Are you worried about unsafe abdominal exercises for prolapse or hysterectomy?
Unsafe abdominal exercises include some of the intense core exercises commonly found women’s exercise classes and gyms .
This information by Pelvic Floor Physical Therapist Michelle Kenway helps you avoid unsafe abdominal exercises with prolapse and protect your pelvic floor from re injury after prolapse surgery or hysterectomy.
Scroll down for:
- 12 abdominal exercises to avoid with prolapse
- Unsafe abdominal exercises in the gym for women at risk (VIDEO)
- How to modify abdominal exercises
- Safe abdominal exercises to choose
- How abdominal exercises can cause pelvic floor problems
- How to identify unsafe abdominal exercises for prolapse
- Will core abdominal exercises flatten my stomach?
- Will Pilates strengthen my pelvic floor?
- How to correctly brace your abdominal muscles
Download “Unsafe Abdominal Exercises For Prolapse” as a user friendly PDF by scrolling down.
12 Unsafe Abdominal Exercises with Prolapse or After Hysterectomy
Intense abdominal exercises should be avoided or modified by women with or at risk of pelvic floor dysfunction. The risk of pelvic floor strain and injury may be increased in these women since research shows that the pelvic floor is forced downwards with abdominal curl exercises 1.
Previous pelvic surgery such prolapse surgery increases the risk of repeat prolapse 2. Some research also indicates that the risk of prolapse is increased in women after hysterectomy 3.
These are intense abdominal core exercises which may have the potential to overload the pelvic floor in women with pelvic floor dysfunction:
1. Traditional abdominal curl or sit-up exercises*
2. Incline sit-ups*
3. Abdominal exercise machines*
4. Oblique sit-ups
5. Oblique machine
6. Exercise ball sit-ups*
7. Exercise ball leg raises*
8. Bicycle legs
9. Double leg raise
10. Hanging knee raise*
11. Pilates Table Top or The Hundred
12. Intense core Plank or Hover exercises.
* These exercises are demonstrated in the Physical Therapist Video shown next
This list of unsafe abdominal exercises doesn’t apply to all women. Women who aren’t at risk or pelvic floor problems may be quite capable of performing more intense abdominal exercises such as those demonstrated in this video below.
Unsafe Abdominal Exercises for Prolapse or After Hysterectomy Video
This Physical Therapist video shows you some of the more intense machine and mat-based abdominal exercises to avoid or modify if you’re at increased risk of pelvic floor problems.
Video Suitability: Women with pelvic floor weakness, prolapse, after prolapse surgery or after a hysterectomy.
Duration: 4 minutes
Prolapse Exercises e-Book
International best selling prolapse exercise guide for women with prolapse and after prolapse surgery.
Prolapse Exercises teaches you how to:
- Exercise safely after prolapse surgery
- Reduce your risk or repeat prolapse
- Avoid unsafe exercises
- Choose pelvic floor safe exercises
- Reduce your risk of prolapse worsening
- Improve prolapse support
- Increase your strength and fitness
- Strengthen your core
- Lose weight
Choose Pelvic Floor Safe Abdominal Exercises
Ideally choose pelvic floor safe abdominal exercises that place minimal pressure on your pelvic floor. These are less intense core abdominal exercises that help you tone and strengthen your deep or innermost abdominal core muscles.
These 5 safe core abdominal exercises can help you get start your safe abdominal exercises.
How to Modify Unsafe Abdominal Exercises?
Many intense upper abdominal core exercises can be readily modified to reduce the load on the pelvic floor.
Techniques to modify abdominal exercises are demonstrated in this abdominal exercise video (right)
To reduce pelvic floor loading with abdominal exercises:
- Breathe out with the effort
- Avoid resisted or weight loaded abdominal exercises
- Avoid over bracing the abdominal muscles during exercise
- Reduce the number of repetitions
- Modify the intensity of abdominal exercises
Intense Core Abdominal Exercises and Pelvic Floor Problems
Intense core abdominal exercises particularly those exercises involving the upper abdominal “six pack” muscles increase downward pressure on the pelvic floor. Research demonstrates when women with pelvic floor dysfunction perform abdominal curl exercises, the pelvic floor is forced downwards 1.
When repeated, intense core abdominal exercises can stretch, strain and overload the pelvic floor muscles and potentially worsen prolapse symptoms.
