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).
- 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.
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.
ABOUT 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.