Follow Us:
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).
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.
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.
.jpg)
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.
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.
If the diaphragm doesn’t descend properly not only will stabilisation be affected but also breathing. This can place a great 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.
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]
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.
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.
The position on all fours (shown above) 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 stomach gripper? Do you suffer with neck pain, back pain or GERD? Let us know in the comments section below.
© 2026 Dynamic Health. Powered by Oncord
Leave a Comment
I’ve spent this time trying to find out d whats going on on my own. Now the monumental task of trying to reverse this…..
Thank you for this post
I realise I have a long road ahead of retraining my body but at least I can now feel things changing for the better.
My symptoms include-
Feeling of a lot of tightness in upper abdominals near the diaphragm.
Feeling of dropping of lower abdo muscles. This feeling is so much that i have to put something around my lower abdominals to support them, so that i dont feel like they are falling .
When i am sitting, i feel alot of pressure/weight on my diaphragm as if the weight of my upper body is dropping on it. When this happens, my head gets heavy and i get a headache as well.
When i am standing, mostly i feel like my lower abdominals are falling and i feel a pressure kind of sensation in the middle part of my belly as if lower abdominal area hanging from that point.
I have breathing issues
I have very weak bladder. I have to go to toilet so many times a day. I cant stop my pee. As soon as i have the sensation, i have to go unless i cant control it. I feel too much pressure
My pelvic floor muscles have gone weak
My core has gone weak.
I am not able to live my life properly
I am under constant stress from the last 2 years.
My movements have gone slow in a way cause i just dont wanna move from a position as i dont wanna move my stomach.
Lastly, i dont think i stomach grip as much now as j have become conscious of it, but i feel the muscles imbalance has grown too much between my upper and lower abdominals which is causing me the issue and also i believe my brain is not sending the right signals to my upper abdominal muscles by keeping it on all the time.
Does anybody else has these symptoms. If yes, please tell me what has helped you. I will forever be grateful to you.
I swear this condition is killing me.!!!!!!!!
strained my chest muscles over working them and sometimes massage helps some.
Keep tying to find an answer. Don't give up.
I’ve had issues with GERD, and now dealing with a strange chest tightness and gnawing just below my ribs under the sternum, that gets worse when I sit straight and relax my stomach, or I lay on my back, looking up at the ceiling.
I was thinking it could be an issue with my lower esophageal sphincter, but I am trying to relieve it is muscular, and clenching my stomach may be the reason.
I’ve made lifestyle changes that I believe have made it better, but if I don’t improve completely in the next couple of months, I will seek medical attention and mention my constant stomach clenching.
Thank you for bringing this issue to light!
-Frank
I m suffering a lot due to such kind of problem, I feet my stomach is displaced may be to hiatus hernia though it is not seen in barium swallow xray
I can barely live , my stomach and abdominal wall feel collapsed, feel everything is being sucked inside
I can’t burp and feel suffocated
What can I do to at least get some relief
Monika
I am with you on tHE suffocating feeling. I feel like I spend half my day going over to a counter or dresser to push up with my arms so I can straighten enough to get a full breath or two, only to let go and collapse and keep going. I’m about to shower and dreading washing my hair because of raising my arms. A shower should NOT exhaust me. Whatever this is, it’s very debilitating and affects every aspect of my life. Except sleep…but who wants to sleep their life away? Well ok, who is able to sleep life away? “Not I” said the collapsing woman who can’t breathe!
I’m going to try and “nutshell” a little history, although my Daddy always told me that my “nutshells” tend to turn into bulk size containers of peanut butter.
Ok. Overweight beginning middle school. Topped out 200 lbs freshman high school. (Oh, Female was 5’ 6” …now I “measure in” at 5’ 1”…IKR?) This girl started sophomore yr high school at 130 lbs. Not eating enough and a Jane Fonda cassette that I used making up how I thought each exercise was supposed to be done. Here begins a cycle of weight fluctuations 130 to 155 to 140 to 150 to 125 to 135….. always with some kind of intermittent exercise, walking, step aerobics, free weights, biking, etc. until I was 29. At 29, a new job for the husband (boyfriend from freshman yr that my sister said I better lose weight if I wanted to keep. Hah! Irony and just hah is all I have about that at this moment) took us to SC. He says “You don’t have to teach now. You just stay home. We won’t have to work around schedules to do stuff, go places, etc.” His job-2nd shift.
