Hypopressives for Pelvic Floor Health
with Christina De Haas
Back in episode two we talked about the basics of pelvic floor health. That episode generated a lot of great feedback. You felt empowered with information about your body. You learned a whole new discipline of physiotherapy you didn’t know existed and maybe you got a little more comfortable thinking about your pelvic floor. Building on pelvic floor physiotherapy is a complimentary modality called hypopressives, and despite its name, it has nothing to do with blood pressure. Hypopressives marry yoga and breath technique with core exercises to improve your pelvic and core health. It helps improve your posture and contributes to your overall wellness. Hypopressives can help you improve the function of your pelvic floor structures, but the overall benefits don’t stop there.
Do you ever experience stress? Anxiety? Can any of us really say no to that? Have you noticed how you’re tightening your shoulders and not breathing properly? Maybe you’ve had abdominal surgery including Cesarean section like I have – three times. If you have spinal degeneration or disc problems, episiotomy, chronic constipation, hemorrhoids, and a whole host of health issues. Hyper presses may allow you to be an integral part of your wellness process. My guest today is Christina De Haas. Christina is a social entrepreneur who offers services through YoglowA, a business inspired by the health and wellness benefits of yoga and movement medicine. She has a Bachelor of Arts from the University of Toronto and is a certified 350 hour yoga instructor including pre-and-postnatal yoga and she has been teaching yoga for nearly 10 years. I’ve been doing yoga with her for the last five and she is my favourite instructor of all time.
When she was introduced to the practice of hypopressives, she knew this was the way to offer the next level of care for her community. Christina, was certified in level one hypopressives by the International Hypopressive Institute in 2016 and has been practicing her poses ever since. She has taught one on one sessions and in a class environment in and around the Sackville, New Brunswick area for the last three years. Christina is also a certified Doula from Douglas College in a Doulas of North America recognized program she completed in Vancouver in 2003 and she has attended births in Vancouver and Nova Scotia for many years. Many of the mothers she supported in birth received follow-up hypopressive care to enhance her Full Mother Care doula package. She has two children and loves being a mother who enjoys finding ways to share her knowledge and creative interdisciplinary ways. Since recording this episode a couple of weeks ago, I received my first hypopressives lesson from Christina. I’ll check back with you at the end of the episode to let you know what I learned.
Christina: There’s a lot around the word hypopressive. So it’s a combination of things that began really in like the history of it is that it’s a yogic practice that was, that has been documented. Right in the beginning of yoga when when people started noticing that there were documents about different body movements and in the yoga it’s called uddiyana bhanda which is a lifting and holding through a breath practice of the body, an expansion of the chest, which hollows out the abdomen. And it was done by men. And so in about 1980, there was some research being done and they came across uddiyana bhanda and did research on, well, if that’s a vacuum happening through the pelvis, that probably does something for the pelvic floor and we should look into that with the core system. So there is not just a core like, your abdominal muscles in the front, that sort of six pack muscle. There is a whole bunch of things that combine to be your core. And what they knew was that the diaphragm and the pelvic floor need to kind of work in conjunction. So when they saw the uddiyana bandha practice and this vacuum effect, the diaphragm is lifting. So they thought, well, let’s look at what the pelvic floor is doing. And they found that the pelvic floor was lifting. So it is a passive practice of a pelvic floor lifting rather than something like a kegel, which is an active pelvic floor lifting. So a hypopressive is a term that ended up coming out of Spain. It’s a little different than uddiyana bandha because they were researching this around any kind of prenatal postnatal practices for women. So when a man was practicing uddiyana bhanda, there is a, the, the lift uddiyana is the lift, the bhanda is a hold and in hypopressives, the term is around low pressure. The hypo, right? Low abdominal pressure. But there is no hold. It has more to do with they found for women especially, but it also works for men, now that there are different ways that you can find this vacuum and hold that is more passive. And that effect is where the pelvic floor lifts. When you’re doing an uddiyana bhanda, there is more of a contraction in the abdomen. But with hypopressives, you’re taught how to not have any contraction. So that it’s more about this whole internal line of muscle and mostly fascia, which is your connective tissue moving. So to come back to answering the posture part, in level one – here are several levels of this – so in level one, you start just seeing how your diaphragmatic breathing is.
