Video Transcript: Planks

Hi, everyone! Dr. Orit Hickman here from Pain Science Physical Therapy. 

Patients often will ask me how they can work up to doing plank exercises. Now, if you’ve watched any of my prior videos, then you know that I’m a huge proponent of graded exposure. If you’ve been experiencing persistent pain for a long time, then just going in doing an exercise exactly the way it is shown can oftentimes cause an increase in pain, especially if you have any prior experience when that exercise might have caused pain and your nerve system is nervous about it. So, what I would recommend is a progression. 

So, with planks, the best way to start is on your hands and knees. Now, assuming this doesn’t hurt the wrists, this is a great place to go. Then, what you would do is, keeping your back nice and flat, you would slowly walk your hands forward into a partial plank position, bringing your hips down. And then, eventually, once you can tolerate that exercise, you go to a full plank position. 

The same would be for the elbows. If it turns out this is just too painful on the wrists, then what you can do is you can start in a partial plank position on the elbows. Feet are relaxed. And then, you work up to being in a full plank position. 

For each of these exercises, what you would do is gently engage your abdominal muscles. You gently pull your navel to your spine. Engage your glute muscles. Make sure that your shoulders aren’t sinking [and] your head is not tilted up. And, start really with very, very small amounts of time. So, maybe you’re in that position for five seconds, and if five seconds feel like too much, then one second. But, you start there, and then you assess how you feel the next day, not even later on that day but the next day. For a lot of the patients that we treat who have persistent pain, their symptoms are fine the same day they have done something new, but then they have a flare up the next day. So, if you do a new exercise and it’s something that is challenging and something that you have fear with, then do it for a very, very small amount. See how you feel the next day. Then, repeat it maybe a day or two later [for] the same amount of time. Maybe it’s five seconds, and, again, assess how you feel the next day. 

Once you’ve done that exercises [for] enough repetitions that you’re able to say “Ok. I know this exercise is not harming me. I don’t feel increased pain with it or increased anxiety,” then go ahead and increase the amount of time that you hold the position.

I hope this helps. If you have any questions or comments, please feel free to make those known to me down below. If you thought this was a good video on a plank progression, then I would love a thumbs up. And, if you’re interested in getting more videos about persistent pain, then please feel free to subscribe. Have a great day!