Sucking In Stomach For Flat Abs Could Lead To Hourglass Syndrome
A. Pawlowski
What is hourglass syndrome? People suck in their stomach for a flat belly and good posture, but chronic stomach gripping can impact breathing, lead to pain.
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TODAY.com
"Suck in your stomach" is a mantra we’ve heard so often around achieving good posture and a good figure that it’s become automatic for many people to constantly tighten their abs.

But it turns out chronic stomach gripping, as the habit is more formally called, can lead to health consequences including less efficient breathing, neck and back pain, and pelvic issues, experts said.

Some have called the resulting problems hourglass syndrome, with TikTok users displaying another potential consequence of non-stop stomach gripping: dimpling at the base of the lower ribs where the upper ab muscles have apparently tightened from overuse.

Julie Wiebe, a clinical assistant professor of physical therapy at the University of Michigan-Flint, called it more of a “fallout” from people attempting to constantly suck in their stomach than a syndrome, but said the health consequences of the habit are real.

“We’ve been sold a bit of a bill of goods around that as women — and men do it, too,” Wiebe told TODAY.

“This generation in their 30s are the first who have really grown up with the idea of core — that we have to keep everything tight all the time… (but) it’s not a healthy choice to be gripping all the time.”

What is hourglass syndrome?

It’s the result of doing stomach gripping for an extended period of time or with too many repetitions “to get rid of any pooch, for lack of a better term,” said Adam Browning, a chiropractor with the Cleveland Clinic’s Medina Hospital in Ohio.

“We want to be perceived as fit, we want to be perceived as healthy, so we want to have a flat stomach,” Browning said.

“When you do it too often, you could get to this place where the anatomy physically changes and it becomes this hourglass syndrome.”

What happens when you suck in your stomach?

Stomach gripping primarily involves the upper abdominal muscles, Browning said. That motion of trying to suck everything up into the rib cage and get it out of sight as much as possible is more intense than just doing a crunch, he noted.

Because of that, the diaphragm, which Browning called the single greatest muscle responsible for breathing, moves up rather than down, interrupting its natural function.

Stomach gripping also creates a lot of force and pressure on your pelvic structures, Wiebe said.

Bottom line: Our body is “designed beautifully” with a team of muscles that balance between pressures and muscular forces, and help us remain stable at the center, but when we grip the stomach all the time and prevent the natural “give” in the abdomen, we interrupt the balance of that system, she noted.

What are the health consequences of chronic stomach gripping?

Inefficient breathing: Belly breathing — similar to what babies and children do — is natural for the body, Browning said. When you breathe, your diaphragm contracts, pulling down on the lungs to create negative space to allow them to expand and bring air in.

The belly naturally expands when this happens, but if you squeeze it in, it reverses the direction of the diaphragm muscle, reducing the efficiency and oxygen transfer in breathing by up to 30%, he noted.

It makes it more challenging to take deep breaths and achieve “that cleansing, beautiful breath that keeps things calm,” Wiebe added.

Pain: Stomach gripping puts additional stress on the clavicle, the first ribs and the lower portions of the neck and creates an imbalance in the soft tissues in the musculature of the core, Browning said. That can lead to neck, shoulder and back pain.

It can make you feel stiff in your hips and make you more sensitive to pain you already have in a different part of your body, Wiebe noted.

Pelvic health issues: If you’re gripping your abs and have incontinence, it could lead to leaking or worsen the problem because of the constant pressure on pelvic structures from above, she said.

How do you know you have hourglass syndrome?

Chronic stomach grippers have highly developed muscles in the upper rectus abdominis, or upper abs, and a lasting tension in that region, Browning noted. You might see more definition in the upper abdominal muscles, while noticing softer lower abs that you have a hard time contracting.

There may be dimpling at the base of the lower ribs where the skin starts to tuck under.

Wiebe has seen people worry that it’s irreversible, but that’s not true: “It is absolutely something that can be altered, but only if you change your strategy,” she said. “We are so resilient. Our body can learn how to do it and it can unlearn it.”

How do you stop stomach gripping?

First, you have to acknowledge you’re sucking in your stomach and believe there’s another way, both experts advised.

Try belly breathing exercises. Feel the difference between the quality of a breath when you squeeze your stomach tight and when you allow it to soften.

Remember that the spine has natural curves so it’s normal to have a little bit of belly that comes forward, Browning said.

When it comes to posture and stability, trainers and coaches have often told people that the abs must be “on” and contracted all the time, but they’re just part of a team of muscles that help you remain stable, Wiebe said. You shouldn’t need to grip your abdomen to walk across a room.

“We’ve gone down this road for such a long time and we’re trying to bring people back towards a more moderate understanding,” she said.

“Women can still look awesome and not have to do this.”