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How to Do Sit-Ups Safely and Alternatives to Try, According to Experts

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How to Do Sit-Ups Safely and Alternatives to Try, According to Experts

When most people think of a strong core or achieving abs, the first exercise that comes to mind is often sit-ups. While sit-ups have long been a go-to for strengthening the core, they’re not always the most effective or safest option for everyone. Proper form and technique are key to maximizing the benefits of sit-ups while avoiding strain on the back and neck.

To provide a well-rounded perspective on how to do sit-ups, we spoke with three experts who shared their insights on the benefits and potential risks of sit-ups, as well as alternative exercises that can help build a strong core without the same level of stress on the body. Their advice offers a balanced view of how to approach core training, ensuring safety, effectiveness, and overall fitness progress. Whether you’re a beginner or a seasoned athlete, understanding how to incorporate sit-ups — or how to replace them with other movements — can help you reach your fitness goals more efficiently and safely.

Many expectant mothers, especially, wonder if sit-ups are safe during pregnancy and whether they should incorporate them into their fitness routines. To provide expert guidance, we spoke with a specialist who will weigh in on the safety and recommendations for core exercises during pregnancy.

Experts Featured in This Article:

Leia Rispoli, MD, is a double board-certified interventional pain management specialist and physiatrist at DISC Sports & Spine Center.

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Anna Larson, PT, DPT, is a doctor of physical therapy at Fusion Wellness and Femina Physical Therapy in Los Angeles, CA.

Meleen Chuang, MD, is a clinical associate professor for the Department of Obstetrics and Gynecology at NYU Grossman School of Medicine, chief of Obstetrics and Gynecology at NYU Langone Hospital Brooklyn, and medical director of Women’s Health, Family Health Centers at NYU Langone (FHC).

Todd Sinett, DC, is the CEO of Tru Whole Care and founder of Backbridge, a back pain device. Dr. Sinett has published four books on treating back pain, available on Amazon.

Sit-Ups: Muscles Worked and Benefits

Most people might assume crunches and sit-ups are the same exact exercise. However, there are a few key differences to note for each movement, particularly when it comes to the muscles involved. “While the terms ‘crunches’ and ‘sit-ups’ are sometimes used interchangeably, sit-ups are usually hinged from the waist, and crunches can be more of a curling of a spine, but it really depends on who you talk to and how people use these terms,” Leia Rispoli, MD, says. “Classically, a crunch is more of a curled movement from a flat position where your elbows meet your knees vs. a sit-up, which is a hinge from the waist with a persistent stable and flat spine.”

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When it comes to performing sit-up exercises, the main muscles used are the rectus abdominis, obliques, transverse abdominis, and hip flexors. “The specific muscles that are worked and utilized involve your core muscles (mostly your anterior core muscles), so all your abdominal muscles, and hip flexor muscles,” Dr. Rispoli says.

A sit-up exercise “involves your abdominals and hip flexors as well because it combines spinal flexion and hip flexion,” Anna Larson, PT, DPT, says. “While crunches involve mostly your abdominal muscles, because the motion is achieved only with spinal flexion.”

There are benefits of sit-ups that relate to movements in everyday life. “A lot of core muscle strength and stability helps protect and preserve the spine,” Dr. Rispoli says. “In general, this helps establish a persistent habit of good posture, which ultimately puts the spine in a protective mode against years of degeneration.”

“Our abdominal muscles form a large part of our core, which give us stability, balance, and improved posture,” Dr. Larson adds. “Strengthening your abdominal muscles also will increase your pelvic floor strength. Improved pelvic floor strength will help to decrease the risk of urinary incontinence and prolapse.”

How to Do Sit-Ups Safely

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  • Start by lying on the floor, with your back against the ground, knees bent and feet flat on the floor.
  • Place both arms crossed at the front of the chest.
  • Bring your upper body and torso up towards your knees.
  • Slowly lower yourself back down to the floor, with control.