*One moment please•••
ALL THE SINGLE LADIES READING THIS —Do not give up your career for the man okay? Okay. Cause divorce was never in my plans until I was told about it after having a lovely baby girl who has severe autism and epilepsy. She is a lovely 15 yr old baby girl and she is my ❤️ on two legs.
Okay, continuing. 29 , no job left me like, “OMG, what? What do people do when they don’t work? Soo, keeping our home, cooking, baking, and getting fit became my “work”. And I became damn good at my job. 5’6” 115 lbs is credited to Jillian Michaels, Mari Windsor Pilates, free weights, elliptical trainer, hiking (Grandfather Mountain once in hurricane force winds— apparently we started just before they closed the trails. I seriously would squat down real fast when the wind would gust because it felt like I was gonna be blown off my feet. Not what you want that high up on that mountain. My husband finally turned around like “what’s up with you?” He laughed and came and tucked my hood inside my hoodie lol), and still some good old step aerobics. I was freaking fit. Oh, and the guy’s that my husband worked with loved me cause I sent baked yummy stuff to them. I was in the best shape I’d ever been in from about 30 right on thru my pregnancy at 37.
Post pregnancy: Wait, pre pregnancy —had difficulties getting pregnant, exploratory surgery-3 incisions, 1 thru naval (ovary scraped from pelvic floor. Awful back pain when I woke, my doctor standing right close saying, “Maggie, you’re gonna be ok, let explain why your back hurts so much”.
She estimated I had very likely lived with endometriosis from teen years (I told my step mom my cramps were really bad SMH). Boiled down, I had all 4 stages of endometriosis all over. Old stuff, apparently about like tree bark, and current and very active shedding monthly, wherever it had made a home.
I put this stuff in so that once I explain my debilitating whatever that’s contouring my body, there might be something that could be contributing?? Oh I don’t know.
Let’s go post pregnancy now. I had planned on getting back to exercise as soon as safe and doable, however, my girl, she was unlike any baby I’d ever cared for, and I was a nanny for numerous families while finishing my degree in Elementary Education. This was MY BABY! So this was very hard in so many ways. My not being able to get back to Jillian and Mari was low on my list of concerns. Endometriosis still wreaking having—when my girl was
18 months, I had complete hysterectomy +appendix (covered in endometriosis tree bark)+scraping of some of the yuck from in there. Huge upside! My doctor worked alongside another doctor who has begun doing hysterectomies without opening the abdomen and agreed that they would work together, back thru the navel (I don’t know…they dissect and make small. No incision, that I knew). Recovered quickly.
Got my sweet girl’s diagnosis of autism around 2yrs of age. Therapists in-home, therapies outside the home, reading, researching, doctors, then…the seizures. One ambulance ride, they had to breathe for my baby girl to keep her alive. You never get something like that out of your head, your heart, your soul. Never. And then there’s self harm (3 investigations by child services—cleared obviously, but still devastating and terrifying). So no. It’s been 16 years since I’ve been able to really take care of this body I live in. In fact, I was tested several years ago and diagnosed with severe narcolepsy and fall seizures (broken nose, fractured spine, craniotomy…a lot of falls).
Going way, way back for a min. 19 years old or so, I leaned, kind of too far out to pick up my 3 year old nephew and holding him mid air, tried not to scream, got someone to grab him because I couldn’t move at that moment. I felt like a hot spear had ripped thru a little to the right of my spine, pain across lower back, more concentrated on right. By lower back, it effects lower back, but very painful, like if my hands were on my pelvic bone then the other hand in the back across from that hand. Oh boy. As lower back goes in to butt cheek. Ummm. Ok, here’s this. 15 years after that happened,(all the while, intermittent pain, sometimes put me out of commission, but I never swept the floor, vacuumed, anything bending, without discomfort) an “old school” chiropractor who could work magic when I could barely walk, took some
X-rays, ran me thru some movements and tests and said I had separation of the sacroiliac joints. Said left side, just slight, but it was the right side that was causing the most pain.
Now, I research things. My Daddy used to call me “20 questions” when I was growing up. So, I’m thinking that because of that low back pain, in order to keep moving and relieve it a little, I tucked my butt. For years I’m thinking. So posterior pelvic tilt? I think.