It’s posture oriented because often our posture, if we’re not holding ourselves properly, right, we have weak transverse abdominal muscles, right? So we come, like we even begin when we’re teaching, we do a check in around posture and breathing, just normal breathing techniques and whether in our perfect health, the rib cage expands on the inhale and on the exhale it’s supposed to be that the transverse abdominal muscles engage and kind of tighten and, squish the breath out. I’m going to talk as gently as I can about this and not be too anatomical. So it’s if like in a proper breath, you want to feel that expansion and then you want your muscles triggering properly to make sure that you exhale properly. But what we’re finding too is that there’s a lot of people who aren’t breathing right. And there’s a lot of people who walk around holding their belly button in to try and flatten out the tummy.
These kinds of things end up giving you a high pressure that presses right down onto the pelvic floor, right? So the postures are, are different ways, like a standing, a folded, seated, and then on the floor ways that you do this vacuum, the vaccuum, this hypopressive breath, and they just help you find in your body where you get that maximum effect of this passive lifting of the pelvic floor.
April: Okay. And so are these kinds of practices and postures meant to be used in conjunction with, you know, pelvic floor physiotherapy or other modes of therapy, or can they be performed on their own? To get a similar therapeutic effect.
Christina: Yeah So they, at first it was a rehabilitation practice. And it is postpartum protocol in Europe that women do this after having babies. Yeah. That was really what they were doing the research for was how can we help women after birth. It’s also to help with diastisis recti, which is when there’s a separation, which you know, many women have after one year of postpartum, they’ve noticed almost 66% of women that they studied had it, had still had this opening, this weakness. So on their own hypopressives can be used as both a prevention. So before you even get pregnant or as any athlete, anyone who’s doing any kind of physical activity to keep the integrity of the whole core system. And then especially after birth, any type of birth, they’re really important to do. And so there’s the prevention side and then there is the, yes, if you’ve seen a pelvic floor physio and they’ve told you that perhaps you have a prolapse, if you’re experiencing any incontinence or anything like that, this practice can be done along with and is highly recommended it be done daily or if not a couple times a week along with anything else you’re doing. Because things like kegels, like we, the, the struggle sometimes is knowing how to both have the strength and the relaxation.
April: So if this has been used in Europe for a number of years, why- it’s only been since I’ve met you and been talking to you that I’ve ever heard about this. What has been the lag do you think in getting it here?
Christina: Probably I, I’d have to look at what the date was, but it’s been here.
April: Oh, it has been, it has been here.
Christina: It has been here, uh say maybe 10 years. And Trista Zinn is the head of Hypopressives Canada. So she came across this and you can read her story if you wanted to on the Hypopressives Canada website. She came across this with a prolapse and was so curious, found out about it and the immediate success that she started having – and she’s a real runner, fitness oriented – she’s a trainer. She just sort of said, ‘Wow, this is amazing. I can’t believe the results.’ And she went straight to Spain where the trainings are and did all her levels of training and brought it here. So the, there are a lot of people doing this as far as I know, Toronto and Westward they even have groups of people – classes – who are doing this. So here I am training in Sackville and I have had a lot of interest and I worked with people in Town and and I just say that there’s not enough knowing yet, possibly me not getting the word out as much as I could. And I think the other side of it though is that it’s dealing with the pelvis and it’s not a comfort zone for so many of us still. So it, you know, talking about sort of things that are still kind of taboo, right? It’s not going to be comfortable. And that’s not for everybody. So unfortunately it tends to be that if somebody has a prolapse and they’re feeling nervous or they really don’t want to have to go surgery or there’s, it’s suggested before surgery, you can try these types of things. We, you know, we end up doing some work together, but as a preventative, I, you know, we brush our teeth twice a day hopefully to take care of our teeth and our mouth and everything. I know people don’t see this region the same way, but we really need to commit to taking care of ourselves because my, my passion really is like, let’s not end up supporting the adult diaper businesses. Right.
April: And when you reach a certain age, you see the advertising everywhere!
Christina: It is everywhere because it’s obviously a growing market. It’s a very fast growing market because people don’t understand that there are ways to help and to fix this.
