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MIMA TUS MÚSCULOS DE LA POSTURA: DIAFRAGMA Y PSOAS

¿Sabes cómo influye el diafragma y el psoas en la actitud postural? ¿Y cómo podemos reducir su tensión postural a través de técnicas de ejercicio? Pues en esta ocasión Low Pressure Fitness ha contado con la colaboración del experto en Reeducación Postural Jordi García para contarnos como mimar el diafragma y el psoas.

 

El diafragma torácico y el psoas suelen ser un conjunto muscular olvidado a la hora de mejorar nuestra actitud corporal. Sin embargo, su relación física requiere de que se mimen el uno al otro, pues el estado del uno afecta al otro y viceversa.

 

¿CUÁLES SON ESTOS MÚSCULOS?

El primer a recordar es el  psoas. Su función en relación al control de la lordosis lumbar y el equilibrio de la pelvis es de sobra conocida.

El segundo músculo fundamental a rememorar es el diafragma. Si cerramos los ojos y alguien nos dice diafragma, la primera palabra que nos viene a la mente seguro que es, respiración. No hay duda que es el principal músculo de la respiración, ahora bien, ¿sólo es un simple pistón para facilitar la entrada y salida de aire del organismo? O por el contrario, ¿tiene alguna que otra función?

 

REPASO ANATÓMICO DEL PSOAS Y DEL DIAFRAGMA:

psoas-lpf

Psoas:

  • Origen/inserción lumbar: Apófisis transversas de todas las lumbares.
  • Recorrido: Desciende hacia la zona superior de la pierna.
  • Origen/inserción en la pierna: En el trocánter menor del fémur.

diafragma-lpf

Diafragma:

  • Origen/inserción periférica: En el apéndice xifoide del esternón.
  • Origen/inserción lateral: En los cartílagos de la cara interna de las de las últimas seis costillas.
  • Origen/inserción trasera: En la última vértebra torácica y primeras lumbares abrazando esta zona de la columna en forma de pilares en la cara anterior, el izquierdo, en las tres primeras vértebras y el derecho en los cuatro primeros cuerpos lumbares.

 

Si analizamos la descripción anatómica, observamos que ambos músculos comparten origen/inserción y fibras musculares en las primeras tres y cuatro lumbares según el lado que miremos. Vemos pues, que hay una relación anatómica indiscutible entre el psoas y el diafragma. Hasta me atrevería a decir, una relación de amor.

 

¿QUÉ RELACIÓN TIENEN CON LA ACTITUD CORPORAL?

Los pilares del diafragma tienen una función tónica íntimamente relacionada con la postura. Al estar en contacto con la columna lumbar deberán estar en equilibrio con toda la musculatura que interviene en la estabilidad vertebral, siendo uno de los implicados en lograr esta estabilidad.

 

Si por algún motivo, estos pilares diafragmáticos están acortados, tiran de las cúpulas diafragmáticas hacia abajo, reducen el espacio abdominal, aumenta la presión de esa zona, y consecuentemente desequilibran la columna vertebral.

 

Si es el psoas el que está acortado, éste tira de los pilares, los sobrecarga, se acortan y descienden las cúpulas del diafragma. A la vez que el acortamiento del psoas puede provocar un exceso de lordosis lumbar. En este caso tendríamos aumento de la presión y debilidad de musculatura posterior de la columna, así como una alteración en la musculatura interna y posterior de las piernas.

 

¿QUÉ NOS INTERESA?

Pues, necesitamos un diafragma lo suficientemente relajado y en sintonía con la porción lumbar del psoas, así ayudarán a un buen control de la columna lumbar y de la pelvis. Es un trabajo en el que están implicados otros protagonistas, pero centrándonos en estos dos músculos deberemos evitar su tensión.

 

¿CÓMO LO LOGRAMOS?

 

1) REDUCCIÓN DE LA ACTIVIDAD DEL SISTEMA NERVIOSO SIMPÁTICO:

El día a día, las situaciones estresantes, los problemas de distinta índole son una carga importante para nuestro sistema emocional y nuestro estado físico. Esto afecta a muchas estructuras del organismo que van desde el sistema inmune, al sistema intestinal y al sistema musculo-esquelético. Y efectivamente al tono del diafragma y a nuestra actitud postural.

