How to Modify Plank Exercise for Safer Core Strengthening

Forward plank exercise

Plank exercise is a very popular core strength exercise performed by women in gyms and exercise classes world-wide. If you have a pelvic prolapse you are likely to want to know how safe the Plank exercise is for your pelvic floor, whether or not you should be doing it and how to strengthen your core and avoid making your prolapse worse.

Read on now to learn:

  • What is the Plank exercise?
  • Which muscles are strengthened?
  • How safe is Plank exercise for your pelvic floor?
  • How to modify Plank exercises?
  • Tips for correct Plank technique
  • Who should avoid Plank exercises?

What is the Plank Exercise?

The Plank exercise is a core abdominal strength exercise, also known as the hover or abdominal bridge exercise. The most popular form of the Plank is the Forward Plank exercise (shown above) which usually involves weight bearing through the forearms and toes, with the body maintained in a horizontal position elevated above the ground.

Muscles used in Forward Plank

The Forward Plank exercise involves a range of different muscle groups in the body working to hold the body above the ground.

The main muscle groups used during Plank are the core muscles that surround the trunk; the abdominal muscles and spinal muscles. Secondary muscles are also involved in stabilising or holding the body in position during Forward Plank and these include muscles around the shoulder girdle, chest, middle back, thighs and calf.

How Safe is The Plank for your Pelvic Floor?

Studies have shown us that intense core exercises force the pelvic floor downwards in women with weak pelvic floor muscles. Women with prolapse are known to have pelvic floor dysfunction. If you have a prolapse, this is an important fact to bear in mind when selecting your core exercises.

The Plank performed in the traditional forward position with weight bearing through the toes is an intense core abdominal exercise and can therefore increase pressure on the pelvic floor. In other words the abdominal muscles have to work hard to support the trunk above the ground during Plank and the longer the position is held, the longer the pelvic floor muscles need to work to counteract the downwards force that is generated.

Safety of Plank exercises for your pelvic floor depends on a number of factors including your:

  • Current pelvic floor strength
  • History of pelvic floor surgery
  • Pelvic floor dysfunction (prolapse, incontinence, pelvic floor spasm/Vaginismus)
  • Chosen type of Plank exercise
  • Overall physical strength

Some women with weak pelvic floor muscles and dysfunction will find that with pelvic floor rehabilitation they may be able to progress their Plank exercises. Others will find that they should avoid The Plank and choose alternative pelvic floor safe abdominal core exercises.

How to Modify Forward Plank Exercise?

If you are seeking to perform the Forward Plank there are a number of ways to modify this exercise to reduce the pressure on your pelvic floor:

1. Change Plank Position

  • Kneeling Forward Plank – rather than weight bearing through the toes, modify this exercise into weight bearing through your knees (kneeling Plank) so that the abdominal muscles don’t need to work as hard to hold the body above the ground. You can also lower your toes to further reduce the load on your pelvic floor (shown below).

Modified Plank Exercise


  • Kneeling Side Plank – side plank reduces the involvement of the strong outer abdominal six pack muscles, so that the pressure on the pelvic floor is reduced. Side plank is shown below, and this can be modified to kneeling Side Plank.

Side Plank


2. Decrease Plank Duration

The longer the body is held above the ground during Forward Plank exercise, the longer the pressure on the pelvic floor is maintained. If you are completing a pelvic floor strengthening program you may find that as your pelvic floor becomes stronger you are able to maintain The Plank for longer without impacting upon your pelvic floor. If you know your pelvic floor is weak, avoid maintaining Plank positions for extended periods of time.

3. Avoid Intense Abdominal Indrawing

Sometimes you may hear the instruction to draw in your abdomen strongly during The Plank. This is not necessary and will in fact increase pressure on your pelvic floor. Your abdominal muscles will be active and strengthen during this exercise – there is no need to over brace your outer abdominal muscles. Ensure correct abdominal muscle activation.

4. Breathe Normally

Try to breathe normally throughout The Plank and avoid holding your breath. Holding your breath during maintained exercises such as The Plank will increase your blood pressure as well as the pressure on your pelvic floor. Make a practice of breathing normally during exercises that require maintained positions and try to breathe out with the effort of strength exercises.

Tips for Correct Plank Technique

  • Commence Plank using the modified kneeling technique described above
  • Tucked your elbows close to your body
  • Keep your shoulder blades back and down
  • Keep your spine straight and your chin slightly tucked
  • Avoid dropping your hips
  • Breath normally throughout
  • Progress to full Plank position only if you are confident in your technique and pelvic floor functioning

Who Should Avoid Plank Exercises?

There is definitely no one rule fits all women when it comes to who should and shouldn’t do Plank exercises. The vital thing to remember is that the core exercises you choose should match the capacity of your pelvic floor to withstand. If you are unsure about the capacity or strength of your pelvic floor muscles, then it can be helpful to see a pelvic floor physiotherapist who can assess your pelvic floor and advise you accordingly.