April: So is the, is the healthcare system clued into this? Are they referring? Are they, are they talking about this as a, as a means of of treatment or is it you have to kind of find it on your own?
Christina: You more so would have to find it on your own. Pelvic Floor Physios are the only ones I know about that are highly recommending this.
April: Right. And they are an emerging treatment modality as well.
Christina: Yeah. So and, and then there are Doulas women who are helping women or anyone other, anyone who’s practicing, supporting at births. There is a bit of a knowledge about this and, and the need after birthing to help the whole system come back to place to help the core settle back in and to reconnect. Yeah. But then if we, you know, thinking about the industries, I mean there are lots of females using tampons. There’s lots of disconnect. I mean there’s chemicals in a lot of the tampons. So there is a whole shutdown that starts to happen through the whole region. And because of that, you know, this work I believe is, is really needed because a lot of us need to go back to reconnecting with this whole core system and the pelvic floor and ensuring the blood flow and everything is there for a really healthy body, healthy periods, healthy birthing, healthy everything. Right. And we’re worth it. We deserve this.
April: Yes. Agreed. Absolutely. Agreed. Can you tell me about the certification process that you, that you undertook to, to be able to practice and offer these kinds of classes?
Christina: So Trista does the trainings. The woman who’s the head and so she came and covers it’s four days. I forget how many hours that adds up to. But anyway, you usually it’s physiotherapists who are in the program. So because I passed her anatomy test, she said, and because I know her and she knows my knowledge of yoga I was included in being able to take the course. So most of the time it is someone who is doing that kind of physiotherapy work and then they have time to possibly offer it in their practice. So for me it’s that I can, because of the uddiyana bandha and the training around yoga practice and having been trained as a doula, it fit really well for my kind of work. The training goes through the history. That training goes through teaching us, well basically, I mean we’re talking about anatomy quite a bit about anatomy. We go through all the different types of incontinence cause there’s various forms of incontinence that people can experience anything from – I don’t know if you ever saw the CrossFit videos that were circulating where people were posting, ‘Oops, I peed’, you know, or sort of like their intense workouts were making them leak. And we talk a lot about anatomy and why that might happen and how that’s a high pressure system happening in the body and that weak pelvic floor, and you know, the stress incontinence versus any kind of prolapse. So there’s various forms of prolapse that women can experience. So we go through the various forms of those. And the way that you can find out about that is not something that we do as a hypopressives trainer or teacher. You would want to go to a pelvic floor physio to find out where you’re at, how things are going, right? Whether you have a prolapse. Cause there’s several stages of it, what kind. So we go through what all of those are so that when someone comes to us and says, ‘Well, I’ve got a level two bladder prolapse’, then I know what they’re dealing with, usually what those kinds of symptoms would be.
And then we, we learned hands on basically how you go through the whole technique, you know, to be able to practice it really well ourselves. And then to be able to pass that on. So it’s a lot of hands on helping someone connect with their diaphragm, making sure the diaphragm is moving and that they’re breathing. So there’s postural and alignment practices. And then there’s the whole teaching of apnea technique, which are, so it’s the breath technique before we go into any of the postures. So how do you teach someone to do that in their body? And that’s quite a lot of teaching and work that we do hands on with each other in the room. So it’s that kind of training.
April: So learning to breathe.
Christina: You’re learning to breathe. Yup. Yeah. We all need to reprogram our breathing. And so we’re kind of like breath coaches in a sense.
And then we’re also physical body practice coaches because we’re checking the integrity of the core system. The transverse abdominal muscles is what the focus is as well, because when they’re weak, we don’t, we slouch, right? We don’t have that proper, we can hold ourselves up type of posture. So there’s a lot of suggestions and ways we can help retrain that transverse abdominal wrapping muscle. That’s actually our deep inner layer of muscle. And then through that it’s then that learning to do the apnea, that vacuum and how you can comfortably do that with counting hands-on, right, with hands, sort of around the edge of the rib cage. And then once the person has been taught or in our practice, we were taught how to safely do that and comfortably do that with all ethics around how you work with someone in a body technique. Then we would learn the different postures that you can then help a person go into because we all have different anatomy, right? We have different needs. So the standing posture we are working through the trainings on how you find which body type needs which one in the standing posture. So when I work with a person, they’re learning which one is the one that works the best for them. So none of us will necessarily be doing it the same. If I, when I had done a class, I would just say go into your standing posture. Sometimes it’s arms are down so that the shoulders are staying away. Sometimes arms are out front, right? So there’s different needs that the body has to be able to go into that vacuum position and have the pelvic floor lift be extremely both noticeable cause you’re hoping people can feel and eventually you do depending on how, how your connection is. And also that you’re getting that maximum effect based on your entire body posture. How many using yup.
