Unsafe abdominal exercises for prolapse and after prolapse surgery include a variety of exercises common place in gyms and exercise classes. This expert Physiotherapist article helps women avoid unsafe abdominal exercises with prolapse and protect their pelvic floor from reinjury after prolapse surgery.
Read on now to learn:
- 12 abdominal exercises to avoid with prolapse ;
- How to modify abdominal exercises
- 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?
- Should I brace my abdominal muscles all the time?
Download “Unsafe Abdominal Exercises For Prolapse” as a user friendly PDF by scrolling down.
12 Unsafe Abdominal Exercises with Prolapse Issues
Intense abdominal exercises should be avoided or modified by women with or at risk of pelvic floor dysfunction to minimize the risk of pelvic floor strain and injury, particularly after prolapse surgery and with poor pelvic floor support.
These intense abdominal core exercises will have the potential to overload the pelvic floor in women with pelvic floor dysfunction:
1. Traditional abdominal curl or sit-up exercises (shown right)
2. Incline sit-ups
3. Abdominal 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.
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 some commonly performed abdominal exercises are demonstrated in this short abdominal exercise video.
To modify pelvic floor loading with abdominal exercises:
- Breathe out with the effort
- Avoid resisted or weight loaded abdominal exercises
- Avoid overbracing the abdominal muscles during exercise
- Reduce the number of repetitions
- Modify the intensity of abdominal exercises (shown in the abdominal exercise video above).
Intense Core Abdominal Exercises and Pelvic Floor Problems
Intense core abdominal exercises particulalry those exercises involving the upper abdominal “six pack” muscles increase downward pressure on the pelvic floor. Recent studies confirm that when women with pelvic floor dysfunction perform sit-up exercises, the pelvic floor is forced downwards. When repeated, intense core 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?
Avoid upper abdominal muscle exercises that involve raising both legs off the ground at once and/or exercises involving 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 abdoiminal 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! We know that it is not possible to spot reduce fat; to flatten your stomach you probably need to lose fat. Regardless of how many sit-up or abdominal strength exercises you do, they will never flatten your stomach. 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?
No, if your pelvic floor is weak, intense abdominal core Pilates exercises can overload and further weaken the vulnerable 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. Abdominal strength exercises or intense core exercises will not strengthen the pelvic floor if the 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. Women having undergone recent prolapse surgery or hysterectomy need to understand that mainstream Pilates is not an appropriate form of rehabilitation exercise when recovering.
Should Abdominal Muscles be Strongly Activated?
No, strongly bracing (contracting) the abdominal muscles strongly is not an appropriate exercise for prolapse or with pelvic floor dysfunction. Strongly bracing the abdominal muscles increases the downward pressure on the pelvic floor. The deep abdominal core muscles are designed to work gently all the time. Appropriate abdominal activation is important to avoid pelvic floor overload in women with prolapse problems.
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. Safe abdominal exercises for prolapse should be tailored 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.
Download these “Unsafe Abdominal Exercises for Prolapse” as a user friendly PDF
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About the author: Michelle Kenway is a Pelvic Floor Physiotherapist, author of Inside Out – the Pelvic Floor Safe Exercise Program for Women along with professor Judith Goh (Urogynaecologist). Inside Out is your complete pelvic floor safe exercise weekly home workout program.
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