Avoid Forward Plank Exercise if your pelvic floor is at risk with:

  • Weak pelvic floor muscles
  • Pelvic floor symptoms during or after Forward Plank exercise
  • History of prolapse surgery, especially recurrent prolapse surgery
  • Pelvic pain and/or pelvic floor muscle tension
  • Pregnancy and early postpartum

Plank exercises can also have potential to place increased strain on the shoulders and lower back. Women who suffer shoulder or lower back pain or dysfunction may worsen these conditions with unmodified Forward Plank exercise.

There are a range of pelvic floor safe abdominal core exercises that women at risk of pelvic floor injury can perform other than The Forward Plank. If you are unsure about your capacity to perform The Plank exercise, then remember the old adage – “If in doubt leave it out”. Meanwhile seek the advice of a health professional to assist you with a pelvic floor exercise program and alternative pelvic floor safe abdominal core exercises.

Inside Out Book & DVDABOUT THE AUTHOR, Michelle Kenway

Michelle Kenway is a Pelvic Floor Physiotherapist and author of Inside Out – the Essential Women’s Guide to Pelvic Support. The Inside Out exercise DVD and book show women how to exercise effectively with pelvic floor safe exercises.

We Welcome Your Comments



  1. Hi…
    I have a c section 4.6 yrs ago.
    I do light exercises, two days ago I was practicing planks and I did two sets of 60 sec holding.
    After 6 hours of that session I start feeling some fullness or heaviness in my vagina.
    Pls guide me.
    It’s soreness of pelvic floor or it is symptoms of prolapse.

    • Michelle Kenway Pelvic Floor Physiotherapist says

      Unfortunately I can’t tell you whether it is just strain or prolapse as this requires an examination however I can suggest that you avoid repeating full plank until your symptoms settle down, do your pelvic fooor exercises and when you do resume plank perform the modified plankWhich is much safer for the pelvic floor. Hope this helps you out

  2. Hi Michelle. I am just wondering whether women with a prolapse can strengthen their pelvic floor enough to be able to (with time) advance exercises like the plank etc? I had a very rough birth 12 weeks ago and have a moderate bladder prolapse as a result. I can’t stand the thought of not being able to advance my exercising one day. Obviously I am still in a healing stage and will not be pushing my body any time soon. I have recently started doing seated stationary cycling, swimming and seated weights – no more than 2kg in each hand and all based on exercises from your ‘inside out’ book. The physios I have seen at the Brisbane RBWH as well as privately all say my pelvic floor is in great shape (so am pretty upset and confused that the prolapse has happened!) with good strength, tone and endurance..although compared to what I used to feel, it all still feels very loose and unsupported. I am a very slight lady and I used to be very active. With enough time and proactive recovery, have you seen enough improvement in young people to get back into activity at least to some degree of what they used to enjoy? The next twelve months I want to spend strengthening my pelvic floor and deep core..I just need a little hope that this really can improve things.

    • Michelle Kenway Physiotherapist says

      Hi Susie
      First and foremost yes your whole body is still early days in terms of recovering added to the fact that you’re looking after a new baby and maybe/maybe not breastfeeding, so I suspect there is more improvement in sight. Your current program sounds ideal for the moment. There is also the potential to use a support pessary to help you exercise in time to come if this is a viable option for you – its something you might speak with your gynaecologist about in time to come if you’re still symptomatic. I think that support pessaries are underutilised by young women – they can sometimes make a very useful difference, not to mention the potential recovery with the load taken off the pelvic floor. Yes even despite having strong pelvic floor muscles the organs can still prolapse – the pelvic floor muscles don’t provide all the support. They work in combination with the strong supportive ligaments and tissues inside the pelvis so a pelvic floor muscles don’t guarantee no prolapse. A caesarean section doesn’t guarantee no prolapse because of the stretch the tissues are under during pregnancy.

      Yes keep up your whole body fitness, strength and your core training. Things will likely improve from this point and perhaps read a bit more on support pessary to keep in the back of your mind if needed too.

      Hope this helps you along

  3. Joseph Chance Watkins says

    Thanks for sharing this article with us, it was very helpful; Jesus Christ Bless you! :)

  4. is there a way to plank without getting on the floor? i have arthritis in my wrists and planking really hurts the wrists

    • Michelle Kenway says

      Hi Mj

      Yes there is a way to modify Plank- style exercise to protect your wrists.

      It’s possible to do similar-type of strengthening with a modified wall push up which will strengthen the core muscles and the chest and shoulders (similar to the Plank). I find that women with sore wrists can usually do the wall push ups more comfortably by resting their hands on an exercise ball rather than the wall during the push up exercise. Take the feet back away from the wall that deistance that avoids overloading the wrists – the further back your feet are from the wall, the greater the pressure on your wrists so modify for your body.

      Let me know how you go!

