How to Modify Abdominal Exercises for Pelvic Floor Protection

How to Modify Abdominal Exercises for Pelvic Floor Protection

Abdominal exercises can be modified for pelvic floor safety Physical Therapist video from

Abdominal exercises can impact upon a woman's pelvic floor, especially when the abdominal exercises are intense and the pelvic floor is weak.

This Physiotherapist video shows how to modify some intense abdominal exercises to reduce pelvic floor loading.

The Problem with Intense Abdominal Exercises

Abdominal exercises that involve strong upper abdominal (‘six pack') muscles increase pressure in the abdomen. This pressure is conveyed to the pelvic floor. If the pelvic floor is not strong enough to withstand this pressure, it is forced downwards causing it to stretch and weaken with repeated or particularly intense abdominal core exercises.

Who is Most at Risk?

Some women are at greater risk than others with intense abdominal exercises. Some women with well functioning pelvic floor muscles will be unlikely to experience pelvic floor problems with intense abdominal exercises. Others are at increased risk, particularly women after previous gynaecological surgery including prolapse surgery, incontinence surgery or hysterectomy.

A woman's risk of pelvic floor injury increases with:

• Weak pelvic floor muscles
• Prolapse (cystocoele, rectocoele, uterine prolapse)
• Incontinence problems (bladder or bowel)
• Overactive pelvic floor muscles
• Pelvic pain.

Your pelvic floor is more vulnerable to injury with:

• Recent pregnancy and childbirth
• Menopause
• Increasing age
• Obesity and overweight
• Chromic coughing
• Chronic straining and constipation
• Heavy lifting

How to Modify Abdominal Exercises

Abdominal exercises can be modified or altered to decrease the load on the pelvic floor.

To decrease pelvic floor loading:
1. Decrease the intensity of the abdominal muscle exercises
2. Reduce the number of intense abdominal exercises
3. Reduce the duration of sustained abdominal exercises (e.g. Plank).

Abdominal Curl Modification

Abdominal curl exercises involve head and shoulder forward raises and should ideally be avoided in women who are at increased risk of pelvic floor strain and injury.The pelvic floor load of abdominal curl exercises can be decreased by:

• Reducing the number of repetitions
• Breathing out during the sit up and avoiding breath holding
• Keeping resistance minimal using abdominal curl machines.

Double Leg Raises Modification

Double leg raises involve raising both legs together at once. The pressure on the pelvic floor with double leg raises is reduced by raising one leg only. Avoid lifting the head and shoulders off the ground. Breathe normally and avoid breath holding or strong abdominal in draw during this exercise.

Plank or Hover Exercise Modification

Plank or Hover is an intense abdominal core muscle exercise. The pressure on the pelvic floor with full Plank or Hover can be decreased by:

• Weight bearing through the knees, not the feet
• Breathing normally throughout
• Decreasing the length of the hold
• Avoiding actively in drawing or over bracing the abdominals during this exercise.

Abdominal muscles can overload the weak or poorly functioning pelvic floor. Abdominal exercises should be modified in women at risk of pelvic floor problems.



Mark Ioffe says:

Is it safe for diastasis recti and umbilical hernia?

Seda Gyonjyan says:

Hi, I have been diagnosed with pelvic floor dysfunction. I am used to exercising regularly and I usually do abs specific and core exercises, which generally include upper and lower body lifting at the same time, also different kinds of planks. Since all these exercises are not suggested, having pelvic floor dysfunction (overly tight muscles), I don't know what other exercises I can do keep my muscles toned. All theses alternative exercises, which are safe, are very easy for me and unproductive. Please advice!

antiTwerpFiles says:

I have NOT been diagnosed with pelvic floor disfunction, but I have noticed changes since my hysterectomy. My doctor says nothing beyond-don't do it if it 'hurts.' I just feel unusual pressure-not pain. But shouldn't I be able to strengthen the pelvic floor muscles enough to provide a balance and still be able to do some of these exercises if I have not yet been diagnosed with disfunction? 

Michelle Kenway says:

Gracias – usted encontrará mis videos recuperación de la histerectomía en mi Tu Tube Canal Michelle Kenway avísame si usted no puede encontrar los considera Michelle

lulubadillo1 says:

muchs gracias por sus videos yo acabo de tener una histerectomia no entiendo bien ingles ,cuales son los ejercicios para mi por favor enviamelos?


Thank you Michelle,I have been fallowing you for awhile and still find your program interesting.

Michelle Kenway says:

Thank you EarthH2oLuma, glad this has helped you, best of luck

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