The plank exercise is a very popular core strength exercise performed by men and women in gyms and exercise classes world-wide. The common forward plank, as seen above, is a very effective core strengthening exercise, however, if you have a pelvic prolapse or weak pelvic floor muscles, it is necessary to modify this common exercise to be pelvic floor friendly.
This core-strengthening exercise is also commonly known as a hover or bridge and is prescribed by many physiotherapists, personal trainers, and gym class instructors.
Muscles used in the forward plank
The Forward Plank exercise involves a range of different muscle groups in the body working to hold the body above the ground. The main muscle groups used during a Plank are the core muscles that surround the trunk; the abdominal muscles and spinal muscles. Secondary muscles are also involved in stabilizing or holding the body in position during the forward plank and these include muscles around the shoulder girdle, chest, middle back, thighs, and calf.
Is The Plank safe for your Pelvic Floor?
Studies have shown that intense core abdominal exercises force the pelvic floor downwards in women with weak pelvic floor muscles. The Plank performed in the traditional forward position with weight-bearing through the toes is an intense core abdominal exercise and can, therefore, increase pressure on the pelvic floor. This means that the abdominal muscles have to work hard to support and maintain the trunk above the ground during the exercise. The longer the position is held, the longer the pelvic floor muscles need to work to counteract the downward force that is generated during this exercise.
Safety of Plank exercises for your pelvic floor depends on a number of factors including your:
- Current pelvic floor strength; your ability to activate and brace your pelvic floor muscles
- History of pelvic floor surgery
- Pelvic floor dysfunction (prolapse, incontinence, pelvic floor spasm/Vaginismus)
- The chosen type of Plank exercise (forward plank on knees, toes or side plank)
- Overall physical strength
Ways to Modify Forward Plank Exercise
There are a number of ways to modify this exercise to reduce the pressure on your pelvic floor:
1. Change Plank Position
Kneeling Forward Plank – rather than weight-bearing through the toes, modify this exercise into weight bearing through your knees (kneeling Plank) so that the abdominal muscles don’t need to work as hard to hold the body above the ground. You can also lower your toes to further reduce the load on your pelvic floor.
Kneeling Side Plank – The kneeling side plank (shown below) reduces the involvement of the outer abdominal six-pack muscles so that the pressure on the pelvic floor is reduced. To perform this exercise correctly; lie on your side so that your hips, shoulders, and feet are stacked. From this position, raise yourself up onto your elbow and raise your hips off the ground so that your body is in a straight line body from the shoulders to the hips. Your weight should be distributed between your elbow and the outer edge of your knee.
2. Decrease Plank Duration
The longer the body is held above the ground during the forward plank exercise, the longer the pressure on the pelvic floor is maintained. If you are completing a core and pelvic floor strengthening program you may find that as you become stronger you are able to maintain The Plank for longer without impacting your pelvic floor.
3. Avoid Intense Abdominal Indrawing
Recently, I was assessing another fitness instructor and was shocked to hear the instruction to draw in the abdomen strongly during The Plank. This is not necessary and will increase pressure on the pelvic floor muscles. Your abdominal muscles will be active and strengthen during this exercise – there is no need to draw in the abdomen and as a result over brace your outer abdominal muscles.
4. Breathe Normally
Try to breathe normally throughout The Plank and avoid holding your breath. Holding your breath during static exercises such as The Plank will increase blood pressure as well as the pressure on the pelvic floor muscles. Make a practice of breathing normally during exercises that require maintained positions (static exercises).
Trainer's Tips for Correct Plank Technique:
- Commence Plank using the modified kneeling technique described above
- Tuck your elbows close to your body
- Keep your shoulder blades back and down, imagine you are trying to un-clip your bra clasp with your shoulder blades
- Keep your spine straight and your chin slightly tucked to protect your neck
- Avoid dropping your hips
- Breath normally throughout
Who Should Avoid Plank Exercises?
As with all exercises, the suitability of the forward plank as a core strengthening exercise is dependent on the individual's ability levels. If you are unsure about the strength of your pelvic floor muscles, then it is recommended that you see a pelvic floor physiotherapist who can assess your pelvic floor muscles and assess your suitability for this and other core exercises.
As a general rule you should avoid the forward Plank exercise if your pelvic floor is at risk with:
- Weak pelvic floor muscles
- Pelvic floor symptoms during or after Forward Plank exercise (symptoms such as light bladder leakage)
- History of prolapse surgery, especially recurrent prolapse surgery
- Pelvic pain and/or pelvic floor muscle tension
- Pregnancy and early postpartum
If you are in doubt about your ability or would like to learn more about pelvic floor safe core exercises seek the advice of a health professional. A health professional with knowledge of pelvic floor safe exercise practices will be able to assist you with a suitable training program and provide you with alternative pelvic floor safe abdominal core exercises.