By Amanda Thebe and Kim Schlag
This was the provocative headline a social media page, with a significant influential presence posted last week. STOP! DOING THE PLANK IF YOU’RE OVER 50!
She later updated the post to add some context, stating “the plank exercise puts pressure on the bladder, which may already be weakened without the influence of oestrogen. To prevent further damage modify the plank position by resting knees on the floor, or speak with your instructor about alternative positions. If you suffer with bladder or pelvic floor problems, prevent further damage by modifying The Plank position, such as resting knees on the floor, or speak with your instructor about alternative positions.”
Yet her stance remained firm, in all her comments and interaction on the post, she stood by her claim that women should stop doing plank after 50.
Well you can imagine the response this evoked. Women over 50 were up in arms at being told they SHOULD NOT do an exercise that had otherwise been a staple part of their exercise program.
So is this statement accurate? Should women over 50 stop doing the plank?
The best way to address this is by telling you what we know happens during menopause. Declining estrogen has been shown to reduce the strength of our skeletal muscle. Skeletal muscle is the stuff that is connected to your skeleton and is part of the mechanisms which help us move. This shows up in a number of ways as women see their strength take a bit of a nosedive and a decrease in their pelvic floor strength.
When a muscle loses strength, either from declining estrogen, from inactivity or from sarcopenia as we age, then one of the solutions to address this is to strengthen the muscle. There is enough evidence to show that we CAN still build muscle as we age, and we should actively seek to do so.
How do the pelvic floor muscles work?
The Continence Society of Australia states, “when the pelvic floor muscles are contracted, the internal organs are lifted and the sphincters tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows passage of urine and feces.”
This should happen naturally, without any conscious thought. But if we experience weakness in the pelvic floor area, it’s important for a woman to retrain the muscles to react and relax intuitively. The best way to do this is working with a pelvic floor specialist, who will help you identify what is causing the dysfunction and what the best exercises are to strengthen the area.
The pelvic floor works as part of the core, to control the internal pressure of your abdomen. These muscles include the diaphragm for breathing, the multifidus which supports your spine and the transversus abdominis (TrA) which are deep core muscles. Usually training the pelvic floor requires you to train all these areas together as a system. If you work with a pelvic health physiotherapist, they might help you learn how to activate a muscle in isolation for those not working optimally. For example, if your pelvic floor muscle is hypertonic (too tight) it maybe due to the underuse of your TrA. In this case, the physiotherapist will help you learn how to activate the TrA and then progress to include all the inner core.
What does that mean for you? Should you STOP DOING THE PLANK IF YOU’RE OVER 50?
Michelle Smith, who is a senior instructor at a national personal training college and teaches ACSM, NASM, ACE and NSCA curriculum to personal training students, argues that this type of statement is harmful. Smith states, “It doesn’t matter your age or whether estrogen causes muscle weakness. Just because it can, it doesn’t mean that every woman will have a compromised pelvic floor sling or have bladder issues. If a woman trains her pelvic floor and performs a well executed plank, she should not be afraid to do so because she reached 50.”
Fear-mongering and blanket statements are harmful on many fronts, but especially during menopause when many women are afraid to jump back into exercise and can lack the belief in their abilities.
Dr. Sarah Ellis Duvall, pelvic health physiotherapist, who studied her doctorate on the pelvis emphasizes that, “if you’re performing a plank correctly, then it can be the best exercise you can do! I’ve seen a full plank from the floor help hundreds of women strengthen their pelvic floor – i.e. the bladder support system. Looking at the research, planks recruit a pelvic floor contraction the same as a kegel, showing they can be a beneficial part of rehab if done correctly. Now, I can think of 15 other exercises that are incredibly risky for the pelvic floor and must be done with great form or it can cause bladder issues, but a plank just doesn’t rank high on that list.
She continues, “if we have everyone at 50 suddenly back off from their exercise routine, it would create an epidemic of pelvic floor issues. When you stop challenging the body you are guaranteed to get weaker over time, estrogen or not. Weakness is a huge issue for pelvic floor health! So, I’m going to argue that if you’re doing a plank well when you hit 50 and beyond, if you back off, it just might create a pelvic floor weakness issue that will lead to having bladder problems. Modifying planks could CAUSE a PF issue!! “
You are unique!
Not all women can and should do planks. Chana Ross, pelvic health physiotherapist advises that they first get assessed for their pelvic health.
Planks may not be for you:
- If after planking you feel pelvic heaviness
- If you’re leaking urine
- If you’re having back pain
- If you’re having hip pain
- If you can’t do it with good form
- If you’re not able to recruit all of the abdominals
The bottom line is, it’s the same thing as any other muscle group you train. If it hurts when you do it, then stop. If you can do it with good form without any symptoms then, yes, you can plank. Ross continues, “Can you retrain everything? No. Will there be some women whose bodies won’t tolerate planking? For sure there will be. It’s no different than any other muscle in your body. As soon as we start fear mongering we’re losing it. We’re missing the point. It’s the always and never statements I take issue with.”
