Modifying the plank

Here is a scenario: You are in a group exercise class and the instructor has asked the class to move into a plank (on the floor on your elbows and toes and lifting up the rest of the body). You know that you are in a high risk group for pelvic floor dysfunction or this exercise always makes you feel that need to go to the bathroom. What do you do? 

Often participants in a group exercise setting feel obliged to do all the exercises that the instructor asks them to do, sometimes to the detriment of their own health and wellbeing. A group exercise class is designed to cater mainly for healthy non injured participants. Sometimes there are modifications offered, but quite often the instructor is not fully qualified to provide all the options that would be appropriate for each participant. It is after all, a group session and not a personal training workout.

Often participants will not realise that they are expected to modify exercises to suit their individual needs. Knowing that you are empowered to make good decisions for your body opens up more class options as you are not limited by classes that are specific to your needs.

How to modify the plank

The plank is not recommended if you are at risk of or have pelvic floor dysfunction. But you can modify the exercise to make it pelvic floor friendly.

1. Start by lying on the floor face down. Turn your head to one side and allow your toes to turn inwards so that your heels roll out to the side. Place one hand underneath your upper abdominals and the other across your lower abdominals, near your hip bones.
2. Gently breathing in and out, focus on lifting your pelvic floor. Hold for 3 to 4 seconds and then slowly release. Repeat this again.
3. The next step is to include your transverse abdominals. Again, breathing in and out gently, lift your pelvic floor and start to draw up your lower abdominals. You should feel a slight change in pressure against your lower hand. If your upper abdominals also contract, then relax again and try to only lift the muscles under your lower hand. This might take a few repetitions and only once this has been mastered, can you move onto the next step. This is what is known as a core contraction.
4. The next progression is to add more load and this is when you lift yourself onto your elbows, lifting your head up but still looking straight down to the floor. Your shoulders and upper back muscles need to feel active, with your chest away from the floor (but not hunching your upper back). Breathing in and out, lift your pelvic floor and draw in your transverse abdominals. Make sure to keep breathing and hold the contraction for up to 10 seconds. Relax your abdominals and your pelvic floor. If you do not feel your muscles relax then this activity is too intense for you and you need to go back to step 3.
5. The final progression is to move onto your knees once you can sustain an activation in your pelvic floor and transverse abdominals. Begin on your elbows, lifting your pelvic floor and transverse abdominals and finally on an out breath, lift up onto your knees so that your head is in line with your hips. Breathe in and out in this position and lower your body to the floor, relaxing your transverse abdominals and pelvic floor. The maximum time that this exercise should be held for is 10 seconds, no longer. If your instructor encourages you to hold for longer, make sure to relax and rest. You can explain to your instructor before or after the class that you will or have modified the exercise to suit your needs and they will find this acceptable if you feel that there is pressure to ‘perform’.

Progress slowly and ensure that you can always feel a relaxation of the pelvic floor between exercises. If you do not have this sensation, then your pelvic floor may be fatigued and you should continue with lying on the floor and focusing on lifting your transverse abdominals away from your hands (and not the upper abdominals).

Written by Marietta Mehanni, Pelvic Floor First ambassador.