 

Una buena estrategia inicial podría ser disponer de veinte o treinta minutos al día dedicados a la relajación y desconexión mental, con un buen trabajo respiratorio, bien sentados o tumbados boca arriba.

 

2)  PRÁCTICA DEL ESTIRAMIENTO MIOFASCIAL GLOBAL:

La presión de nuestra actividad y de nuestras emociones hace que tendamos a cerrar o acortar toda la musculatura anterior y a debilitar la posterior. A través de ejercicios de stretching (estiramiento) miofascial por cadenas miofasciales podemos ayudar a flexibilizar y equilibrar el tono postural de las mismas. La secuencia de ejercicios de Low Pressure Fitness, basado en técnicas estiramiento postural global con incidencia en el auto-crecimiento axial, puede ayudar a lograr una activación involuntaria de la musculatura profunda vertebral. Esto ayudará a que los músculos superficiales posteriores se vean descargados, liberados. Uno de los objetivos de la práctica de ejercicios de estiramiento miofascial global es abrir la cadena miofascial anterior ayudándonos con la acción de la gravedad que facilitará el trabajo de los músculos fásicos de la espalda.

 

Por otro lado, mantener la postura y centrarnos en la respiración nos permitirá incidir en toda la cadena muscular y respiratoria que une el diafragma con el psoas. Deberemos inhalar profundamente y exhalar poco a poco dejando que el aire salga libremente. La práctica en pared nos facilitará el mantenimiento de la pelvis en una posición neutra, de alinear la espalda y tener un soporte para la normalización del tono entre el psoas y los isquiotibiales.

 

estiramiento-miofascial-LPF

Ejercicios de estiramiento miofascial global de la Wall-Series de LPF.

¿CÓMO PODEMOS POTENCIAR EL EFECTO DEL ESTIRAMIENTO?

 

3) ACTIVACIÓN CINTURA ESCAPULAR Y ASPIRACIÓN DIAFRAGMÁTICA:

Este tercer punto puede combinarse a las posturas de estiramiento miofascial globales del hablábamos en el apartado anterior consiguiendo unos efectos mayores sobre la relación del psoas con el diafragma. Tanto la activación de la cintura escapular como la aspiración diafragmática (vacío abdominal) facilitan el estiramiento la cadena miofascial anterior y consecuente reequilibrio muscular en la zona posterior, sobre todo  a nivel dorsal y lumbar.

 

¿POR QUÉ LA IMPLICACIÓN ACTIVA DE LA CINTURA ESCAPULAR?

Cuando se separan las escápulas (abducción) se logra la contracción de los músculos serratos que a su vez están relacionados con la postura y tono postural del diafragma. Esta activación del serrato anterior logra un efecto automático e involuntario de relajación de las cúpulas del diafragma, es decir, ayuda a su aspiración produciendo una pequeña acción de estiramiento de los pilares diafragmáticos. Éstos a su vez estiran de las fibras del psoas.

 

decoaptación-lpf

Por tanto, la decoaptación escapular de forma activa lograr aumentar  ligeramente el espacio abdominal, reducir la presión en la zona y facilitar el reequilibrio de la musculatura implicada en el control lumbo-pélvico.

 

¿QUÉ EFECTOS TIENE LA ASPIRACIÓN DIAFRAGMÁTICA?

La aspiración diafragmática es la técnica respiratoria que consiste en elevar y abrir la caja torácica en apnea espiratoria. Esta técnica de vacío abdominal provoca un estiramiento del diafragma debido a que, como ya hemos visto, tiene inserciones costales. A su vez las cúpulas ascenderán ligeramente y provocarán el efecto de succión tensionando toda la faja abdominal. Al realizar esta acción provocamos un mayor trabajo de estiramiento de los pilares del diafragma y del psoas, que nos interesa en el caso que se encuentren acortados.

 

Estos dos puntos son principios técnicos fundamentales que siguen todos los ejercicios de Low Pressure Fitness. A continuación os presento un ejercicio de estiramiento miofascial global en pared (Wall-Series) de Low Pressure Fitness.

wall-series-lpf

Ejercicio Wall-Series LPF realizado en estiramiento miofascial global de la cadena posterior combinado con aspiración diafragmática para potenciar el efecto de estiramiento.

