To wrap or not to wrap

To wrap or not to wrap

If you’re considering shelling out $10-$50 on an abdominal binder (or wrap) after pregnancy simply to help slim down your middle, let me propose an alternative: a biofeedback tool to help re-train your deep abdominal muscles that costs about the same or even less.

Abdominal binders work by compressing your abdomen and doing the job of your transversus abdominis (your deepest abdominal muscle) to provide stability for your core.  A biofeedback tool works by helping you to strengthen your actual transversus abdominis without substituting with your outer abdominal muscles.

There are cases for and against wearing an abdominal binder, but little research (in most cases, no research) to back up those cases.  I’ll give those arguments to you to help you decide what to do.  Of course, if it was prescribed to you by your physician, midwife, or physical therapist for a particular reason, by all means wear it.

 

Cases FOR wearing an abdominal binder:

To assist the healing process:  It’s pretty common after a C-section to be given an abdominal binder to help with healing.  If you have other young children at home and your doctor gave you an abdominal binder, it is a good idea to wear it as prescribed after a C-section to allow the healing process to take place while you inevitably have to wrangle your other little ones from time to time.

Certain cases of diastasis recti: Physical therapists sometimes use abdominal binders for severe diastasis recti (separation of the abdominal muscles down the middle) rehabilitation if the deepest abdominal muscle, the transversus abdominis just isn’t engaging yet and mom needs a little extra help getting started with rehabilitation in the beginning.  That’s definitely on a case-by-case basis.

Appearance benefits:  For many women, the most compelling result of using an abdominal binder is a temporary, slimmer looking appearance.  If you see before and after pictures of someone who used an abdominal binder, you’re probably looking at the “after” right after they took off the binder.  An “after” photo 12 hours later, after they ate dinner, would probably convince you the abdominal binder is a waste of money.  Abdominal binder companies have an easy job to sell their wares, though.  When you look down at your post-pregnancy body and it doesn’t look so “post” pregnancy, it’s easy to believe you need a miracle to help.  Plus, your body will slim down pretty quickly anyway with no binder, so it’s easy for abdominal binder companies (and the women who recommend abdominal binders to their friends) to attribute that success to their product.

Pelvic pain:  If you have a problem with your sacroiliac joint (SI Joint), where your pelvis meets your spine, there is some research to support using a pelvic belt, which is different from an abdominal binder and sits lower on your waist (Hammer, 2015).

 

Cases AGAINST abdominal binders:

No help for pain or distress:  If you only have the binder for pain, know that there was a 2016 study that showed abdominal binders did not provide any additional pain or distress relief after C-section (Gillier 2016).  If you were given an abdominal binder at the hospital simply for pain, talk to your doctor about it, she may tell you it’s okay to free-belly it without a binder if you so choose.

Questionable help for back pain: When all types of lumbar support apparatuses are grouped together, the research shows lumbar supports (abdominal binders are one type of lumbar support) are not effective for preventing low back pain.  The jury’s still out on whether they can help to treat low back pain when used together with other treatments (VanDuijvenbode 2008).  So if you were given an abdominal binder as part of a treatment plan with another treatment, go for it.  If you’re buying one on your own as the mainstay of your self-care plan for your back pain, the research shows you’re not going to get the relief you seek.

Increased pressure for your healing pelvic floor:  When your abdomen and its contents are compressed, that intra-abdominal pressure has to go somewhere, right?  Much of that pressure gets pushed downward, toward your healing pelvic floor.  Your pelvic floor is comprised of the muscles, ligaments, connective tissue, and nerves at the base of your pelvis.  That pelvic floor got stretched out during pregnancy, and if you delivered vaginally it took an extra beating during delivery.  Even though you can’t see it, your pelvic floor has to heal, too.  If you’re wearing an abdominal binder and pushing lots of that abdominal pressure toward your pelvic floor, you’re not really giving your pelvic floor a fair shake at healing.

Your transversus abdominis is not getting to work like it should:  Your transversus abdominis has to contract correctly to be a natural internal corset.  It stabilizes your core during functional movements all throughout the day, and it has to be re-strengthened after pregnancy.  If you’re wearing an abdominal binder, your transversus abdominis is losing the chance to fire throughout the day as it should.  Also, your transversus abdominis and pelvic floor muscles must work together to function properly for dynamic movement throughout the day.  Wearing an abdominal binder puts pressure on the pelvic floor and at the same time does the job of the transversus abdominis, robbing them both of the chance to work together.

You can learn the details of how this pelvic floor – transversus abdominis duo works together here.

 

Now for the alternative:

If you’ve read through these points and decided not to spend that $10-$75 on an abdominal binder and that money is now burning a hole in your pocket, I have an alternative!  Or, if you are still going to be using an abdominal binder but want some extra help rehabilitating your core, I have a suggestion!

My favorite piece of post-pregnancy exercise equipment is my Chattanooga Biofeedback Stabilizer.  It’s essentially a blood pressure cuff with a few tweaks to make it a little easier to use for its intended purpose.  The Chattanooga Stabilizer costs about $50 on Amazon, and a blood pressure cuff costs about $10.  I have both, and both will do the trick, but I prefer my Chattanooga Stabilizer because it’s a little easier to use.  Plus I spent more money on it, so I feel like I should be using that one.

You can find out more about the pressure biofeedback stabilizer and how to use it here.

 

Here’s how it works:

When you’re doing your core drill exercises on your back, a correct transversus abdominis contraction should mean that your body is really stable.  When you use a biofeedback cuff, too much pressure shifting (too much movement from you) will be visible as the needle moves on the dial.  That indicates to you that you’re substituting with your outer abdominal muscles.  In other words, it will keep you honest while you do your exercises.

If you find that you rush through your core exercises, a tool like this can be really helpful, but let me warn you: it’s frustrating at first because the needle will move a lot, and it takes some effort to adjust your exercises to do them right.  Now that I use one regularly, I can really feel the difference on the days I use my Stabilizer, and on the days I don’t, I sort of feel like I’m wasting my time.  And I don’t like wasting my time!

I decided to free-belly it after both of my pregnancies, and you can see my progress after my second pregnancy here.

 

Please note: I am an Amazon affiliate, so if you purchase a BP cuff or a Chattanooga Stabilizer by clicking one of the links above, Everymom Athletics does get a small percentage of what you spend.  I am not, however, affiliated with Chattanooga or any BP cuff company that would bias this article.

References:
  1. Hammer N, Möbius R, Schleifenbaum S, et al. Pelvic Belt Effects on Health Outcomes and Functional Parameters of Patients with Sacroiliac Joint Pain. Eldabe S, ed. PLoS ONE. 2015;10(8):e0136375–23. doi:10.1371/journal.pone.0136375.
  2. Gillier CM, Sparks JR, Kriner R, Anasti JN. A randomized controlled trial of abdominal binders for the management of postoperative pain and distress after cesarean delivery. Int J Gynaecol Obstet. 2016;133(2):188-191. doi:10.1016/j.ijgo.2015.08.026.
  3. van Duijvenbode ICD, Jellema P, van Poppel MNM, van Tulder MW. Lumbar supports for prevention and treatment of low back pain. van Duijvenbode I, ed. Cochrane Database of Systematic Reviews. 2008;(2):CD001823-CD001823. doi:10.1002/14651858.CD001823.pub3.
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