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Are you Stomach Gripping?

Are you Stomach Gripping?

Stomach gripping (or clinically known as ‘the hourglass syndrome’) is a common dysfunction which can be an underlying factor in many pain syndromes. It occurs due to too much tension in the upper abdominals and dysfunction of the diaphragm (the muscle that sits under your lungs).

The diaphragm: more than just a breathing muscle

Stomach gripping, Low Back Pain, Neck Pain, GERD, Sciatica, Chiropractor, St Helier, Jersey, Dynamic Health.

You can think about the diaphragm like an umbrella that sits under the lungs at the bottom of the ribcage. Normally the diaphragm will contract towards its outer margins, which are attached to the lower ribcage at the front + sides and to the spine at the back. This pulls the centre of the diaphragm (or the spike in the umbrella) down, inflating the lungs and stabilising the spine.

Stomach gripping, Low Back Pain, Neck Pain, GERD, Sciatica, Chiropractor, St Helier, Jersey, Dynamic Health.

However, with the hourglass syndrome the diaphragm contracts in the opposite direction, towards the centre (the spike in the middle of the umbrella) which pulls the lower ribs in. This gives rise to the typical narrow waisted or hourglass appearance. Other clues of the hourglass syndrome include a ‘turned up’ belly button or a horizontal crease either at the level of, or just above the belly button. ‘Turning up’ of the belly button is a sign of muscle imbalance of the abdominals; with the upper section working much harder than the lower abdominals and pulling the belly button upwards.


So you may be wondering what’s the problem? A tight stomach and a narrow waist – doesn’t sound so bad to me! However, this altered pattern of muscle activation can have some far reaching effects.


Stomach Gripping and Pain

Low Back PainStomach gripping, Low Back Pain, Neck Pain, GERD, Sciatica, Chiropractor, St Helier, Jersey, Dynamic Health.

The diaphragm is a key stabiliser of the low back, so when it isn’t working correctly the low back is left vulnerable. This also means other muscles have to work harder to compensate for dysfunction of the diaphragm, specifically the extensors of the lowback. In the picture opposite you can see the extensive ‘sausaging’ of extensors (thick red arrows) as these muscles work overtime in an attempt to support this patients back as he lifts his head. Ideally we would see more balanced activity of these muscles and less ‘sausaging’. This constant overworking of these muscles can lead to continual tightness and pain.


Neck PainStomach gripping, Low Back Pain, Neck Pain, GERD, Sciatica, Chiropractor, St Helier, Jersey, Dynamic Health.

If the diaphragm doesn’t descend properly not only will stabilisation be affected but also breathing. This can place a large strain on the neck. As described above, the centre of the diaphragm should descend downwards expanding the abdomen (belly breath) and inflating the lungs. In the hourglass syndrome this normal pattern of motion doesn’t occur and, in most cases, when breathing in, the chest and shoulders elevate instead to compensate. This puts a lot of stress on the muscles of the neck and is a common factor in headaches and neck pain.


Acid Reflux

Along with its breathing and stabilising roles, the diaphragm also functions as a sphincter – helping to prevent the stomach contents traveling back up into the oesophagus. It has recently been found that people with GERD (gastro-esophageal reflux disease) have decreased diaphragmatic function and improving diaphragm function may have a role in GERD treatment [1] [2]



Why Stomach Gripping occurs

There are 3 main causes to why this hourglass syndrome occurs:

1. Poor habits/ aesthetics

Everybody wants a flat stomach but actively holding the stomach tends to lead to an unbalanced activation of the stomach (with the upper section working much too hard). If this is done for prolonged periods this your brain can  ‘rewire’ from your normal pattern of stabilisation to this altered version. A bit like a virus corrupting a computer program.

2. Non-ideal Development

Sometimes the ‘program’ of muscle activation isn’t quite right from the start. This is thought to be the case in around 30% of babies [3]. Abdominal gripping is a common compensation strategy that babies may develop as a result and which can persist into adulthood. Click here to read more on this topic.

3. Protective patterns

Stomach gripping can develop as part of muscle guarding with a painful injury and may remain long after the pain has disappeared. “After an injury tissues heal, but muscles learn. They readily develop habits of guarding that outlast the injury.” Janet Travell, M.D. White House Physician for John F Kennedy.


