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Modifying exercise programs

As you know, one size doesn't fit all when it comes to exercise, so if you have a client with, or at risk of, pelvic floor problems, it's important to tailor their exercise program to suit their needs.

As a fitness professional your challenge will be to consider:

  • Which of your clients are at risk of pelvic floor problems?
  • Are the exercises you are prescribing pelvic floor friendly?
  • How can you help your client achieve their health and fitness goals whilst protecting their pelvic floor?

Why modify an exercise program?

Modifying an exercise program for a high risk client will ensure their pelvic floor is protected from damage. This is no different to an injury to any other one of their muscle groups.

For example, if your client has an injured ankle, it is essential to give that ankle time to heal, before returning to exercise or sport. This would be done by modifying their exercise program to rebuild the strength, flexibility and stability of their ankle, until the healing process is complete.

The same is the case for the pelvic floor, which should be protected from further damage, whilst allowing the client a suitable timeframe to get back in control. 

Identifying high risk clients

The Continence Foundation has developed a simple screening tool to help you identify clients with, or at risk of, pelvic floor problems.  

These can be used at your initial consultation, to help identify what kind of exercise program would suit their pelvic floor fitness needs. 

Things to consider when modifying an exercise program

Exercises that increase intra-abdominal pressure have the potential to place more stress on the pelvic floor, and should be avoided or modified for clients with, or at risk of, pelvic floor problems. 

Examples of these exercises include:

  • abdominal exercises (e.g. sit ups, curl ups, crunches, double leg lifts, exercises on machines)
  • medicine ball rotations
  • deep lunges or side lunges
  • wide legged or deep squats
  • jump squats
  • lifting or pressing heavy weights
  • lat pull down with heavy weights
  • leg press machine with heavy weights
  • dead lifts
  • high bench step up step down
  • exercises with both feet off the ground (e.g. chin ups, tricep dips), and
  • full push ups.

Exercises that place downward force or pressure on the pelvic floor can also stress the pelvic floor.  Examples of these exercises include:

  • running
  • jumping
  • star jumps
  • skipping
  • boxing
  • high impact exercise classes that involve jumping and running, and
  • sports involving stop-start running and rapid direction change (e.g. tennis, netball, basketball, hockey, touch football).

As a general rule:

  • avoid prescribing high impact or high intensity exercises that place downward pressure on your client's pelvic floor, and
  • instruct them to monitor their pelvic floor whilst exercising, to make sure it isn't dropping or pushing down.


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