The Ab Exercises Your Pelvic Floor Actually Needs

If you’ve ever been told to avoid ab exercises because of leaking, prolapse, or pelvic floor symptoms, you’re not alone. I once had someone warn me I was going to push my uterus out of my vagina if I did too many sit ups (talk about fear-mongering!)

Many women are warned that sit-ups, planks, or “core work” will make things worse, so they either stop training their abs altogether or stick to gentle, low-load movements forever.

But here’s the truth:

Your pelvic floor does not improve by avoiding abdominal strength.
It improves when your abs are trained well, in coordination with breathing, movement, and load.

The problem isn’t ab exercises. It’s actually the avoidance of these ab exercises!

Why Ab Strength Matters for the Pelvic Floor

The pelvic floor doesn’t work in isolation. It functions as part of a pressure management system that includes:

• The diaphragm

• The abdominal wall

• The low back

• The hips
  

Every time you:

• Lift something heavy

• Cough or sneeze

• Run, jump, or change direction

Your abs help manage pressure so it’s not all dumped downward onto the pelvic floor.

When the abs are weak, poorly coordinated, or constantly over braced, the pelvic floor often takes the hit. That's why women experience:

• Leaking during exercise

• Pelvic heaviness

• Urgency

• A feeling of needing to “clench” to feel supported
  

Avoiding ab strength doesn’t fix this, it actually makes it worse!

The Problem With Most “Pelvic Safe” Ab Advice

A lot of pelvic friendly core advice unintentionally creates new problems.

Common issues include:

• Over-bracing (“draw your belly button in”)

• Flattening the spine aggressively

• Avoiding trunk flexion, like sit ups, entirely

• Never progressing load
  

This can lead to:

• Rigid, non-responsive core muscles

• Poor pressure adaptability

• Increased pelvic floor tension

• Fear of movement

  
  

A healthy core and pelvic floor need strength, movement, load, and variability, not just protection. This doesn’t mean every ab exercise is appropriate for every body at every stage, but complete avoidance is rarely the answer.

These exercises show up repeatedly in pelvic rehab, not because they’re trendy, but because they train the exact coordination the pelvic floor relies on.

What the Pelvic Floor Actually Needs From Ab Training

Effective ab exercises should:

• Allow normal breathing

• Challenge the core to stabilize while the limbs move

• Gradually introduce load and force production

• Train the abs to work with the pelvic floor, not against it
  
  

The Ab Exercises Your Pelvic Floor Actually Needs

1. Deadbugs (With Intentional Breathing)

Why they work:
Deadbugs train the abs to stabilize the trunk while the arms and legs move, exactly what happens in real life. When paired with calm breathing, they encourage reflexive pelvic floor support rather than forced contraction.

Tip: engage the lower abs gently—imagine zipping from your pubic bone toward your ribcage without holding your breath or flattening your spine.Think about drawing your two hip bones together in the front.

Common mistakes:

• Holding the breath (try exhaling while you drop opposite arm and leg)

• Moving too quickly

• Flattening the back aggressively into the floor
  

Best for:

• Back pain

• Early postpartum

• Rebuilding core-pelvic coordination

  
  

2. Side Planks (Knees or Feet)

Why they work:
Side planks challenge lateral core strength, which is essential for pelvic stability during walking, running, and single leg tasks. They also reduce asymmetrical loading through the pelvis. Another breathing tip: you should be able to inhale and exhale the whole time you’re performing these. Breath holding should be avoided and puts a ton of pressure down on the pelvic floor!

Common mistakes:

• Dropping the hips

• Neck tension (can happen more easily if you hold the breath)

• Gripping the pelvic floor
  

Best for:

• Hip instability

• Pelvic asymmetry

• Runners and athletes
  

3. Single Leg Stance + Around the Worlds

Why I like it:
This exercise challenges single leg balance, core stability, and hip flexor strength all in one. Your core is responsible for keeping the trunk stable while moving the arms around the head, but is also assisted by the glutes keeping the pelvis steady and stable while standing on one leg. The pelvic floor must manage rotational forces during daily movement all the time (dishes, reaching, etc.).

Common mistakes:

• Allowing the spine to move as you rotate around the head

• Letting the pelvis tip one direction

• Losing rib-pelvis alignment

Best for:

• Athletes

• Getting glutes and core to fire together

• Functional core training

4. Bear Plank Variations

Why they work:
Bear planks challenge core stability while gradually removing support. This creates automatic engagement without excessive bracing, an ideal environment for the pelvic floor to respond naturally.

Common mistakes:

• Holding the breath

• Over-bracing or “sucking in”

• Excessive shifting side to side
  

Best for:

• Postpartum progression

• Dynamic stability

• Pelvic floor over-grippers
  

5. Weighted Sit-Ups (Yes, Really)

Why they work:
Despite social media fear-mongering, trunk flexion is a normal, necessary movement. When sit-ups are performed with good breathing, control, and appropriate load, they improve abdominal strength and pressure tolerance, both critical for pelvic floor health.

Common mistakes:

• Momentum-based reps

• Poor breathing coordination

• Excessive pelvic gripping

Best for:

• Return to higher-impact activity

• Building true abdominal strength

• Long-term pelvic resilience

  
  

A Note on Breathing (Because It Matters A LOT)

The goal isn’t to force the pelvic floor to contract during every ab exercise.

Instead:

• Exhale naturally during effort

• Allow the ribcage to move

• Let the pelvic floor respond automatically

  
  

A pelvic floor that’s constantly “on” is just as problematic as one that’s weak.

The Takeaway

Your pelvic floor needs you to stop avoiding ab exercises.
It needs:

• Strong, adaptable abs

• Coordinated breathing

• Gradual exposure to load

• Movement in multiple planes

When the core does its job well, the pelvic floor doesn’t have to work overtime.The pelvic floor can finally release the tension it may have been holding onto for years.

If ab exercises have been making your symptoms worse, or you’ve been afraid to train your core at all, that doesn’t mean your body is broken. It means the system needs to be retrained.

Inside The Pelvic Reset, we go deeper into all things pelvic floor and teach you what you need to know to take back control of your pelvic health.

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