What you can do

The first step is to learn to relax your upper abdominal muscles. This can be very difficult initially in seated a standing positions, especially if you have been doing it for a long period of time.


Stomach gripping, Low Back Pain, Neck Pain, GERD, Sciatica, Chiropractor, St Helier, Jersey, Dynamic Health.

The position on all fours (shown opposite) is usually a good place to start. Adopt this position and relax the stomach. Think about dropping your stomach to the floor. Next, take a relaxed breath in, expanding the stomach and sides of your ribs. You should feel you stomach move into your thighs but you shouldn’t feel the shoulders lifting. Breathe out, again focus on relaxing the stomach. Repeat this breathing cycle for 3-5 minutes 3-5 times per day.   Once mastered you can integrate this pattern into your daily postures and movements – sitting, driving, standing, and walking before progressing to more advanced exercises.  


Are you an abdominal gripper? Do you suffer with neck pain, back pain or GERD? Let us know in the comments section below.


Images reproduced from :

  • Kolar, P. (2014). Clinical Rehabilitation. Alena Kobesová
  • Liebenson. C., Journal of Bodywork and Movement Therapies



  3. Meholjic, A. (2010). Can a Motor Development of Risky Infants Be predicted by Testing postural Reflexes According to Vojta Method?. Materia Socio Medica, 22(3), 127-131



54 Responses to Are you Stomach Gripping?

  1. Love your article on stomach gripping. It makes so much sense and explains why so many people are suffering . A little knowledge can go a long way.
    Hope people take the time to read this .

    • Hi Naomi,

      Either a physio or chiro who is familiar with this issue should be able to help. Feel free to book a no charge initial consultation so see what would be best for you.

  2. Diagnosed with gall stones and GERD having sore ribs and back, more concerning shortness of breath when climbing stairs etc

  3. Thanx for this. I have all of the above symptoms and it occurred to me that they are caused by wrong breathing. Eventhough I have permanent abdominal breathing I’ve noticed that when I breathe out I grip my stomach. Now I am trying to learn what relaxed exhale is like. Intead of going backwards, like the stomach withdrawing, which causess the grip, maybe it should move downwards,like I allow it to fall – from a sitting of a standing position.
    Your articel was helpful. Thank you

  4. OMG!!!!!!!! I cannot believe this!! I have every single symptom listed and a couple more… I have been having issues with my belly for a couple of years. I had gastric bypass the R-Y procedure) so i was opened vertically. I then had 3 additional surgeries for hernia repair,small bowel obstruction and skin removal. In the last 6 months, i have noticed symptoms I have never had before. If i allow my upper abdominal muscles to relax, I barely can breathe. Holding my muscles tight all day long is exhausting and uncomfortable. I then noticed that for about a month, i wake up and vomit most days. I am very nauseated but i have always attributed that to my surgical history. This is different. I feel like my insides are not being supported. I have a left upper rib that literally pops out of place and i attribute it to the weakness in my diaphragm. The only comfortable position is laying flat or in a Cat position. I have low back pain suddenly, I have acid reflux symptoms, and for about a month I have complained or neck pain also, attributing that to a bad pillow. After reading this, i clearly have all the symptoms. THANK YOU!! Is stretching alone going to fix this or do I need to see a doctor. It’s causing me anxiety because it always feels like someone just punched me in the stomach.

  5. I think I’m a stomach gripper. I have most of the symptoms listed above. It all started after my gallbladder surgery. I had so many tests done and they couldn’t find anything that’s wrong with me. I started to notice when I bend forward to pick something up, I have to brace myself because I feel like I’m going to fall over. My shortness of breath is terrible and I have a very poor appetite. My anxiety is pretty bad too. I’m going to give this a try and see how it goes.