April: And then do people go and do this on their own? Do they continue doing it with a practitioner, you know, how often is necessary to do these kinds of practices to see sustained improvement? And then is there a point where you stop doing them to maintain what you’ve, what you’ve built essentially?
Christina: So to begin with, it’s an hour is the first, the first session just so that you can go through an intake and in the intake. What we do is we go through first we talk a little bit about what’s going on, what symptoms are showing up, what the person’s exercise regime might be. And then we do a, what we call an initial assessment, where we go through all the core anything that may affect the core. So the whole core system is we’re looking at diaphragm, we’re looking at the transverse abdominal muscles, we’re looking at multifidus, which is back muscles, and then the pelvic floor. So any, there’s, there’s all kinds of things that can show up that somebody is experiencing. So you know, their diaphragm, it may be that they have asthma. So of course then we know they’re not, that breathing pattern is, is off. With their back it might be that they’ve had you know, a disc out of place, out of alignment that’s going to change the whole core systems function. Transverse abdominals, you know, anything where there’s bloating, any kind of distended belly, any irritable bowels if you’ve had C-section, anything like that. So there’s all these different things that we’ve people have gone through in our life that show up as weaknesses. And so we just get an idea of what in your specific experience that is.
April: So that really goes well beyond birth.
Christina: Definitely. Yeah. So.
April: And birth related injury or trauma, right?
Christina: Yeah, this is for everyone. And it doesn’t matter what age you are because things like incontinence, as you know, again, I’ll go back to that CrossFit, the videos that were being posted, it’s not age related, it can be lifestyle activity related that things can show up.
And all it means is that you need a little lifestyle change with these kind of hypopressives to just reconnect. So to go through that after we do the assessment and see what someone might need. Sometimes it’s a way the person will take away just that they need to practice the breath technique of just a different type of breathing in a different posture so that they’re taking themselves step-by-step to where you have to go. Depending on what is noticed in that assessment, we check to see where the pressure level might be as well. So there is a bit of a hands on around the abdomen because there are different areas where the weaknesses can be showing up. And then the first practice to, to learn the first posture is always the one on the floor. So we start laying on the back – it’s the most, usually the most relaxed position. Find where the arm placement needs to be and then just talk through how you begin to breathe and the connection with the expansion of the chest. Because in order to be able to come into the practice, it’s, you need to be comfortable with an exhale and a pause because the, the, the hypopressive is done in an apnea. You’re in a breath hold. And just having that first experience often is just this whole body shift because it’s something most people haven’t done. Some yogini yogis have been doing uddiyana bandha. They need to be retrained just like I had to be retrained because it’s not the hold, it’s more passive. So then what you, the way I set it up and I can go to people’s homes as well to make it really easy for when they need this.
‘Cause the follow-up after the hour, depending on what we find can be several weeks of half hour practice. And once we get the floor technique done, then you can move into the other postures. And once you start learning it, you can do it at home. You can practice any of this on your own time to explore that. And then it’s a check-in. So for me, even it’s been several years of doing this. I still, if I’m, you know, away in Toronto or Trista’s coming to Halifax for training or something, I still go and have appointments with her to check in, make sure that I haven’t started cheating or going back to an uddiyana bandha practice. So once you learn them, the best part is, even if you just learned one of them and it’s really working for your body, you’re on your own, you can go and do it whenever, you know, as often as you need to daily, which usually it’s about less than 15 minutes. Wake up, you can lay down on the floor, do three of these and you’re on with your day.
April: What sparked in you that you wanted to learn this?
