Breathing

From the picture you can see the relationship between the diaphragm and the pelvic floor. If you utilise this connection properly you can be working and strengthening your core and pelvic floor throughout your whole day! Let me break it down for you:breathe_titledMany of us with our busy lives and the stress of money and the limited time we perceive that we have despite the technology that we now own that was supposed to allow us more time and freedom – which ultimately has tied us down more (but that’s for another rant at another time!!) – have forgotten how to breathe and use our rib cage and lungs properly.

If I were to ask you to take time out now – lie down on your back with your knees bent and your feet flat on the floor and breathe, how do you do it? Do you:

  1. Inhale through your mouth and exhale through it?
  2. Inhale into your tummy?
  3. Inhale into your upper chest?
  4. Move your shoulders?
  5. Inhale through your nose?

I would like you to think about your anatomy – Feature-image-Oh-Coccyx-My-Coccyx-300x300@2xIf you look at the picture you can see that your rib cage is like the bellows that house your lungs – it follows that if you open and close your ribs you will allow more space for your lungs to inflate – you will also notice that your rib cage is not only at the front of your body!

Now after reading this next bit I’d like you to have a try at breathing again – in the same supine (on your back) position as you tried before!

  1. Inhale slowly through your nose – it is a design point – if you breathe through your nose – the hairs in your nose send all sorts of important information to your brain – like temperature, oxygen mix….and much, much more
  2. Put your hands round your rib cage with your fingers pointing to the front and your thumbs feeling the back – as you inhale you are going to push your hands at the side of your body and out of your back with your ribs – inflating your own carefully designed bellows
  3. As you do this your diaphragm stretches out across the bottom of your ribs – allowing your pelvic floor to relax
  4. The you are going to exhale through your mouth as if you are misting a mirror – as you do your ribs are going to close and your diaphragm will relax back under your ribs – helpfully without any extra work from you – pulling your pelvic floor and core upwards and inwards as it does
  5. The wider you can get your ribs – the better the synergistic movement from your pelvic floor

You are not going to:

  1. Inflate your tummy
  2. Lift your shoulders

You are going to:

  1. Inhale for a count of 3 and exhale for a count of 6 – to slow down your heart rate and calm your frantic world!!
  2. Come to a class and learn so much more….

Happy breathing.

Different types of incontinence

So you may be have been told that post baby – or with age – that leaking urine or faeces is normal – it’s what you should expect.

This helps to breed indifference to what can be a problem that is easily (ok you do need to work at it!) rehabilitated. Tena lady and other sanitary towel companies make money from you being told that this situation is normal – that there’s not really too much you can do about it – it’s common – put on a pad and get to an exercise class or just get on with your life.

There are more than one type of incontinence that you can suffer from:

Stress –

  • Loss of control of bladder function
  • When laughing, coughing or sneezing
  • On movement or impact – this can be high or low
  • You may leak when with legs apart, you simply bend over or walk upstairs –
  • These are your fast twitch muscles not firing properly – being weak and also they may also be too tight – essentially your bathroom muscles not opening and closing when you want them to

Urge

  • ‘Key in the lock’ scenario – you made it home and now have a pressing urgency to go pee/poo
  • Being caught short
  • A need to go immediately
  • No possibility of holding it in
  • These are your slow twitch muscle fibres that are weak – and perhaps tight too

Overflow

  • When you void or go pee but there’s something left behind
  • Feeling of not fully emptying the bowel or bladder
  • Higher risk or urinary tract infection

Mixed

  • When you suffer from a combination of the symptoms above.

Hypopressive exercise uses thoracic breathing to decrease the pressure on the pelvic floor – lifting the pelvic floor muscles and working the ‘friend to your pelvic floor muscles’ muscles that surround your pelvic floor to lengthen and strengthen them.

Kaisa (master trainer in Hypopressives) Answers to questions posed by Julie Wiebe PT

Below are answers to a lot of questions you might have about Hypopressives- why not come along to a class and see what you think for yourself! www.hypopressivescotland.com

It is great to see a community of people who are dedicated to improving quality of life for women with pelvic floor issues learn about the Hypopresive Method. As you can imagine it is difficult to describe something in short blog posts, you tube videos when the skills and theory behind the method takes 60 hours to teach. It is also understandable that you should have doubts and questions as information in English is limited and the method is very unique.

