Surya Namaskar A as Therapeutic Practice: Supporting the Pelvic Floor & Core

Surya Namaskar A is often treated as a warm-up—a familiar sequence we move through almost on autopilot. But from a therapeutic yoga perspective, Sun Salutation A is anything but neutral. The way we breathe, time effort, and transition between shapes can either support the pelvic floor and deep core—or quietly undermine them.

In this post, we’ll explore how adapting Surya Namaskar A can help meet the needs of the pelvic floor and core, particularly for students who experience instability, pressure, prolapse symptoms, hypermobility, or a general sense that vinyasa feels heavy or unsupported.

This approach isn’t about fixing the sequence or doing it “right.” It’s about understanding how the system works so the practice can become more supportive, buoyant, and sustainable.

Rethinking the Core: More Than Abdominals

A common metaphor is the soda can as core container. Consider it's strength when pressurized from within versus empty. But the core also needs to be adaptable to side bend, forward fold and backbend.

When many people hear the word core, they think about abdominal strength—often some version of tightening or bracing the belly. But therapeutically, the core is better understood as a container, bounded by:

The respiratory diaphragm at the TOP

The pelvic diaphragm (pelvic floor) at the BOTTOM

While the deep abdominal wall, spinal stabilizers, and connective tissue wrap around the waist and abdomen, forming the SIDES of the container.

This container isn’t meant to be rigid, although it can brace and stabilize for highly demanding poses. The core container is designed to be responsive, adjusting moment by moment to changes in breath, posture, and load.

The pelvic floor, in particular, isn’t a single muscle or a flat “floor.” It’s a complex, elastic structure that needs to lengthen, recoil, and adapt thousands of times a day. When it’s asked to grip constantly—or when it’s bypassed entirely—it loses that adaptive capacity.

Breath, Pressure, and Pelvic Floor Function

One of the most important therapeutic concepts for understanding pelvic floor support is the relationship between breath and Intra-Abdominal Pressure (IAP).

On an inhale: - The respiratory diaphragm descends - Pressure increases within the core container – The pelvic floor naturally responds by widening and moving down. This is an essential part of how the core works and just as important as any toning with exhales.

On a relaxed exhale: - The pelvic floor recoils and lifts - the respiratory diaphragm ascends - Pressure decreases.

On an active “forceful” exhale: students can actively “brace” the side walls of the core and  draw upwards from the pelvic floor to maintain the pressure that stabilizes the spine.

The natural pulsation of the pelvic floor (its upwards and downwards movement in coordination with the breath) is not something we need to force. In fact, many pelvic floor issues arise when this rhythm is interrupted—either by chronic gripping or by bearing down under load.

In yoga practice, especially in flowing sequences like Surya Namaskar A, how we time movement with breath has a direct impact on whether this pressure system works with us or against us. Consciously choosing to brace the core container during the transitions, like Chatarungha, hopping back or forward, can make the movements buoyant and powerful. Ensuring that the pelvic floor relaxes during inhales is a crucial part of ensuring the core is a pulsation, not a constant gripping.

Why Traditional Vinyasa Cueing Can Be Problematic

Traditional vinyasa cueing often follows a simple logic:

·       Inhale to open or lift

·       Exhale to fold or close

While this makes sense, many students need to train the core to also support rising and expanding movements, not just closing and folding ones. Adding pauses to inhale gives students time to build adequate internal pressure so their exhale can consciously recruit ALL sides of the core container and maintain this stabilizing pressure.

If these movements are performed without adequate support—the pelvic floor may experience increased downward pressure at exactly the wrong moment.

From a therapeutic standpoint, it often makes sense to ask a different question:

Does this movement require the core to maintain neutral spine or to minimize the spine backbending or rounding excessively?

Exhale as Effort: A Therapeutic Reframe

For many students—especially those who are hypermobile, postpartum, peri- or post-menopausal, or managing pelvic floor symptoms—exhaling during effortful transitions can be profoundly supportive.