    • Hi Ali, Sorry to hear you are having problems. If you are in Jersey I would be happy to have a chat and see if we can help. Steffen

  6. Hi, I have all of the above symptoms. I have chronic IBS over past 20 years. I have so much fo discomfort around my upper stomach feels like muscle tightness. I don’t feel pain but the tightness stops me sitting comfortably and the only way that I can mitigate the discomfort is by lying done on my back. Its not easy fro me do the posture you posted above as it used to be one the most relaxing posture for my low back pain in past. Any suggestions to reduce this tightness around my upper stomach is so appreciated. Thanks!

    • Hi Mary. Stomach probelms such as IBS, chrons or UC can also drive a stomach gripping pattern. Have you had your IBS fully investigated?

      • Hi Steffens, thank you for your quick reply. It’s much appreciated! I have had the same symptom of severe bloating to the extend as if I am 7 month pregnant and this started since 1999 after an sport accident/ ice skating and fell down backward lucky I hadn’t break any bones but I got sever muscular issues that been treating it for years through seeing chiropractor and massage therapist together sometime physio. I get better until stress set my body off. That all said, I had an endoscopy done back in 2006 and that showed acid reflux and didn’t have any type of hernia. I also had barium swallow X-ray done and that was all okay too. Interestingly when I wear my sport bra then I don’t feel the tightness as much? I’m frustrated and exhausted of not knowing what to do.

      • Hi Steffen, thanks for your reply. I have had endoscopy done back in 2005 and I had similar extensive bloating. No sign of hiatus hernia. It showed acid reflux. The stomach griping and muscle tightness all around upper belly and around my diaphragm is very uncomfortable. It feels as if you are wearing something tight and causing pressure. I do not have pain but it’s pressure and tightness feeling in the muscles. When I release gas helps to take that pressure off. When I’m lying down on bed it helps to mitigate the tightness and almost don’t feel that anymore. Thanks

  7. Hi Steffen, thanks so much for your reply! I sent you a reply few minutes ago but not sure it went through. I have had endoscopy done back in 2006 and it was showing acid reflux and not any hernia. I also had barium swallow back in 2000 and that also showed acid reflux. My symptoms is exactly same as for bloating ever since 1999 when I first stared showing symptoms of bloating and was as severe ever since and that said it flares with stress. When I do deep breathing it looks like my bloating goes down by half. I get bloated really bad with distension and that it looks like a 7 months pregnant women. It’s frustrating and I have tried chiropractors and Massage therapy was helpful but due to Covid we can’t go for any fo those. Meditation is helpful. When I lye down on my back feels immediately better and my bloating goes down. I also wanted to let you know that I have started getting this IBS severe bloating symptoms since 1999 and that happened after severe stress and an sport accident while was ice skating. I have taken Losec for many years but stopped taking it because of side effects. I try to help the IBS symptom with natural medicine. I’m a scientist / molecular biologist and that strongly believe in traditional medicine.
    Kind regards,

  8. Very interesting article and so much relates to my breathing pattern, back and neck pain. I have periods where whole ribcage under the breasts feels stiff and sore and also rib bones in the front combined with lower back pain. Just wanted to ask you – could an irritated or stiff diaphragma cause burning pain just under the lower ribs? Feels as if my skin is sunburned, but deeper down. Could it be muscles or maybe likely nervepain? Have just been diagnosed with Chrons, but to me it does not feel like it is related to intestines, but difficult to know. Burning pain is not really listes as a Chrons symptom as far as I can tell. It is not from my stomach. It follows the shape of the lower ribs in the front and is often accompanied with burning sensation on my back as well. Today both back and stomach pain (burning) got worse after a walk. Have been chronically ill for 10 Years so this body had been through a lot. This burning pain especially in the front is very annoying so just had to send you a question.

    • Thanks for your question. Your symptoms could be related to the diaphragm but I would recommend getting a assessment to rule out the possibility of nerve pain.