Concretamente, en este ejercicio estamos en una situación de auto-crecimiento axial, apertura de la cadena anterior, posición neutra de la pelvis con flexión dorsal de los pies. Mantenemos una decoaptación activa escapular y extensión de muñeca para incidir más en la tensión miofascial anterior de los brazos. Finalmente, en esta posición al expulsar todo el aire realizaremos una apertura costal en apnea espiratoria. Pruébalo de la mano de un entrenador especialista y cuéntanos tu experiencia!

 

Autor: Jordi García
Licenciado en Ciencias de la actividad física y el deporte, Postgraduado en psiconeuroinmunoendocrinología y entrenador de reeducación postural

SOUTH AFRICA DIRECTOR, SHIRLEY BOERSSEN & HER PERSONAL EXPERIENCE WITH HYPOPRESSIVES

Low Pressure Fitness is very proud to announce the new incorporation of Shirley Boerssen as the Director of South Africa for the PressureLess workout. With this great announcement, we wanted to share her own testimonial after developing a diastasis due to her second pregnancy and how she felt a massive change training hypopressives.

« I have always been intrigued by human behaviour, movement, natural healing methods and wellness. I definitely wasn’t the sporty person at school, but I did ballet, I have always loved dancing and movement and even did aerobics and callanetics as a teenager in the 90’s. After school I completed my Psychology Honors Degree, but it felt like something was missing. I completed a Personal training and Group Fitness Instructors qualification. I wanted to work more intimately with smaller groups and decided on completing a Pilates Instructors mat work qualification, enjoying the rehabilitative angle of the method. I gained a lot of experience at a physiopilates studio, working with the deskbound corporate with postural problems to clients with sports injuries. I have worked intensively with pre and post natal clients, running my own groups as well as working for PreggieBellies South Africa and training throughout both of my pregnancies. I am also a qualified holistic and sports masseuse and completed a Biomedicine course as part of a Naturopathic/Nutritional Therapy study. I have been studying and working within human behaviour, fitness and health and wellbeing for 21 years.

With my second pregnancy I developed diastasis. Applying ALL my knowledge could not rehabilitate my problem. I remembered talking to devastated clients in the past, trying to put them at ease, telling them to take it easy and at the same time I’d be worried and concerned as I could see bellies bulging with the conventional core and breathing techniques….and for the first time I understood what they felt. Still looking pregnant, even if only to myself, almost a year and half post-natal, was not fun, it was devastating. I developed digestive issues and lower back pain as my Transversus Abdominis became weaker, something was out of balance and it affected me in more than just a physical way.

I was trained in Low Pressure Fitness technique for the first time by Janet Kimmel from Vancouver, over December of 2015 and I was amazed by the quick, automatic response my body had to the technique. The results were amazing and visible within the first 2 weeks of the programme. Suddenly I had a magical moment, a realisation connecting my educational background and experience gained from each individual client up to then. I had to learn more about the technique, I had to experiment more on myself and I had to introduce this to all the woman suffering from diastasis, prolapse, urinary incontinence or those just not knowing how to safely train or retrain the core muscles, work on the postural alignments and most importantly, to prevent pelvic floor problems. In South Africa’s multicultural society, talking comfortably about the pelvic floor is not always the case and the reality is that so many woman (and men) don’t even know what the pelvic floor is and/or suffer in silence. My mission in South Africa is first of all to create awareness of pelvic floor and core health for woman, men and children/teenagers within a supportive, educational and empathetic way, within a fitness environment. Low Pressure Fitness system is an amazing platform to achieve this. Training and educating instructors and professionals in this technique changes the whole training program, rehabilitative outcome and prevention of a variety of problems. South Africa has an amazing culture of sports, fitness, a fresh awakening to health and wellbeing,more people are outdoors either running a trail or cycling, the benefits of LPF system on oxygen usage and in competitive sports is astounding and caters for a huge market in South Africa.

My approach to health and wellbeing, fitness and longevity is holistic in nature. I look at the whole person as a being connected within a mind, body and soul and LPF fits in perfectly with this approach. It affects the sympathetic nervous system, stimulate excitation and increase metabolism. One of my favourite benefits of LPF is that it empowers the clients, giving them back the power and control within their bodies.

