10 Pilates Exercises To Avoid For Pelvic Floor Safe Exercises

PilatesAre you unsure about which Pilates exercises to avoid?

Unfortunately some classical Pilates exercises may increase your risk of pelvic floor problems.

This information helps you continue to enjoy the benefits of Pilates by knowing which intense core abdominal exercises you may need to modify or avoid.

Every woman has her own individual pelvic floor risk factors. Those Pilates exercises suited to some women may not necessarily suit others.

Pilates Exercise 1 – Hundred I

Hundred Pilates Exercise

Hundred I

The Hundred I involves raising your head and both legs off the mat.

Maintaining The Hundred position uses your outer core abdominal muscles, creating downward pressure onto your pelvic floor from within your abdomen.

Modify Hundred I to reduce the load on your pelvic floor, by keeping your head, shoulders and one foot in contact with the mat throughout. Raising one leg reduces the load on your pelvic floor when compared with both legs raised.

Pilates Exercise 2 – Hundred II

Hundred II Pilates Exercise

Hundred II

Hundred II is a more advanced Pilates exercise with the legs extended shown above.

This Pilates exercise is an intense core abdominal muscle exercise that is difficult to modify so you may choose to avoid this exercise if your pelvic floor is at increased risk of injury.

Pilates Exercise 3 – Roll-Up

Roll-Up Pilates Exercise


Pilates Roll-Up is a classic Pilates mat exercise designed to strengthen the abdominal core muscles.

If your pelvic floor can’t withstand the load created, it will be repeatedly forced downwards with each successive Roll-Up.

Pilates Exercise 4 – Single-Leg Stretch

Single-Leg Stretch Pilates

Single-Leg Stretch

Single-Leg Stretch strongly activates your outer core abdominal muscles increasing the load on your pelvic floor.

Modify Single-Leg Stretch stretch by keeping one foot and your head in contact with the mat throughout.

Pilates Exercise 4 – Double-Leg Stretch

Double Leg Stretch Pilates

Double Leg Stretch

The first of the classical Pilates “stomach series” is usually provided as a progression from Single-Leg Stretch.

Modify Double-Leg Stretch with both knees bent, both feet and head in contact with the mat and activate your deep core abdominal muscles while circling your arms out to your sides.

Pilates Exercise 5 – The Scissors

Scissors Pilates Exercise

The Scissors

The Scissors Pilates exercise usually involves the head and both legs raised off the mat.

Modify Scissors by engaging your deep abdominal muscles correctly, raising only one straight leg at a time and keeping your head and shoulders in contact with the mat.

Pilates Exercise 6 – Teaser

Teaser Pilates Exercise


Teaser is one of the more advanced classical Pilates exercises. This is an intense core abdominal exercise.

Teaser increase pressure on the pelvic floor (and the lower back). Teaser is a difficult exercise to modify to reduce pelvic floor loading and you may seek to avoid this exercise if your pelvic floor is at increased risk of injury.

Pilates Exercise 7 – Push Up

Push-Up Pilates


Push Up technique shown above is an intense core abdominal exercise that increases loading on your pelvic floor.

Push up can be modified to a kneeling Ladies Push Up to reduce the load on the pelvic floor.

Pilates Exercise 8 – Leg Pull Front

Leg Pull Front Pilates

Leg Pull Front

Leg Pull is a challenging abdominal core exercise often performed from full Plank position.

While Plank can be modified by kneeling, raising the leg single leg from kneeling plank should be avoided to prevent undue strain on the pubic symphsis (i.e. the joint where your two pubic bones meet).

Pilates Exercise 9 – Rollover

Rollover Pilates Exercise


Rollover is a classical Pilates exercise for spinal stretching and core control.

Repeatedly raising both legs overhead strongly engages the abdominal muscles and therefore increases the pressure on the pelvic floor. If your pelvic floor is at increased risk of injury you may seek to avoid this exercise.

Rollover is difficult to modify to reduce pelvic floor loading.

Pilates Exercise Technique 10 – Imprinting The Spine

Many classical Pilates exercises are still performed with imprinting the spine or flattening out the curve in the lower back.

Joseph Pilates advocated imprinting the spine as a method to provide additional support to the spine.

Why does imprinting continue? Ultrasound Machine

When Joseph developed his classical Pilates series in the early to mid 1900’s he didn’t have the technology we have today.

