Pelvic floor safe exercises for core muscles are essential for women with or at risk of pelvic floor dysfunction.
This article teaches women how to identify pelvic floor safe core abdominal exercises and protect the pelvic floor .
Read on now to learn:
- Pelvic floor problems from intense core exercises
- Are you at risk from unsafe core exercises?
- Which abdominal core exercises are potentially unsafe?
- Pelvic floor safe exercises for core muscles to choose
- 5 tips for pelvic floor safe abdominal muscle exercises
Core abdominal exercises and pelvic floor problems
Problem 1: Stretched pelvic floor muscles
Exercises that strongly engage the upper abdominal muscles such as sit-up or abdominal curl exercises increase downward pressure on the pelvic floor. These exercises cause the pelvic floor to stretch and 
weaken if it lacks the strength to withstand this downward pressure (shown right). For this reason is vital to avoid exercises that place pressure on the pelvic floor if it is at risk of injury.
Problem 2: Overactive pelvic floor muscles
Intense core exercises can cause the pelvic floor muscles to become overactive with spasm and unable to relax. Increased pelvic floor muscle tension causes the pelvic floor muscles to become too tight resulting in pelvic pain, bladder and bowle problems and pain with sexual intercourse.
Are you at increased risk of pelvic floor dysfunction with unsafe core abdominal exercises?
If you answer yes to any of the following questions your risk is increased:
- Previous gynaecology surgery (prolapse surgery, hysterectomy, bladder repair)?
- Pelvic prolapse?
- Incontinence (bladder or bowel)?
- Previous menopause or beyond?
- Recent childbirth?
- Overweight?
- Pelvic pain?
Core abdominal exercises to avoid or modify
Intense upper abdominal muscle exercises are those most likely to contribute to pelvic floor dysfunction including: 
- sit-up exercises
- fit ball sit-ups
- abdominal crunch
- twisting crunch
- Pilates or Yoga style exercises with both legs raised in the air and your head off the ground
- Pilates or Yoga exercises that involve intense upper abdominal activity such as "The Hover" or "The Plank" (shown right)
- abdominal exercise machines
- bicycle legs both legs raised in the air
Pelvic floor safe exercises for core muscles
The most appropriate abdominal exercises for minimising pelvic floor pressure are:
- Seated fit ball core stability exercises – this includes exercises such as arm reaching, alternate leg extensions and both.
- Gentle lying down core stability exercises that do not involve bracing your abdominal muscles strongly.
- Whole body exercises that incorporate your abdominal muscles such as swimming.
Core exercises can often be modified to reduce the amount of pressure on or tension within the pelvic floor.
Tips for pelvic floor safe exercises for core muscles
- Use your abdominal muscles gently, never brace them strongly
- Allow your abdominal muscles to rest, avoid constant over bracing
- Choose seated fit ball exercises and positions for whole body strength exercises
- Choose lying down abdominal exercises that do not involve raising your head or both legs in the air
- Avoid sit-ups and abdominal crunch exercises, especially if you are at risk of pelvic floor dysfunction
- Avoid intense core strength exercises in exercise classes including some Pilates and Yoga classes; speak with your instructor about modifying your exercises to the intensity of your core exercise.
We welcome your comments below
For information regarding pelvic floor safe core abdominal exercises refer to Inside Out – The essential women's guide to pelvic support by Michelle Kenway Physiotherapist and Dr Judith Goh Urogynaecologist.
Please read our disclaimer regarding this information
This information is provided for general information only and should in no way be considered as a substitute for medical advice and information about your particular condition.
While every effort has been made to ensure that the information is accurate, the author accepts no responsibility and cannot guarantee the consequences if individuals choose to rely upon these contents as their sole source of information about a condition and its rehabilitation.
Copyright © Pelvic Exercises.com.au
All this time I ‘ve been doing stomach crunches and other abdominal exercises- thinking I was helping my body. I had an abdominal hysterectomy eight years ago with removal of uterus, ovaries, ovarian cysts,fibroid tumors,repair of vaginal wall, bladder, rectum and rectal hernia.
I now have ANOTHER bladdr prolapse and am facing major surgery AGAIN.
I wish someone would have advised me a little better.
Dear Bonita I totally understand what you are saying. Unfortunately there is a lack of information for women regarding this huge issue of abdominal exercise and pelvic floor prolapse. Yes it is important for women to exercise and stay healthy and well. I think we need to be kind to our bodies and lay off the intense abdominal exercise, especially if we’ve had vaginal deliveries or if our pelvic floor is at risk such as with menopause, chronic straining and particularly after already having ahd pelvic floor surgery. Good luck with your surgery and with your future safe exercise. Regards Michelle
Bonita-
That’s just awful.
