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This one is going to ruffle some feathers.
Hypopressives. Low pressure fitness. Whatever your algorithm is calling them this week. The theory has been the same since 1984: you do the breath, you hold the posture, your intra-abdominal pressure drops, and your pelvic floor switches on because of that pressure drop.
Nobody had measured the pressure.
Silvia Saraiva did. She trained 36 women who had never done a hypopressive in their lives, gave them two weeks to practice, then brought them into the Motor Function Measurement lab at the University of Ottawa with an intra-abdominal pressure sensor, EMG inside and out, and ultrasound running. Supine and standing. With the hypopressive posture and without it.
The pressure didn't drop.
The pelvic floor did turn on. Just not through the mechanism we have all been teaching.
Here's what makes this conversation worth your time: Silvia is hypopressives-trained. She still teaches them. She has patients who seek her out specifically to learn them. She is not here to tell you to stop. She is here to tell you the explanation doesn't hold up.
🔹 What a hypopressive actually is, broken all the way down
🔹 The theory, and where it came from
🔹 Why the measurement tools matter more than most of us want to admit
🔹 What happened to intra-abdominal pressure lying down versus standing
🔹 How hard the pelvic floor actually worked, compared to a max contraction
🔹 Whether nailing the posture changed anything
🔹 If the pressure didn't drop, what IS causing the contraction
🔹 What Silvia tells the patients who ask her to teach them
🔹 Where hypopressives fit if strength is the goal
Silvia Saraiva, BScPT, MScHK, is a pelvic health physiotherapist and researcher who completed her Master of Science in Human Kinetics at the University of Ottawa under Dr. Linda McLean. Her paper is out now in Physiotherapy, and there is a second one coming.
When you learned hypopressives, or taught them, was the pressure drop the whole point? I want to know what you were told and what you think after listening to the pod!
Saraiva S, McLean L. Intra-abdominal pressure and pelvic floor muscle activation observed during hypopressive exercises performed in supine and standing: An observational cohort study. Physiotherapy. 2026 Sep;132:102316.
Silvia on Instagram: @thepelvicgirl
The lab: @mfm_lab
00:00 Intro
01:00 Why we have never covered hypopressives
01:45 Meet Silvia Saraiva
02:25 Ottawa to northern Ontario
05:45 How far the nearest pelvic floor physio really is
06:55 Why hypopressives are big in Brazil, Spain and France
07:35 What a hypopressive actually is, step by step
09:00 The theory: pressure drops, pelvic floor turns on
10:00 Why how you measure it matters
10:50 The tools: pressure sensor, EMG, ultrasound, dynamometry
14:40 Crosstalk, motion artifact, and the problem with earlier studies
16:15 What clinicians miss when we skim to the conclusion
18:45 Who was in the study
21:05 Training beginners, and the expert who flew in
23:45 Are hypopressives easy? No.
28:15 The findings
30:00 Did position or posture matter?
31:30 If the pressure didn't drop, what is causing the contraction?
32:40 "You're just not doing it right"
33:30 What Silvia tells patients now
35:35 What about a high tone pelvic floor?
37:40 Prolapse and first line care
38:20 What she would study next
42:30 When the explanation is wrong but the results are real
43:40 Where to find Silvia
The Active Mom Podcast — a real mom's guide to pregnancy, postpartum, perimenopause & beyond, for active moms and the professionals who help them get there.
Quick-hit conversations with moms, providers, and researchers... because you don't have a lot of free time (you're probably listening at 1.5x right now).
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