Chest binding is an everyday occurrence for many people and despite this there has not been much peer reviewed research done into the effects of binding. This changed in 2016 when a study was conducted into the health effects of binding in the transmasculine community.
The study compiled a list of 28 negative physical outcomes of binding. Out of the 1800 respondents 97.2% indicated they experienced at least one of these negative outcomes due to binding. The highest reported effects included chest pain, back pain, poor posture and breathing difficulties.
Chest pain, back pain, poor posture, and breathing difficulties, these are very common reasons for attending a Pilates mat class. In all my classes I can guarantee that I have someone with one of these issues, or perhaps all of these issues and this may have been what encouraged them to attend Pilates classes. Pilates can help improve these areas, particularly in combination with manual therapy.
With chest binding, these issues may have been caused or compounded by binding.
For many people removing a binder is not an option and they should not be required to remove a binder to exercise.
Chest binding is often perceived as a physical activity to create the outward appearance of masculinity. The psychological effects are not usually considered; chest binding is an act of self-care. The 2016 study found that the mental health effects of binding were almost universally positive.
Joseph Pilates firmly believed in the connection between mind and body. He believed that a healthy mind and a healthy body were both necessary for healthy living.
This is very true. If someone feels uncomfortable or anxious in anyway then whatever their body is doing is irrelevant because their mind will be focusing on their discomfort and their anxiety. It will not have a positive lasting impact and I firmly believe that Pilates can create positive changes to people’s bodies and movement.
There will be movements that may not be achieved or may prove more challenging whilst wearing a binder, but the goal is still to improve movement.
Below are 5 easy exercises that can be done at home that will help to alleviate and minimize symptoms experienced through chest binding.
Breathing
Breathing is often considered a fundamental of Pilates. It teaches a pattern of breathing called lateral thoracic breathing which uses the muscles between your ribs to expand your ribcage and allow the diaphragm to move.
This kind of breathing can be difficult to achieve whilst binding, instead try diaphragm breathing also known as belly breathing. This will help achieve deeper inhalations and exhalations and allow the diaphragm to move.
- Find a comfortable position to be in, this could be sitting or lying, wherever you feel most comfortable
- Place a hand on your belly, below the edge of the binder
- Imagine there is a balloon under your hand and as you inhale the balloon is going to fill with air
- On the exhale all of the air will gently fall out of the balloon, letting the balloon deflate
- Do as often as you like. You can also add in some self-massage to the muscle tissue around the diaphragm. Find the bottom of your ribcage then massage just below your bottom rib. This can help the diaphragm to move and release any tightness in that area.
Open Like a Book
This is a great exercise to open through the chest and upper back and rotate through the spine. This will help improve posture, but it will also encourage length in the pectoralis muscles which can become short and tight when binding.
There are two pectoralis muscles – major and minor.
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Pec minor attaches to the third to fifth ribs and the coracoid process of the scapula – basically the raven’s beak (coracoid) hooky bit of the shoulder blade. Its job is to help stabilize the shoulder blades and raise ribs during inhalation.
Pec major is a large fan shaped muscle that makes up the bulk of the chest muscles. It has a clavicular part that connects to the collar bone, a sternal part which connects into the sternum and ribs, and the two then converge together into a tendon that attaches to the humerus, the upper arm bone.
Its primary function is moving the humerus into flexion, adduction, and internal rotation.
- Lay on your side with shoulders and hips stacked, knees bent, arms out in front of you with palms touching. You may need a pillow or towel to support your head
- Take a breath, then on the exhale engage your abdominal muscles (abdominal muscles knitting together towards your belly button, this will help stabilize the body), start to drag the top arm along the bottom arm, over the chest, rotating and opening through the chest
- The hips and legs should stay still
- Inhale to bring the arm back
Hug a Tree
If the pectoralis muscles are short or tight, they can stop the wide feeling along the back as they will draw the shoulders forward and start to inhibit arm movement. This exercise will create length through the front of the chest, encourage the shoulder blades to move, and start to help free up the breath.
- Lay on your back, knees bent and feet hip distance apart
- Bring your arms over your chest as if you were hugging a tree – fingertips together with elbows bent, shoulders relaxed
- Breath in to prepare then on the exhale open the arms to the side, leading with the elbows and taking the arms as far to the ground as you can comfortably go without arching through the back – you may want to add some abdominal connection to help stabilize the pelvis whilst doing this exercise
- Inhale at the end of range of movement
- Exhale to bring arms back to centre
Cat
Cat is a spine stretch that encourages sequential movement of the spine, length through the front of the legs, stability through the pelvis, and length through the neck.