Some might want to start out with both hands behind your neck, but for safety, try to keep the arms crossed at the chest first, especially if you’re a beginner. “You want to keep your lumbar spine and your neck and your head all in one plane,” Dr. Rispoli advises. “You don’t want to put any extra flexion or strain on the neck, and you don’t want to use your arms that are positioned behind your head to hinge your neck in a flexion position and pull from there.” She adds: “If the initial engagement of the muscles is too difficult to get off of the floor immediately for those first few degrees, then you should use some sort of propped mat to help eliminate those first few degrees of difficulty.”

Note for beginners: “When starting out with this exercise, it is helpful to have someone stabilize your feet or place your feet under something sturdy such as a couch,” according to Dr. Larson. “Placing a small ball or a couple of pillows behind the back can help to engage the deeper abdominal muscles and help increase your strength gradually over time.”

“The best starting position is with a pillow behind the back or small ball, as this will help encourage spinal flexion, and the engagement of the abdominals instead of overrecruiting the hip flexors. This also decreases the load to the neck as the angle takes some of the strain from the neck muscles and focuses more on the abdominals,” Dr. Larson adds.

Sit-Up Alternatives

Todd Sinett, DC, believes you can do much more than sit-ups to help your core. “I wrote a book entitled ‘Sit-Ups Are Stupid and Crunches Are Crap,’ which provides an outline of exercises and stretches that help to strengthen our core,” he says. “To name a few I love: dead bugs, bird dog, leg raises, planks. You want to focus on exercises that elongate the body and spine.”

Dead bugs: “Anything laying on your back while alternating moving your legs or arms, such as a dead bug, is a great way to build deep core strength,” Dr. Larson says.

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Bird dogs: “Another way to challenge core stability is on hands and knees alternating reaching your opposite arm and leg, also called a bird dog.” Dr. Larson adds.

Leg raises or planks: For pre- or post-natal women, “pelvic tilts, modified planks, leg raises, side-lying exercises can help strengthen core while also ensuring safety during pregnancy. Light aerobic exercises, weightlifting, moderate brisk walking, and cycling on a stationary bike are good options,” Meleen Chuang, MD, says.

Pelvic tilts: “An alternative exercise can be something like a pelvic tilt, where you’re in a sit-up position, but instead of raising your upper trunk, you’re just flattening your back to the floor and contracting and engaging your core and abdominal muscles,” Dr. Rispoli, MD, says.

Jade Esmeralda (she/her), MS, CSCS, is a health and fitness staff writer and a strength and conditioning specialist. A lifelong martial artist and dancer, Jade has a strong passion for strength and conditioning, sports science, and human performance. She graduated with a Master of Science degree in exercise science and strength and conditioning from George Washington University.

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Mere minutes of daily vigorous exercise can cut your risk of 8 diseases | CNN

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Mere minutes of daily vigorous exercise can cut your risk of 8 diseases | CNN

Move more. Sit less. For many years, that’s been accepted guidance for people wanting to get healthier.

Now that message is getting refined, with a growing body of research suggesting that certain types of movements may be more beneficial than others when it comes to health benefits.

The intensity of your exercise may matter as well. A new study published in the European Heart Journal found that a small amount of vigorous activity may be linked to lower risk of eight different chronic diseases.

The findings raise questions about why intensity matters and how people can incorporate more intense exercise routines into everyday life. To better understand the study’s implications, I spoke with CNN wellness expert Dr. Leana Wen, an emergency physician and clinical associate professor at George Washington University. She previously served as Baltimore’s health commissioner.

Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.

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CNN: What did this study examine about exercise and its relationship to chronic disease?

Dr. Leana Wen: This investigation looked at how the intensity of physical activity is related to the risk of developing a range of chronic diseases. Researchers analyzed data from two very large groups in the UK Biobank, which is a long-term health study in the United Kingdom that tracks medical and lifestyle information from hundreds of thousands of participants. One group included about 96,000 people who wore wrist activity trackers that objectively measured their movement, and the other included more than 375,000 people who self-reported their activity.

The researchers followed participants over an average of about nine years and examined the development of eight conditions: major cardiovascular events, atrial fibrillation, type 2 diabetes, immune-related inflammatory diseases, fatty liver disease, chronic respiratory disease, chronic kidney disease and dementia, as well as overall mortality.

