Ultimate List Of Unsafe Core Exercises For Prolapse

Unsafe core exercises can worsen prolapse symptoms and weaken the pelvic floor.Unsafe abdominal exercises

While it’s important to have good core strength, many abdominal core exercises can overload the pelvic floor.

If you’re living with a prolapse or after prolapse surgery it’s vital to avoid unnecessary strain on your pelvic floor to reduce your risk of prolapse worsening or repeat prolapse after prolapse repair.

Read on now for this extensive list of unsafe core exercises:

  • Mat core exercises to avoid
  • Equipment-based core exercises to avoid
  • Machine-based core exercises to avoid

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Strength & Core Workout for Women (Download or Hard Copy)

Strength & Core Workout DownloadStrength & Core video is a pelvic floor friendly core exercise workout with Physiotherapist Michelle Kenway

This whole body workout that strengthens your core abdominal and pelvic floor muscles in addition to whole body strength and posture training.

Strength & Core Benefits

Strength & Core Workout includes exercises designed to:

  • Exercise safely and avoid injury
  • Train core abdominal muscles
  • Strengthen pelvic floor muscles
  • Strengthen & tone hips, butt and thighs
  • Improve posture
  • Strengthen back muscles
  • Improve body weight management
  • Improve flexibility

Unsafe Abdominal Core Exercises For Prolapse

Why are some abdominal core exercises inappropriate with prolapse issues?

Intense abdominal core exercises force the weak pelvic floor and prolapse downwards!

When repeated over time, these abdominal core exercises can progressively stretch and weaken the pelvic floor. Prolapse problems can worsen when the pelvic floor is weak. Many women report worsening of prolapse symptoms with intense core abdominal exercises.

Some women with prolapse problems may be able to modify and perform some of these core exercises after pelvic floor rehabilitation.

Avoid the following core exercises if you’ve undergone prolapse surgery unless advised otherwise by your surgeon or Pelvic Floor Physiotherapist.

1.Unsafe Core Exercises – MatCrunches

  • Crunches or sit-ups: lying down head and shoulders raised forwards off mat
  • Double leg raises*: lying down both legs raised simultaneously (modify to single leg raise)
  • Bicycle legs: lying down both legs raised, legs cycle in air
  • Scissor legs: lying down both legs raised, straight legs criss-cross above the ground
  • Plank or Hover*: prone weight through forearms/hands and feet (modify Plank to kneeling and decrease time maintained)
  • Dead bugs*: lying down both knees bent and legs raised, arms extended towards ceiling- single leg then extends towards ground (modify this unsafe Pilates core exercise to single leg raise and single leg extended)
  • Reverse crunches: lying down both legs raised towards ceiling- buttocks are then raised off mat
  • Medicine ball sit ups: sit up exercise holding medicine ball to chest
  • Seated knee tucks: sitting with both legs raised and knees bent- legs then extend away from body
  • Men’s push ups: prone weight through hands and feet as body lifts and lowers from mat
  • V sit: unsafe Yoga core exercise seated on mat with both straight legs raised and trunk leaning backwards
  • The Hundred: lying with both legs raised with hips and knees at right angles, head and shoulder blades raise forwards off the mat

* May be modified by some women with prolapse to reduce pelvic floor loading

2. Unsafe Core Exercises – EquipmentBall exercises to avoid

  • Weighted hula hoop
  • Russian twists: recline sit up position with medicine ball rotated across the body
  • Exercise ball crunches: crunches lying back over the ball
  • Exercise ball pull in: prone push up position with ball under shins, knees then tuck to roll ball towards body
  • Exercise ball hover: leaning forward on ball with forearms resting on ball in kneeling or on balls of feet
  • Double leg ball raises: lying down ball between legs, raise and lower ball
  • Ab roller: ab roller frame supports body for abdominal crunch
  • Ab wheel: wheel with handles supports body weight as it is rolled to and from body
  • Sit up bench: bench supports body for crunches
  • Hanging leg or knee raise: hanging via arms as both knees or straight legs are raised and lowered

