To Bind or NOT to Bind…

We get a lot of questions about belly binders, maternity belts, and everything in between.  As a physical therapist, I have some strong opinions on bracing during injuries because of the evidence . But with pregnant and postpartum women, we aren’t just looking for stability like in an ACL sprain or tear. There is so much more that goes into the answer for pregnant and postpartum women---- I look at pressure system, fascial response, scar healing in a Csection, pain or instability like in pubic symphysis disorder,  and so much more. 

But what does the evidence say?

Well, not much. It’s disappointing to say the least, but there isn’t much actual research out there. A  systematic review of 17 studies (this is a good amount of studies with a large sample size, but we prefer RCT or randomized control trials for the best evidence) analyzed many articles out there and gave a summary of the paltry research. 

Here is my (sometimes unpopular) opinion:  I don’t like bracing overall for postpartum women. Research shows that for sacroiliac or SI instability,  there may be some good results, but overall, there is not enough evidence to show an overall effect in the postnatal period in reducing pain, increasing function ,or increasing overall quality of life. 

OK, that’s part of the issue, but  here are some things I also consider: How does it affect women handling their abdominal pressure? How does it affect their fascial response and their overall coordination of the pelvic floor and core?  These are important and specific to pregnant and postpartum women.  

What I have found is that the human body will ALWAYS take the past of least resistance. It’s an amazing mechanism to try to keep your body balanced. If your core can rely on something to do its job, it will.  Belly banding inhibits your core from responding to loading, but that’s opposite of what we have learned with research----your body actually likes the right amount of load to heal. 

What about if I only use a band or garment for a little bit of the day?

Again, here comes my unpopular opinion.  I would ask yourself, why?  If it’s to decrease pain or increase function. Then  maybe. There is some research on decreasing pain , especially after a Cesarean section, but there is also equal research that shows that isn’t true.   Otherwise, even small amounts of time confuses the core and fascia about their role.  Should they turn on? Should they support? Your abs are left in limbo and  in essence, this leads to more weakness and a lack of coordination. 

So, now let’s get to prenatal or pregnant women.There is  some research regarding pubic symphysis disorder or SI instability where the goal was to decrease  pain and improve your function.  Using a support  garment of some sort was shown to help, especially with hip adduction which is needed for healthy hips. So if the reason to use a support garment is pain vs. support ,  I say go ahead, but always have an exercise or active program  to support that passive treatment.  

In Summary, here’s my take: 

Postpartum--invest in a good pair of high waisted yoga pants vs a belly binder. You will have a form of support  you may like, but it is also  functional and won’t interfere with your bodies’ way of healing, transferring pressure, and recruitment of core muscles.  Plus, who doesn’t love yoga pants. 

Pregnant:  If you have pain in your pubic symphysis or Sacroiliac joint, find a PT who specializes in pregnant women and get their findings first. If it is instability , a compression or support garment typically won’t have an adverse effect and can help some pain and function, but it should also be followed by the right exercises for your body.

Any questions about belly binding or compression garments?  Email us at info@fitpartum.com or make an appointment with us!

Szkwara JM, Milne N, Hing W, Pope R. Effectiveness, Feasibility, and Acceptability of Dynamic Elastomeric Fabric Orthoses (DEFO) for Managing Pain, Functional Capacity, and Quality of Life during Prenatal and Postnatal Care: A Systematic Review. Int J Environ Res Public Health. 2019;16(13):2408. Published 2019 Jul 6. doi:10.3390/ijerph16132408ound clinical decisions for investing money, time and effort.