I feel extremely privileged, humbled and bursting with excitement to represent LPF in South Africa, first country on the African continent. I know this technique will be a game changer for many women and men; to those working in the health industry and their patients and clients »

Shirley Boerssen

LPF South Africa Director

Je me suis formée dans différentes disciplines sportives mais rien d’aussi merveilleux que Low Pressure Fitness…vous avez ravivé la flamme et l’amour de ma profession, en plus de m’aider à m’ouvrir à de nouvelles perspectives et rêves

Je suis Leticia Cancelo, coach sportive, qui a commencé son aventure professionnelle dans une petite salle de sport de quartier à Vigo. Durant toutes ces années j’ai exercé et me suis formée dans différentes disciplines sportives mais rien d’aussi merveilleux que Low Pressure Fitness. Actuellement je vis à Barcelone et je continue à travailler dans le secteur sportif; ces trois dernières années je n’ai pas eu beaucoup de motivation pour différentes raisons,mais vous avez ravivé la flamme et l’amour de ma profession, en plus de m’aider à m’ouvrir à de nouvelles perspectives et rêves.

Merci beaucoup à vous tous qui formez cette grande équipe parceque en plus de vendre de la « santé »,vous vendez du rêve et de la motivation. Tamara et Piti vous vous complétez à merveille,vous êtes de grands professionnels avec de grandes qualités humaines, ce qui en cette époque est presque un miracle.J’espère pouvoir continuer à grandir avec vous. Merci beaucoup de m’avoir transmis votre passion.

Je vous embrasse.

Leticia Cancelo

Entraineur de LPF et coach sportive.

J’ai pu constater entre autres améliorations: une augmentation au niveau de l’hématocrite, une augmentation de la capacité vitale et de l’amplitude thoracique dans les différentes analyses et examens médicaux pratiqués.

Mon nom est Andreu et mon premier contact avec les exercices hypopressifs, a eu lieu lorsque j’ai commencé la pratique de l’apnée en compétition avec le club Apnea Vallés, (groupe d’entrainement partenaire de l’ association « Apnea Catalunya »), dans lequel les exercices hypopressifs font partie intégrante des sessions d’entrainement.

Dès que j’ai commencé à pratiquer, j’ai immédiatement ressenti une grande amélioration , tant dans mon tonus abdominal que dans la durée des mes apnées . J’ai alors décidé que Juanma Molleja (entraineur LPF) me fasse un planning d’entrainement personnalisé, avec un protocole combinant exercices statiques , exercices dynamiques et sessions avec le training mask, en fonction des charges de travail que le calendrier de compétitions me permettait pour chercher à arriver au meilleur niveau à chacune d’elles.

Ce type d’entrainement m’a donné de très bons résultats aussi bien en piscine qu’en mer. J’ai pu constater,dans les différentes analyses et examens médicaux que j’ai faits cette année là, entre autres,  une augmentation au niveau de l’hématocrite, une augmentation de la capacité vitale et de l’amplitude thoracique, en plus de l’amélioration de mes temps d’apnée et de récupération et de la capacité d’adaptation de mon corps à la profondeur.

Andreu Corvillo

Apneiste de compétitión

 

Low Pressure Fitness present at “Rehabilitation for life”

The interest about the application of the Low Pressure Fitness in the prevention and rehabilitation of the pelvic floor dysfunctions led the School of Health of Viseu, inviting Eunice Moura, Low Pressure Fitness coach in Portugal for a lecture in the context of the 6th Congress  » Rehabilitation for life » on January 28, 2016.

“Rehabilitation in differentiated health care”  was the name chosen for the table of Eunice Moura and with a presence of a physician, a rehabilitation nurse from the Center of rehabilitation medicine in Alcoitão, and a rehabilitation nurse of the Garcia da Orta Hospital.

With an attentive and interested audience, the themes developed and clarified about Low Pressure Fitness aroused interest of some people who have shown curiosity in getting to do more training and increase knowledge of the Low Pressure Fitness technique in order to use it in their working environment to ensure better results  both in terms of the rehabilitation of the pelvic floor muscles, and globally, ensuring a better quality of life for patients. 

