Q: Which Ab exercises are safe for prolapse? Asking for a friend. A: Short answer: It depends. Long Answer: Keep Reading.

The Long Answer

I wish I had a magic formula, but there isn’t one! Any exercise can be a bugger to prolapse or support it. Over-focus on exercises that target the abdomen may not be OK for you in this moment of your recovery process timeline. The forces you are generating at the center can be overwhelming to the pelvic musculature and support tissues below. Those tissues are regaining strength, coordination, timing, and resilience. They may not be able to match those forces and pressures from above (yet!). Rather than have a nice or naughty list of exercises (unsafe or safe for prolapse), let’s generate some ideas to help tailor an activity to you as an individual. Your tissues, your strategies and your recovery timeline. 

How? Tailor to Make it ‘Safe’ for Prolapse

How, not what

A study by O’Dell (2007) compared the intra-abdominal pressure generated in crunches vs downward dogs (yoga). Participants generated a range of pressures that were similar for both activities. Some did a low pressure crunch, while others did a high pressure downward dog. Therefore, the activity wasn’t the bad guy, how they did it made the activity potentially symptom free or symptom full. Adapting how you are doing the activity can help you keep any activity in the lower pressure range. Thus, more tolerable to your tissues. Not holding your breath during an activity is a great place to start. Learn more here: Intra-abdominal Pressure: Friend or Foe?

How much?

If an activity is bugging your prolapse (or any other pelvic health issue) consider how much you are doing. Often the volume of abdominal work in exercise programs is out of balance with the amount of time devoted to other muscle groups. If you are postpartum – please remember your whole body went through the pregnancy, not just your abs. Look at your workout plan, and balance out the program. 30 ab-targeted reps may be enough and keep you symptom free…..whereas 300 reps may ramp-up your symptoms. 

How fast?

Speed is a big consideration when tissues are healing and regaining resilience. Slow it down! When re-building timing and coordination, one often needs to give it some focus. The pelvic organ support system may need time and practice to be able to catch-up. Learning to use the abdominal-diaphragm- pelvic floor system together within movements and fitness will help build that timing. That system may need to start slow. Then you can gradually pick up speed. 

How about try something new?

The abdominals are active in other movement and fitness patterns. If ab strength and tone is what you are hoping for, then that can be achieved even without a traditional ab exercise. The abdominals are active when you do a push-up and when you do a squat. While the abs are active, the forces and pressures generated in the activity are distributed more globally. They aren’t so focused on one muscle group that can overwhelm the pelvic floor. It might be a good place to start.

Tailor your program to YOU and your symptoms! By applying some new ideas, you can help make any exercise safe for prolapse. And please, stay hopeful!

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