A binder could, depending on the method of binding, limit movement through the thoracic (mid-back) portion of the spine.
Be aware of this. Still aim for movement or that sense of movement as it will help to free the breath as well as improving spinal mobility, but, don’t be concerned if there isn’t much movement.
You are aiming for your spine to look like an arch, or a rainbow, or an angry cat whichever image you most relate to.
This version of cat is broken down into 4 breaths as I find this helps people to connect with their spines a bit more.
- Start in four-point kneeling which is on all fours – wrists under shoulders, knees under hips, neck long so looking at a point just in front of your fingertips and your back in a comfortable position
- Breath in, on the exhale think of the abdominal muscles knitting together and up which is going to draw the pubic bone up towards the naval and tuck the tailbone under
- Breath in, on the exhale engage the abdominals and think about continuing curling through the pelvis into the low back
- Breath in, on the exhale carry on arching through the back lifting through the ribcage and thoracic spine – try to avoid rounding the shoulders and bringing them up to your ears, this gives the sense of the thoracic spine moving without it moving
- Breath in, on the exhale release the neck and look to the thighs
- Breath in to return to the start position
Plank
Plank is one of my favourite exercises to get my clients to do because it is such a good all-round exercise and can be easily modified to make it accessible to everyone.
It creates length through the front and back of the body, gets your stabilizing muscles switched on, and will help to condition those pectoralis muscles.
- Start in four-point kneeling, press the little fingers into the mat to encourage width and stability through the shoulder blades
- Take a breath in, on the exhale engage the abdominal muscles as you take the legs back into plank position. You want to have a long line from your head to your heels – try not to sink down between your shoulder blades or squeeze your bum too much
- Hold for as long as is comfortable, then come out of the position and try again
This exercise can be modified by bending the knees to the mat, this will decrease the load working your body and give you more stability. You can also go down onto your forearms if this exercise gets into your wrists or you sink into your shoulder blades. This position will decrease the load and put you in a more stable position for your shoulders.
References
Cumming, R., Sylvester, K., and Fuld, J. (2016). ‘Understanding the effects on lung function of chest binder use in the transgender population’. Thorax, 71 (3), A227
Eyssel, J., Koehler, A,. Dekker, A,. and Sehner, S. (2017). ‘Needs and Concerns of Transgender Individuals Regarding Interdisciplinary Transgender Healthcare: A Non-Clinical Online Survey’. PLoS ONE, 12 (8), pp 1-26
Peitzmeier, S., Gardner, I., Weinand, J., Corbet, A., and Acevedo, K. (2016) ‘Health impact of chest binding among transgender adults: A community-engaged, cross-sectional study’. Culture, Health & Sexuality. 19 (1), pp 64-77
Schmidt, S. (2018). ‘Chest Binding Can Lead to Chronic Pain. This Genderqueer Massage Therapist Wants to Help’. Washington Post, 26 December. Available at: https://www.washingtonpost.com/local/social-issues/chest-binding-can-lead-to-chronic-pain-this-genderqueer-massage-therapist-wants-to-help/2018/12/26/cfadf6cc-0493-11e9-9122-82e98f91ee6f_story.html?noredirect=on
TransGuys. (2017). “Chest Binding 101 – FTM Binder Guide: FTM Binding.” http://transguys.com/features/chest-binding
Turban, J.L., Winer, J., Boulware, S.D., VanDeusen, T., and Encandela, J.A. (2018) ‘Knowledge and Attitudes Toward Transgender Health’. The Clinical Teacher, 15 (3), pp 203-207
Vincent, B. (2018). Transgender Health: A Practitioner’s Guide to Binary and Non-Binary Trans Patient Care. London: Jessica Kingsley Publishers
Wittenberg, H. (2018). ‘Transgender Care for Medical Providers’. Helping Medical Providers Understand Transgender Healthcare. Available here: https://pelvicpainrehab.com/pelvic-floor-dysfunction/5556/helping-medical-providers-understand-transgender-healthcare/
Wylie, K., Knudson, G., Khan, S.I., Bonierbale, M., Watanyusakul, S,. and Baral, S. (2016). ‘Serving Transgender People: Clinical Care Considerations and Service Delivery Models in Transgender Health’. Lancet, 388, pp. 401-411
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