To combat this issue, Orlando Health, a network of not-for-profit healthcare facilities, partnered with a CrossFit gym in Orlando, Florida to create a workout routine adaptive for people in wheelchairs. The goal was to help patients in wheelchairs feel empowered and able to work out alongside other CrossFitters with ease.
According to a press release from Orlando Health, the new routine is designed specifically for wheelchair-bound patients recovering from spinal cord injuries. The organization says it was eager to partner with CrossFit because they see first-hand how important fitness is to recovery, and felt it was a way to further help their patients.
“After a spinal cord injury, it is crucial that patients build their strength to be able to perform daily tasks like pushing their wheelchair and transferring in and out of their chair,” says Shreya Bhola, a rep for Orlando Health. “These modified workouts are focused on upper body and core exercises that help patients get more independent while also preventing long-term health issues such as diabetes and heart disease.” The group will also be working with coaches at the gym to train them on the particular needs of people who use wheelchairs.
The program is currently underway at just the one CrossFit facility in Orlando, and is specifically catering to one type of physical disability. (CrossFit also offers a variety of adaptive workout trainings for its instructors, to ensure people all across the country are able to include athletes with physical disabilities.) But hopefully, this model could help other gyms and clubs re-assess the needs of people with disabilities and adaptive athletes, and better serve them in the future—because everyone should feel included in the fitness community. Other fitness instructors, take note!
If you’re obsessed with all things Pilates, you already know about the best athleisure, accessories, and self-care moments to incorporate into your practice. However, you may be less familiar with a type of breathwork that can improve your practice — and help you feel more grounded.
Enter hypopressive breathing, a deep breathing exercise that involves emptying your lungs completely. It’s similar to the uddiyana bandha in yoga (or an “abdominal lock”).
“It involves breathing in a way that creates a vacuum-like effect in your thoracic, abdominal, and pelvic cavities by decreasing the pressure, causing a lift and toning of the pelvic floor,” says Anouska Shenn, a certified Pilates instructor and founder of The Office Yoga Company.
But before we get into how to do it, let us clear up one thing: Don’t try any breath-holding exercises during your practice, since Pilates focuses on breathing through movements.
That said, practicing hypopressive breathing before, after, or separate from your Pilates workouts can help support your practice in a number of ways.
What is hypopressive breathing?
Hypopressive breathing is a technique that involves completely emptying your lungs and holding that breath to create a vacuum. It serves as a core exercise that can benefit your pelvic floor health.
Think of it this way: Your abdomen is a closed pressure system. That means that when the pressure changes—like with a cough, deep breath, or force like a lift—your abdominal structures need to be able to manage that pressure properly. That’s where pelvic floor exercises, like hypopressive breathing, come in.
“When we’re not managing that pressure properly, gravity takes it and sends it down into the pelvic floor,” says Blair Mauri, MS, OTR/L, a pelvic floor therapist and owner of Blair Mauri Pelvic Health. “Repeated downward pressure not only weakens the pelvic floor, but can also cause it to become extremely tense.”
That tension may lead to symptoms such as incontinence, pelvic organ prolapse, painful sex, low back pain, or chronic constipation. “Hypopressive breathing is an excellent way to optimize pelvic floor function, as it provides a natural lift to these tissues without increasing the tension,” says Mauri.
Improving your pelvic floor function can relieve pelvic pain or low back pain, improve your oxygen and energy levels, promote digestion, and support your movement throughout your Pilates practice.
In fact, an eight-week program of hypopressive exercises improved pelvic floor muscle strength and urinary incontinence symptoms in women ages 18 to 60 with pelvic floor dysfunction and urinary incontinence symptoms, per a 2022 study1 in Neurourology and Urodynamics.
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Plus, hypopressive breathing can work your lungs in a way that benefits your Pilates practice. “Optimizing your rib mobility is also important for diaphragm function and getting the most out of your breaths,” adds Mauri.
How do you do it?
First, take a few deep breaths and see where you notice that pressure (in this case, your breath):
Is it focused in your chest or belly?
Are your ribs moving apart as you breathe in?
You should feel some mobility in all of these areas, not just one. “Rib mobility is especially important for proper hypopressive technique, so you may need to start here,” says Mauri. “Take some time to retrain your breathing so that everything expands on the inhale and comes back together on the exhale.”
Once you’ve honed in on that, you can move on to your hypopressive breathing exercises, following Mauri’s instructions:
1.
Gently exhale as if you are fogging a window. Don’t send any pressure or force down into your lower belly or pelvic floor.
2.
After you exhale, hold your nose and close your mouth and “pretend” to inhale without actually taking in any air. Think about widening those ribs, which will make your stomach begin to look concave.
3.
Hold this for 3-5 seconds and then inhale.
How does it benefit your Pilates practice?
This breathing technique shines as an add-on to your Pilates practice. You don’t want to hold your breath during Pilates moves (after all, Pilates is all about coordinating movement with breath), but hypopressive breathing exercises can serve as bumpers for an effective workout.
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“Hypopressive breathing is designed to stand alone, but you can use it as part of your warm-up or to close your Pilates practice,” Shenn says.
Pelvic floor strengthening is already often a key element of Pilates. In fact, a 12-week Pilates program focused on pelvic floor strengthening significantly improved stress urinary incontinence symptoms in women ages 45 to 70, with the results lasting even six months after the program, per a small 2020 study2 in the Journal of Alternative and Complementary Medicine.
