Hourglass Syndrome: Why You Should Stop Sucking In Your Stomach

Have you ever felt a little bit self-conscious about your body and “sucked in” your stomach to try to look thinner? Most of us have, at one time or another.

What you might not realize, though, is that there’s a medical term for this action, and that doing it too often or for too long can have health implications. “Stomach gripping,” as it’s called, can lead to back pain, breathing issues and other concerns.

“Stomach gripping is the process of repeatedly and extensively contracting the muscles of your upper abdomen in order to pull your stomach up and in,” explains chiropractor Adam Browning, DC. “It can alter the movement patterns of your abdominal muscles, which leads to imbalances known as ‘hourglass syndrome.’”

Dr. Browning explains what hourglass syndrome is, how it happens and what you need to know to remedy or avoid it.

What is hourglass syndrome?

Although you might’ve grown up learning that an hourglass is a desirable body shape, don’t be fooled by the name of this condition. Hourglass syndrome isn’t the same as having an hourglass figure — and hourglass syndrome can be both painful and problematic.

“Hourglass syndrome is the result of performing stomach gripping often or for an extended period of time,” Dr. Browning says. “The muscles of the upper abdomen become hypertonic, or tight, and the muscles of the lower abdomen become weak and underused.”

This happens because stomach gripping activates several muscles, including three kinds of abdominal muscles:

• Upper fibers of the rectus abdominis: This pair of muscles stretches down from your ribs to your pelvis, holding your internal organs in place and keeping you balanced. This is where “six-pack” abs form.
• Internal obliques: This pair of muscles attach just inside your hip bones and midline stomach, on the sides of the rectus abdominis. They play a key role in twisting and turning movements.
• Transversus abdominis: Located below your internal obliques, this deep muscle layer helps stabilize your trunk.
• Diaphragm: Located just underneath your lungs, this is the muscle that helps you breathe.

“In each case, the muscles you contract increase intraabdominal pressure and push your lungs and stomach contents higher into your rib cage,” Dr. Browning explains.

Why does it happen?

The more you grip your stomach muscles, the more you train them to malfunction — but you might not even realize you’re doing it.

Stomach gripping can happen for a few different reasons. When you’re in pain, for example, from an injury or after a surgery, you may breathe shallowly to try to protect your core muscles from hurting even more. Most often, though, stomach gripping is something people do for aesthetic reasons.

“You might perform it both consciously and subconsciously to try to achieve a slimmer figure or a flatter stomach,” Dr. Browning says. “It seems to be consistently tied to a perception that flat abs are an indicator of health or athleticism. What starts as a self-conscious or coached behavior to flatten your stomach can become a systematic or chronic behavior carried into adulthood.”

Hourglass syndrome is most common in cisgender women, from adolescence into their mid-thirties, but anyone can have it.

Side effects of stomach gripping

Sucking in your stomach every now and then isn’t going to do you any harm, but too much of it can cause problems.

“As with any muscular imbalance, the effects can be far-reaching,” Dr. Browning warns. He walks you through some of the possible implications for your health.

Breathing issues

“With stomach gripping, your diaphragm learns to contract in the opposite direction, which can pull the lower ribs up and in, instead of pulling down and creating negative space for the lungs to expand with inhalation,” Dr. Browning explains.

This means that when you suck in your stomach, there’s less room available for your ribs and lungs to expand. And when your lungs don’t have the space they need, the surface area for oxygen transport is limited — and you simply can’t breathe your best.

Ultimately, stomach gripping can reduce your oxygen intake by as much as 30%.

Neck and back pain

The muscles in your mid and lower back are responsible for supporting your upper body. But when stomach gripping messes with the muscles in your core (abdomen), your neck, shoulders and back pay the price in pain.

“As your body tries to find space for your ribs to expand, your lungs start to press upward instead of down, which can cause neck pain,” Dr. Browning says. “Because of the way your muscles are attached, this upward movement can cause increased structural strain in the mid and lower back, which are anchors for your contracting abdominal muscles.”

Pelvic floor problems

Stomach gripping takes place in your abdomen and diaphragm, but it can ultimately also affect your pelvic floor muscles.

“Your soft tissues are weakened by being in a constant state of stretch, without the ability to contract on their own with the same frequency or strength as those in your upper abdomen,” Dr. Browning notes.

A weak pelvic floor can cause urine leakage during everyday activities like laughing, coughing or sneezing.

How to know if you have it

In addition to the health issues listed above, these physical signs may represent an imbalance in your abdominal muscles:

• A slightly upturned belly button
• One or more noticeable horizontal creases around or above your belly button.
• Good, firm definition in your upper abs but a significantly softer lower ab region (that is, a “pooch”).

But you may not see any visible evidence of stomach gripping or hourglass syndrome.

Beyond noticeable signs, Dr. Browning advises doing a mental inventory of your mentality and practices.

“The easiest way to recognize the condition has to do with recognizing your own motivations and behaviors of the past and looking for muscle imbalances,” he says. “For many people, I think it’s possible to take a moment to reflect honestly and find patterns of the behavior in multiple places.”

Ask yourself whether you tend to:

• Spend a lot of time “sucking it in.”
• Obsess over trying to flatten your stomach.
• Focus on ab workouts more than other body regions or muscle groups.

“Individually, each of these possible identifiers is nonspecific,” Dr. Browning says, “but together they can provide insight into what may or may not be going on.”

How to fix hourglass syndrome

Hourglass syndrome is treatable, but it’s not as easy as just “letting it all hang out.” Dr. Browning shares some tips for getting your body back on track if it’s become accustomed to stomach gripping.

1. Try to break the habit: The first step toward correcting stomach gripping is acknowledging that you do it. Only when you’re aware of the behavior can you make an effort to stop it.
2. Practice proper breathing: Learning diaphragmatic breathing can help you retrain your body and brain. “You want to allow your belly to expand naturally with each inhalation,” Dr. Browning says. Though you can learn and practice it on your own, you may need extra coaching from a yoga instructor, physical therapist or doctor, depending on how ingrained your current breathing habits are.
3. Address strength deficits: This one requires the assistance of a healthcare professional, like a physiotherapist. “They can help you target soft tissue relaxation of the upper abdominal musculature and focus on strengthening and activating your altered muscles,” Dr. Browning explains.

Bad habits are hard to break, and stomach gripping is no different, especially when it’s borne of discomfort or discontent with your body. By striving for body positivity or body neutrality, you can learn to love the skin you’re in — and finally, give those abdominal muscles a break.