3. Unsafe Core Exercises – Machine

  • Ab crunch machine: seated resisted incline forwards
  • Cable crunch: weighted cables provide resistance for seated or kneeling crunches
  • Captains chair: frame supports upper body with body suspended and knees raised to chest

Key Points For Unsafe Core Exercises

Some intense core abdominal exercises can weaken the pelvic floor. If you’re living with prolapse problems it’s important to choose pelvic floor friendly core exercises and avoid those that are most likely to strain your pelvic floor.

Keeping your core muscles in good shape can help you manage your pelvic floor and prolapse problems.

Choose appropriate deep abdominal core exercises and try to avoid those unsafe core exercises most likely to cause pelvic floor strain and weakness.

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Where To Next: Pelvic Floor Safe Core Exercises (Video)

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  1. Is the armcycle (bicycle-type machine used for the arms) a pelvic-floor safe exercise? Do you have any suggestions on best seating posture, or other suggestions for this? Thanks.

  2. Hi Michelle
    I had rectocele surgery in April and have recovered well but need to do some cardio exercise. I love hula hooping. Is this safe for my pelvic floor?
    I love all the advice and videos you have and have purchased your two pelvic floor safe videos which are helping me gain strength.
    Best wishes

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Sue
      Thanks for your email, I’m glad to have been able to help you with your health and fitness. Sue Hula Hoop is quite an intense core exercise when using the weighted hoops so this I would avoid however there’s no research on Hula Hoop and the effect on the pelvic floor. I suspect that Hula Hoop should not be an issue (using a light weight hoop), if you notice any strain or symptoms then obviously discontinue it as you would any activity that aggravated symptoms. Keep up your pelvic floor exercises long term too to ensure that your repair is well supported too. All the best

  3. Hi Michelle. I’m a 38 year old mother of two with a history of chronic lower back pain , sciatica and shoulder impingement. I was a gymnast as a young girl and plenty of other activities so naturally I have continued high level activities into adult hood. I started your DVD’s 2 weeks ago when I realised I could not exercise so intensely with these chronic conditions anymore. I have no prolapse but I have weakness with my bladder. I love your dvd’s and I do them 3x week with cycle classes and aqua classes on other days. I coach gymnastics to kids so I still do handstands etc with no issues. Basically, I have stopped heavy weight lifting after doing it for approx 15 years. And I have stopped plyometrics and running. I get a painful lower back, sij pain and tight hips when I push my body too much or if I do chin ups and heavy weights. I trust your opinion and wonder if you could guide me with what I should or should not be doing. Surprisingly, your workouts are quite challenging especially when you do it correctly! Thanks Michelle. I wish I could visit you for an appointment! I live in Sydney!

    • Author: Michelle Kenway Pelvic Floor Physiotherapist says

      Hi Rebecca
      This is a belated reply, my apologies. Rebecca I wish i could advise you however no having assessed you I’m unable to do so. I do think weights are important and achievable for most women – it’s usually a matter of knowing what’s appropriate for your body. Have you tried doing low resistance pelvic floor friendly weights like those in your DVDs in the gym? It takes time to build up as you know. I would suggest initially avoiding exercises that are potentially compromising for your lower back and SIJ such as heavy dead lifts, lunges, leg press however you may be able to proceed with exercises such as weighted bridges, light mini squats and appropriate upper back strength work such as seated row. It would be really helpful if you could work with a Sydney based Physio to help guide you – let me know if you need a contact there. I sympathize with you as you obviously love being active Rebecca

  4. Can you use an elliptical if you ave a prolapsed bladder.

    • Michelle Kenway Physiotherapist says

      Hi Melissa
      Elliptical is a low impact exercise. For many women with mild-moderate prolapse this type of low impact exercise using low resistance through the legs and avoiding intense arm resistance should feel comfortable. As for all exercises monitor prolapse symptoms during and after the elliptical and cease if it causes any problems. Here’s some more information on using the elliptical machine safely. All the best