    • Hello C. I just wanted to let you know that you are not alone in this skin burning. I found this article, and like most, I was searching for answers to my own weird issues. Periodic bloating, feels like my stomach I’d in a vice, it’s soooooo squeezy I have such shortness of breathe. I also have multiple compression syndromes and I’m trying to discern if SMAS or MALS might be contributing factors. I have all these other symptoms, except I cannot control the shortness of breath. Things feel so emergent on the inside, it is definitely alarming. I’ve been to the E.R. a few times. Having May Thurner, I sometimes worry the “plueritic chest pain” and the “welling tightness” in chest and stomach sensation are pulmonary embolism. But I have been checked. The burning skin sensation happens as well, although I have not had an “episode” lately. I definitely bug my doctor about it regularly. I work in construction. I’m a very physically active person. I could go on forever about my strange issues, but I just was hoping it would give some of you comfort in knowing. I’ve been stuck this way for over 6 years and it began with the diagnosis of my hiatial hernia via colonoscopy/ endoscopy. Things are never what it seems with the body I’ve learned, and most recently, I’m told by doctors all this additional pain is deferred pain from the stomach.

  9. I’ve got poor posture, GERD, the crease across the stomach, and low back/pelvis pain (SI joint). I had no idea this even existed.

  10. Oof. I have a horrible gastric history, hiatal hernia, crazy back and neck pain, and I KNOW for a fact I do this because I was a vocal performer in my 20’s and was afraid of looking fat while I was singing, so I learned to breathe while ‘sucking in.’ That’s very eye opening.

    • Hello everyone,
      I am happy to hear and know my problem is not my heart. I have all of the above unfortunately and it’s terrible. I am so scare , my belly is turning upside down , my back is so painful, my lunge and like someone pokeing me with a sharp object. My Ribs , under my breasts , my back , my lower back , between my 2 breast . It’s all over very painful. I was recently dynose with stomach hernia .
      I wish everyone the best and hope all get better soon.

  11. Okay I 100% do this and definitely have hourglass syndrome. It’s crazy because those red arrows are the exact locations I have regular muscle pain. I’ve been doing the breathing exercises and stretches and it’s amazing how different it feels just to breathe now. Are there other exercises or things to do that can help decrease that line or the damage caused by this problem? Thank you for all of this info.

    • Hi Kelsey, glad your feeling a little better. Seeing a good massage therapist to work on areas of residual tightness (like the upper abdominals, psoas and hips rotators) can be helpful for chroinc/ stubborn issues. From a exercise standpoint the goal is to progress into more challening psoitions whilst maintaining a good breathing pattern and spinal allignment – An assisted deep squat hold (like a normal deep squat but hoding onto something like a door handle to reduce some of the weight) can be a good progression once you are good with the rainbow breathing positon. (the squat position is really the same as rainbow breathing but turned vertical). Hope that helps.

  12. Thank YOU!!! Now that I have read this article I realize that I have been a “gripper” for most of my life! Became extreme this past week or so in response to medical issues and stress related to those. I have dealt with many of the symptoms throughout my life; acid reflux, neck and back pain. I have scoliosis and have a Harrington rod in place. Was placed in 1980. Do you think this fact has contributed to my gripping?

    • Potentially… Pain, stress, trauma and surgery can all exacerbate this gripping pattern. But it can also largely be corrected or at least managed even if this is the case. Good luck!

  13. I didn’t know this was a thing. But I have the horizontal line above my belly button where my stomach dips in some. As I’ve gained weight, my stomach looks like a B from the side. And my lower belly fat just hangs. So while I’m not a super big person, my stomach shape makes me insecure. I have pcos which makes me gain weight between my hips. But now I’m scared my stomach will always look like this.

    • Hi Haven. Don’t panic it is resolvable in most people with some simple exercises and training. It can be exacerbated by abdominal disorders like PCOS but there any many approaches to help with that also. Take a look at the work of people like robb wolf, rhonda patrick, chris kressor or terry wahls for approaches for PCOS. Good luck 🙂

      • Hi, I’m 14 years old and about 4 years ago I began insecure of my weight. I was a little chubby from having such a big appetite. I can’t remember exactly when,but I developed a habit of holding in my gut. For a while I didn’t think about it, until about a year ago I decided to lose weight. I ate the normal three meals a day but nothing in between. I became conscientious of everything I ate, even a small piece of candy. My parents started to notice the rapid decline in my weight during check ups. During my recovery about 4 months ago I let go of my belly and thought, I’m all better now. Just recently I went to the doctor and I found out that I’m extremely constipated and blocked up with gas. I also feel tightness in my abdomen which is making it hard to breath,and I’ve been having irregular periods. It been almost three month since my last period. I have most of the symptoms listed. Please, I need more advice. I’m afraid.

