Safe Abdominal Exercises for Women
Safe abdominal exercises are a must for women with or at risk of pelvic floor problems.
This Pelvic Floor Physiotherapist article helps women exercise core abdominal muscles safely and with confidence. It teaches how to identify pelvic floor safe abdominal exercises and and how to recognize potentially unsafe core exercises.
Read on now to learn about safe abdominal exercises with:
- Pelvic floor problems associated with some intense core exercises
- Is your pelvic floor at risk from unsafe core exercises?
- Which abdominal core exercises are potentially unsafe?
- How to modify some frequently performed abdominal core exercises;
- Pelvic floor safe abdominal exercises to choose; and
- 5 tips for pelvic floor safe abdominal exercises.
Core Abdominal Exercises and Pelvic Floor Problems
There are two main problems potentially arising from the wrong core abdominal exercises for your pelvic floor:
Problem 1: Stretched pelvic floor muscles i.e. pelvic floor too loose
Exercises that strongly engage the upper abdominal muscles such as sit-up or abdominal curl exercises increase downward pressure on the pelvic floor. These exercises cause the pelvic floor to stretch and weaken if it lacks the strength to withstand this downward pressure (shown here). For this reason is vital to avoid unsafe abdominal exercises that place pressure on the pelvic floor if it is at risk of injury.
Problem 2: Overactive pelvic floor muscles i.e. pelvic floor too tight
Intense core exercises can cause overactive pelvic floor muscles where the muscles spasm and become unable to relax. Increased pelvic floor muscle tension causes the pelvic floor muscles to become too tight resulting in pelvic pain, bladder and bowel problems and pain with sexual intercourse.
Is your pelvic floor at increased with some abdominal exercises?
If you answer yes to any of the following questions your risk of pelvic floor problems is likely to be increased:
- Previous gynaecology surgery (prolapse surgery, hysterectomy, bladder repair)?
- Pelvic prolapse?
- Incontinence (bladder or bowel)?
- Menopause or beyond?
- Recent childbirth?
- Pelvic pain?
Core Abdominal Exercises to Avoid or Modify
Intense upper abdominal muscle exercises are those most likely to contribute to pelvic floor problems. These exercises have the potential to stretch and weaken the at-risk pelvic floor:
- Sit-up exercises
- Swiss ball sit-ups
- Abdominal crunches
- Twisting crunches
- Pilates or Yoga style exercises with both legs raised in the air and your head off the ground (shown right)
- Pilates or Yoga exercises that involve intense upper abdominal activity such as “The Hover” or “The Plank”
- Abdominal resistance exercise machines
- Bicycle legs with both legs raised in the air simultaneously.
Pelvic Floor Safe Abdominal Exercises
The most appropriate abdominal exercises for minimizing pelvic floor pressure are:
- Seated Swiss ball core stability exercises – this includes exercises such as arm reaching, alternate leg extensions shown in this video link.
- Gentle lying down core stability exercises that do not involve bracing your abdominal muscles strongly shown in this video link.
- Whole body exercises that incorporate your abdominal muscles such as swimming.
How to Modify Intense Core Exercises?
Core abdominal exercises can often be modified to reduce the amount of pressure on or tension within the pelvic floor.
- Pilates-style exercises with both legs raised in the air can be modified to place less pressure on the pelvic floor. This is achieved by raising only one leg at a time off the ground.
- Intense core abdominal exercises such as The Plank or Hover can be modified by kneeling rather than weight bearing through the feet. Avoid strong abdominal bracing with these or any abdominal core exercises to reduce pressure on the pelvic floor. Side plank will place less downward pressure on the pelvic floor than prone plank on the hands and knees/feet.
- Relax the abdominal and pelvic floor muscles having once braced them during exercise.
5 Tips for Pelvic Floor Safe Abdominal Exercises
- Use your abdominal muscles correctly gently, never brace them strongly
- Allow your abdominal muscles to rest, avoid constant over bracing
- Choose seated fit ball exercises and positions for whole body strength exercises
- Choose lying down abdominal exercises that do not involve raising your head or both legs in the air
- Avoid sit-ups and abdominal crunch exercises, especially if you are at risk of pelvic floor dysfunction
- Avoid intense core strength exercises in exercise classes including some Pilates and Yoga classes; speak with your instructor about modifying unsafe abdominal exercises to the intensity of your core exercise.
Safe abdominal exercises are essential knowledge for women who are at increased risk of pelvic floor injury with exercise. If you can choose pelvic floor safe abdominal exercises, and modify or avoid those exercises most likely to cause pelvic floor problems, then you will help to reduce your risk of pelvic floor problems caused by inappropriate abdominal core exercises.
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.