Doing This Type of Breathing as Part of Your Pilates Practice Can Help Strengthen Your Pelvic Floor

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.

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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.

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.

“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.

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.