It is vital to avoid overloading the pelvic floor with unsafe abdominal exercises with a prolapse and after prolapse surgery.
How to Identify Unsafe Abdominal Exercises for Prolapse or Hysterectomy?
Intense upper abdominal muscle exercises often involve:
- Raising both your legs off the ground at the same time
- Raising your head and shoulders off the ground whilst lying down on your back
Both these types of exercises will increase the downward force on your pelvic prolapse and pelvic floor. These exercises require strong pelvic floor muscles to counteract the associated downward pressure and are not appropriate abdominal exercises for prolapse.
Will Abdominal Exercises Flatten Your Stomach?
No, this is a myth.
Unfortunately our society has a culture of abdominal strengthening and women are often led to believe that the more abdominal muscle exercises they perform, the flatter their stomach will appear!
It’s not possible to spot reduce fat; to flatten your stomach you probably need to lose fat.
Research shows that sit-up or abdominal strength exercises will not flatten your stomach or remove abdominal fat 4. The way to flatten the appearance of your stomach is to lose body weight by reducing your fat intake and perform more appropriate safe core abdominal exercises.
Will Pilates Exercises Strengthen Your Pelvic Floor?
If your pelvic floor is weak, some intense abdominal core Pilates exercises can overload and further weaken your pelvic floor. Women with prolapse or after prolapse surgery need to know about potentially unsafe Pilates exercises.
Some women with pelvic floor dysfunction mistakenly believe Pilates exercises will strengthen their pelvic floor.
Intense core exercises will not strengthen your pelvic floor if your pelvic floor is weak and not working well.
The more intense core abdominal exercises women perform, the more downward pressure they place on their pelvic floor. Some women actually develop or worsen pelvic floor dysfunction as a direct result of intense core strength exercises.
Pilates exercises and classes can be problematic for women who have had previous hysterectomy, prolapse surgery and/or incontinence surgery. Women with or at risk of pelvic floor dysfunction should be screened prior to attending Pilates sessions and their Pilates exercises modified accordingly if the risk of pelvic floor dysfunction exists.
Mainstream Pilates is not always an appropriate form of rehabilitation exercise when recovering from their surgery after recent prolapse surgery or hysterectomy.
How to Correctly Brace Abdominal Muscles
Appropriate abdominal activation is important to avoid pelvic floor overload in women with prolapse problems.
Abdominal muscles should be gently activated by drawing the lower abdominal wall in towards the spine and maintaining this gentle contraction. The deep abdominal core muscles are designed to work gently all the time.
Strong bracing (contracting) of the abdominal muscles strongly is inappropriate for women with prolapse or with pelvic floor dysfunction. Strongly bracing the abdominal muscles increases the downward pressure on the pelvic floor.
If you are living with a prolapse or after prolapse surgery it is wise to avoid unsafe abdominal exercises that can overload the pelvic floor. Pelvic floor safe abdominal exercises for prolapse are those that are matched to a woman’s pelvic floor capacity.
If you apply these expert guidelines to your exercise program, you will be more likely to avoid unsafe abdominal exercises for prolapse and protect your pelvic floor from dysfunction.
More Related Videos & Information
1 Barton A, Serrao C, Thompson J, Briffa K (2015) Transabdominal ultrasound to assess pelvic floor muscle performance during abdominal curl in exercising women. International Urogynecology Journal.Volume 26, Issue 12, pp 1789–1795. https://link.springer.com/article/10.1007/s00192-015-2791-9
2 Wiskind A, Creighton S, Stanton S (1992) The incidence of genital prolapse after the Burch colposuspension. Am J Obstet Gynecol. Aug;167(2):399-404. https://www.ncbi.nlm.nih.gov/pubmed/1497042
3 Swift S.(2000) The distribution of pelvic organ support in a population of female subjects seen for routine gynecologic health care. Am J Obstet Gynecol. 2000 Aug;183(2):277-85. https://www.ncbi.nlm.nih.gov/pubmed/10942459
4 Vispute S, Smith J, Lecheminant J, Hurley K (2011) The Effect of Abdominal Exercise on Abdominal Fat. J Strength Cond Res. Sept 25(9):2559-64. https://www.ncbi.nlm.nih.gov/pubmed/21804427