Hey mamas! Enough with the sit ups already, stop planking, and honestly don’t even think about burpees. Your poor pelvic floor just wants to recover, the beautiful soft tissue in your abdominal cavity is gently rebuilding and strengthening, and the very last thing they want is to have a wackload of pressure forced against their fragile entities while they heal. Why not find an exercise that works with them and aids them along their journey. An exercise that gently lifts the pelvic floor, reduces the force on the abdominal cavity and provides a sense of relief in all of those elusive places that you have been neglecting.
FIRST OFF WHATS WRONG WITH CRUNCHES?
I will focus on the population that I work with, postpartum women. After having a baby the connective tissue between the rectus abdominals (RA: 6 pack muscles) is often stretched and weaker than prior to pregnancy. The pelvic floor, is also stretched, sometimes has been torn, cut or damaged by interventions and is obviously weaker than before pregnancy. Even a women who has had a C-section has a weaker pelvic floor since the weight she carried during pregnancy caused strain on the pelvic floor for nine plus months. During a crunch the superficial abdominal muscles contract and come closer together drawing the pelvis and the head closer together. Because the space between the head and pelvis gets smaller the pressure in the cavity increases and pushes out wherever there is an opening or a weakness. When a women who has these weaknesses whether symptomatic or not, the pressure will often push the abdominal muscles further apart and worsen or cause a DRA. Or the pressure will move downwards which could push organs downwards against the pelvic floor weakening the tissues or worse yet could lead to fecal or urinary incontinence (peeing or pooing) or prolapse of organs. Low back pain can also be present as, you guessed it, this is another area where the pressure can be forced and the multifidus (back muscles) may not have the strength to withstand the pressure. With proper training of the Pelvic Floor and the deep abdominal Transverse Abdominal (TA) muscles being activated prior to the bigger and pushier RA muscles, only then is a ‘good’ crunch possible, ditto for planks and variations of both of them.
It seems people either are aggressively addicted to working out or they hate exercise and any form of movement altogether. I aspire to lead my clients down a middle road where exercise is worked into their daily lives and is enjoyable, moderate and realistic. So removing crunches from some hard core clients regime was easier said than done. In reality they needed something to get their ‘fix’. Something to substitute in place of the dreaded crunch. Enter Hypopressives.
WHY HAVEN’T I HEARD OF THIS TYPE OF EXERCISE?
One of the reasons they have been slow to go mainstream, in my opinion, is because no one wants to talk about peeing your pants and losing organs out of your vagina. Right? The other reason is that many health care professionals are hesitant to suggest these exercises because the research is not up to date as of yet. In my opinion it appears the individuals involved in the actual business of these exercises (Trista of Low Pressure Fitness) are more focused on getting the word out to the public by training others (for good reason) rather than sitting in labs testing and writing papers to convince the less easily convinced. Well I am not one to be embarrassed easily nor am I one to ignore experiences in hopes of waiting for research to catch up. I have practiced hypopressives myself, felt the relief of my pelvic floor, felt the lift and experienced the secondary benefits of a toned midsection, improved posture, improved ease of breathing… so I am happy to help my clients integrate them into their routines.
WHERE DID THEY COME FROM?
Hypopressives were created in Europe by Dr. Marcel Caufriez in 1980 in hopes of helping postpartum women to recover from pelvic floor dysfunctions (incontinence, prolapse). At that time typical ‘core’ exercises were focusing on strengthening the superficial abdominals which caused an increase in pressure in the pelvic floor and abdominal cavity. Women with prolapses and/or incontinence experience a worsening of symptoms when the pressure increases ie: when running, sneezing, coughing, laughing and jumping etc. So by routinely exercising in this way symptoms tend to worsen and the pelvic floor tends to weaken and suffer over time.
To help women recover from childbearing it is important to be able to work with the entire body rather than just the abdominals, or just the pelvic floor. Our bodies are one beautiful, intelligent and connected entity so it is not possible to strengthen one area without taking into consideration a weakness or habitual contraction of another area. When we do train in this manner symptoms often emerge in other areas. For example, if a women presents with a DRA (separation of the abdominals) and is advised to wear a belly binder and proceed with her normal activities, once can imagine what would happen. The pressure that was originally exerting force on the abdominal wall will now be redirected by the firm belly binder and forced to whatever area has room to expand or release the pressure…downwards…. Just like squeezing a tube of toothpaste.