Christina: So it showed up for me because a friend of mine had fibroids and she was really concerned about her whole pelvic health and she was talking to me about it and I said, you know, I think we’d both known Trista growing up. And I said, ‘I think Trista’s doing pelvic health work and she’s not too far from, you should contact her.’ So this was kind of this, you know, and then I contacted her and said, actually, ‘What is this that you’re doing exactly?’ Because I’ve had kids and you know, I’m not a runner, but I do a lot of physical activity. And you know, you start to notice some changes. I wasn’t experiencing anything that was making me feel like, ‘Oh, I have to go see somebody’. But I was really interested in the body technique because I love through yoga body postures, body practices, and I’m very comfortable with my pelvic floor and love the idea of doing something other than Kegels to keep myself feeling healthy. And what I learned doing these is it is one of the most pleasurable experiences that I could say happens. And I would love women and men and anyone to know. But women, especially when you get this pelvic floor passive lifting, it’s quite incredible. It’s very worth doing.
April: All right, you’ve piqued my interest. I’m going to have to dry it.
Christina: My saying for a little while was there’s nothing like a Yoni lift to help a woman feel great.
April: That’s probably true. That’s probably very true. Yeah, I love that.
Christina: So and the good news there was that my friend did go and started practicing hypopressives and learning about it and she was able to get rid of her fibroids. They shrank and went away. Yeah. So this technique,
April: No surgery?
Christina: No surgery, no surgery. There are many, many prolapses as well – if it’s a level one or two, it’s not too much that can have, can be resolved. It has been able to change for women yet for men pro, anything around prostate issues. There is a really good core practice and doing this has really helped even with recovery. So many benefits.
April: So how would someone get in touch with you to explore this?
Christina: So I’m happy to have you call or text my cell. So (506) 536-7380. Or you can email and it’s email@example.com.
April: Okay, perfect. All of that will be in the show notes.
Christina: I was going to say I’m spelling it out. I really, really would love to know that and to see more people coming in to share this knowledge and this practice with everyone because I feel like we deserve to have a really healthy core system and the way it makes us feel, it’s we’re worth it. And you know, we need to feel like we’re able to be out and about without wanting to find bathrooms, without feeling like we’re going to have to spend money on things like diapers. You know, I’d love to see the revolution. And this is in Europe too. The whole idea is that this is this revolution that we are going to stay out of adult diapers.
April: Yeah. So it’s a body connection exercise, an empowerment exercise, an investment in self, exercise. Anything else? It feels good. That’s amazing. That’s amazing.
Christina: No, it would be very worth trying this and learning it because yes, exactly. You come back to it and you’ll remind yourself, ‘Oh yeah, why I do this?’ Because this feels really good.
April: It’s – it sounds like a really easy investment to make in yourself. All right. I’m going to check it out and then we’ll report back once I’ve done this for a while. Thank you, Christina.
Christina: Thank you.
April: It’s been such a pleasure.
So my first hypopressive session was eye opening. I learned that I actually have diastasis recti, which I actually had no idea was the case. I learned that my breathing and my posture and the way that I hold stress has tightened the fascia in my back, particularly on my left side because I’m left-handed, which means I am not breathing into my entire diaphragm. I really had to concentrate on breathing into my back to loosen the fascia. The first breathing technique, which Christina mentioned is done on the floor, was easy to learn and actually does feel really relaxing. There’s something very calming about the breath technique and there is a new awareness about my body that I didn’t have before just in breathing into my oblique abdominals. By breathing into them, I mean focusing on those muscles in my mind’s eye while I’m doing the breathing, I woke up the next morning with sore oblique abs, which is exactly the point, but I was really surprised, It was with relaxed effort – this is not a high school gym class crunches situation – I was able to activate, isolate, and work my abdominals just by breathing. I’ve been doing the breath techniques every few days and definitely notice variations on how tight the fascia in my back is on various days. I’m actually not able to immediately connect with my pelvic floor, but I feel confident I will with future guidance from Christina, which is coming up again for me this week. I highly recommend it. It only takes a few minutes a day. A huge thank you to Christina for joining me today. You can find links and show notes at podcast.anointment.ca please subscribe to Ripple Effect where ever you enjoy your media. You can find ripple effect on iTunes, Google, play, Stitcher and Spotify. I’m your host. April MacKinnon. Join us again for future episodes. It’s been such a pleasure being with you today.
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