  5. Hello Michelle,
    When could pelvic floor safe exercises be started post delivery? Some suggest to wait for 6-8 weeks and some others say 3 days for vaginal delivery and 10 days for cesarean. I’m confused.
    The exercises I am talking about are gentle indoor walking, bridges, adductor squeeze, single leg straight leg raise, clamshells, sidelying hip abduction, modified curl ups for diastasis recti and kegels.
    Thank you

    • Michelle Kenway Physiotherapist says

      Hi CRK The type of exercises that are appropriate differ from one woman to the next according to the type of delivery and any complications. I’m not sure what type of delivery you’ve had or whether things were straight forward so unfortunately I’m unable to answer. All abdominal curls should be avoided after birth at least until pelvic floor strength is recovered

  6. Hi, is it safe to use a power plate machine to exercise after having a prolapse repair (anterior wall) and hysterectomy 2 years ago. Thank you.

  7. I just discovered the stairmaster and l love it. Better weight lost and faster calorie burn. But is it making my moderate to sever prolapse worse? I hate to give it up!

  8. Hi Michelle,

    I’m an active mid-40’s woman and I recently had a posterior and anterior repair. I’ve been given the all clear to return to exercising, which is how I discovered your blog and the great information it contains. I have a question I hope you can help me with that is not entirely exercise related. For several years now (prior to my surgery) I have been using an exercise ball at work instead of a chair. I’ve absolutely loved it, as I haven’t had any back strain in years. However, now I’m concerned that sitting on it for long periods may put too much pressure on the pelvic area in the form of passive exercise. Clearly I will build up to using it for long periods of time again, but in your expert opinion, is it a bad idea to return to this practice? I can find a lot of information about safe and unsafe ball exercises, but nothing about using it for long periods as a chair.

    • Michelle Kenway Physiotherapist says

      Hi Kirs
      I don’t see a problem in using an exercise ball for seating as long as it’s used in moderation and yes obviously graduating this practice over time. I would not suggest using an exercise ball for extended periods of time while recovering from prolapse surgery. It’s beneficial to have good core control for long-term management after prolapse surgery.

  9. I have bladder prolapse and am wondering if exercising on an elliptical machine would be advised?

  10. Hi Michelle, I see that you are not a fan of the plank and advise modifications. I have also been looking at Tasha Mulligan’s Habit website of which I am sure you are aware and she is a great advocate of the plank. She recommends doing them with hands on a bench or second/third stair and I’m wondering if you think that this is enough of a modification. I had a rectocele and cystocele repair 5 years ago and despite constant constipation they are holding up quite well but I am really fed up with not having a flat stomach as I always did before all this happened. I’d welcome your comments.

    • Michelle Kenway Physiotherapist says

      Hi Kate

      Thanks for your question – it’s a frequently asked one!

      First and foremost I think it’s vital to realise that no amount of abdominal exercise will flatten the stomach. I think so many women unfortunately still believe and are misled by the myth of spot reduction. It’s just not possible to spot reduce fat from any area of the body with exercise – yes we can tone but the best toned abs in the world won’t be visible if you store your fat on your abdomen. Rather the approach should be whole body exercise to reduce fat combined with appropriate core abdominal exercises.

      The ability to support the pelvic floor against the pressure generated by the Plank exercise varies from one woman to the next, it’s impossible to say that Plank or even modified Plank is safe for everywoman with prolapse. I find that some women with prolapse issues become symptomatic with Plank and modified Plank while others can cope with it quite well. This is because pelvic floor strength is very individual as is upper body strength (to hold the Plank) and probably other factors too. The big thing to realise is that your risk of repeat prolapse is increased owing to your previous prolapse surgery along with ongoing constipation so it would be wise for you to avoid intense abdominal core exercise such as unmodified Plank as a minimum.

