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Dead-Bug and Bird-Dog are two of my favorite poses to work the abs and back without adding pressure to the pelvic floor. I often give students a choice between the two in my group classes, making it possible for people with knee pain or who want to adjust the intensity of their workout to participate in the full class.
If you are looking for a great ab workout that doesn't hurt the pelvic floor (assuming your doctor gives the thumbs up), then I encourage you to try one or both of the exercises mentioned in this blog. Let me give you tips on how you might do these poses safely. We will start with explaining some tips on how to do Dead-Bug, which is a lot gentler and doesn't add pressure to the knees. I always recommend doing this posture first, and moving on once your core and pelvic floor feel stronger.
Dead-Bug Tips to Strengthen the Pelvic Floor, Lower Back, and Abs (video)
Lay flat on the back with the feet on the ground at hip-distance apart. If your rib cage is popping up, you will want to put a blanket or pillow under the head to bring it back down. **The sacrum should stay flat on the floor for the entire exercise**
Raise both arms directly above the shoulders and reach toward the sky.
Inhale, allowing the belly to expand upward and the pelvic floor to drop down. This relaxes and stretches the pelvic floor.
Exhale when moving the leg and opposite arm outward. The exhale naturally lifts the pelvic floor. KEEPING THE BACK IN A NEUTRAL POSITION (sacrum stays nice and flit on floor), slowly extend the heel along the floor. At the same time, you have the option to start raising the arm opposite to the leg being extended over the head.
DO NOT extend the leg and arm so far that your back arches off the ground. This pulls the pelvis out of a neutral position and causes strain on the pelvic floor. Stop the motion (even if you've only moved a few inches) as soon as you feel engagement in the spine without the arch. This is as far as you need to move to get the benefits of this pose for the pelvic floor, lower back, and abs.
As soon as your exhale finishes (don't hold your breath), start to inhale and expand the belly as you move your limbs back to the starting position. Repeat on the opposite side.
When you are finished with the exercise, gently hug the knees to the chest to release any tension you may have been accidentally holding in the pelvic floor. (I like to wiggle the knees apart a bit to help with this.)
WHY THIS POSE WORKS SO WELL: The sacrum stays flat and the back does not arch in order to keep the pelvis in a neutral position, which means the pelvic floor is moving evenly. You work the ab muscles and low back because you're maintaining the spine position while extending the limbs.
HOW TO LEVEL UP: If you want to increase the intensity, you can lift the heel a few inches off of the floor as you extend the leg. You can also adjust the pose so that you pull the knee toward the armpit instead of stopping with the feet flat on the ground (making sure to keep the sacrum flat and the spine aligned). I'll have another post on this modification in the future.
Bird-Dog Tips to Strengthen the Pelvic Floor, Lower Back, and Abs (video)
Bird-Dog is a much more intense pose than Dead-Bug. Even though both poses work the same muscle groups, you have to work harder to maintain a neutral spine and pelvis simply because you do not have the floor to support your back. That doesn't mean it can't be done when you have pelvic floor concerns, but you do need to be careful.
Come to a kneeling position (knees on a pillow or blanket is fine). Keep the shoulders above the wrists and the knees directly below the hip points.
Raise the rib cage to maintain a straight (neutral) spine and pull the tailbone back so that it comes up toward the head. This mimics the straight spine that you saw in Dead-Bug, allowing you to maintain the natural curve of the lumbar spine. Gaze at the floor so you do not strain your neck.
Inhale deeply, allowing the belly to drop down (pelvic floor relaxes here).
On the exhale, slowly lift one leg behind you. Keep the hips constantly level and pointing toward the ground as the leg extends. You can simply drag the foot behind you and engage the butt cheek connected to the extended leg when it is as straight as you want it, or you can raise the leg up to be parallel to the back. DO NOT arch your spine or drop your rib cage at any point in this pose. It is best to stop the motion when you feel the abs and back engage, even if your leg has only moved a few inches, so that you keep the spine and hips in the proper position. THIS is what will keep the pelvis neutral and your pelvic floor properly aligned.
If you are comfortable with the leg extending and can balance, you also have the option of extending the opposite arm directly above the head (keeping it in-line with the spine) before or during the movement of the leg. Alternatively, you can also keep the knees on the ground and just extend one are at a time (on the exhale). So long as the spine and pelvis stay nice and level, extending any limb will work to strengthen the back, pelvic floor, and abs.
On the inhale, bring your leg and/or arm back to the starting position. Be sure that your inhale allows the belly to expand. This deep belly breath is what relaxes the pelvic floor and releases tension, which is important for your pelvic health.
Repeat this exercise on alternating sides. I typically do sets of six, but you can do more or less depending on how your body feels.
Once you have finished the exercise, extend the arms in front of you and push your booty over your heels with a straight spine (pulling the tailbone back) as you come into child's pose. Just like pulling the knees up in Dead-Bug, coming into child's pose here makes it easy to release tension you may accidentally be holding in the pelvic floor and spine.
WHY THIS WORKS SO WELL: The spine stays in a natural ("straight") position with the upper back staying solid and the tailbone pulling back, which helps you maintain the natural curve in the lumbar (lower) spine. This keeps the pelvis in neutral, so the pelvic floor stretches and lifts evenly. You naturally engage the abdominal muscles as you maintain the spine and rib position while extending one or two limbs, so the spine, abs, and pelvic floor are constantly working together.
HOW TO LEVEL UP: If you want to increase the intensity, you can pull the knee through and toward the chest instead of stopping and resting it down. DO NOT round the spine here, but keep it solid and level with the floor. You also can work on just one side of the body at a time, which works the muscles more intensely. Normally, I cue students to exhale on the hardest exertion in the movement of the pose so that the pelvic floor naturally lifts up and decreases the pressure "down there." However, if you opt to bring the knee toward the chest, you may be more comfortable breathing in when the leg extends and exhaling when the knee comes toward the chest (I prefer this). Listen to your body and see which breathing technique works best for your pelvic floor situation.
I hope you found this tutorial to be helpful. These are two of my favorite poses to do some sneaky core work with my students, and there are a lot of modifications that can be done when you get stronger.
If you are interested in taking full-length classes focused on the pelvic floor, check out the video catalogue and live class schedule on the main website: www.yogabelowthebelt.com