How to modify abdominal and core exercises to keep your pelvic floor safe

How to modify ‘the plank’ to keep your pelvic floor safe?

Here is a scenario: You are in a group exercise class and the instructor as asked the class to move into a plank (on the floor on elbows and toes and lifting up the rest of the body). You know that you are in a high risk group (see attached article) 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 dictates and sometimes to the determent 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.

Modifying the plank

  1. Start by lying on the floor face down. Turn the head to one side and allow the toes to turn inwards so that the heels roll out to the side. Place one hand underneath the upper abdominals and the other across the lower abdominals near the hip bones
  2. Gently breathing in and out, focus on lifting the pelvic floor. Hold for 3 to 4 seconds and then slowly release. Repeat this again.
  3. The next step is to include the transverse abdominals. Again, breathing in and out gently, lift the pelvic floor and start to draw up the lower abdominals. You should feel a slight change in pressure against the lower hand. If the upper abdominals also contract, then relax again and try to only lift the muscles under the lower hand (across the hips). This might take a few repetitions and only once this has been mastered, can you then go 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 the head up but still looking straight down to the floor. The shoulders and upper back muscles need to feel active with the chest away from the floor (but not hunching the upper back). Breathing in and out, lift the pelvic floor and draw in the transverse abdominals. Make sure to keep breathing and hold the contraction up to 10 seconds. Relax the abdominals and the pelvic floor. If a relaxation is not felt, then the activity is too intense and move back to lying on the floor.
  5. The final progression is move onto the knees once activation in the pelvic floor and the transverse abdominals can be sustained. This begins on the elbows lifting the pelvic floor and transverse abdominals and finally on a breath out, lift up onto the knees so that the head is in line with the hips. Breathe in and out in this position and lower the body to the floor and relax the transverse abdominals and pelvic floor. The maximum time that this exercise should be held for is 10 seconds, no longer. If the instructor encourages to hold longer, make sure to relax and rest. You can explain to the 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 you pelvic floor is fatigued and continue with lying on the floor and focusing on lifting the transverse abdominals away from your hands (and not the upper abdominals).