The key finding was that the proportion of activity done at vigorous intensity mattered. People who had more than about 4% of their total activity classified as vigorous had substantially lower risks of developing these conditions compared with people who had no vigorous activity at all. The numbers were stunning, with the participants having the following results:


  • 63% lower risk of dementia,

  • 60% lower risk of type 2 diabetes,

  • 48% lower risk of fatty liver disease,

  • 44% lower risk of chronic respiratory disease,

  • 41% lower risk of chronic kidney disease,

  • 39% lower risk of immune-mediated inflammatory diseases,

  • 31% lower risk of major cardiovascular events,

  • 29% lower risk of atrial fibrillation, and

  • 46% lower risk of death from any cause.

These results are amazing. Imagine if someone invented a medication that could reduce the risks of all these diseases at once — it would be very popular! Crucially, even people who exercised a lot still benefited if the proportion of time they spent doing vigorous physical activity was increased. Conversely, people who were relatively inactive also benefited from adding just a little bit of higher-intensity exercise to their daily routines.

CNN: What counts as “vigorous” physical activity?

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Wen: Vigorous activity is generally defined as exercise that substantially raises your heart rate and breathing. A simple way to gauge it is the “talk test.” If you can speak comfortably in full sentences while exercising, you are likely in the low to moderate range. If you are so out of breath that you can only say a few words at a time, that is vigorous.

Running, cycling, lap swimming or climbing stairs quickly could count. But this also depends on people’s baseline fitness. For some individuals, taking longer strides with walking can be vigorous exercise. Others who are already fairly fit would need to do more. It’s also important to remember that vigorous activity doesn’t have to be in the context of a structured exercise plan. Short bursts of effort in daily life, such as rushing to catch a bus or carrying heavy groceries upstairs, can also qualify if they raise your heart rate and make you breathless.

CNN: Why might higher intensity exercise provide additional health benefits?

Wen: Higher intensity activity places greater demands on the body in a shorter period. This type of movement can improve cardiovascular fitness, increase insulin sensitivity and support metabolic health more efficiently than lower-intensity activity alone. Some studies have also linked vigorous activity with cognitive benefits.

Greater intensity may have distinct benefits across different organ systems. The researchers found that some conditions, such as immune-mediated inflammatory diseases, appeared to be more strongly linked to the intensity of activity than to the total amount. On the other hand, type 2 diabetes and kidney disease were influenced by both how much activity people did and how intense it was. Why this is the case is not yet known, but intensity appears to have a significant impact across diseases affecting multiple organs.

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CNN: How much vigorous activity do people need?

Wen: The threshold for people seeing a benefit appears to be relatively low. The researchers found that once people reached more than about 4% of their total activity as vigorous, their risk of developing chronic diseases dropped substantially.

To put that into practical terms, we are not talking about professional athletes dedicating their lives to hours of high-intensity training. Everyday people may see benefits from just doing a few minutes of vigorous effort daily.

CNN: How can people realistically incorporate vigorous activity into their daily routines?

Wen: One helpful way to think practically is that vigorous activity does not have to happen all at once. It can be accumulated in short bursts throughout the day.

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People can take the stairs instead of the elevator and do so at a faster pace than usual. When they are heading to work, they can add some speed walking. They can park farther away when grocery shopping and walk briskly while carrying groceries.

Structured exercise also can incorporate intervals where people alternate between moderate and more intense effort. If you’re swimming laps, you can warm up at a more leisurely pace, then do a few laps at a faster pace, then again at a leisurely pace and repeat. This suggestion applies to any other aerobic exercise: Aim for multiple intervals of at least 30 seconds to a minute each where your body is working hard enough that you feel noticeably out of breath.

CNN: What about someone who is older or has mobility issues?

Wen: Not everyone can or should engage in high-intensity activity in the same way. Vigorous activity is relative to that person’s baseline. For someone who is not used to exercise, even a short period of slightly faster walking or standing up repeatedly from a chair could be considered high intensity. And not everyone may be able to walk. In that case, some exercises from the chair can have aerobic benefits.