Caufriez developed this technique to effectively decrease the pressure in the abdominal and pelvic cavity (Hypo= Low) while eccentrically contracting the respiratory and postural muscles. We have Trista Zinn of Low Pressure Fitness Canada to thank for singlehandedly bringing Hypopressives to the attention of Canada’s women’s health workers and aiding to the change in how we work with postpartum women.
OK WHAT DO YOU ACTUALLY DO?
Let me try to explain them as simply as possible…. There are various postures that a trained instructor will teach you. The postures in the first level are static. They are often found to be challenging to hold for the duration of the breathing exercises. The positions vary from lying on ones back, kneeling, quadruped or standing. An instructor will work with you to determine where you should start and which ones you should avoid based on any other conditions or injuries you may have. After you have mastered getting into the proper position (harder than it sounds for even the fittest gym bunnies out there), then the breathing component is added. Again, in simplistic terms, you are instructed to take deep lateral costal breaths while releasing the abdominals completely (hardest part for many clients), on exhalation you are encouraged to grow taller by lengthening your spine and your arms or legs (or both) depending on whichever position you are in. After 3 “rest breaths” you exhale all of the air and perform a false inhale. Which means you do not actually breath any air in, just like when one jumps into a pool…resist breathing BUT expand your ribcage in 3 dimensions while continuing to let go of the abdominals. This expansion in the ribcage causes the diaphragm to act like a vacuum and draws up the pressure from the abdominal cavity and therefore decreases the pressure in the pelvic floor. Its a bit of an experiential process that is difficult to put into words, as you can see.
WHAT ARE THE BENEFITS?
- Eccentric lengthening of the postural muscles (taller, leaner)
- Diaphragm lengthening (more efficient breathing)
- Decreased intraabdominal pressure (aid DRA recovery)
- No pressure on pelvic floor (decreased symptoms of incontinence and prolapse)
- Increase Vascular Flow (increased athletic and sexual performance)
WHAT DO I WEAR?
Any comfy clothing and nothing on your feet. This is why practicing hypopressives is easy, pajamas are perfect attire for them. I tend to ask my clients to roll up their shirts or wear a sports bra when performing the exercises so I can check if they are contracting their abdominals and I can watch for other signs that they are performing the exercise properly.
IS THERE ANY EQUIPMENT?
No. A towel or soft surface to lie on is enough. Eolos is a breath trainer that some instructors carry to help clients who are struggling with achieving good lateral costal breaths. It adds resistance to the breath, just like adding more weight to an exercise and the resistance heightens their awareness of which muscles need to be activated and which muscles are unnecessarily contracting and inhibiting the exercise.
OK HOW DO I START?
Each trainer has their own protocol. My clients specifically must do a consultation and assessment prior to the purchase of any package. I then sell packages in a set of either 4 or 8 sessions. For hypopressives I strongly recommend 8 sessions as it might take weeks to get the breathing right before we combine the postures and breathing. It is completely person dependent. In 4 sessions you can expect to only learn 3-4 of the postures. In 8 weeks we should be able to go through all of the level 1 postures and you will have a routine to practice on your own 2-3 times a week.
I’M PREGNANT CAN I DO THEM TOO?
You can learn and benefit from the postures but you cannot perform the apnea breaths until after you have had your baby and fully recovered. I usually advise clients to visit a postpartum physiotherapist prior to starting any exercise program including hypopressives.
STATIC BREATHING EXERCISES AND POSTURES, THEY SOUND EASY! WHY ISN’T EVERYONE DOING THEM?
In reality once you get the hang of hypopressives they are fairly easy. The challenge is, for many clients who are used to high intensity exercise, that performing static breathing exercises is more effort for them to set time aside to do because it can be a bit mundane. This is why some of my clients check in once a week or every two weeks so they are held accountable. I will also be offering group classes in the winter for clients who have gone through personal sessions with me and are looking for an affordable way to keep up with them.
Another reality is that taking a good deep breath and decontracting the abdominals is way harder than most people think. In our modern, stress laden society there are a lot of immobile ribs, hunched and even immobile shoulders, habitually clenched abdominals, tucked and also contracted glutes (bums)… first we have to work on getting mobility back into these and other areas, and only then can we start to learn and benefit from hypopressives. So please be prepared to start very slow and to allow your body (and brain) to integrate the changes needed to accommodate a proper breath. By taking the time to decontract first you will reap not only the benefits of hypopressives but the luxury of fluid mobility and clarifying breath.