      I hope this helps you Kate
      All the best

  11. Thanks Michelle.
    Those extra pointers are very helpful. I really appreciate all you do and the advice you give. I feel a lot more confident in my activites & exercise with your website, emails and answers to individual questions to refer to.

  12. Hi Michelle,
    Thanks for this list of exercises to avoid. It’s really helpful to have them listed together like that. I just have a few questions, if you don’t mind. I have a ‘stage 1’ bladder prolapse & my Pilates teacher is very good at modifying exercises for me. She’s been on a couple of courses related to pelvic floor dysfunction & often tells the class members to engage their pelvic floor during exercise. Could you give me your opinion on the following exercises, please?
    Firstly, we do a scissor legs exercise but lie with a firm foam block under the hip and propped up on the elbow, so the spine is parallel to the floor and legs are already raised off the floor, so there is no lifting of the legs involved. Do you think this modification removes the risk?
    Secondly, we do a side bridge, very similar to the one demonstrated in the McGill video you posted a link to. My Pilates instructor calls it ‘seated mermaid’-the upper arm is swept up & over the head as the hips are lifted.
    Lastly, we do a half plank, starting in an all fours position, then walking the hands forward, so there is no press up movement involved, but rather than resting on elbows and knees (as I have seen you demonstrate), we are supported on hands and knees.
    Are any of these going to overload my pelvic floor, in your opinion? I hope I’ve explained them well enough! I haven’t felt any more symptomatic following these but obviously don’t want to put myself at risk.
    Thanks, Michelle.

    • Michelle Kenway Physiotherapist says

      Hi Mary

      Yes it’s just so tricky to know isn’t it. Unfortunately I can’t answer specifically for you however I can tell you the following:

      *Any double leg raise exercise is an intense core exercise.
      *Side bridges involve muscles that are less likely to overload the pelvic floor.
      *Modified kneeling plank is tolerated by some women but not others with prolapse – this is very individual as for many core exercises with prolapse.

      If unsure about your level of pelvic floor support it’s best to seek an appointment with a Pelvic Floor Physio who can advise you accordingly.

      All the best

  13. Hi Michelle, I am 51 yr old, I couldn’t have children due to me having Endometriosis in my late 20’s. I had the Endro operation for it, but now have been diagnosed with an overactive bladder which is annoying! Could you please tell me what exercises do you suggest would be good for me and what would not be good for me as I am going to a gym at present. Also do you think the purchase of the Aquaflex pelvic floor exercise system would be good for that or should I start off with something else as a beginner? Thanks.

    • Michelle Kenway Physiotherapist says

      Hi Colette

      I’m sorry to read about the trouble you’re having. Colette if you haven’t already done so, I think that it’s really important to get the cause of your OAB assessed so that you know the cause is possible i.e. are your pelvic floor muscles weak? Is the cause linked to previous endometriosis? ect. The standard recommendations for pelvic floor safe exercise apply; choose low impact exercises, avoid intense abdominal exercises and choose appropriate strength exercises and techniques. These are outlined at length in the videos and articles on site, you might like to start at this link for pelvic floor safe exercises for women. My first book Inside Out – the essential women’s guide to pelvic support provides a concise version if you need a handbook guide to assist you.

      All the best

      • Hi Michelle,
        Thanks Michelle for the info I will have to ask my Specialist when I see her next whether the cause is from having endometriosis in the past or because I am going through Menopause now is causing this overactive bladder?

        Kind regards,

  14. Hi Michelle,

    I had a hysterectomy approx. 1 1/2 years ago as well as prolapse surgery with the TVT for my bladder. I had done reformer pilates for approximately 8 years, which I absolutely love! I recently started back at a studio that is great but I am not sure they have the knowledge to modify the exercises I do (they use videos and a trainer to assist) as I have had to explain that I cannot do planks or both legs in tabletop. I have been doing some hundreds but with legs out straight. I am concerned about undoing the prolapse surgery and really would love to have a one on one with a reformer pilates instructor to go through each basic exercise and assist me in what I can and cannot do as well as the modifications. I would really like to train to be a pilates instructor someday as it is a real passion of mine. Is this something your studio could assist me with? As I would love to come to your studio regularly it is not convenient but would certainly be able to come out a few times to get an better understanding as to the exact exercises which do not work for me.