Here are answers to some of your doubts.

This technique has been around since the 1980s so it isn’t new but it is just now making an entrance in the English speaking world. It is part of hospital procedures and postpartum recovery protocols in Belgium where it was first discovered and studied by Marcel Caufriez. Over 6000 therapists have been trained in the method and almost 2000 fit pros as well. Thankfully finally we have trainers in English speaking countries so you are finally hearing about the method. Since it has been used for years by uro-gyno physios to treat prolapses and incontinence it has a strong clinical backing.

We’re reviewing the English texts but do remember that the science concepts have been simplified for clients so most certainly they are incomplete for a professional. The neurophysiology concepts behind the method are very complex. Please see this blog for the 3 requirements for an exercise to be considered hypopresive: http://hypopresives.com/hypopresives/three-requirements

The neurophysiology concepts include hypopresives stimulating the pneumotaxic center (pontine) of the brain via hypopresive postures that are amplified by the apnea and ribflare causing hypoxia and hypercapnea. The neumotaxic center, which is responsible for the resting tone of the respiratory muscles (diaphragm, ab wall, pelvic floor, serratus anterior, etc.), responds via neurological divergence that stimulates an activation or decrease in tone in the various muscles. The neurophysiology concepts are far too complex to answer here. They are fully explored in the 60 hours of HM training our master trainers receive.

HM seeks to normalize the postural tone of the diaphragm and the results here are excellent. The concept is full unrestricted mobility of the diaphragm and to normalize its resting position. Not sure where you got the idea that HM “takes the descent of the diaphragm out of the picture”. Also the rib flare comes from the serratus anteriors which are the postural antagonists of the diaphragm and thus help relax the diaphragm. It isn’t the change in pressure that causes the involuntary contractions of the core when performing HM (it was the original hypothesis but it was proven incorrect via research as the contraction comes before the change in pressure when measured by a pressure gauge in the rectum/esophagus and deep EMG of the pelvic floor).

“Here’s the thing, we need that pressure gradient and fluctuation of pressure created by the diaphragm in the abdominal cavity for a host of functions: it triggers breath (take Mary Massery’s course everyone!), contributes to circulation of lymph and blood, massages organs and contributes to bowel movement, sets up rest/work cycles of our postural muscles, and contributes to postural control.”

Of course and that is why HM helps to normalize the diaphragm function. HM also improves vascularization and the latest studies are looking at lymp

  • Hypopressive exercises can be performed anywhere
  • You are not alone
  • Hypopressives can help at any age
  • It is NOT ok to pee when you sneeze
  • Low Pressure Fitness - International - I am trained in LPF Fitness - Hypopressives to Level 3 and have also trained with Hypopressives UK
  • Classes available for mums and babies, helping you to get back to you
  • Improve posture, breathing and stamina
  • Classes are suitable for men and women
  • Training in Spain
  • Feel more you - increase stamina
  • One of these mats is for you - change the way you train
  • One of our Hypo babies helping mum get in the right position
  • Alignment and posture are super important
  • Clear and careful instruction will help you to progress steadily in group sessions
  • Hypopressives are a Low Pressure Fitness programme - practiced not just by post natal mums -it is now being embraced by the fitness industry as a way to create strong functional abdominals
  • 1-2-1 and group sessions are available
h circulation which is also improved. HM also improves intestinal transit and it fantastic for correcting posture.

“So here are my questions: How do Hypopressives address these other functions of the global system that impact continence, digestion, circulation, respiration, postural stability, etc?”

HM is a global system that does just that. Via neurological divergencies muscle resting tone is improved which is the main reason for the improvements in continence, injury prevention, etc. HM stimulates the sympathetic nervous system which causes improvements in these areas as well. The rhythmic performance of the exercises works with the emotional system. Through the neurological divergencies muscle tone is normalized which aids in postural improvements, proper mobility, etc. The autoelongation used through the techniques normalizes curvatures of the spine (does not cause lumbar kyphosis like you commented) and allows for rehydration of the intravertibral disks. Respiratory parameters are improved via normalization of the tension in the upper airway muscles, improving the functionality of the diaphragm as well as changes on a cellular level such as improvements in hematocrit and EPO. Again, it is hard to summarize something that takes hours to explain during the courses.