We now know from ultrasound studies1 that the deep core abdominal muscles work most effectively with the normal inward curve in the lower back rather than back flattened or imprinted position.

Imprinting the spine recruits or engages the strong outer abdominal muscles that are responsible for increasing the load on the pelvic floor.

If you’re seeking to strengthen your deep core abdominal muscles (i.e. transverse abdominis and internal oblique muscles) try to keep the normal inward curve in your lower back during your exercises.

Key Points For Pilates & Your Pelvic Floor

Every woman is different and there is no one rule fits all when it comes to how well suited some Pilates core abdominal exercises are to your pelvic floor.

If your pelvic floor is at increased risk of injury modify or avoid Pilates core abdominal exercises involving:

  • Both legs raised off the mat
  • Head and shoulders raised off the mat
  • Weight bearing through the hands and feet only


Inside Out Book & DVD

with Pelvic Floor Physiotherapist
Michelle Kenway

Learn how to exercise and avoid exercises that overload the pelvic floor causing pelvic floor problems.

Inside Out book and DVD is a complete exercise solution for women seeking to exercise safely and protect their pelvic floor.





1. Sapsford RR, Hodges PW, Richardson CA, Cooper DH, Markwell SJ, Jull GA. Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn. 2001;20(1):31-42.


  1. Thank you so much Michelle, it’s good to have such a detailed list of exercises and pictures to help people identify them. I teach Classical Pilates and I have found your book and website a very valuable resource to assist at risk clients with modifications. I’m encouraging other teachers to be more aware as well and I always recommend anyone with concerns to take a look at your site and sign up! Pilates mat classes are a real growth industry and there is very little awareness of the possible risks for those with weak pelvic floor muscles, so I think it’s so important to have the sort of information that you are making available. I have used a partial roll-back to modify the full roll up, and make use of resistance bands to assist as well. That is rolling back only part way from sitting, knees bent and both feet down. Feet anchoring a resistance band, with the ends held in the hands. Teasers can be modified in a similar way. What are your thoughts on this?

    • Michelle Kenway Physiotherapist says:

      Hi Sarah

      It’s great to hear from you and to hear what’s happening in Classical Pilates at the moment. Also great to hear about what you’re doing to help women stay involved in Pilates – thanks so much for sharing this.

      With regards to your modified partial roll back are you saying that using the resistance band you use the back extensors to do the work and then hold the resistance band on the return to upright position?


  2. That sounds about right. The band stretches as they roll back and then contracts as it assists the roll up. I have also taken out the rolling exercises such as rolling like a ball, but they miss the spinal massage.

    • Michelle Kenway Physiotherapist says:

      Hi Sarah

      That sounds like a good modification – it’s probably wise to continue to avoid roll ups & even modified roll ups with women at high risk (e.g. post prolapse surgery) especially in view of the latest information findings on abdo curl exercises in today’s newsletter. I think it’s also a matter of quantity too; the greater the number of reps the more the pelvic floor descent.

      All the best Sarah

      • Thanks Michelle, we don’t use high reps in Classical. 5 roll ups max

      • Fiona UK says:

        Hello Michelle,

        Recently I tried some Pilates core strengthening exercises, and it wasn’t long before I realized they were doing more harm than good. Then I found your very helpful website.

        I live in the UK and am about to purchase your book “Inside Out”, but would just like to check with you if it will be suitable for me. I have a uterine prolapse and use a ring pessary, (some of the Pilates exercises were making this sore inside); I also have scoliosis and have had a mastectomy.

        Many thanks,


        • Michelle Kenway Physiotherapist says:

          Hi Fiona

          Thanks for your email enquiry – yes the issue with Pilates is the intense core exercises when the pelvic floor is compromised. Yes Fiona the Inside Out book includes information on core exercises to avoid however the new Prolapse Exercises book also includes this information and much more that will be very relevant for you dealing with uterine prolapse long-term. This book is also a available in downloadable format.


          • Fiona UK says:

            Hello Michelle,

            Thank you so much for the information. I have sourced a copy of your Prolapse Exercises book here in the UK and will purchase it later today.

            The NHS here gave me advice about trying Pilates core exercises and I found exercise routines on the web, but neither gave any direction as to how to exercise with a prolapse. I was so pleased to find your website and books.

            Again, many thanks,


          • Michelle Kenway Physiotherapist says:

            My pleasure Fiona, thanks so much for your feedback