Hypopresive Exercise Techniques

This incredible method to work the core was created by Marcel Caufriez.  He discovered back in 1980 that women doing traditional abdominal exercises for postpartum rehabilitation recovered worse than the women who did nothing.  In addition, he noticed that if a woman performed a diaphragmatic aspiration during a vaginal exam, her (uterine, bladder) prolapse was reduced.  With these discoveries he started looking for exercises that were beneficial for the core without simultaneously being detrimental to the pelvic floor.  Thus Hypopresive Exercise Techniques were born.

Now, 30+ years later his methods are very sophisticated and have a solid scientific base as well as years of practical use with clients.  Until recent years the techniques have mainly been used in treatment of functional pathologies (urinary, digestive, and vascular) and as the main rehabilitation tool during postpartum.  Now the techniques have been adapted and are ready to be used in fitness to prevent pathologies as well as a modality of exercise to improve general fitness.

Benefits of Hypopresive Exercise Techniques include:

  • Reduction of waist size and flattening the abdominal wall (average 8% reduction)
  • Increase in abdominal and pelvic floor muscle tone (average 58% increase)
  • Decrease in pelvic congestion
  • Static and biomechanic normalization of the pelvic viscera
  • Prevention and treatment of incontinence and prolapses
  • Improvements in sexual sensations and ability to orgasm
  • Normalization of posture (especially posterior chain)
  • Improvements in vascularization of the lower limbs
  • Activation of the sympathetic nervous system

Hypopresive Techniques are global neuromyostatic techniques that adjust musculo-tendinous tension in visceral, parietal, and skeletal tissues.  Hypopressive exercises are postures that reduce intra-abdominal pressure and stimulate an INVOLUNTARY reflex contraction of the pelvic floor and core muscles.  This is the key difference between HET and any other exercise program for the core.  All other programs (pilates, core stability, etc.) use VOLUNTARY contractions.

The pelvic floor muscles are made up of 85%-95% of type I (tonic) muscle fibers while the composition of the abdominal muscles is about 75% type I muscle fibers and only 4% of type IIb (phasic, fast twitch) fibers.  Thus it makes sense to focus core training to stimulate the type I fibers.  It is important to train the type II fibers as well, but respecting the physiology, only 5 to 25% of our training should be geared toward stimulating the type II fibers.

Further more, it is essential that the involuntary or tonic tone of the core first be reprogrammed before moving on to exercises for the phasic muscle fibers.  Due to neural co-activation of the muscle fibers in these areas, the more hyperpresive exercises are done for the voluntary muscle fibers, the further the involuntary fibers will be deactivated.  This was demonstrated in a study in 2007 by Caufriez.  The subjects performed traditional abdominal exercises (stimulating voluntary fibers) during six weeks. The results showed that this caused the base tone (involuntary function) of the pelvic floor to decrease by 32.7%.  Therefore, not only are typical abdominal exercises ineffective, they actually cause pelvic floor and core base tone weakness.  Base tone weakness is directly related to incontinence and prolapses as 100% of women with urinary incontinence have poor pelvic floor muscle tone while only 50% have poor pelvic floor muscle strength.

Here are some more studies that show the benefits of Hypopresive Exercises:

A study of 100 women (Esparza, 2007), average age of 36, with hypotonic pelvic floor muscles and stress urinary incontinence showed an increase in pelvic floor muscle tone (I.I.I.) by 58% and loading tone (shock absorption capacity) by 48% after a 6 month program of 20 minutes of daily hypopresive exercises.  In addition, this study showed a 20% increase in contractile muscle strength and a 6% decrease in waist circumference (p= 000,3).

In 2007, Fernandez found similar results with a group of older adults (mean age 68,5 years).  After training with hypopresive exercises 4 times per week for 6 months, they showed an increase in base tone by 23,5%, loading tone by 25,3%, and perineal blocking during exertion by 108,4%.  Hypopresive techniques have been shown to be a useful tool in solving issues with incontinence in older adults of both sexes; in 85,7% of cases symptoms of urinary incontinence (stress or mixed) were decreased or disappeared completely as measured by the ICIQ-SF questionnaire.

Further studies by Caufriez (2007), showed positive results after a 10-week hypopresive program done just 1 hour per week.  The subjects’ postures improved demonstrated by a repositioning of the plumb line, a decrease in lumbar lordosis (p=99,9%), a decrease in cervical lordosis (p=99,8%), a decrease in dorsal kyphosis (99,5%), and a decrease in scoliosis (p=96%).  The subjects also reported a highly significant improvement (p=95%) in their sense of postural comfort (better mobility, better flexibility, less pain, and feeling lighter).

Recently a longitudinal study was completed by the University of Santiago and the University of Vigo.  The study included 126 women between the ages of 25 and 60 (mean age 42,8 years) divided into two groups.  Both groups did abdominal exercises for 30 minutes, 2 times per week for the 14 week duration of the study.  The group that did hypopresive exercises showed a significant decrease of waist circumference by 3,5cm on average and a decrease of 2,8 points on the Spanish version (Espuña et al, 2004) of the urinary incontinence questionnaire IU ICIQ-SF.  This equated to incontinence being completely resolved in some of the subjects (Rial and Pinsach, 2010).

Studies in progress seem to suggest an enhancement in cellular resistance to acidosis and an increase of the hematocrit during exertion.  As of now it can only be hypothesized that these changes could be due to a splenic contraction reflex or an augment in erythropoietin.