Individuals who have specific medical conditions should consult with their primary care clinicians before embarking on a new exercise routine. People with mobility issues also may benefit from working with a physical therapist who can help to tailor exercises appropriate to their specific situation.

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CNN: What is the key takeaway for people trying to improve their health?

Wen: To me, the main takeaway from this study is that it’s not only how much total exercise you get but also how hard you push yourself that matters. And you don’t have to have a lot of high-intensity exercise: Adding just a little has substantial health benefits across a wide range of chronic health conditions.

At the same time, exercise needs be practical. People should look for opportunities to safely increase intensity in ways that fit their daily lives. The most effective approach to physical activity is a balanced one: Exercise regularly, incorporate more challenging activities when you can and build habits that are sustainable over time.

Get inspired by a weekly roundup on living well, made simple. Sign up for CNN’s Life, But Better newsletter for information and tools designed to improve your well-being.

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‘Not what the fitness industry is trying to sell you’: this is the one simple move everyone really needs to be doing, according to an exercise scientist

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‘Not what the fitness industry is trying to sell you’: this is the one simple move everyone really needs to be doing, according to an exercise scientist

Ask any exercise scientist what they would prescribe to someone serious about staying strong into their 50s and beyond, and the answer is rarely what you’d hope for — and certainly not what the fitness industry is currently trying to sell you.

It isn’t long sessions on one of the best under-desk treadmills or a stationary bike like the Peloton, nor the kind of machine-based exercises that isolate muscles without ever teaching them to work together.

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Ellie Kildunne built her powerful body by keeping things simple – focusing on these fundamentals

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Ellie Kildunne built her powerful body by keeping things simple – focusing on these fundamentals

Despite being named World Rugby’s Women’s 15s Player of the Year, England rugby star Ellie Kildunne admitted on an episode of Just As Well that the ‘gym was never easy’. In order for her to feel her best, she sticks to a no-nonsense approach to training and nutrition that focuses on the fundamentals: consistent exercise and eating enough.

‘If I haven’t put the work in, if I’ve skipped reps, if I haven’t eaten the right amount for the game, I would feel anxious,’ she says in her cover interview for Women’s Health UK. ‘But I’ve never put myself in that position because I want to be the best.’

What does being the best mean to her? ‘I want to become world player of the year twice. That’s my focus. Anything else that happens is by the by.’

On her episode of Just As Well last year, she said strength training now makes her ‘feel powerful’, while she ‘hates running’ – but a lot of her training involves speed, agility and endurance practice for her time on the pitch. That mix of conditioning and strength means she has built a strong, fast and resilient body.

Speaking of her physical transformation, she admits her personal body image hasn’t always been positive: ‘Body image is such a mental challenge,’ she tells Women’s Health UK. ‘My body is what made me World Player of the Year… I’ve got to remind myself of that.’ Visibility helps too: ‘We’re in that transition phase… social media is starting to lean more towards athletic women… I see people that look like me now.’ Now, Ellie says when she sees a muscular person, she thinks, ‘Respect. Because I know exactly what goes into that.’

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Headshot of Bridie Wilkins

As Women’s Health UK’s fitness director and a qualified Pilates and yoga instructor, Bridie Wilkins has been passionately reporting on exercise, health and nutrition since the start of her decade-long career in journalism.

After earning a first-class degree in journalism and NCTJ accreditation, she secured her first role at Look Magazine, where she launched the magazine’s health and fitness column, Look Fit, before going on to become Health and Fitness writer at HELLO!

Since, she has written for Stylist, Glamour, Cosmopolitan, Marie Claire, Elle, The Metro, Runner’s World and Red. Today, she oversees all fitness content across Women’s Health online and in print, spearheading leading cross-platform franchises, such as ‘Fit At Any Age’, which showcases the women proving that age is no barrier to exercise.

She has also represented the brand on BBC Radio London, plus various podcasts and Substacks – all with the aim to encourage more women to exercise and show them how. Outside of work, find her trying the latest Pilates studio, testing her VO2 max for fun (TY, Oura), or posting workouts on Instagram.   

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