Hypopressives: More than just a breathing exercise
I was introduced to low pressure fitness, aka Hypopressives, a few years ago through my pelvic and women’s health colleagues. I had heard about its use to help alleviate and reduce pressures in the pelvis which can influence pelvic organ prolapse. But that was all I knew and I was still getting some pretty good results with breath work, optimizing thoraco-pelvic alignment and functional integration of deep core and pelvic floor exercises.

However, after seeing more and more patients only get to about 90% better with some residual pelvic organ prolapse symptoms, plateauing results with diastasis/ hernia/ core control recovery, and even patients with deep thoracic tension and restrictions, I went looking to find more specific answers to see what could get them that last 10% better. Visceral manual therapy helped quite a bit and gave me a different perspective on the integration of not only muscular, joint, fascial, neural but also visceral mobility and their effects on pressures, as well as the importance of overall gut health (see my other posts on Functional Nutrition - in the works at this time). But there was still something missing - so I sought out more information on this low pressure fitness program to learn more.
I am lucky enough to have a trainer in my city who teaches it and so I went for a few sessions. Initially, I was unsure as to the reasoning and full idea behind it. The apnea didn’t seem super functional to me (and function is my life-force in Physio) - we shouldn’t be walking around holding our breaths all day or even with heavy daily lifting. Maybe for powerlifters, but what about the rest of us that don’t lift that heavy? And for people who don’t have a prolapse, could it be of benefit? Next, the postures did’t seem that different, so why have so many in variable positions? Would they really make that much of a difference?
After playing with it for a bit, with the help of my trainer, I wasn’t seeing much change (to be fair, I do not have a prolapse and I am not a weight lifter) and it was actually irritating my system a bit (I later found out I was working too hard and so creating too much tension). So I went to learn more from the Canadian guru in Toronto this June and here is what I found.
First, a brief background on Hypopressives (based on my new knowledge & understanding). It is a postural respiratory technique to assist in the restoration of the internal deep stability system by lengthening the tissue in specific postures to reflexively activate and build the type I postural, endurance muscles (rather than the type II, fast moving muscles we more associate with traditional strength training). It also helps to redistribute the pressures within the body cavities to a more balanced positioning.
As for the functionality of it, hypopressives and the apnea are not intended to be functional, with us walking around all day with this breath hold. It is only a tool to connect more deeply to the tissues and stability muscles as described above. The postures are meant to be fluid and opening playing with different fascial and muscular chains to get whole body balancing. When you learn how to be in and use the postures and apnea correctly, there is this amazing internal growing and lengthening that happens that allows everything to fall into it’s place. I have never felt so light in my body! It’s like the tension has been lifted and just let’s go where my previous stretching and yoga could not reach.
Hypopressives also assists with enhancing proprioception of the deep core through improving the resting tone of tissues, partly in activating more type I fibres but also in how it allows the pressures to be better distributed within the body cavities. This is not only fantastic news for my postnatal or menopausal women with reduced core strength, reduced abdominal tone (aka “mommy tummy”), diastasis recti, and pelvic floor dysfunction including urinary incontinence, pelvic pain, sexual dysfunction, pelvic organ prolapse, and constipation, BUT also for men with other poor pressure dynamics including inguinal hernias and pelvic floor dysfunction, as well as many other benefits like circulation, lymphatic drainage, reduced waist circumference, and more.
All in all this has been an illuminating time being on course and working with this technique personally and with patients since. I am so excited to continue to work with this exercise technique for not only abdominal (i.e. DRA) or pelvic floor dysfunction but also for decompression of joints, fascia, viscera and nerves that need a bit of a different input than just tensing and compressing. I think it will also be of great benefit to integrate and supplement training for athletes (especially young female athletes) to assist with that deep stability system and to internally lengthen and decompress to provide complimentary training to their already high intensity, strength training - both of which will help to reduce injury, improve performance, lung capacity, and recover post-injury.
You can see my pics below of me day1 of the course, and day 2 of the course with just a little bit of instruction and exercise. It’s not huge but pretty interesting for a 24 hours period!! Note the alignment of my shoulders and the space between my arms and trunk (back view), head and arm alignment, abdominal pressure, and resting gluteal tone (side view), and abdominal pressure and arm alignment (front view). Check back in a few weeks when I post some other pics on how it’s progressing. For more information on hypopressives/ low pressure fitness, please visit hyporessivescanada.com and coresetfitness.com.
Photo credit (above): hypopressivescanada.com



Disclaimer - Everything shared is for informative purposes only. It is not intended for assessment, diagnosis or treatment purposes. If you feel there needs to be further investigation, please seek out a qualified health care professional for a proper assessment.