    • Michelle Kenway Physiotherapist says

      Hi Heather
      Thanks for your message – unfortunately we’re not a Pilates Studio. You can find Physiotherapists who run Pilates studios by contacting the Australian Physiotherapy Association or visiting their website and searching under ‘Find a Physio‘ All the best for your training!

  15. Thank you for all of your excellent work. I can’t tell you what a help it has been to me. I live in the states and have had two repair surgeries (bladder sling, uterine suspension) and while i have an excellent doctor, no one gave me any info on how to modify my activities/fitness afterwards! I have shared your work with my doc and tell all my friends about you. I see weighted hula hoop is now on the list and I have been using one daily (until reading your post!) – should I cease hooping? I only did 100 or so rotations/day so nothing too intense. But I definitely don’t want to undo any surgical repair. Blessings!

    • Michelle Kenway Physiotherapist says

      Hi Carie
      After 2 repairs I would suggest leaving weighted hula hoop – there’s no functional benefit, it won’t trim your waist and it really involves quite strong outer core contraction which can increase pelvic floor loading.
      All the best

  16. I have a mild bladder prolapse and I’m 6 weeks postpartum. My question is does this mean I am restricted for the rest of my life? Or just until everything moves back into place?

    • Michelle Kenway Physiotherapist says

      Hi Ariana

      In the early weeks and months postpartum your pelvic floor is very vulnerable to more injury – now is the time to restrengthen your pelvic floor with pelvic floor exercises. Unfortunately a prolapse is an overstretching of the tissues and this will always be with you however as your body recovers from childbirth you will likely notice less in terms of symptoms, especially if you rehab your pelvic floor muscles. Long-term you will be wise to take a moderated approach to core exercises and make sure that your pelvic floor is in great shape before you consider returning to the more intense exercises.

      Does this explain adequately?

  17. Hi Michelle,

    I was wondering about the exercise where we are seated on floor with knees bent and feet on floor and move the torso slightly back towards floor (I have heard it called 1/2 roll back in pilates)? I have been trying this without flexing my lower back (so not rolling back, but hinging) just slightly until I feel my lower abs contract (and doing a kegel contraction at the same time). It seems to not bother my mild/mod prolapse. Interested in your thoughts. Thank you!!!

    • Michelle Kenway Physiotherapist says

      Hi Mel

      Yes good question I’m familiar with this exercise – while you’re asymptomatic for the moment I would be inclined to change this. If you’ve got a mild to moderate prolapse you’re better off leaving that particular exercise and doing the McGill sit up you can see it here in the first exercise shown in this video (avoid the second exercise in this video if your pelvic floor is ‘at risk’).

      Hope this helps you out Mel

      • Oh Michelle thank you, that is a great exercise! I completely forgot about it. I did a lot of his work after I herniated my lumbar spine. Can I bother you with another question please…how do we address the oblique exercises with a mild to moderate prolapse? Are the kneeling side planks (like in the McGill video) safe? Or small side bents kneeling against the physio ball or even standing/leaning against a sofa?
        So grateful for your knowledge and guidance!

        • Michelle Kenway Physiotherapist says

          Mel I like the kneeling side planks and don’t see a pelvic floor overload issue with them (apart from recent prolapse surgery in which case I’d avoid).

