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 Prolapse | Incontinence | Diastasis | Hernia | Athletic Performance | Aesthetics | Wellness


Hypopressives are nothing new.  Historically, in Yoga practice a hypopressive maneuver called the Uddiyana Bhandha has been used for thousands of years for purposes such as visceral mobilization, respiratory muscle strengthening, and diaphragmatic mobility. In the late 1970's the technique was adopted by bodybuilders such as Arnold Schwarzenegger and renamed the "abdominal vacuum".  Bodybuilders posed using the technique to visually reduce their waist size while simultaneously highlighting their thoracic muscles.  In 2006 Dr. Tamara Rial and Piti Pinsach began teaching the Hypressive technique in Spain, based on their research findings supporting it's use in resolving many different pelvic and abdominal dysfunctions. In 2014, they created Low Pressure Fitness, a full body exercise program incorporating the findings of their research as a method to: 

  • Tone deep abdominal and pelvic floor muscles

  • Enhance posture

  • Prevent all types of herniation (abdominal, vaginal, etc.)

  • Regulate and/or improve respiratory parameters

  • Prevent and/or reduce the symptoms of urinary incontinence

  • Improve the management of intra-abdominal pressure

  • Improve venous return

  • Prevent musculoskeletal injuries

  • Improve limbo-pelvic stabilization

  • Enhance quality of life and well-being


Although now used widely throughout Spain, Europe, Brazil and Canada, Hypopressives were not introduced to the US until 2015. Internationally, Low Pressure Fitness and/or Hypopressives are considered a part of fundamental training to help counter the forces of popular high impact sports (i.e. cross fit, running, volleyball, etc.)  Moreover, it is now the standard of care for postpartum women in France, Spain, and Brazil among other countries. 

Hypopressive literally means Low Pressure.  The majority of traditional postural exercises - including core exercises (crunches, planks etc.) are HYPER-pressive, which means that they actually increase abdominal and pelvic pressure. HYPO-pressives decrease internal pressure within the abdominal and pelvic cavities.  Many medical conditions such as diastasic recti, pelvic organ prolapse, urinary incontinence, hernias and back pain can be seen as a dysfunction of core pressure.  In Spain, Brazil, and France women with urogynecogical diagnoses described above are prescribed Hypopressives.  Beyond a treatment option, women around the world have also embraced hypopressives as a form of core toning with an impressive aesthetic benefit.

Carol Harmon of Core Functional Wellness performs the Low Pressure Fitness hypopressive exercise pose Athena
Carol Harmon of Core Functional Wellness performs the Low Pressure Fitness hypopressive exercise pose Hestia


Q: What is the difference between Low Pressure Fitness and the Hypopressive apnea?

A: Low Pressure Fitness is the exercise program developed by Dr. Tamara Rial and Piti Pinisch based on their research.  It is a series of postural holds with a specific breathing pattern which strengthens and tones the inner core muscles, provides postural and breath re-education while simultaneously decreasing intra-abdominal pressure.  A feature of the Low Pressure Fitness Program is the Hypopressive Apnea which is performed during the Low Pressure Fitness exercise program.  

Q: Who can benefit from Low Pressure Fitness?

A: People choose Low Pressure Fitness for a variety of reasons. Some women have a goal of "healing" or improving a specific medical concern such as diastasic recti, pelvic organ prolapse, incontinence, or lower back pain.  Men may be interested in healing an abdominal hernia or recovering from prostate surgery. Some use the exercises as an adjunct to their workout routine because they like the aesthetic benefit of a slender, toned core and improved posture.  Athletes frequently use Hypopressives for breath training or as a way to counter the increased intra-abdominal pressures created by activities such as Cross Fit, running and volleyball.  

Q: Are there any medical contraindications to doing Low Pressure Fitness? 

A: There are no medical contraindications to the Low Pressure Fitness program. There are, however, some medical contraindications to performing the hypopressive apnea. Persons with hypertension (high blood pressure), heart disease, COPD, an active cancer, fibromyalgia or pregnant women should not perform the apnea. They can still do the Low Pressure Fitness Program without the apnea, which provides many of the same core benefits. Women with an IUD can perform the hypopressive apnea under physician supervision. 

Q: How is Low Pressure Fitness Taught?

A: Initial sessions are performed one-on-one with the instructor due to the technicalities of the postures and breath sequences which must be mastered before group instruction.  In person instruction can be performed either in clinic, online or outdoors. Clients begin in one-on-one instruction, then may progress to a small group instruction and/or group class exercise via online instruction. At CORE Functional Wellness we offer both in clinic instruction and online instruction through Zoom as part of a client's treatment plan.


is proud to be one of the first 21 Occupational and Physical Therapists trained by Dr. Rial in Low Pressure Fitness in the United States. Carol is excited to bring this technique to women who want to learn a way to better manage abdominal and pelvic pressures to prevent and correct core dysfunction; with an added bonus of improved abdominal tone and posture.

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