      All the best

  5. Hi again Michelle,
    Thanks for replying, I’ve since been back to my gyno and he informs me that I have a prolasped bowel as well, I was thinking this after all the reading I have done, he tells me I have a stage1 bowel and a stage 2 bladder.. As I’m not ready to have surgery just yet he has recommended that I try the magnetic chair for the next five weeks, however with doing this I can’t do pelvic floor excerise, till after as they need to see if the chair works. What are your thoughts on this as I’ve not read anything on the chair. Also if I have a pressery than do you think I can run again.. thanks once again Cath

  6. Hi michelle, I have just been told that I have a prolasped bladder and I’m totally bewildered about it all. My doctor said when he checked me out that it is a prolasped bladder, then he asked me what I do for a living, I clean cars, then he said when your willing to stop working then come see me and I’ll operate, until then I’ll just have to live with it… My question is after reading lots and lots about it, how do I know what level it is and by doing exercises can I improve my prolaspe…. I have like an egg shape at the entrance of my vigina, I dont to my knowledge have a bladder leakage, I only go to the bathroom once or not at all through the night and only when needed through the day, I empty my bladder every time. So I’m not sure what stage I’m at and this worries me.. I have brought your inside out book and inside out strength dvd. What else can I do, can you please help as this is driving me mad…. I have to say I’m 55 and this is the very first time I’ve ever heard of prolasped anything…

    • Michelle Kenway says

      Hi Cath
      The severity of your prolapse is measured by how far down it extends wthin (and beyond) your vagina. Your doctor should be readily able to tell you this having assessed it. Whenh the prolapse is visible at the entrance of the vagina it is usually at least moderate not mild severity. We know that in women with mild-moderate prolapse that strengthening the pelvic floor muscles helps reduce symptoms and lift the prolapse higher however not with sever prolapse. Having said this, you do heavy work involving alot of bending forwards which must be making things very uncomfortabloe for you by the end of your shift.

      Cath if you can get an appointment with a gynaecologist you may be able to discuss the possibility of being fitted with a support pessary to hold up your prolpase and help you continue working and defer surgery for the moment if that’s what you choose to do. I do think that your work is potentially an issue after prolapse surgery in terms of contributing to repeat prolapse if there is alot of heavy bending forwards cleaning work involved and you would be well advised to condifer this too.

      This article on support pessaries will give you some more information – the more you know, the better you will be able to manage.

      Don’t hesitate to reply further with any more questions Cath

  7. Hi,

    I did go to P.T. for several visits post op. I am almost back to my normal work-out routines with modifications. I believe my tissues are just spent. I wish my surgeon had used the mesh originally but I guess he had his reasons.

    I’m not going to have the surgery until January. So I’ll continue to do my exercises and get as strong as I can.


  8. Hi,

    In January of this year I had a hysterectomy, ovary removal and bladder resuspension. My surgeon used my ligaments to resuspend the bladder. He didn’t want to use mesh as he said that with this intense surgery it would increase my chance of infection. Three weeks ago I noticed I was prolapsing again. I went to my surgeon Wednesday and he said I will need another surgery to resuspend my bladder as the one from January failed. This time he will be going through my belly button and will use mesh. My recovery will be easier.
    As you can imagine I am very upset. I have slowly returned to exercise following your guidelines. I even went to a Physical Therapist who specializing in women’s health.
    I don’t plan on having another surgery until this January. I need to build up my sick leave as I used 6 weeks already.
    Has this happened to anyone out there?
    I’m not blaming my surgeon. I believe my tissues are just a mess.

    • Michelle Kenway says

      Hi Sharon

      I am really sorry to read this, it sounds as though you have done everything possible in your control to ensure success – unfortunately repeat prolapse can happen even with the best of surgeons and the best management post op. This is because there are many factors that can contribute to prolapse recurrence since so many factors that impact upon your pelvic floor. These include: bowel management technique/constipation, body weight, the strength & support of your pelvic floor tissues and muscles, activities of daily living including lifting requirements, general exercise load, chest problems (cough), allergies (sneeze) etc I have seen this happen to patients in the past despite best intentions so you are definitely not alone in this regard.

      If you now have time before surgery it may be worth revsiting your physio to ensure that your pelvic floor muscles are in best shape possible before your repeat op. and to problem solve whether there are any other factors that you may be able to address to ensure your success. I wish you all the best and will be keen to hear how things go for you.


  9. Hi, I had a prolapse after my first child (10 months later) and did some exercises to help strengthen them. I am about to have my second child and was wondering what information you have to help me to strengthen them again this time as my physio had me doing exercises that seem to conflict with what you recommend.

    • Michelle Kenway says

      Hi Melanie
      Thanks for your question – which core muscles are you trying to strengthen at the moment? Abdominal or pelvic floor or both? Obviously very important to avoid intense core abdomininal exercises especially during pregnancy and with a prolapse.

      • Hi Michelle, pelvic floors to start with and then core once I have strengthened (once baby arrives.) Do you recommend one of your books that would guide me? I have one of your DVDs.

        • Michelle Kenway says

          Hi Melanie
          THis sounds like a great approach to your exercise management (pelvic floor now, and gentle core when your pelvic floor has recovered after your baby has been born). Lisa Westlake is an Australian physio and she has a great book for postanatal exercises called Mum’s Shape Up – it is an excellent resource for women seeking to return to safe exercise after childbirth. Hope this is what you are after.
          Best of luck

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