 

Midwifes at Indonesian hospitals learn Low Pressure Fitness

The R-evolution of Low Pressure Fitness has arrived to Indonesia. A series of seminars for midwifes and women´s health care about the pressureLess workout are taking place at several hospitals of the Kasih Group around the country. The first seminar “Be healthy and recover after pregnancy with Low Pressure Fitness” was a complete success of attendance. 150 Indonesian midwifes participated in the seminar presented by Harry Setiarso at the hospital Restu Kasih (RSIA).

seminar midwifes low pressure fitness

Indonesian midwifes are known as BIDAN who usually live in rural or sub urban areas where there are no doctors or hospitals. They help women delivery. Their tools are: a bucket, water, some oil, sheets, and their hands and heart full of love and kindness. It was the first time the assistants heard about the “hypopressive concept” to recover women´s pelvic floor and core muscles after pregnancy. The Director of Low Pressure Fitness Indonesia Low Pressure Fitness Indonesia also remarked the importance of proper physical condition before pregnancy, appropriate breathing techniques and exercise during pregnancy.

PELVIC FLOOR HEALTH WITH HYPOPPRESSIVES

What if we could address pelvic floor issues with only postures and breath?

 

On Mar 5 & 6th, 2016, PABC hosted Trista Zinn & Tamara Rial (Phd), as instructors for “Hypopressives/Low Pressure Fitness for Pelvic Health” at the University of British Columbia (UBC).  Many who attended the course were pelvic floor rehab specialists.  Many who attended the course also had personal reasons for being there.  If our current pelvic/core rehab model is effective, why are there physios with prolapses, cystoceles and pessaries?  It seems we’re still looking for the ‘right’ answer.

 

The Hypopressive Theory is based on the concept that the abdominal pressures we generate with curl-ups, planks, jumping and Pilates-type strengthening are often too great for the pelvic floor.  As a consequence, we are literally pushing our organs out the bottom. The intention of the Hypopressive exercise is to generate negative pressures in the abdominal cavity to literally traction the pelvic organs upwards, enabling the pelvic floor and Transversus Abdominus to work in shortened ranges.  Low Pressure Fitness training is a global approach to the core/pelvic floor.  It is not based on strength of the pelvic floor on its own, but concentrates on the function of the pelvic floor’s intricate relationship with the core as a whole.  The other significant difference between traditional pelvic floor strengthening and the Hypopressive (low pressure) exercise is Type II muscle fiber recruitment.  The key core muscles are 70% slow twitch fibers, which increase their volume and recruitment only with sustained contraction, (unlike a Kegel which emphasizes reps/sets with resting phases – type I fiber training).

 

Along with serratus anterior and posterior, multifidi, the thoraco-dorsal fascia, transversus abdominus, and the pelvic floor, the real key player in these exercises is the diaphragm.  Using rib and diaphragm mobilization techniques, we free up the rib cage to enable improved lateral costal breathing.  Then, the patient is instructed through a combination of spinal stabilization cues that are sustained, aiming to pull the diaphragm’s central tendon upwards.  In the exhalation phase, relaxation and lengthening of the diaphragm occur.  At this point the patient performs a prolonged apnea, drawing the abdomen inwards and upwards, whilst maintaining the postural cues.  The exercises progress to a series of sustained poses with the apnea, some of which are capable of generating negative 20-30 mm Hg as measured in the pelvic floor.  In first attempts, the exercise is very challenging, and requires repeated cueing by the therapist.  However with repeated practice it becomes comfortable and habit-forming.

 

The list of conditions which will benefit from this technique include, but are not limited to: urinary incontinence, uterine/bladder prolapse, erectile dysfunction, fibroids, hemorrhoids, pelvic pain, nocturia, cervical cell dysplasia, rectus diastasis, inguinal and abdominal hernias, constipation and low back pain.  It is estimated that greater than 40% of women experience pelviperineal pathophysiology, and low back pain incidence is twice that.  Other beneficial effects include improved alignment and postural stabilization, increased lumbar mobility, increased hamstring expandability, decreased cervical and lumbar lordoses, decreased thoracic kyphosis and scoliosis correction.  Waistlines also shrink, which explains why the Europeans are keen to integrate the technique.

 

This is an invaluable tool which not only has the potential to generate above average results with our pelvic health patients, but also has the ability to transform our entire client population.  It is a risk free, preventative, global exercise system, which improves well-being, aesthetics and physical performance.  If spinal health is a measure of our longevity, the Hypopressive technique is a ‘game changer’.  Become an instructor – let’s generate a Canadian wide Low Pressure Fitness movement.  We will be the new kid on the block and our patients will shine.  

 

Acknowledgements

We would like to thank  Katharine Hasz and PACB sharing this letter with Low Pressure Fitness after attending Level 1 LPF course in Vancouver.