  18. Hi Michelle,
    Thank-You, Thank-you!!! I received my order yesterday!! I now have actual resource that I can go to when in doubt. I want to make sure when I do certain exercises that I do them correctly.
    I am 64 years old. I just retired from work in June. I was told by my doctor over the summer that I have osteoporosis. I have been post menopausal since I was 55 years old. About four weeks ago I myself found that I have a uterus prolapse. I have an appt with my doctor but until then I looked for resource and found very little. All I could find was what exercises not to do but never an example of how to modify those exercises. That’s how I found you. I can’t thank you enough because I felt all alone. Now I continue to workout but know how to modify certain moves.
    Thank You Again

    • Michelle Kenway Physiotherapist says

      Hi Patti
      Well that is exactly what I want to hear – it’s tricky to exercise safely with prolapse and osteoporosis but definitely manageable if you stick with the correct exercises and techniques. Post any questions you have Patti!
      All the best & thanks for commenting!

  19. What about kettle bell swings? Or Russian twists? Are these safe?

    • Michelle Kenway Physiotherapist says

      Hi Jane

      Good questions – leave Kettle Bell swings (see listed here under resistance exercises to avoid).

      Great reminder on Russian twists especially with both feet raised – these are intense core exercises to be avoided and I’ve added them to the list above accordingly many thanks Jane!


  20. Thank you for this great information!

  21. Hi Michelle,

    I had a vaginal hysterectomy 2 years ago, a small bladder tear during surgery but no issues once healed. Are there any issues with me doing these exercises? I had a back injury 12 years ago and a lot of my rehab was ball work.

    Many thanks for your response,

    • Michelle Kenway Physiotherapist says

      Hi Rebecca
      Your history of back injury and pelvic surgery do increase your risk of pelvic floor problems. How much load your pelvic floor can tolerate will depend upon how well it is functioning (strength & overall function for support). Use a moderate approach to your core exercises Rebecca. Many of the intense core abdominal exercises listed here are completely inappropriate with back problems and need to be avoided. There is no functional benefit for you from crunches and this exercise is not appropriate with back issues or pelvic floor weakness.

      I hope this helps!

  22. Dear Michelle
    I got your latest email today with a long list of unsafe abdominal exercises. I have been using a pessary for about 9 months while I am exercising and my pelvic floor seems to be ok. I enjoy doing weight training and the pessary seemed to be a good solution to allow me to go back to doing some harder exercise and running. I have assumed that with a pessary in place I can do pretty much any exercise except particularly jarring things like box jumps. I am wondering if this is correct. I did start to have slight bladder issues 3 months ago after a session with a trainer, and since then I have avoided doing exercises that might result in the pessary coming down out of position – like burpees. I am 40 years old and have a mild prolapse – forceps delivery 2.5 yrs ago. I have been seeing a Physio in Sydney but I she is not as experienced as you. Pity I don’t live in Brisbane!
    Kind regards

    • Michelle Kenway Physiotherapist says

      Hi Sarah

      Thanks for sending this through – it’s an excellent question! It’s difficult to answer this for certain as there’s currently just not enough research into how exercise impacts the pelvic floor and prolapse. It’s great that you can exercise with the pessary in, there really should be more pessaries fitted to help women exercise. If you think about the way it works, it takes up the slack of the prolapsed tissues and supports them in the vagina which stops or reduces the bulging and some of the associated symptoms. I think you’re wise to avoid high impact jumping and burpees (burpees are risky for the lower back, pelvic floor and nonfunctional anyway so best left alone).The question remains as to whether your pelvic floor muscles and supportive tissues are still being compromised by the intense core exercises even though the pessary is holding up the prolapse. They are definitely in the higher risk category with your history of forceps combined with age and current prolapse. This could mean that the pessary might act as a temporary bandaid that might disguise weakening of your pelvic floor supports even though things feel ok. Moderation with exercise is really the key with a pessary in place until we know more. If you notice the pessary moving with exercise then be alert to that particular exercise. There’s no great benefit from doing really intense core abdominal exercises unless you’re an athlete so stick with light-moderate core so that you don’t weaken your pelvic floor further. Once again it’s great to hear that you’re exercising and managing so well with the pessary – just keep alert to symptoms and stick with moderation.

      All the best