No health risk here ‒ at least not caused by permanently sucking in their tummies. REUTERS
No health risk here ‒ at least not caused by permanently sucking in their tummies. REUTERS

Don’t suck it up, buttercup

By The Washington Post Time of article published Nov 20, 2021

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Permanently holding your tummy in has long-term health risks

Allyson Chiu

Heather Jeffcoat is a keen observer of people.

“I notice people,” said Jeffcoat, who ascribes her perceptive eye to her nearly two-decade career as a physical therapist.

“I notice how people walk. I notice how people stand. I’ll just be like, ’Oh, that person’s gripping their gluteal muscles, or that person looks like they’re gripping their abs’."

The latter observation ‒ a behaviour some experts call “stomach gripping”, or what’s more widely known as sucking in your stomach ‒ is one that Jeffcoat said she often saw among the patrons at her usual coffee shop, which is next to a spin studio in Los Angeles.

“They’ll be dressed in their spin clothes, basically a crop top or a sports bra and capris, and I’ve noticed it,” she said.

Then, her physical therapist’s brain starts whirling: “I wonder if they have back pain. I wonder if they have pelvic floor dysfunction.”

The pervasiveness of the habit can largely be attributed to a common approach to fitness that’s overly focused on the abdominal muscles, as well as societal beauty standards that emphasise a flat stomach, said Julie Wiebe, a clinical assistant professor of physical therapy at the University of Michigan-Flint.

Sucking in the stomach and keeping your abdominal muscles tense as you go about your day might seem innocuous, but Wiebe and other experts say the habit could have physical and mental consequences over time.

Beyond potentially affecting the pelvic floor muscles, which are involved in posture, urination, bowel movements and sex, sucking in your gut all the time “could alter the mechanics of your abdomen; it could alter its ability to respond to demands in the environment”, Wiebe said. “It could change your breath patterns.”

The term “stomach gripping” referred to when people activated their upper abdominal muscles and held them in a contracted state for prolonged periods, said Sarah Hwang, an assistant professor of physical medicine and rehabilitation and obstetrics and gynaecology at Northwestern University’s Feinberg School of Medicine.

If the muscles were trained to always be activated, it could affect the entire core, including the pelvic floor muscles, said Hwang.

Hwang, who treats people with pelvic floor issues, said she addressed tense abdominals in her patients regularly.

Habitually contracting your oblique abdominal muscles could exert force down on the pelvic floor muscles and potentially cause the pelvic floor to become overwhelmed, which could have consequences such as incontinence and pelvic organ prolapse, said Jeffcoat, the president-elect of the Academy of Pelvic Health Physical Therapy.

“When you activate those upper abdominal muscles, you’re creating an increase in intra-abdominal pressure at baseline,” Hwang said. “Then when something happens to increase that pressure even further, like coughing or laughing or sneezing, the pelvic floor muscles can’t overcome that increased pressure, and people will have urinary incontinence.”

But Wiebe noted that the effects of sucking in your stomach could extend beyond the pelvic floor. You might notice that it was harder to take deeper breaths, or develop soreness and stiffness in your lower back and hips. Contracted muscles were also less responsive, she said, meaning you could be affecting your body’s ability to absorb impact from activities such as running.

“I’m not saying don’t ever engage your abs again,” Wiebe said. Instead, it was important to “understand that they are part of a functional whole, and they’re intended to play on a team, and they need to be appropriately engaged for the task you’re up against”.

But breaking the habit and learning to relax your muscles isn’t always easy, especially if you’ve been sucking in your stomach for years.

Many people’s fixation with having a flat stomach, or at least the appearance of one, had largely been fuelled by a well-intentioned idea about health and fitness ‒ having a strong core ‒ that had been taken to the extreme, Wiebe said.

“We sort of prescriptively said, 'pull your navel to your spine’,” she said, referring to the common exercise instruction. “We’ve never nuanced that. People have interpreted it as we’re going to hold it tight all the time.”

Meanwhile, societal beauty standards and ideals had also evolved to put a premium on flat tummies and ripped abs, making many people feel more self-conscious about their stomachs, said Ann Kearney-Cooke, a psychologist who specialises in body image and eating disorders.

Most people, including many who are in overall good health, don’t have sculpted stomachs, and she and other experts emphasised that holding in your gut was not a healthy behaviour in the long term.

A key initial step is recognising you were gripping your abdominal muscles when you didn’t need to, Wiebe said. While you should engage those muscles if you were lifting a barbell, you shouldn’t be tensing them at full strength when you were standing in line at the grocery store.

Jeffcoat agreed, saying: “The problem is you shouldn’t have to be consciously gripping it. It shouldn’t be that you’re constantly going 80 to 100 (percent of your maximal tension). It should be close to 20 to 30%."

To begin retraining your muscles, experts recommend consciously trying to relax and let your stomach out.

When you're prasticing breathing, Wiebe suggests doing inhalations with an emphasis on easing the stomach and pairing that with meaningful movements, such as descending into a squat. Combining inhalation with movement can teach the body to use the trunk muscles in a different way, so you're no longer relying only on your abdominals.

What's more, Kearney-Cooke said, ask yourself how much of a difference it really made to suck in your stomach.

“You might be holding in your stomach and it may look flatter, but are you looking tense or are you looking not that joyful?” she said. “It’s not just your stomach, it’s the whole picture of you that people see ‒ your smile, your eyes.

“There’s enough to be stressed and tense about. Stop tensing your body that way. You’ll feel better.” - Washington Post

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