This is ridiculously long. I just don’t know what might kind of be part of a whole picture of what I’m going to try to explain. It’s awful. Just awful.
Ok, let’s see. First 5’6” to 5’1”. I had not had my height measure in years. I just knew that my ex husband and my boss (family friend-he’s not the boss of me lol) kept saying things like “sit up straight”, “why are you leaning over like that?”, “Maggie, honey, your posture was so much better when I met you and over the years. Why do you hunch over all the time now?”
Nice right? And all I knew to say was “I go thru every day battling gravity. I have to press down on the edge of a counter top to get a good breath and to take the weight of this bowling ball in my gut away “.
Now, I have a crease across my abdomen but it’s higher than you hear with the hourglass syndrome. By crease, it feels like someone has sutured, with Gore-Tex, from the inside across that line and it works on a pulley. Depending on what I do, even how much of a hurry I have to do things in, and definitely raising my arms at all. Lifting any thing with a little weight to it, I have to battle not to just become a person walking around with my head somewhere around my knees. Seriously, it will physically tighten or pull so intensely that, I don’t know how to explain it. I cry. When my girl’s not here. I scream, I get angry, frustrated. And it has gotten so far out of control and the thing is, I don’t know what I did to get here. You know, belly button to spine…Mari Pilates, but that was a very conscious action, I knew when to do it, I knew how, it wasn’t “sucking in”. It became a very familiar muscular movement done with intensive purposes when I engaged. Where this crease is I wouldn’t think could be caused or effected by “sucking in”.
This is sad and it sickened me but it was when I realized, ok, this is not exhaustion or JUST physical, something is going wrong in various areas. I was sent to a doctor by my heart doctor (heart doctors can request sleep latency test for narcolepsy, or refer, whatever it’s called. IDK I found it interesting) another doctor, not sleep lab, to rule out lupus. That doctor wasn’t caring about no lupus, he wanted to know what is with your back? Found out about 5’1” at that appt. Oh, and fractured spine because he wasn’t letting me outta there without X-rays of my back. Sad part. The girl says, “ok, I want you to just raise your arms straight up above your head. I start to do it, I CAN’T without it bending me forward/pulling the crease back, that bowling ball weight, it just crumpled me. She pulled down a bar from above me and said sweetly, “it’s ok, just hold on to this bar”. And she raised it, you know, to however she needed me to be for the X-ray.
There’s more I think I’ve put together, could be wrong. My esophagus is closed. Well, not completely obviously but one of my hospital stays they were asking health questions so I told them about my “heart attacks” on the right side though (serious pain, all I ever said through 17 hours of back labor was “this is intense”, so yeah, my right side heart attacks hurt like hell). Well, my heart was great, so esophagus next. All these little cups of stuff that I wasn’t really looking forward to lined up with a machine to take pictures. I drank a little of the first little cup, X-ray, one person looks at it, calls somebody in, 2nd person looks, tells me, drink another swallow of this one. X-ray, 3rd person called in, looking at X-ray, here, drink the last bit of this first cup. X-ray. “Ok, we’re gonna stop there. The doctor is going to want to do, I forget the name of the test, to see what’s going on with your esophagus. No point in you drinking any of these because that first cup is just dripping thru.”
Huge hernia. And I just know it’s connected. I’ve had that test before and didn’t have a hernia. I was fine, everything was good.
This is a humongous bulk bucket of peanut butter. I’ve never been able to “nut shell” anything. When I tell someone about a movie, I talk longer than it takes to watch the movie.
Oh, why haven’t I been to see my “old school” chiropractor? He passed away. Haven’t gone anywhere else because, well, lost insurance. Did I mention single mother of my miracle girl with severe autism? Yeah, and narcolepsy and driving to a job you can get really don’t go hand in hand. I do a little work from home for my boss who’s not the boss of me lol. I roll on my exercise ball often just to stretch that area of my abdominal crease out, if I could live on it, I would. I use an exercise band to stretch chest area which feels incredible and I do a couple of things with it like rows to try and work those muscles between my shoulder blades. A lot of times, if I have just a minute to, I’ll just simply tighten then it clinch, you know, pull them together. No band, just a minute of time so, clench, and clench…
If anyone is still reading, God bless you! And if you’ve got any ideas…please.
Thank you for taking your valuable time to read. Really. Thank you.