“Hypopressive breathing complements a Pilates routine, as it also retrains and strengthens the deep core along with your pelvic floor,” says Mauri.
A strong and coordinated deep core and pelvic floor gives you more stability as you move your body throughout your Pilates practice—and throughout the rest of your day.
“Our pelvic floor muscles work together with our deep core muscles to stabilize the spine—supporting our posture and providing a solid foundation for all of our movements,” says Shenn.
Tips to get started
As you integrate hypopressive breathing into your Pilates routine, Shenn recommends keeping these tips in mind:
Start with 1-3 sets of 3 repetitions, resting between sets.
If you’re a beginner, practice your breathing lying down or seated, before progressing to more challenging positions like side-lying or quadruped (a four-point kneeling position).
Do your hypopressive breathwork on an empty stomach (it’s recommended to not eat at least two hours beforehand, since this type of breathing involves suctioning the abdomen inward and upward).
Avoid wearing clothes that are too tight—including collars, waistbands, and belts—as they can impede your breath.
Very little research has been done on the effect of breathwork on babies in the womb, so avoid hypopressive breathing if you’re pregnant.
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One more thing to note: Certain preexisting health conditions like high blood pressure can also be contraindications for breathwork, so always check with your doctor first and consider working with a trained provider to make sure your form is correct.
Molina-Torres G, Moreno-Muñoz M, Rebullido TR, Castellote-Caballero Y, Bergamin M, Gobbo S, Hita-Contreras F, Cruz-Diaz D. The effects of an 8-week hypopressive exercise training program on urinary incontinence and pelvic floor muscle activation: A randomized controlled trial. Neurourol Urodyn. 2023 Feb;42(2):500-509. doi: 10.1002/nau.25110. Epub 2022 Dec 8. PMID: 36482844; PMCID: PMC10107869.
Hein JT, Rieck TM, Dunfee HA, Johnson DP, Ferguson JA, Rhodes DJ. Effect of a 12-Week Pilates Pelvic Floor-Strengthening Program on Short-Term Measures of Stress Urinary Incontinence in Women: A Pilot Study. J Altern Complement Med. 2020 Feb;26(2):158-161. doi: 10.1089/acm.2019.0330. Epub 2020 Jan 9. PMID: 31916840; PMCID: PMC7044776.
Pilates was created in the 1920s in New York City by Joseph Pilates and many of its exercises were originally used to help World War I patients rehabilitate injuries. Today, Pilates is used more for fitness than for physical rehabilitation, although its focus on building a strong core may help prevent or speed along healing from other injuries.
If you’re considering giving this mind-and-body-focused workout a try, it’s key to have a grasp of Pilates’ foundational moves so that you can safely make the most of this muscle-building, endorphin-inducing workout.
The benefits of Pilates
Pilates is a unique fitness practice in that it focuses on more than just burning calories and achieving toned muscles—although you’ll do both of those things with a regular cadence of classes.
Pilates is focused on three principles, according to the Pilates Foundation: breath, whole-body health, and whole-body commitment, with “the whole-body encompassing mind, body and spirit.” Within those principles, the concepts of breath, concentration, centering, control, precision and flow are mainstays in any well-rounded Pilates practice.
“There are many benefits of Pilates that go beyond toning muscles or getting in a great workout,” says Rebecca Kennedy, CPT, a Peloton Pilates and Tread instructor. “Some of the top benefits of Pilates for me are that it improves posture and balance, helps with overall flexibility and mobility, and is low-impact and low-stress on your joints.”
Additionally, Kennedy notes Pilates can be an excellent complementary workout to other fitness activities like running, cycling, or strength training.
Lastly, Kennedy believes the mind-body connection that is achieved from a frequent Pilates workout is unmatched in the fitness world. “A regular Pilates practice will improve your mind-body awareness while improving mental focus and concentration,” Kennedy says. “Its emphasis on enhancing breathwork can also have the effect of reducing feelings of stress and anxiety.”
Beginner Pilates tips to keep in mind
Before diving into Pilates head first, remember to listen to your mind and body—it’s better to forego a move or modify it than cause yourself pain or injury. While it may be tempting to launch into some of the more advanced Pilates moves, it’s better to view each movement with “curiosity, instead of just trying to do each move and check off a box,” Kennedy says.
She recommends nailing the basics of the moves featured below—and not just acing the look of a move, but truly internalizing the breathing rhythm, form, and alignment of these foundational Pilates movements before becoming overly concerned with time spent in a movement, number of reps, or moving into more challenging variations of a move.
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“A common misconception about Pilates is that you need to be flexible and also have a ton of equipment to get started with your practice,” Kennedy says. “Neither of these things are true. You do not need to be flexible to start a Pilates practice, and much of the equipment used is all extra, so don’t let either of those misconceptions hold you back from beginning a foundational practice.”
Finally, Kennedy reminds those who are new to Pilates that this is a slow, methodical practice. “Move slower than you think you need to, and always move with control,” Kennedy says. “Take modifications for any exercise that feels too challenging—it’s better to take a modification that allows you to maintain good form, breath control, and pelvic floor connection than to rush through a movement.”
The best Pilates exercises for beginners
Kennedy demonstrates each of the 10 moves in the video below. Follow along with her or scroll down for detailed exercise instructions.
1. The hundred
The Pilates hundred works your core and introduces the concept of timing your breath with your movements.
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