Katharine Hasz Physical Therapist,

currently lives in Tofino, B.C., with a home-based practice, integrating manual therapy, acupuncture, cranio-sacral and visceral techniques. LPF leve 1 trainer.

Low Pressure Fitness lands in the Vatican Hospital

On Wednesday, Feb. 10th, 2016, Mimi Rodriguez Adami delivered a Seminar on the Low Pressure Technique for instructing hypopressive exercise at the CEMI (Centro per Medicina dell’Invecchiamento) of the Policlinico Agostino Gemelli in Rome. The Policlinico Gemelli is a University Hospital, working with the Università Cattolica del Sacro Cuore (Catholic University of the Sacred Heart) to train medical personnel, perform research, study and adapt the latest methods and technology available.

The hospital has an in-house fitness center, Healthness, which is used by patients for rehabilitation and physical therapy and for external clients who want to train for fitness with specialized personnel.

The seminar was attended by over 50 persons, including physical therapists, physical education graduates specialized in adaptive exercise and physicians. After the presentation the participants were invited to participate in a brief demonstration of the basics of the technique: the posture, the breathing and an expiratory apnea. Their response was very positive and the Healthness management has decided to embrace Low Pressure Fitness and have all the physical therapists and personnel working in the gym, train to be able to teach hypopressive exercise using the Low Pressure Fitness technique to both patients and healthy clients.

Healthness management has also offered to host all future Low Pressure Fitness training workshops in Rome and promote the method locally and nationally.  Low Pressure Fitness in Rome will look forward to holding all its training workshops at the Healthness Center of the Policlinico Gemelli.

Mimi Adami, LPF Italy Director

Look good and feel better in 2016 with Low Pressure Fitness

One of the most popular resolutions for the new year is to join a gym to look good and feel better. Low Pressure Fitness is an innovative workout that can help to achieve these goals. It’s called the PressureLess workout and the benefits are remarkable. It is an opportunity for personal trainers and healthcare providers to begin 2016 with a different goal and new training tools.

What is Low Pressure Fitness?
A technique that is built on the foundation of yoga´s eastern wisdom and supported by spine rehabilitation exercises from western medicine. The purpose is to reduce high impact stress on the body and overpressure on the spine and core structures. LPF results in toned muscles, enhanced respiratory capability, greater strength, improved appearance and better sexual performance.

Why The PressureLess Workout?
Some internal structures are too weak to support the demands of daily activities. Exercising in a safe way using careful techniques can decrease internal pressure, develop correct postural habits and enhance breathing. This approach will help restore muscle balance and rejuvenate your life : it is the The PressureLess Workout.

Who benefits from Low Pressure Fitness?
Sedentary individuals and elite athletes can benefit from Low Pressure Fitness. Beginners can learn new exercises with appropiate instruction making practice safe and low risk. Elite athletes can enhance performance and reduce the risk of pelvic floor dysfunction. Low Pressure Fitness can be performed alone or as part of an Integrative health/fitness program.

If you want to look good and feel better, Low Pressure Fitness can be your 2016 exercise resolution.

Low Pressure Fitness & Physiotherapy Association of British Columbia

With the purpose of Keeping British Columbians Moving for Life, the Physiotherapy Association of British Columbia invited Tamara Rial and Trista Zinn to give a course on Low Pressure Fitness for pelvic floor health in March, 2016 in Vancouver. The Physiotherapy Association of British Columbia (PABC) provides leadership and direction to the physiotherapy profession, fosters excellence in practice, education and research and promotes high standards of health in British Columbia. Founded in 1927 as a Branch of the Canadian Physiotherapy Association, the PABC became incorporated in 1945.

Low Pressure Fitness is a revolutionary and global approach to Core Health that combines a unique breathing technique with varying postures and poses. Practiced worldwide, this method of training in being recognized in North America for its wide range of health benefits. While initially developed as a non-surgical treatment for women with pelvic floor health issues, the pressureless workout has evolved into a complete core training program that benefits all ages and lifestyles.

This course will explore the theory behind LPF, explain its practical applications, and will discuss the evolution of LPF from a rehabilitation tool to a full body reprogramming method.
More information about this course is available at: http://bcphysio.org/content/pabc-course-educ-hypopressives-low-pressure-fitness-pelvic-floor-health-trista-zinntamara