The active exhale: - Encourages natural recoil of the pelvic floor – Naturally recruits the abdominals – Should reduce downward pressure

Inhales: Hold the pose to expand if it is traditionally done that way, then start the exhale just before moving into the next pose. These intentional pauses—give time to reeducate the core so that with practice, in time, the core remembers what it is supposed to do automatically.

This subtle shift can completely change how supported Surya Namaskar A feels.

Surya Namaskar A as a Laboratory

Rather than thinking of Sun Salutation A as choreography to get through, try approaching it as a laboratory for sensing support.

Here are a few therapeutic principles to explore:

Start with Posture (Stack!)

Before moving, notice your standing alignment. A neutral pelvis, lumbar spine and ribcage (Tadasana!) allows the diaphragms to move in coordinated uninterrupted rhythm with the breath. When the ribcage leans back or rounds forward, or if the low back overarches or the pelvis tucks, the respiratory and pelvic diaphragms are cut off from the fullness of the breath.

When the core is unstacked, the core is not at its full power.

Move just after the Exhale begins; Pause for Receptive Inhales

Feel the internal pressure expand in all directions on inhales and then focus your attention on feeling the ‘snap’ or recoil of the pelvic floor with each exhale.

Center the uplift from the perineum, the structurally strong, absolute center of your pelvic floor. Let go of superficial cues that may be too far forward or back (originating the uplift from “stopping the flow of urine” or “stopping the passing of gas”.)

A common image for the power of an uplifting exhale is the fountain. (But remember to let the water fall and pool on inhales!)

Find your Mula Bandha Exhale Imagery

The power of the core originates in the pelvic floor rising from the perineum, like:

• A Fountain spraying water upwards

• A rising Carasoul pole

• A Pulley drawing upwards

• An Arcade Claw lifting up a prize

• A tissue pulled up out of its box

Let this imagery help you channel lightness and buoyancy.

Chaturanga, Plank, and Load-Bearing Moments

Load-bearing poses like plank and chaturanga are often where the value of more deliberate pelvic floor strategies become apparent.

• Create an “airbag” in the low back and abdomen that prevents the lubar spine from moving

• Let this image help lift the core against the downward drag of gravity

• Notice if the pressure on your wrists and shoulders is less when the airbag is fully inflated and taut

Who Might Benefit Most from This Approach?

This way of working with Surya Namaskar A can be especially helpful for:

• Students with pelvic organ prolapse or prolapse symptoms

• Those experiencing incontinence

• Hypermobility or connective tissue disorders

• Postpartum or post-surgical recovery

• Anyone who has trouble “floating forward” through vinyasa transitions

• Anyone who feels that vinyasa leaves them depleted rather than energized

That said, many students without obvious symptoms report feeling lighter, stronger, and more integrated when effort and breath are timed more thoughtfully.

A Note for Teachers

Cueing pelvic floor support doesn’t require graphic anatomy or excessive verbal detail. Simple, functional cues—such as inviting exhale during effort or pausing to breathe before transitions—can be enough.

Most importantly, remember that pelvic floor support is contextual and individual.

Many students need to focus on relaxing the pelvic floor and should not practice mula bandha or kegels. What helps one student may not serve another. Encourage curiosity rather than compliance.

Closing Thoughts

Surya Namaskar A doesn’t need to be abandoned or overhauled to become therapeutic. Small shifts in timing, pacing, and intention can transform it into a powerful practice for cultivating core and pelvic floor support.

When the breath leads and effort is well-timed, the pelvic floor doesn’t have to brace or collapse—it gets to respond.

And that responsiveness is at the heart of therapeutic yoga.

Teacher Takeaway

Don’t assume students know how to engage their cores!

• Train effort to happen on exhales.

• Train relaxing and stretching the pelvic floor on inhales and in poses that naturally encourage this action.

• Cue the pelvic floor using imagery and simple anatomy

• Build breath awareness in quieter moments, during warm up or recovery after exertion, to feel the natural movement of the respiratory and pelvic diaphragms with the breath.

• Train the core to support neutral spine before moving to advanced poses that demand a trained and stable core.