2 Unsafe Core Strength Exercises for Women With Prolapse

Are you unsure about choosing the right abdominal core  strength exercises for your prolapse?

Are you wondering how to tone your tummy and protect your pelvic floor?

These 2 commonly performed core strength exercises can often be modified according to individual risks and overall pelvic floor condition.

Video suitability: General

Video duration: 3 minutes 30 seconds

Please scroll down below this video for more information about these intense core strength exercises for women with prolapse

Problems With Intense Abdominal Core Strength Exercises and Prolapse

Research tells us that intense abdominal core strength exercises increase the downward pressure on the pelvic floor (and prolapse).

The effect is like squeezing a sauce bottle – squeeze the sides of the bottle and the pressure created forces the sauce out.

When some women squeeze the outer abdominal muscles surrounding their trunk, the pressure created forces the pelvic floor down, particularly women who’ve had a vaginal delivery.

You can imagine that forcing the pelvic floor down repeatedly with intense core exercises can stretch and weaken the pelvic floor and potentially worsen prolapse problems, particularly in women who’ve undergone previous prolapse surgery.

2 Core Strength Exercises to Avoid or Modify

Core Strength Exercise 1: The Forward Plank

Forward Plank exercise is a popular core strength exercise designed primarily to strengthen the core abdominal and spinal muscles.

Forward Plank is commonly performed weight bearing through the forearms and  feet.

The action requires intense outer abdominal muscle contraction – overweight women need to contract their abdominal muscles intensely to raise their trunk off the ground often making this an unsuitable exercise for these women with pelvic floor (or lower back) problems.

Modify or Avoid Forward Plank

Women with weak pelvic floor muscles and those at risk of prolapse worsening may choose to avoid the Forward Plank until their pelvic floor muscles in favor of pelvic floor friendly core strength exercises.

Other women may choose to modify Forward  Plank to reduce the load on the pelvic floor.

This is an individual decision for women – many women after prolapse surgery in particular will need to avoid Forward Plank and Modified Forward Plank.

How to Modify Forward Plank

If you are confident that your pelvic floor muscles can withstand the modified version here is the technique:

  • Start in prone position with your forearms resting on the mat
  • Gently activate your deep abdominal muscles
  • Activate your middle back muscles drawing your shoulder blades together and slightly down
  • Activate your pelvic floor muscles before and during this exercise
  • Slowly raise your trunk and pelvis off the mat
  • Keep your knees and feet in contact with the mat
  • Breathe normally throughout this exercise (avoid breath holding)
  • Maintain the raised position briefly before lowering your body back to the mat and relaxing your abdominal and pelvic floor muscles back to resting position

Modified Plank Exercise Progression

If you feel confident that your pelvic floor can withstand this exercise you may choose to increase the length of time you maintain the exercise and increase the number of repetitions you perform within your level of personal comfort.

Note: If you notice prolapse symptoms associated with this exercise then cease it in favour of an alternative pelvic floor friendly abdominal exercise

Core Strength Exercise 2: The Hundred Pilates Exercise

Many Pilates classes commence a warm up with ‘The Hundred’ exercise. This exercise is designed to promote core strength and stability and increase circulation at the start of a class.

The Hundred activates the strong outer abdominal muscles when the head is raised forward from the ground, in particular Rectus Abdominis (6 Pack muscles). This technique increases the load on the pelvic floor.

How to Modify The Hundred Exercise

This exercise is readily modified into a pelvic floor friendly exercise using the following technique:

  • Start in lying down on your back
  • Both feet should be flat and knees bent
  • Head should remain down in contact with the mat throughout this exercise
  • Gently activate your deep abdominal muscles
  • Activate your middle back muscles drawing your shoulder blades together and slightly down
  • Slowly raise one bent leg above your body so that this hip and knee are positioned at right angles
  • Maintain this position and breathe throughout this exercise
  • Lower your leg back to starting position

Modified Hundred Exercise Progression

Progress this exercise modification by slowly lowering the raised leg towards the ground and then raising it back above the body keeping the normal curve in the lower back.

You may choose to start with a couple of repetitions and see how your body tolerates this exercise before progressing the number of repetitions you perform.

Key Points for Core Strength Exercises for Women

Some intense core strength exercises generate pressure that can overload the pelvic floor (and prolapse) forcing it downwards.

If your pelvic floor is weak or if you have a prolapse/after prolapse surgery modify or avoid intense core abdominal exercises such as the Plank and The Hundred. These exercises are readily modified to reduce the downward pressure on the pelvic floor.

Women at increased risk of prolapse problems are likely to need to avoid The Plank modification until their pelvic floor strengthens. Many women can modify abdominal core strength exercises and continue to exercise their abdominal muscles while protecting their prolapse from worsening or recurring.


prolapse exercises

with Pelvic Floor Physiotherapist Michelle Kenway

Learn how to exercise safely, strengthen your prolapse and reduce your risk of prolapse worsening.

Prolapse Exercises is a complete exercise guide for women with prolapse seeking to exercise safely and protect their pelvic floor.




  1. Jeniffer says:

    Are you familiar with the Curves gym program? I am wondering if this is safe for me, as I have a prolapse (which is much improved since doing your exercises). I need to lose weight – which is entirely around my stomach (I look and feel like I am 6 months pregnant) – and feel something like this three or four times a week might help me shift it. My diet is fairly good and I believe it is entirely my lack of exercise which has been the cause of my packing on all this weight. I am 65.

    • Michelle Kenway says:

      Hi Jeniffer

      Yes I am familiar with Curves. Here is the review article I wrote on Curves exercises and pelvic floor problems, I hope this helps. If you’re completely inactive at present just getting active is going to help however many women will be unable to achieve the exercise dose required for significant weight loss with Curves.

      Losing weight requires cardiovascular exercise where the heart rate is elevated. The more time spent exercising the more weight you can expect to lose. There is currently good evidence to support short doses of high intensity exercise for weight loss – I tend to favour stationary cycling for prolapse problems as women can usually achieve a good intensity of exercise without compromising their pelvic floor.

      All the best to you

  2. Hi Michelle, I used to be a keen rower and sculler, however after having a hystrectomy 18 months ago, I went back to rowing 8 months post op and had to give it up after having mild prolapse front and back. I manage this Ok now by following your advice and exercise plan. I would like to try sculling again but no at the expense of causing my prolapse to worsen. I can’t find any links or advice for any masters (46) who have had this op and returned to rowing/sculling.

    • Michelle Kenway Physiotherapist says:

      Hi Sara

      Yes sculling/rowing is one of those tricky issues isn’t it. Your question may be read by another woman who might reply here. I do have this rowing machine video onsite that may help you a little however the sculling technique is probably quite specific.I think the resistance needs to be kept really low with ‘at risk’ pelvic floor and sculling which therefore means slower speed I’m guessing?


  3. do your exercises address prolapse issues with the upper abdomen muscles?

    • Michelle Kenway Physiotherapist says:

      Hi Lisa
      Yes the when the upper abdominal muscles contract strongly this can be problematic for women with prolapse. The focus should be on appropriate contractions of the deep abdominal core muscles rather than the upper abdominal muscles.

  4. I’ve added using a Pilates circle between my knees when I do my bridges. I squeeze it together when I go into a slight bridge. Is this a good idea with prolapse ? Desperately need to know this , thank you! I have noticed a huge good difference in incontenience but recently added Pilates circle.

    • Michelle Kenway Physiotherapist says:

      Hi Beth
      Using a Pilates Circle involves muscles inside your size, it doesn’t involve your pelvic floor and should not make any difference to prolapse.