Hypopressives Contraindications and Modifications

Hypopressives, also known as Low-Pressure Fitness, is a popular fitness and rehab method gaining recognition for its potential benefits in improving core strength, posture, and pelvic health.

A key advantage of Hypopressives is its accessibility - you need no equipment, except your body and breath. It is suitable for all ages and conditions. It includes multiple modifications and has very limited contraindications.

Hypopressives are made of 3 pillars:
Lateral breathing or rib expansion
Alignment or placement/activation of your body and
Apnea or the breath hold.

Contraindications are only for the Apnea i.e. do not do the apnea if you're contraindicated. You can always do the lateral breath and alignment any time you like.

Contraindications	Reason
Any lung or heart surgery	Hypopressives involve changing intra-abdominal pressure, which may strain surgical areas. Opt for the lateral breath for heart and lung health and safety after surgery or transplants.
Ehlers–Danlos syndrome - vascular	With a high risk of arterial injuries and fragile organs, stick to lateral breath work and avoid pressure on the heart and lungs.
Heart fibrillation	Practise lateral breath and poses for better blood pressure control and hydration. If you have experienced this only once and know it was related to stress, thyroid or other treatable issues that are under control, you can do the apnea.
Incarcerated Hiatal Hernia	Stick to lateral breathing to avoid any increase of tension in the trapped stomach portion, potentially obstructing blood flow.
Ostomy surgery	Starting with only the lateral breath, and do not practise the apnea breath until consulting a specialist for safety. Wear a pad initially.
Pregnancy	Embrace lateral breathing and poses for improved posture and myofascial tone during pregnancy and as a preparation for birth. Avoid apnea since it may affect the baby. After the 1st trimester, refrain from exercises that require lying on your back.
SVES (Supraventricular Ectopic Beats)	Focus on gentle lateral breathing and poses to alleviate stress, anxiety, and heart rhythm issues. This can help reduce symptoms.

Here are recommended modifications if you have any of the below symptoms

Symptoms	Modification
Abnormalities of the vertebrae and bones (e.g., spina bifida, scoliosis, Klippel-Feil syndrome)	Selene rolling (in the intermediate Hypopressives course) should be avoided with Klippel-Feil syndrome and spina bifida. Scoliosis with spinal fusion should avoid the standing pose that requires you to flex the spine (the pose is called Hera). You can instead do the hip hinge pose (the pose is called Artemis). If the ribs feel uneven use a small wedge cushion or a towel to balance them out - you will know you have it right when it feels comfortable.
Arthritis (e.g., osteoarthritis, rheumatoid arthritis)	Keep joints moving with daily posture variations and short holds in poses.
Breast implant	Wait for 6 weeks after your procedure before attempting lateral breath work and any hypopressives poses. You can do gentle lateral breaths before this, but avoid extremes. After 6 weeks you can practice hypopressives fully.
Bowel intussusception	Gently integrate all aspects of Hypopressives - pay extra attention to your body and breathing not to create more strain.
Cataract surgery	Avoid apnea or inversions (positions where the head is lower than the pelvis) for 12 weeks post-surgery.
Cholecystectomy	After gallbladder surgery, perform seated or standing lateral breathing for lung function and healing in the first week. Gradually add shorter apneas (don’t breath hold as long as in the videos) from week 2-3.
Diaphragmatic hernia gliding	Avoid inverted poses (positions where the head is lower than the pelvis) the all four positions with elbows on the mat.
Glaucoma	Avoid inverted poses (positions where the head is lower than the pelvis), such as the all fours positions on elbows and focus on relieving eye pressure.
Heart Umbrella Procedure	Consult a specialist before considering apnea; other components of lateral breath work, alignment are suitable and useful.
Herniated disk in the neck	Avoid the pose that requires you to flex the spine (the pose is called Hera).
Hip Operation	Use lateral breathing without apnea, sitting, standing, or laying down. Start gentle poses and apnea from week 6, maintaining even weight distribution.
High blood pressure (Hypertension)	Start with gentle lateral breathing and poses; consult a doctor before attempting apnea.
IBS/ Chrons	Avoid the apnea when having a flare up.
Loeys-Dietz Syndrome	Consult a specialist before attempting apnea to avoid heart-related issues.
MS	Adaptations may be necessary based on the stage of MS, as everyone's experience is unique. Please chat with us so we can assist you.
Neck issues (injury)	Focus on neck position, avoid tightening the neck, closing the throat and treat apnea as a gentle breath pause.
PEG (gastronomy in the stomach)	Consult with a doctor or specialist before attempting apnea due to abdominal insertion.
Uterine fibroids/ Myoma	If you have an enlarged abdomen due to fibroids, some Hypopressive poses may be challenging. Listen to your body and avoid discomfort-inducing positions.
Wheelchair	Hypopressives can be done from a wheelchair, starting with the sitting pose and adding arm, wrist, neck movements and exercise bands for upper body strength and engagement.

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Updated on: 20/11/2023