Age and menopause should not be the dictator of whether you can do a plank or not. In fact, Michelle Fraser, pelvic health physiotherapist, thinks we should reframe the whole argument. “Perhaps it is not “what” exercise we are doing that is the most helpful guideline, or what age we are, but “how” we are performing the exercise. Like many effortful exercises, the plank has the potential to increase intra-abdominal pressure, which can lead to increased pressure on the bladder. This is particularly true if the person performing the exercise is unable to maintain an optimal breathing pattern because the physical demand of the exercise is beyond their current ability. A 55-year old woman may easily be able to perform plank, using their inner core optimally and with a helpful breathing pattern, while a 40-year old woman may not be able to perform a modified version (such as on the knees rather than on the feet) without holding their breath or without gripping their muscles. In these examples, plank may be appropriate in the first case, and a modified version may not be appropriate in the second case. Rather than vilifying a particular exercise or setting age parameters, it may be more helpful to assess what each individual is capable of doing while maintaining optimal mechanics and breathing.”
How to do a good plank:
There are different starting points for performing a plank and you need to determine where yours is. Our best advice is to work on different angles of incline or perform on your knees. The main focus should be to have impeccable form so that you can breathe properly, you can recruit all your inner core muscles and you are not in pain.
Here are some cues to help you:
- If you are not ready for a full plank, either start on your knees or work on an angle. Over time get closer to the ground. Kitchen counters and staircases are a great starting point.⠀
- For a straight arm plank, make sure your hands really work. Imagine gripping the floor like your trying to pick it up.
- For a plank on your elbows, imagine pushing through the floor with your elbows
- This peachy cue will help you engage your glutes to protect your lower back. Squeeze your butt cheeks like there’s a $100 bill that we’re trying to take out.
- Engage your whole core by bringing the front ribs and hips closer together to create a feeling of tension.
- Be patient. Build up slowly working on nailing your form rather than doing it for a long time. Quality over quantity is your friend.
If you struggle with anything from the above list, you may benefit from seeing a pelvic floor physiotherapist to ensure a balance of the individual components of the inner core. Doing plank with these excellent cues will work great as long as you can actually recruit all components of plank in the amount required (not “gripping”) and are able to relax the pelvic floor afterwards, and are able to breathe while in plank.
Other things that can help you:
- Topical estrogen has been shown to help with many GSM symptoms and can help you recruit the muscles surrounding your bladder like your sphincter and urethra.
- Diaphragm breathing in conjunction with pelvic floor exercises like kegels.
- Retraining your whole core to work as a unit and to identify any weak links.
- Seeing a pelvic floor specialist to identify the cause of your problem, which may be muscles that are too weak or too tight.
Chana reminds us that history has often dictated what should happen to a woman, “it’s the always and never statements that drive me insane. We’ve been told for so long what we should and shouldn’t do that we’ve lost the ability to be individuals and to think for ourselves. I think the best way to empower women is to be educated about this stuff, to educate ourselves. This gives you the power to choose, if you choose to never plank because you’ve decided that’s what right for your body, then more power to you! Nobody has to do planks, but if planking’s something you really want to do, let’s figure out how to get you there. It’s not rocket science. The goal should be to help women reach their goals not to tell them what their goals are.”
You are not fragile
Women in menopause are often represented as being weak and broken, when this is far from the truth. Lynda McClatchie, pelvic health physiotherapist wants this narrative to change. “ I don’t want any woman to believe she has become that fragile. This kind of thinking is brutal and will literally change her brain. I do think that while she is doing a plank she should engage her pelvic floor (and know that she is doing it correctly) and breathe properly. Obviously she should start at a level that is appropriate and build from there.” And we will all be at a different level, and that’s OK!
When fear-based statements like these are made, with no evidence to support them, a disservice is being done to women. Katie Taylor, runs The Latte Lounge, another large online platform for midlife women , challenged this social media influencer, “For those of us who run sizeable online platforms, or are looked upon as ‘influencers’ (a word i don’t like to associate myself with) we have a huge responsibility to look after the women who come to us for support and ensure that we are providing them with scientifically sound and evidence based advice, not scaremongering like this. Using sweeping statements like this, is totally unhelpful and confuses women further, usually the most vulnerable and desperate women who come to us often when they’ve run out of places to go. We have a duty of care to look after them and signpost them safely and correctly.”
The final word
GP and menopause expert, Dr Louise Newson couldn’t agree more, “women need to do the right exercise for them and many of my patients who are over 50 regularly do planks!! Our advice to you is to make an informed decision on your exercise choices based on your individual goals and needs. Take these clickbait statements with a pinch of salt, and find reputable experts (like the many featured in this article) to make an informed decision about your health and wellbeing.
Finally, take some inspiration from the following photos. An army of Over 50 Women who won’t be driven to fear by sweeping statements like these. We would love to see your photos too. Post on social media using the hashtag #PlankingOver50 and we will feature you in our stories.