Pressure management is how we change the pressure within our abdominal cavity during movement, exercise, and daily life. We call the pressure that we manage intraabdominal pressure or the pressure within the abdominal cavity. We need to change the pressure within our abdominal cavity to:
Stabilize the spine
Manage or alleviate pressure management-related symptoms such as heaviness in the pelvic floor, hernias, leaking, or coning
Optimize performance
What helps us manage intra-abdominal pressure?
The core canister helps us manage pressure. Your core canister includes your:
Transverse Abdominals (TA)
Internal Obliques (IO)
Pelvic Floor (PF)
Multifidus (MF)
Diaphragm (DA)
The coordination of these muscles helps us manage the pressure within the abdominal cavity. Just like everything else in our body, our core muscles work together, rather than in isolation, to manage pressure, stabilize the spine, and support foundational movement patterns. This is why only doing kegels or crunches, exercises that focus on isolated muscle movements tends to not help if you are having pressure management-related issues.
How do we know if we have a pressure management issue?
Pressure management-related symptoms could cause other issues to become worse. Symptoms associated with not properly managing pressure could include:
Coning of the abdominal wall (center portion pushes out further than the rest of the abdomen)
Hernias
Heaviness in the pelvic floor
Incontinence or leaking of urine
These symptoms could be a sign that pressure is not being properly managed, and that the core muscles are not coordinating with one another. But, these symptoms could also worsen some core or pelvic floor related dysfunction such as:
Diastasis Recti (DRA, Coning or Hernias)
Hernias
Pelvic Organ Prolapse
This is why managing pressure is so important! It can help to relieve a lot of discomforts and also alleviate or help support the healing from common issues during pregnancy and postpartum.
How do we manage intra-abdominal pressure?
We manage intra-abdominal pressure with breath coordination, aka how we breathe helps us manage pressure (or mismanage it).
When we inhale, the diaphragm moves down and increases the pressure within the abdominal cavity. This helps to stabilize the spine with pressure. Typically, we want to inhale during the eccentric portion of the movement to aid stability.
For example: when you are lowering in a squat, or moving with gravity, you want to inhale or increase the pressure.
When we exhale, the pelvic floor and abs lift up and in, increasing the muscular force (and density of the abdominal wall) to help it withstand the pressure on exertion.
For example: when you are coming up out of a squat or moving against gravity, you want to exhale to counter the pressure.
NOTE FOR BREATH COORDINATION WITH LIFTS:
If you are late pregnancy (28 weeks +) or early postpartum (4-6 months or less postpartum), we would recommend inhaling WITH the eccentric portion of the movement to help better manage pressure with a healing core canister. We would also recommend doing a preparation exhale BEFORE moving into the concentric portion of the lift. This means right before you begin to stand up from the squat, exhale to lift up and in and then stand up. This can help you work on the coordination of the pelvic floor with the rest of the core.
If you are earlier in your pregnancy and beyond 4 months postpartum, you could inhale at the TOP of the eccentric portion and hold your breath to aid stability. This will increase the pressure more in the core canister, so we need to ensure we have a strong enough abdominal wall to withstand this pressure. For exhalation outside of late pregnancy and early postpartum, you can exhale as you begin the concentric portion OR at sticky points throughout the lift (more advanced technique). Be mindful of any of the pressure management-related symptoms that could warn you that the breath strategy you are using may not be optimal quite yet.
Why do we want a strong core?
A denser abdominal wall can better withstand pressure changes in the core canister. Denser structures are less easily manipulated and can meet increased demands, such as exercise, sneezing, laughing, jumping, and daily life.
In early postpartum or late pregnancy, it can be more challenging to manage pressure due to the abdominal wall being thinner. The belly stretches during pregnancy to accommodate for your baby’s growth, and then needs to heal postpartum. This thinner abdominal wall can make it more challenging to manage pressure. This is why we recommend using breath coordination strategies that do not build as much pressure (inhaling WITH gravity, and exhale AGAINST gravity), and we need to be mindful with how much demand we are putting on our bodies with exercise.
This is also why lifting weights throughout the motherhood transition can be helpful because when we lift weights, it helps to increase the density of our abdominal wall. This will help us better manage pressure, alleviate symptoms, and increase physical performance.
Learn more about pressure management and how to coordinate breath to movement in our online fitness programs. We include educational videos with our fitness programs so that you can better learn HOW to approach fitness throughout each phase of life to optimize your results.