        • Hi Karina, If you have been gripping for a long time this can result in some a more ‘fixed’ pattern that can remain even when consciously relaxing the stomach. This may need some hands on treatment and further exercise to resolve completely. This residual gripping pattern may be the cause (or at least part of the cause) for the constipation and gas but is unlikley to be the cause of the period irregularity so you should get that investigated fully. If further treatment doesn’t change your constipation and gas symptoms consider some additional nutitional/ supplementation approaches.

  14. Thanks for this article, Steffen! I was a dancer growing up and as I’ve gotten older (I’m in my mid-20s) I’ve developed all of these symptoms and the physical appearance that comes from this. I am based in Minnesota in the US. Is this something I could go to a general physical therapist for support for? Or do you think a pelvic floor therapist would have better knowledge? Being in my mid-20s, I would love to get control over this and retrain my body as to prevent future issues. Thank you!

  15. Wow, my mind is blown! And that takes some doing! I was born with some health issues that put me on the alternative health pathway my whole life. Naturally, I’m drawn to articles such as this. Seeing this one has been eye-opening for me. I lived through the 80’s which of course, glamorized the hourglass figure. Which I proudly attained, unknowing of the cost. Until now, I’d been under the impression that an hourglass figure had been something I should be proud of regardless of how I felt. Now I’m rethinking this. So it sounds like a woman really isn’t supposed to have a narrow waist like that after all, right? Are the exercises I’ve seen women doing that seem to widen the waistline (i.e, planking) actually better or worse for the diaphragm? What stomach-flattening/strengthening exercises would you recommend to strengthen overall gut health?

    • Hi. It largely depends how you do them! Planks and side bridges can be OK if done well. Often abdominal exercises with a rotational component can help to prevent the upper abdominals over contracting – take a look at the “low oblique sit” exercise on youtube for a rotational variation. Crunches/ sit ups are generally best avoided as it can be very difficult not to overactive the upper abdominals if you are prone to doing so. “Deadbug” type exercises are generally a better option than crunches.

  16. Hi I have this I think. I have the crease in the abdomen and tightness in the belly and back. It’s fine if I’m rested off my feet but after an hour or so on my feet the muscles indicated with red arrows get tight and I have slot of discomfort but I wouldn’t say pain. I also get headaches. I’ve had X-rays and ct scans and mri. And all normal.

  17. I’m not sure what’s worse, the breathing problems i’ve been left with or that I used to think the “second boobs” was a defect with my ribs and that they stuck out too much causing that look. Little did I know it was because I sucked in my stomach from the age of 7/8 until now at 26. The back problems and constant tense neck muscles make sense now. We were so little and so impressionable, I always see my 4 year old “sucking in her gut” when I try to put her pants on (ones with buttons) and I always tell her she doesn’t have to do that. If the pants can only be buttoned by sucking in your gut then they no longer fit and that’s okay! I always try to remind her that she’s a little kid growing really fast and it’s normal for her clothes not to fit the same all the time either. I try really hard as a mom of 2 girls to remind them our tummy and body shapes change from day to day from all kinds of minor things. If I had guidance like that I think I would be much better off. A lot of parents think their kids are overweight when it’s just normal childhood growth. There are periods when infants get wider but don’t get taller! Then they spend 6-12 months only growing taller but not really putting on weight! It’s NORMAL and it’s NATURAL!

  18. I must have been sucking my stomach in for years and never knew it would cause this. Now I’m almost 30 and have gerd with barretts esophagus. I’m hoping these stretches help.

  19. Hello I am from India. I have this problem for more than 12 years. Sometimes it’s absolutely normal. Sometimes I have a feeling that something is stuck below my left rib. I had my endoscopy done in 2008. That time it was informed that diaphragm is slightly red. Thereafter couple of times barium x-ray was done but nothing was seen. I think It’s something like hiatus hernia or is enlarged spleen. I am confused. After reading this article I feel my breathing is wrong.But I have not understood exact pattern mentioned in your article. Can you please elaborate it.

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