About Leslie Howard

As a yoga practitioner and teacher, Leslie specialize in the use of yoga for many issues but specifically for pelvic floor problems. After suffering from hypertonic pelvic syndrome, she found relief from her symptoms by a careful application of Iyengar-style influenced yoga and breath work and since then she has continued to refine and develop the application of yoga for the pelvic floor for herself and others. To this end, for the past 18 years, Leslie has taught women of all ages to practice yoga to alleviate pelvic floor conditions, including urinary incontinence and pelvic pain, through a combination of small group teaching, public workshops, and national and international conferences.

Leslie’s approach is trademarked as Pelvic Floor Yoga. She is also the author of Pelvic Liberation. Twice a year she teaches a 20-hour Pelvic Floor Yoga teacher training for therapeutic application of yoga and pranayama to help alleviate symptoms for pelvic floor issues. Leslie is the co-director of the Nest Yoga 200 Hour Teacher Training program. Her courses are approved as continuing education with Yoga Alliance and the International Association of Yoga Therapists. She is a certified Yoga Therapist and educator through the International Association of Yoga Therapists (IAYT).

To hear Leslie’s whole talk including a guided pelvic floor exercise routine, sign up for OnDemand at www.YogaMovesOnDemand.org

Leslie’s Iyengar Yoga Training and Experience

Leslie Howard has over 3800 hours of yoga study and 25 years of yoga teaching experience. Unlike the western medical academy, there does not exist an analogous institution of higher learning in yoga. Instead there exist various schools of yoga and students who learn through close apprenticeship with a teacher. Iyengar yoga is known for its focus on anatomy including proper alignment of the body, precision of asanas, sensitivity to injury, and keen attention to asana sequencing. She has studied intensively with top-tier teachers in the Iyengar school including Ramanand Patel, Tony Briggs, Patricia Walden, Manouso Manos, Peter Thompson and others. Leslie holds a 320-hour Advanced Studies Certificate from Piedmont Yoga Studio, a 300-hour Tony Briggs teacher training certificate, and a 500 hour Yoga Alliance and IAYT certification.

Clinical research in yoga for incontinence

In conjunction with the University of California at San Fransisco, Leslie conducted a pilot study on yoga for incontinence for women over 50 in which participants experienced a 70% improvement in symptoms using Leslie’s methods during a six week program. The National Institute of Heath commissioned a bigger study over three year which yielded even better results than pilot with participants experiencing a 75% improvement in symptoms. These studies are further proof that her methodology works.

Types of incontinence

Stress Incontinence 

Stress Incontinence occurs when there’s added pressure on the pelvic floor from coughing sneezing, or jumping. If the pelvic floor is weak with muscles that are too lax or too tight and unable to respond to the added pressure, incontinence can result. With this type of incontinence people don’t feel like they have to go to the bathroom and there is a clear cause and effect. Stress incontinence paired with constipation indicates the muscles are too tight.

Urge Incontinence

Urge incontinence is a common symptoms in MS. People experiencing urge incontinence feel like they have to go to the bathroom really badly and worry they won’t make it to the toilet. With urge incontinence there is not an obvious cause of the incontinence. This type of incontinence usually is caused by tight pelvic floor muscles combined with a weak bladder–brain connection due to nerve damage. It is sometimes referred to as an overactive bladder.

Anatomy of the pelvic floor

The most superficial muscle of the pelvic floor surrounds the urethral sphincter, the vaginal opening and the anal sphincter. This muscle is suspended from the front and back connecting behind the public bone and the tip of the tailbone. These muscles help with opening and closing the urethra. There is an internal and external sphincter muscle. When the bladder is full the internal sphincter opens giving you the sensation of having to pee. A weak external sphincter can lead to incontinence.

The second layer of pelvic floor connects the two sits bones. The center of the pelvic floor is the perineum. The third, deepest layer of the pelvic floor is the largest, deepest and ideally strongest muscle of the pelvic floor and connects behind the public bone and to the sides of the tail bone. The rotation of the thigh bones can affect the pelvic floor, they should be externally rotated.

When we inhale the respiratory diaphragm moves down and widens, which gently presses on all the organs into the pelvic floor. Think about breathing into the pelvic floor widening on the inhale and attempting to lift on the exhale. The lift should be gentle, not clenching with all your might.

Slouching and crossing the legs puts the pelvic floor in an asymmetrical position which can lead to weakness. Your pelvic floor and lower abs work together to make everything more stable. You can practice engaging just the left then just the right side to feel any differences and become more aware. The transverse abdominis is like a deep inner corset set of muscles which cinches when it engages and puts a lot of pressure on the pelvic floor.

Kegels typically instruct people to squeeze all the pelvic muscles at once instead of in isolation, which doesn’t address any left-right or front-back disparities.

Top Tips

  1. Put up the pelvic floor before a cough or a sneeze.
  2. People with flat feet have a higher rate of pelvic floor issues — tightness in the bottom of the foot can contribute to tightness in the pelvic floor as can tightness in your jaw.
  3. Rolling the feet can hep the pelvic floor to relax.

Connect with Leslie through her website