Abs. Abs. Abs. We're told to hold in our stomachs. Stand upright and suck in that belly. But this habit comes with health risks, experts warn.
For decades, beauty standards have emphasized the importance of a flat, toned stomach and rock-hard abs. But on TikTok, people are warning about what happens when you grip your tummy too much.
"Hourglass syndrome," which now has more than 14 million views on the video sharing platform, is the result of sucking in your stomach for an extended period of time. Because you're contracting only your upper abs, the result is a muscular imbalance in your core, which causes the appearance of creasing or indentation.
Despite its name, it's not a disease or official medical diagnosis. "It's a strategy for how you're using your muscles. You're gripping them in a particular pattern that creates this aesthetic of dimpling," says Julie Wiebe, a clinical assistant professor of physical therapy at the University of Michigan, Flint.
Over time, however, there can be physical health consequences, experts warn.
What is 'hourglass syndrome'?
"Hourglass syndrome" is the result of sucking in your stomach, which keeps your upper abdominal muscles tense and your lower abdomen weaker and underused. Physically, you may see it as creasing at the base of the lower ribs.
The inspiration behind the name probably stems from societal pressures to be thinner, says Alexis Shoope, a physical therapist based in Houston.
"Think of how Barbies' bodies were made. Their stomachs go in a lot, then their hips would go out. That's what a lot of women think: 'Oh, if I suck in, I'll have that appearance.'"
What are the health risks of sucking in your stomach too much?
When you contract your abs for an extended time, it can create pressure on your pelvic structures, which may lead to incontinence or urine leakage during everyday activities such as laughing or coughing.
"The role of the abdomen is important in how you control your center in order to stay balanced while we move around throughout the day," Wiebe says. "But because we have put such high value on abdominal work only, we've messaged that you need really strong abs, and we've done it in such an unbalanced way." Additional risks include stiff hips, neck and back pain and ineffective breathing.
"If you grip your abdomen then try and take a deep breath, it's challenging," Wiebe says, adding that deep inhalation is important for stress relief and pain response. "The diaphragm can't come down against the pressure that's been created in the core."
Is it permanent? How to fix hourglass syndrome
The good news is that "hourglass syndrome" is typically reversible. Just as we've learned to grip our stomach muscles, we can also unlearn it. Awareness of the problem is the first step to stopping it.
"Most people have been sucking in their core for years, doing it throughout certain exercises or even if they're just sitting," Shoope says. "We're not going to see a quick change, because it's going to take time. But the biggest thing is acknowledging it and learning some of the basics so you can figure out how to stop."
Wiebe, who has more than two decades of experience in pelvic and abdominal health, recommends belly breathing exercises to retrain your brain and body to expand naturally. But more important, it's a mental challenge to combat problematic beauty standards requiring flat stomachs at the expense of our own health.
"We're told our stomachs should be hard and strong. The reality is they should be flexible and dynamic," Wiebe says. "We need to change those dangerous beauty standards. There are so many people providing us with different body types and sizes in different ways, and I hope that changes how everyone views themselves."
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