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Hi, Ann! I often see women working out at my gym wearing waist trainers like the Kardashians wear. Are these good to help train your core? I just had a baby, and I want to make sure that I’m doing the right thing!”

This is a very relevant question that women’s health physical therapists get all of the time! But before we get into the nitty gritty of waist trainers, I want to start by reviewing the anatomy of the “core.” It will help everything become much clearer.

When I talk about the “core,” I’m referring to the deep central stability system made up of the diaphragm, pelvic floor, transversus abdominus, and the multifidus muscles. These four muscles need to work as a coordinated system, along with the glutes and back extensors, in order to provide a stable foundation for the body’s movements. I discuss the anatomy of the deep central stability system in depth here.

The deep central stability system provides support for all the movements we do in normal daily activities and in our training sessions. Coordinating our breathing (which is largely controlled by our diaphragm) with our pelvic floor muscles is vital in order to maintain continence, support the spine, and provide a stable foundation for lifting weights. I discuss proper coordination of the diaphragm and pelvic floor in this article, which includes a video to help you harness the power of your deep central stability system.

What I haven’t discussed previously is the anatomy of the internal organs in the abdominal cavity. In the area of the waist or “core,” we have the small and large intestines, stomach, liver, kidneys, uterus, and bladder. These structures are protected by the ribs and the bony pelvis. The lungs are a bit higher than the abdominal organs, but also protected by the ribs. The organs move a bit during the breathing cycle—on inhale, as the lungs inflate, the organs descend slightly; on exhale, as the lungs deflate, the organs ascend slightly.

If you picture your “insides” like the contents in a tube of toothpaste, then you can pretty easily picture what happens if you apply pressure in the middle of the tube of toothpaste: Some of the toothpaste goes up toward the top of the tube and some goes down toward the bottom of the tube. Or picture a balloon being squeezed in the middle: The air goes to the top and the bottom. Something similar happens with your internal organs when you wear a waist trainer. Squeezing increases the pressure in the middle of your abdominal cavity, pushing pressure down onto the pelvic floor and up onto the diaphragm. Your organs shift accordingly.

This photo from my good friend, pelvic health physical therapist Julie Wiebe, BSc, MPT, illustrates this concept. To understand this topic in detail, check out this article on her website.

For those who haven’t heard of waist training before, or just don’t know exactly what wearing one entails, it’s a process that involves wearing a latex garment or a tightly laced corset to cinch your waistline. It’s used to give women a more exaggerated hourglass figure, creating a very small waist while maintaining the curves of the hips. Most websites that sell waist trainers recommend starting out wearing them for two to three hours per day, and progressing to eight to 10 hours per day, six days a week, in order to gradually reshape the anatomy of the abdominal area. Many sites recommend wearing waist trainers during workouts for “added benefits.” They claim that waist trainers can assist with weight loss and shaping the midsection.

The recommendation is to tighten the waist trainer a bit more every week in order to make the waist smaller and smaller, in an effort to get the organs to shift—some down, some up. This forces the intestines to reshape into the available space.

However, what most people don’t realize is that wearing a waist trainer not only changes the natural positioning and shape of your internal organs, it also changes their functions.

• Waist trainers restrict breathing, making it difficult to take a deep breath. (Remember those fainting couches in the 1800’s?). When the lungs can’t adequately expand, we can’t get adequate oxygen to our body and brain. Boom! We pass out.
• They make eating difficult. In fact, it may be that this alone helps women lose weight during the time they are doing waist training. Restricting and reshaping the intestines can also lead to problems with nutrient absorption from food during the digestive process. The intestines need space to contract and move food along, but when the intestines are compressed for a long time, this disrupts the normal digestive process.
• Waist training can lead to issues with the bowels such as constipation or gas, and issues with burping and belching due to increased upward pressure on the diaphragm.
• The downward pressure onto the pelvic floor can cause or worsen issues with incontinence and/or Pelvic Organ Prolapse, especially if a woman has underlying predisposing factors such as multiple pregnancies, ligament/connective tissue looseness, or mistiming of the deep central stability system. I have written more about the deep central stability system here and here.

What’s more, since you’ve recently had a baby and are in the process of recovering and re-establishing proper function of your core and pelvic floor, it’s worth mentioning that waist trainers are different than abdominal binders. After having an abdominal surgery or giving birth, many women, especially those dealing with diastasis recti (a separation in the center of your abdominal muscles due to pregnancy) wear abdominal binders for a short time. They function to provide outside abdominal support and help women restore their deep central stability system. They are not worn for the purpose of reshaping the organs, and they should never restrict breathing or digestion.

In the United States, most physicians and physical therapists don’t typically recommend abdominal binders post-pregnancy, because it is vital to retrain the deep central stability system to restore function of the pelvic floor and deep abdominals. “Bracing” typically isn’t necessary and doesn’t contribute to the restoration of strength and function.

However, in many cultures, they are a mainstay of postpartum care. While I don’t typically recommend them, if wearing one makes a woman feel like she’s able to function better and with less abdominal pain, I’m perfectly OK with integrating them into the postpartum recovery process. We utilize them in the early postpartum period as we work to restore complete function to the entire deep central stability system through physical therapy. GGS Advisory Board member Jessie Mundell addressed the topic of postpartum abdominal binders here.

There’s no magic bullet out there to “spot reduce” any area of the body, including the waist. Health, functional strength, and fitness are only found through consistent work and healthy living. At Girls Gone Strong, we are committed to helping you reach your goals in the safest way possible!

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