“How does the person return to function when downward pressure from normalized breathing resumes (perhaps normalized breathing never does?) Or the downward displacement of impact loading occurs? “

HM reprograms the core to properly manage intra-abdominal pressures so daily function improves and risk of injury from prolapses is reduced. Removing excess postural tone from the diaphragm also is an important factor in optimal function. When people return to their previous activities (perhaps with impact) their bodies can handle these activities better with less risk.

“While Hypopressives is also trying to move us away from this extreme that caused so much abdominal pressure, have they done it with yet another extreme? Hypopressives feels to me like our over-focus on abs all these years….a willingness to sacrifice other parts of the system for the sake of one part.”

HM is a global system that takes into consideration not just the biomechanical parts but also the parasympathetic vs sympathetic nervous systems, the emotional system, the person’s diet, even the temperature of the room and color of the lights. It goes well beyond just abs and seeks to reprogram the person’s body map and balance out their nervous system as well as the musculoskeletal system.

“For example, in the video above you can see there is a huge use of neck muscles (Sternocleido-mastoids are very prominent) to pull this off.”

What you are seeing is yes, activation of the SCM but what makes it seem more prominent than it is is the decrease in thoracic pressure which creates indents at the collarbone.

“So they have improved prolapse (which really is awesome, don’t get me wrong) but now do they have headaches and jaw pain? For some that is worth the risk. And from an aesthetic point of view…are we trading unflattering bellies for barrel chests?”

Actually HM doesn’t cause headaches or jaw pain. Yes, some people in the beginning will have a hard time activating their serratus anteriors and will over use upper traps etc. But this shortly gets improved and the end result is less pain and activation of the proper muscles. HM doesn’t seem to create barrel chests. After the 30+ years of its use this hasn’t been noted.

“Where’d the organs go? Are they sure they are up?”

Organs are lifted up. It has been studied via ultrasounds and MRIs.

“And finally, yes, the pelvic floor needs to go up…but it still needs to learn to go down too, even if you have a prolapse or incontinence, and handle impact loading. How do Hypopressives address this need?”

HM seeks to improve resting tone of the pelvic floor and for it to have proper shock absorption abilities (including responding to pressure by moving down and back up). Marcel Caufriez has actually developed a “tonemeter” that measures the resting tone of the pelvic floor in addition to its ability to produce force.

“I did get a chance to “try” a basic Hypopressives activity at this years APTA Combined Sections Meeting. The session leader readily indicated this was her interpretation of the activity and I am readily admitting it was my attempt at interpreting that in my own body.”

It would be nice to know if the session leader had been trained by Marcel Caufriez or has just tried to understand the method via youtube… If she isn’t fully qualified to teach HM then she most likely wasn’t able to explain the method to everyone correctly.

“The result was I could feel my pelvic floor get sucked up involuntarily as I performed the maneuver. But it only stayed up as long as I held my breath and had my diaphragm in a locked position.”

HM has certain benefits that are very immediate and others that are achieved after the reprogramming phase is complete. Eventually the resting position of the internal pelvic organs changes but no, it does not happen after one day.

“What happens when things go back to “normal”? Or is breath holding their new norm? More questions”.

HM sessions usually last about 20 minutes during which people perform apneas and rest breaths. “Normal” breathing never ceases except during the apneas.

“Based on what I can decipher, Hypopressives appears to be another form of a static positioning and holds to achieve central stability. Another non-functional strategy when dynamic central stability is the goal.”

Your deciphering is a bit off track which is understandable due to the lack of information available to you. HM does just what you promote, improves dynamic central stability as it reprograms the core to do its job involuntarily.

I hope that has helped to answer some of these questions (and perhaps brought on some others). My initial reaction to this method was a bit like yours so I understand where you are coming from. I spent some years writing to associations in the USA for opinions and information (back in early 2000s) and none was available. So, please have some patience as it is a lot of work to get the information translated and available to the English speaking world. Plus the method is complex so the best way to learn is by doing the full courses and trying the techniques on yourselves and clients to see the fantastic results first hand. It is also important to note that we have thousands of colleagues around the world who are using these techniques with great success. That was what “won me over” in the beginning. I realized that pelvic floor physios wouldn’t continue to use a method that didn’t produce the desired results. Realizing that HM was the main rehab technique used for postpartum propelled me to learn more about it and trust that my colleagues were onto something that improved the quality of life for women.

Sunny greetings from Spain! Please let me know if I can be of further assistance.

