“In and Up” Made Simple: Breathing, Core Pressure & Pelvic Floor Health for Women and Men
- ingridtonelli
- Sep 1
- 5 min read
If you’ve ever been to a Pilates class, you’ve probably heard your teacher say the words “in and up.” Maybe you nodded, did your best to pull your belly in, and hoped you were doing it right. But have you ever stopped and asked: What exactly am I pulling “in” and what am I lifting “up”?
For a lot of people, this cue can feel like a mystery, or worse, like a command to “suck in your stomach” until you can’t breathe. If you’ve been guilty of holding your breath or tightening your abs so much that your face turns red, you’re not alone.
The truth is, “in and up” isn’t about creating six-pack abs or walking around with your belly permanently braced. It’s actually a breathing strategy, one that can completely change the way your body manages pressure, supports your spine, and keeps your pelvic floor healthy.
And here’s why this matters:
For women, too much downward pressure can stress the pelvic floor, leading to issues like leaking, heaviness, or prolapse (especially after having children).
For men, unmanaged pressure can push out at the groin, causing or worsening hernias.
For everyone, poor pressure management can contribute to back pain, constipation, or make diastasis recti (abdominal separation) harder to heal.
Your understanding of this pattern can also translate in how you breathe, lift, and move all day long. When you understand what “in and up” really means, you can protect your core, your back, and your pelvic floor.
Let’s dig into what’s really happening inside your body, why women and men experience pressure differently, and how to train smarter (not harder) so you can stay strong, mobile, and leak-free, whether you’re rolling like a ball or picking up your toddler.
Your Core Is More Than Your Abs: Meet Your “Pressure Canister”
Imagine your trunk as a soda can.
The lid is your diaphragm (your main breathing muscle just under your ribs).
The sides are your ab muscles, including the deep “corset” muscle called the transversus abdominis.
The bottom is your pelvic floor, a hammock of muscles that supports your bladder, uterus/prostate, and bowel.
When the can is intact, it holds its shape under pressure. When one part is weak, pressure bulges somewhere else, like a dented soda can that’s easier to crush.
What Happens When You Breathe
Here’s the simplest way to think about it:
When you inhale: Your diaphragm moves down. This pushes pressure downward, so your belly, sides, and back expand slightly, and your pelvic floor stretches like a spring being gently loaded.
When you exhale: Your diaphragm moves up. Your ribs draw inward, your abs wrap gently toward the spine, and your pelvic floor springs back upward, helping lift and support your organs.
This up-and-down rhythm is natural, your pelvic floor moves with every breath, even when you’re not thinking about it.
Key takeaway: Healthy breathing is a partnership between your diaphragm, abs, and pelvic floor. They work together like a team.
What “In and Up” Really Means
When Pilates teachers say “in and up,” here’s what they’re really asking for:
“In” — a gentle hugging-in of your waist on the exhale (think corset, not vacuum).
“Up” — a light lifting feeling through your pelvic floor, like you’re zipping from your sit bones toward your belly button.
It’s sublte, but efficient. No breath-holding, no sucking your stomach flat until you can’t move.
Same Physics, Different Bodies: Why Women and Men Feel It Differently
Everyone has the same basic pressure system, but anatomy changes how pressure escapes when it gets too high.
Women: A Wider Pelvic Outlet
Women’s pelvises are usually wider and have a bigger “exit” at the bottom. This design is perfect for childbirth, but it also means there’s more space for pressure to travel downward. Over time, especially after pregnancy or vaginal birth, the pelvic floor can weaken or stretch.
That’s why some women experience:
Stress incontinence (leaking with coughing, laughing, jumping)
Pelvic organ prolapse (bladder, uterus, or rectum pressing downward)
A feeling of heaviness or dragging after long days or workouts
Men: Narrower Pelvis, But a Weak Spot at the Groin
Men have fewer pelvic floor issues, but they have a natural “hole” in the abdominal wall — the inguinal canal. It’s where the testicles descended before birth, and it’s a weak spot.
When men strain, brace, or hold their breath repeatedly, pressure can push through this spot, creating an inguinal hernia (a bulge near the groin).
Why Age, Pregnancy, and Menopause Matter
Pregnancy and Birth: The pelvic floor stretches under load and can be injured or overstretched during delivery.
Postpartum: Muscles, fascia, and nerves may need time (and training) to recover.
Perimenopause & Menopause: Lower estrogen affects collagen and tissue support, which can make incontinence or prolapse more likely.
Aging (all genders): Connective tissue becomes less elastic, making pressure-related problems more common.
The Problem with Breath-Holding and “Belly Gripping”
Many people think bracing hard is protecting their spine, but it can actually overload the pelvic floor or abdominal wall. Signs you’re overdoing it:
Noticing downward pressure or heaviness in the pelvic area
Seeing your belly bulge or dome down the midline
Feeling lightheaded or dizzy after an exercise
Instead of clenching all day, aim for a dynamic core, one that moves with your breath.
Practical Tools to Make “In and Up” Work for You
1. Practice 360° Breathing
Put your hands around your lower ribs. Breathe in and feel your ribs expand to the sides and back, not just the front. This teaches your diaphragm to drop and your core to expand evenly.
2. Gentle Pelvic Floor Lift
On your exhale, imagine your pelvic floor gently lifting, like you’re sipping a smoothie through a straw. Not a hard squeeze, just enough to feel support.
3. Learn to Relax Too
Your pelvic floor needs to lengthen on inhale. If it’s always tight, it can’t lift well when you need it to. Think: “drop” on inhale, “zip” on exhale.
4. Notice Warning Signs
If you feel leaking, heaviness, bulging, or groin pain, that’s your body saying “too much pressure!” Lower the load, change your breath pattern, or modify the exercise.
When to Get Professional Help
See a pelvic floor physical therapist if you notice:
Leaking pee (even “just a little”)
Feeling like something is “falling out” or heaviness in the pelvis
Persistent back or hip pain
Groin bulge or pain (men)
Doming down the midline (diastasis recti that isn’t improving)
These specialists can teach you how to coordinate your breath, core, and pelvic floor for life.
The Big Picture
“In and up” is not a command to hold your stomach in forever, it’s a breathing tool to help you move better and stay strong from the inside out. When you exhale and gently lift, you’re using your body’s natural system to protect your back, control pressure, and keep your pelvic floor healthy. This is one of the most empowering things Pilates can teach you, how to work with your body’s design, not against it.
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