontinence frequency over the 3-month period. Women in the muscle stretching/strengthening (without pelvic floor muscle cuing and relaxation training) control group reported more than 56% reduction in leakage episodes.

Stress urinary incontinence episodes decreased by an average of 61% in the yoga group and 35% in the control group (P = .045). Episodes of urge incontinence decreased by an average of 30% in the yoga group and 17% in the control group (P = .77).

The take away? We know behavioral techniques have been shown to improve quality of life and decrease frequency and severity of urinary incontinence episodes.3 Couple this with our clinical interventions, and our patients have a way to reinforce the work we do in the clinic by themselves, or socially within their community. Yoga can be another tool in the toolbox for optimizing pelvic health.


1) Diokno AC et al. (2018). Effect of Group-Administered Behavioral Treatment on Urinary Incontinence in Older Women: A Randomized Clinical Trial. JAMA Intern Med.1;178(10):1333-1341. doi: 10.1001/jamainternmed.2018.3766.
2) Huang, Alison J. et al. (2019). A group-based yoga program for urinary incontinence in ambulatory women: feasibility, tolerability, and change in incontinence frequency over 3 months in a single-center randomized trial. American Journal of Obstetrics & Gynecology. 220(1) 87.e1 - 87.e13. doi: 10.1016/j.ajog.2018.10.031
3) Huang, A. J., Jenny, H. E., Chesney, M. A., Schembri, M., & Subak, L. L. (2014). A group-based yoga therapy intervention for urinary incontinence in women: a pilot randomized trial. Female pelvic medicine & reconstructive surgery, 20(3), 147-54.

Pelvic Floor Level 1 is Heading to Kenya
Interstitial Cystitis Overview

Upcoming Continuing Education Courses

Mar 22, 2019 - Mar 24, 2019
Location: Tri-City Medical Center

Mar 22, 2019 - Mar 24, 2019
Location: Mount Saint Mary’s University

Mar 23, 2019 - Mar 24, 2019
Location: Spooner Physical Therapy

Mar 23, 2019 - Mar 24, 2019
Location: Alta Bates Summit Medical Center

Mar 29, 2019 - Mar 31, 2019
Location: St. Joseph Mercy Ann Arbor

Mar 29, 2019 - Mar 31, 2019
Location: Marathon Physical Therapy

Mar 30, 2019 - Mar 31, 2019
Location: Core 3 Physical Therapy

Mar 30, 2019 - Mar 31, 2019
Location: Atlanta PT

Apr 5, 2019 - Apr 7, 2019
Location: Vanderbilt University Medical Center

Apr 5, 2019 - Apr 7, 2019
Location: Athletico Physical Therapy

Apr 6, 2019 - Apr 7, 2019
Location: University Hospitals

Apr 6, 2019 - Apr 7, 2019
Location: Aurora Medical Center

Apr 6, 2019 - Apr 7, 2019
Location: Cancer Treatment Centers of America - Chicago, IL

Apr 6, 2019 - Apr 7, 2019
Location: Princeton Healthcare System

Apr 12, 2019 - Apr 14, 2019
Location: Mary Free Bed Rehabilitation Hospital

Apr 12, 2019 - Apr 14, 2019
Location: Bon Secours St. Francis Health System

Apr 13, 2019 - Apr 14, 2019
Location: Mercy Hospital

Apr 13, 2019 - Apr 14, 2019
Location: Advantage Physical Therapy

Apr 26, 2019 - Apr 28, 2019
Location: Asante Rogue Valley Medical Center

Apr 26, 2019 - Apr 28, 2019
Location: Advanced Physical Therapy of Little Rock

Apr 26, 2019 - Apr 28, 2019
Location: Mercy Hospital

Apr 27, 2019 - Apr 28, 2019
Location: Fitness Matters

Apr 27, 2019 - Apr 28, 2019
Location: Loyola University Stritch School of Medicine

Apr 27, 2019 - Apr 29, 2019
Location: SUNY Upstate Medical University

May 3, 2019 - May 5, 2019
Location: University of North Texas Health Science Center

May 3, 2019 - May 5, 2019
Location: Comprehensive Therapy Services

May 3, 2019 - May 5, 2019
Location: Michigan Medicine

May 3, 2019 - May 5, 2019
Location: Summa Health Center

May 4, 2019 - May 5, 2019
Location: Regions Hospital

May 13, 2019 - May 15, 2019
Location: Touro College: Bayshore