Ab workouts for women are not all the same when it comes to managing prolapse problems!
Some popular abdominal exercises increase the risk of pelvic floor loading and prolapse worsening.
It’s often confusing to know which abdominal exercises to avoid especially if you’ve been diagnosed with a prolapse or after prolapse surgery.
Read on now to learn:
- 11 commonly performed ab workouts for women to modify or avoid with prolapse; and
- 6 expert tips to help you keep your abs in shape and protect your prolapse.
What’s the Risk with Intense Ab Exercises and Prolapse?
Intense abdominal workouts in women can overload weak and poorly functioning pelvic floor muscles (which women with prolapse usually have).
If you have pelvic floor dysfunction, overloading your pelvic floor muscles with unsafe abdominal exercises can increase your risk of:
- Prolapse occurring
- Worsening prolapse symptoms and severity
- Repeat prolapse after prolapse surgery
11 Ab Workouts for Women to Modify or Avoid with Prolapse
Knowing which abdominal exercises have potential to overload your pelvic floor will help you exercise and protect your prolapse.
When women with pelvic floor dysfunction do traditional abdominal crunch exercises their pelvic floor is forced downwards
You can just imagine what happens to your prolapse if it’s repeatedly forced downwards with even more intense exercises than crunches … pelvic floor stretch, tissue strain and prolapse worsening!
Research1 at the Biomechanics Lab at San Diego State University showed that some popular ab workouts for women involve intense upper abdominal muscle contractions (i.e. rectus abdominis or ‘6 pack’ muscles) – even more intense than the traditional crunch exercise.
These ab workouts are listed below in decreasing order of intensity according to the study findings. The brief exercise description accompanying each exercise is intended to help you identify the exercise.
*The percentage number listed next to each exercise describes how intensely the abdominal muscles contracted compared with a traditional crunch exercise (outlined in more detail further on)
Abdominal Exercise 1: Bicycle Manoeuvre (248%)*
Bicycle manoeuvre is shown right lying flat on ground with both hands behind the head and both legs raised with knees to 45 degrees, alternate legs through cycle pedal movement. The elbow is touched to the alternate knee during the cycling motion.
Abdominal Exercise 2: Captain’s Chair (212%)
Gym exercise equipment where upper body is fixed and legs are suspended vertically below the body. Both knees are raised simultaneously towards the chest before being lowered back down to starting position.
Abdominal Exercise 3: Crunch on Exercise Ball (139%)
Crunch on the exercise ball is shown right performed lying with the middle back on the exercise ball and knees bent to right angles. The upper torso (head and shoulders) is raised off the ball no more than 45 degrees before lowering torso back to starting position.
Abdominal Exercise 4: Vertical Leg Crunch (129%)
Vertical leg crunch is shown below (right) performed lying down on the ground with both hands behind head and both legs raised vertically above body with legs crossed at the ankles. The head and shoulders are raised off the ground lifting the trunk towards the thighs before lowering back to starting position.
Abdominal Exercise 5: Torso Track (127%)
Torso track is an abdominal exercise machine. The machine is used in a semi-prone kneeling position where sliding handles are gripped to support the body weight and the trunk is moved forwards and backwards while suspended above the frame of the machine.
Abdominal Exercise 6: Long Arm Crunch (119%)
Long arm crunch involves a traditional crunch being performed with both arms raised above the head, hands clasped and upper arms beside the ears as the head and upper torso are lifted and lowered to and from the ground.
Abdominal Exercise 7: Reverse Crunch (109%)
Lying on the ground with both legs raised in the air and knees bent at right angles. The legs and feet are pressed upwards towards the ceiling and then returned to right angle starting position.
Abdominal Exercise 8: Crunch with Heel Push (107%)
Heel Push is a traditional crunch or sit up exercise. This variation of traditional crunch involves both of the heels digging into the ground and the balls of the feet raised off the ground rather than the traditional position of feet flat.
Abdominal Exercise 9: Ab Roller (105%)
Ab Roller is a machine used kneeling in a similar manner to Torso Track. The body weight is partially supported through the upper body and the trunk is moved forwards and backwards above the ground by gripping handles attached to a small roller or wheel.
Abdominal Exercise 10: Hover (100%)
Hover also known as ‘The Plank’ exercise is a popular ab workout for women in Pilates and Yoga classes. This exercise involves weight bearing through the hands or forearms and the balls of the feet with the body held prone and suspended above the ground.
Abdominal Exercise 11: Traditional Crunch (100%)
Lying flat on the ground with knees bent and hands behind the head or arms folded across chest. The head and shoulders are raised off the ground to 45 degrees before being lowered back down to the ground. The feet remain flat on the ground and knees bent at right angles throughout this exercise.
* What does the Percentage Mean?
Each exercise is listed along with a percentage of the intensity of rectus abdominis contraction compared with the traditional crunch exercise during this study.
For example the bicycle manoeuvre involved the most intense rectus abdominis contraction with 148% more muscle activity than the traditional crunch exercise, so this is an intense upper abdominal muscle exercise requiring caution with prolapse problems.
6 Tips for Pelvic Floor Safe Ab Workouts for Women
Is it possible to train your abs and protect your pelvic floor? Absolutely!
Increase the safety of your abdominal workout by:
- Knowing your individual risk – the risk of prolapse problems is increased in women with; existing prolapse, after prolapse surgery, poorly functioning pelvic floor muscles and/or after instrumental vaginal delivery
- Avoiding intense upper abdominal exercises if your risk of prolapse is high
- Choosing pelvic floor safe tummy toning ab workouts that your pelvic floor can readily withstand
- Modifying intense abdominal exercises to a manageable level of intensity your pelvic floor can withstand
- Being alert to group exercise situations where ab workouts for women are often designed for mainstream rather than individuals with pelvic floor dysfunction
- Being cautious with abdominal exercise equipment involving high resistance or heavily loaded abdominal exercises
- Never assuming your abdominal exercises are safe for your pelvic floor just because you’re in a women’s only gym, Pilates or Yoga class.
If you’re living with prolapse problems or after prolapse surgery, knowing which abdominal exercises involve intense upper abdominal contractions can help you make informed choices about your exercises to avoid prolapse injury.
Ab workouts for women can be modified to train the abdominal muscles effectively and protect the pelvic floor from injury. If you’re not sure about your risk of prolapse worsening or repeat prolapse after prolapse surgery, why not see a pelvic floor physio for assessment and guidance to help you keep your core in good shape!
ABOUT THE AUTHOR, Michelle Kenway
Michelle Kenway is a Pelvic Floor Physiotherapist and author of Prolapse Exercises Inside Out. Prolapse Exercises is a complete exercise guide for women with prolapse and after prolapse surgery seeking to exercise safely and protect their pelvic floor. This guide includes effective pelvic floor safe core abdominal strength exercises designed for women with prolapse problems.
1Francis P, Kolkhorst F, Pennuci M, Pozos R, Buono M, (2001) An Electromyographic Approach to the Evaluation of Abdominal Exercises. ACSM’S Health & Fitness Journal, Volume 5, Issue 4