Kaisa Tuominen
Hypopresive Method UK Country Master Trainer

 

Chronic Pelvic Pain (CPP)

Chronic pain ramps up your nervous system this in turn reduces respiration- respiration is particularly affected with pelvic pain as women suffering tend to round forward over the pain. This altering of posture does in itself also limit the ability to breathe as the lungs and diaphragm cannot operate at full function when one is stooped over .

Try it: curl your head and spine forwards and trying doing a diaphragmatic breath. Now try it upright – see the difference?

Try it: Lying on your back take a rolled up towel and place it across your shoulder blades. Keep your knees bent and feet flat on the floor. This mobilises your thoracic spine, opens your chest and encourages improved upright posture. Now use diaphragmatic breathing, inhaling through your nose for a count of 2 and exhaling through your mouth for a count of 4. This will help calm the nervous system, move your diaphragm and relax your upper back.

When we inhale the respiratory diaphragm drops yo help expand our lungs. The  pelvic diaphragm mirrors this and lowers adding mobility and circulation to the pelvic floor – by working to increase the depth of respiration we can improve pelvic floor movement.

 

Your pelvic floor – why traditional exercises don’t work!

Losing the strength in your pelvic floor be it post pregnancy or through other trauma can have a huge impact on you as a person, your relationships and the daily activities you choose to do.

Let’s look at traditional methods!

The sit up….

ABDOMINALES TRADICIONALESSomething for you to try first as doing and feeling is better than just reading.
Lie on your back, place your hands on your tummy near the bottom. Now cough. What happens? Does your stomach push out? Does your pelvic floor move down? Something as simple as a light cough can produce a lot of pressure. As you are already on your back, try a traditional abdominal crunch or abdominal exercise of your choice (not too many!). What happens? Can you feel the increase in pressure downwards, outwards, on your back, neck?
4
Pulling your belly button in toward your spine all day is like squeezing on a tube of toothpaste.  As toothpaste will be pressed out of the hole of the tube, so too will the pressure you create attempt to push through any weak point you may have in your core. So if you like hundreds more have been pulling your tummy in and chest breathing to make your self appear slimmer…you have been doing yourself and your diaphragm a disservice!  Over time, these weak points can eventually manifest themselves in any number of symptoms of a dysfunctional core.

Continue reading

Incontinence (you are not alone)

Too few women and men discuss incontinence. It can have a marked effect on quality of life, social engagements, friendships. It is makes your world smaller. I used to ‘joke’ that I needed to know where all the public toilets were before we left the house. I would plan a route. I got really good at quick outdoor peeing. I wouldn’t spend the day on the beach or go out on the town with my friends (the taxi ride home was too painful)..

Incontinence effects more people than I once realised it needs to be spoken about, with the growing use of forceps, oxytocin and induced labour comes a rise in incontinence and a reliance on incontince pads. Women use Tena ladies to be able to exercise, live, laugh and go about their daily tasks. Kegels and Tena lady don’t appear to be solving this problem.

Let’s look at the reasons:

Hormonal and physical effects of pregnancy and childbirth are the main reasons why women are much more prone to incontinence than men.

Statistics show that women who have had a baby vaginally are 2.5 times more likely to suffer incontinence than those that haven’t.

During pregnancy there are changes in renal physiology resulting in changes to frequency of voiding and stress incontinence- other symptoms during pregnancy and post pregnancy are: urinary urgency, urge incontinence, incomplete emptying and slow stream.

The increase in stress incontinence during and after pregnancy is the result of damage to the fascias, ligaments, pelvic floor muscles and nerves supporting and controlling the bladder neck and uretha.

Post partum incontinence increases the likelihood of long term incontinence- women post partum who suffer from incontinence are more than 3 times likely to still suffer five years later.

I know all too well how invontinence can lead to depression. You want to be enjoying your baby, meeting friends etc. but every decision/event is ruled by your incontinence. I lost friends, I was too ashamed to explain. My intimacy with my husband changed. I felt dirty all the time. I needed the toilet all the time. Most women don’t want to talk about it. But talk we must!

I had no idea that oxytocin during labour increased my risk of incontinence in later life….did you?

WE NEED TO TALK ABOUT IT

Hypopressives have helped to strengthen my pelvic muscles and the connective tissue supporting my bladder. I pee like I did before