The pelvic floor and core exercises

Your abdominal muscle strength may exceed the ability of your pelvic floor.  If you have or are at risk of pelvic floor problems, it is important you train for the ‘weakest link’ and put your pelvic floor first. There are a number of ways to modify your core exercises to protect your pelvic floor:

  • Cease strong abdominal (tummy) exercises
  • Reduce the level of your tummy muscle exercise program (see below for suggested exercises that are pelvic floor friendly)
  • Avoid breath-holding by exhaling with effort
  • Maintain good posture
  • Lift your pelvic floor first and hold it during the exercise, then relax afterwards
  • Notice how many repetitions you can do before your pelvic floor muscles tire. You may need to add some rests, or reduce the number of repetitions you do in a row, while your pelvic floor muscle fitness improves.

If you are pregnant, early postnatal, post gynaecology surgery or post prostate surgery there are also more gentle abdominal exercises that are recommended during these phases. Seek advice from a continence and women’s health physiotherapist or your fitness professional to check which of the pelvic floor safe exercises are best for you. It is important to build up your pelvic floor muscle control first and then you will be able to progress to doing some more challenging abdominal exercises again.

Pelvic floor friendly core exercises

  • single leg extension with one leg supported by a hand on stationary knee or moving foot on ball
  • knees side to side with feet on ball
  • modified plank on hands or knees with a slight bend at the hips
  • wall push ups
  • ball bridge (feet on ball or back on ball, +/- single leg lift)
  • arm and leg lift on all fours
  • leg lift sitting on the ball
  • shoulder rotations with back on the ball
  • standing balance work on the bosu or balance disc

Please note: while these exercises are pelvic floor friendly, you will also need to consider the number of repetitions, intensity, number of sets, length of rest, activation of your pelvic floor muscle and your fatigue level – which also affects your pelvic floor function.

Core exercises to avoid

  • sit ups, curl ups, crunches
  • abdominal exercises with medicine ball
  • V-sit
  • hundreds
  • double leg lowers
  • plank position on hands and feet (eg ‘hovers’, full push ups)

But how do I get flat abs?

If you’re aiming for a flat tummy then sit ups and crunches aren’t the best option. They will tone the ‘six pack’ muscles but will not flatten the tummy.  Excessive upper abdominal tension that can occur with lots of sit-ups will often make the lower abdomen appear as a ‘pot belly’. Low-impact aerobic exercise to help lose extra abdominal fat is important.  Pelvic floor exercises, when done correctly with relaxed upper abdominals and normal lower abdominal co-contraction, will also help to achieve flatter abs.

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