I’m right there with you. After I had my daughter I was doing crunches and all types of things that I now know are wrong. I feel like most medical practitioners don’t care about your long term health and just do what they need to do to get you out of their exam room or hospital bed.
I found out that there are also pelvic rehab places that some hospitals have that can help further advise you on pelvic exercises so maybe you should try that before major surgery. I hate that you have to go through surgery again.
Thanks Rhetta for the kind response. I did go to a different ob/gyn group and was told they can do the surgery vaginally as opposed to another abdominal- YEAH! It’s still surgery, but it will be NOTHING like what I went through before. The recovery was HORRIFIC.This new DR. told me she feels any excersise is fine, if you modify it- so I do crunches, but only lift my head until I feel a slight tension in my stomach. I aso do isometrics.
Good luck with whatever you face.
Hi Michelle,
) What is your opinion on sitting crossed legged (tailor pose)? My instinct says this wouldn’t be good for my pelvic floor, but pre-op I used to enjoy the stretch in this position, and so would value your opinion.
firstly I would like to thank you for the information on this website & in your book, it has really helped me following my abdominal hysterectomy in June. A friend pointed me in your direction & I was so grateful, a) to be able to have something positive to focus on & ‘do’ in the post op period and b) for alerting me to the danger of prolapse. Why don’t the doctors tell us this??
I’ve been practising the exercises in your book & am gently progressing but as I approach my 12 week post op mark I am looking forward to starting yoga again. Your book is very informative on this subject but I do have one question, its only a small thing, but I am slighly paranoid about my pelvic floor now (!
Keep up the good work Michelle…I wish you were available on the UK NHS!!
Re Sitting cross legged and pelvic floor/hysterectomy recocvery
Hi Sarah
Thanks so much for your comments, I am glad to have helped and I really appreciate your kind feedback.
Regarding sitting cross legged on the ground I don’t see that it could affect the pelvic floor, especially if you have not had a prolapse repair as well. Perhaps if you had prolapse repair/perineal work done there may be some stretching sensation. I am not aware of any research that has been done in this particular topic.
When you are seated your pelvic floor is supported, however I would think that sitting cross legged and leaning forward as in some yoga style stretches, the pressure in the abdomen would increase, and be transferred directly to the pelvic floor ( a little like squeezing a tube of toothpaste in the middle). This is not to say that sitting cross legged creates a risk for the pelvic floor, I don’t think this can be said with certainty. I do suspect that legs wide open and leaning forward would increase pressure on the pelvic floor- to what extent I am not sure and I wish I could be clearer. Women with a pre-existing prolapse would I think readily detect a bulging sensation with this type of exercise. Is it dangerous to the pelvic floor? Who knows suffice to say that I would take care with leaning forward cross legged if I noticed it increased pelvic pressure and I had a pre-existing pelvic floor problem.
Wish I could be more help with this question. Hope you have a great recovery Sarah
Michelle
Thank you so much for your thoughts Michelle. I will proceed with caution … (I haven’t previously had a prolapse – just trying to prevent one happening!)
Hello Everyone: I just had the hysterectomy and prolapse repair (abdominal) which my surgeon advised has an approximate 87% success rate as opposed to the vaginal which had a 60% plus success rate. I was pleasantly surprised at my post op check-up to be referred to physical therapy to learn the proper core exercises also. All I have read states no Pilates, Yoga (two of my absolute favorites) or crunches; nothing where head or legs are off the floor putting pressure on the midsection! Bonita, so sorry to hear of your second surgery, good luck. Thanks for this website and all the valuable information. Allice
Hi Alice
Thanks so much for taking the time to tell your story.
Best of luck with your recovery and return to safe exercise.
Cheers
Michelle
Hi Michelle, I have your book, INside Out and I am eager to get my body back into shape after a davinci vaginal hysterectomy (late Aug, 2011; ovaries left intact). The reason for the hysterectomy was uterine prolapse and I am 61 and in great walking shape but my natural apple shape has become intolerably fat in the upper abs (lower are fine). I have not actually gained weight, more like it shifted all to my upper belly. I need some strong suggestions for safe ab exercises. I would work with free weights, fitness ball and mat. Thanks for your help!!!!
hello everyone,
i am 2 weeks post surgery,
vaginal hysterectomy and pelvic floor repair my ovaries and tubes in tact and dont mind saying its been 2 weeks from hell for me,
for years i have been doing ab crunches etc thinking its been the right thing for my body and had even signed up to a gym promoting everything your page tells you NOT to do.
until i read the information provided i was unaware the damage that can occur through ignorance…i feel that gym's should be more aware of this and medical professions need to tell all women this as it is defininately NO walk in the park having these types of surgeries.
thank you for the information and look forward to getting back on track with the right information.
to all the ladies hope you all have speedy recoveries…Bonita i do hope you have success in your second surgery.