Multidisciplinary Hypopressive Method: A New Trend in Exercise

For years people have been depending on health and fitness facilities and trainers to make them look and feel better. The choices for these individuals are diverse: cardio, muscle training, spinning, aquafitness, Crossfit, Pilates, Yoga, dance—you name it, there’s something for everyone. However, with all this diversity there has often been something lacking in the workouts to make them more effective: consideration of intra-abdominal pressure.

Brief History

The Multidisciplinary Hypopressive Method—or MHM—originally started in Europe during the 1980s as a physiotherapeutic method for postpartum women with pelvic floor dysfunction. Twenty years later, knowledge of this pelvic floor rehabilitation method expanded to the fitness community that applied it to core health and the prevention of pelvic floor dysfunction, prolapse, and incontinence. In the past five years, however, the concepts of the MHM have been applied to more than just core, adapting its usefulness to every physical training activity that exists. The International Hypopressives Council (IHC) was formed to encourage research, study, apply, promote, and disseminate knowledge of hypopressive exercise throughout the member countries.

What Does the MHM Entail

The MHM is based on posture and breathing; that’s what makes it so easily adaptable to all techniques: rehabilitation, exercise, and sports. After an evaluation of the patient/client, the professional will work first on his/her posture to facilitate learning how to breathe properly. Breathing properly in the MHM entails correct management of intra-abdominal pressure to avoid increasing pressure on the pelvic floor, back, and lower anterior abdominal area. However, without proper posture full 3-D breathing is not possible.

The Importance of Posture

Since the MHM can be applied to every therapeutic, exercise, and sports activity, it is taught in many positions: standing, forward flexion, lunge, kneeling, quadruped, seated, supine, and side-lying. Initially, the positions are static to learn/improve neutral hip, spine, and shoulder position and stabilization, fundamental to being able to advance to the next level. Once the participant has integrated these fundamental elements, the poses become dynamic, asymmetric, and, ultimately, rotation and torsion are added to the movements, allowing their assimilation into all physical exercise and activities.

While perfecting posture and control of our bodies we integrate the uplifted breathing technique, after all, we do need to do both together all the time.

The Importance of Breathing

Breathing is the first and last thing we do in life. The diaphragm, aside from being the prime mover in breathing, is also a postural muscle of utmost importance and has an immense effect on most of the body systems: cardiorespiratory, circulatory, nervous, digestive, musculoskeletal, lymphatic, genitourinary, etc. By training the diaphragm through our breathing techniques, we are affecting the entire body.

In MHM, 3-D breathing is done by increasing ribcage expansion. The participants are encouraged to increase proprioceptive awareness of their breathing and visualize “opening” the ribcage to allow more air to enter and exit the lungs while not raising the shoulders to involve the thoracic outlet and activate the sympathetic response. They are taught to use their hands on the ribs to “feel” the thoracic expansion and contraction and learn how to control the duration of the respiratory cycle (inhale and exhale).

The thoracic diaphragm works as a pump that affects the other diaphragms of the body, especially the pelvic diaphragm, also known as the pelvic floor. So, while working on ribcage expansion on the inhale, we are also working with abdominals (our expiratory muscles) on the exhale. Here we use the MHM’s uplifted breathing technique. Once this technique is consolidated, we can add expiratory apnea with results that are immediate and effective.

MHM for Women

While hypopressives were originally conceived as rehabilitation for post-partum pelvic floor dysfunction, it soon expanded to perimenopausal women, many of whom had hypotonic pelvic floors, prolapses, and incontinence. However, working with these populations, the effects of the technique expanded and were also seen in the reduction of back pain, anecdotal effects on the reduction of diastasis recti, enhancement of intestinal function as well as a decrease in waistline circumference. Using the MHM in exercise is easily integrated into activities of daily living because breathing and posture are fundamental to everything we do.

MHM for Men

Strangely enough, while women respond most quickly to the MHM, men also have pelvic floors that respond to thoracic diaphragmatic function. So, it stands to reason that the MHM is also beneficial to the masculine population. We see the effects in treating men with prostatic dysfunction, incontinence due to radical prostatectomies, pudendal nerve compression, and entrapment, and potentially erectile dysfunction. While you can’t generalize that the MHM is a cure-all, we do see that by correcting posture and breathing techniques men can also prevent compression on the pelvic floor and inflammation of the pelvic organs.

MHM for Both

Both men and women who have begun using the MHM for the above-mentioned problems have also happily noticed another unexpected result: the enhancement in their sexual function and sensitivity in the genital area as a secondary effect of using the MHM.

Conclusion

This is a very simplistic description of the Multidisciplinary Hypopressive Method. The components of the MHM are based on the most recent research regarding fascia, biotensegrity, neurodynamics, neuroeducation, and the polyvagal theory. The important thing to remember is that the MHM has numerous applications within the health, fitness, and sports communities, dependent upon the competencies of the professional and the needs of the participants.

For further information, please contact the International Hypopressives Council at hypopressives.international.

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