Hypopressives: what they are, what they're for and what the evidence says

What hypopressives are

Hypopressive abdominal gymnastics (HAG) combines specific postures —standing, kneeling, sitting or lying down— with a breathing sequence: you inhale, exhale fully and, without taking in air again, open your ribs as if you were about to breathe in. That “false inhalation” creates a sense of suction: the abdomen draws in and the diaphragm rises. You hold it for a few seconds and then return to breathing normally.

It differs from a classic abdominal exercise in that the trunk does not flex and nothing is pushed outwards: the aim is to work with low intra-abdominal pressure, paying close attention to the alignment of the spine, shoulders and pelvis.

What they can offer you

• Body awareness: learning to feel and activate the deep abdominal wall without holding your breath.
• Posture: the self-lengthening postures invite you to grow tall from the crown of your head and to position your ribcage better over your pelvis.
• Breathing: the rib-opening work helps to mobilise the ribs, something often lost through stress or long hours of sitting.
• A calm practice that sits well alongside other disciplines such as yoga, pilates or strength training.

What the evidence says (without exaggerating)

The scientific reviews published so far conclude that the evidence on hypopressives is still limited and of variable quality. A systematic review comparing different exercise programmes concluded that alternatives to pelvic floor muscle training (such as hypopressives or pilates on their own) do not increase pelvic floor strength in the same way. A more recent scoping review points to promising results for posture and some abdominal parameters, but calls for more high-quality studies.

In practice, this means something simple: if you leak urine, feel vaginal heaviness or have significant diastasis, the first step is an assessment with a physiotherapist specialising in the pelvic floor. Hypopressives can accompany that process, not replace it.

Hypopressives are not recommended during pregnancy, or for people with uncontrolled high blood pressure. Postnatally, it is best to wait for your medical check-up and, if possible, a pelvic floor assessment.

How to start safely

• Learn the technique with a professional: the breath hold and rib opening have subtleties that are easy to get wrong on your own.
• Start with few repetitions (3–5 breath holds of a few seconds) and rest, breathing calmly, between them.
• Never force it: if you feel dizzy, feel pressure in your head or any discomfort, stop and breathe.
• Practise on a light stomach and at a time of day when you can be relaxed.
• Combine them with strength and whole-body movement: the body is best cared for through several doors at once.

How we work with them at INNER

In INNER's Hypopressives sessions, breathing and posture serve the deep musculature. Laura is trained in RSF Hypopressives (Caufriez Method). We work in small groups or one-to-one, in Sarrià, Sant Gervasi and Pedralbes or in an online session, adapting each posture to your stage of life and coordinating with your physiotherapist when you need it.

This content is for general information and does not replace an assessment by a healthcare professional. If you have pain or an injury, are pregnant or have recently given birth, check with your doctor or physiotherapist first.