Wearing a Binder: Recommendations and Exercises

If you haven’t read it yet, check out Wearing a Binder: Physiological Effects. I will refer to the same areas of the body and some of those effects in this post.

GENERAL RECOMMENDATIONS

• Try to wear it as short a time as possible. Most recommendations state no longer than 8 hours but if you work 8 or 10 or 12 hour days, that just isn’t possible. Just know that the longer you wear it, the worse the above effects will be.
• Try to wear it as few days as possible. If you have severe dysphoria and can’t leave the house without a binder on, try to have one day a week where you stick close to home so you can stay binder free. Or try other slightly less compressive options as many days of the week as possible.
• Avoid exercise while wearing a binder. Your lungs cannot expand the way they need to during exercise which forces your heart rate to go up significantly more to compensate. Also, you will have poor spinal and shoulder mobility, causing stress and damage to other joints, muscles, and tendons.
• Do not bind while sleeping. When we sleep we are not aware of discomfort. You could be causing damage and not know about it. Also, while you are unconscious and thus not aware of dysphoria, this is the ideal time to take a break from binding.
• Never bind with ace bandages. The tension in the wrap can shift over time causing one layer to loosen and another to tighten beyond what is safe.

EXERCISES

Deep breathing

Benefits lungs, ribs, and pelvic floor.

For the following exercises:

• Best done in a seated position but can be done lying on your back.
• If you start to get light-headed, breathe normally until it clears.
• If you have COPD, skip the first exercise and focus on breathing all your air out between each deep breath in.

Active Breathing Cycle

• Take a deep breath
• Hold it in for 2-3 seconds
• Let all the air out by compressing the lungs until they are empty
• Take a full deep breath, then breathe normally for 5 breaths
• Repeat 3-5 times

Diaphragmatic breathing

• Place a hand on your upper belly, just below your breastbone
• On each breath in, take a deep breath, pushing your tummy out into your hand
• Try to minimize the rise or widening of your chest
• Try to only move your tummy to breathe
• Cycle of 5 belly breaths and 3 regular breaths
• Repeat 3-5 times

Lateral Costal Breathing

• This one is a little harder and may take some practice
• Place your hands on the sides of your ribs (either by bending your elbows or giving yourself a hug)
• On each breath in, take a deep breath, trying to make your chest as wide as possible and pushing your ribs out into your hands
• Try to minimize the rise of your chest and the expansion of your belly
• Cycle 5 wide breaths and 3 regular breaths
• Repeat 3-5 times

Spine and rib movements

Restores general mobility to the spine and ribs.

Thoracic Side Bending

• In a seated position, hold on hand on your ribs at the side.
• Bend towards that hand, bringing the other arm up and over your head.
• Hold stretch for 10-20 seconds while breathing deeply.
• Repeat to the other side.
• Repeat each side 3-5 times.

Thoracic Rotation

• In a seated position, cross your arms high on your chest so you’re grasping your shoulders.
• Gently rotate as far as you can one way, and then slowly as far as you can the other way.
• As you go, you should feel less resistance and be able to rotate a bit further without pain or muscle cramping.
• Repeat 15-20 times.

Flexion and Extension

• In a seated position, reach forward, curling your neck, shoulders, and upper back as you breathe out.
• Take a deep breath in, opening your arms, pulling your shoulders back, and arching your upper back.
• Complete 5 repetitions, take a break to breathe normally for 3-5 breaths, then repeat 2 more times.

Spinal Twist

• Lie on your back on a carpet or mat with your knees bent up and your arms spread out on the floor.
• Keeping your shoulders flat on the floor, let your knees, hips, and lower back rotate down to one side.
• Take a deep breath in and out, then pull your knees up and rotate them the opposite direction.
• Alternately, you can start by lying on one side and, keeping your knees on the floor, lift the top arm and rotate your shoulders across to try and get them flat on the mat and then repeat on the opposite side.
• Repeat 5-10 times.

Neck Range of Motion

• Tip your ear to your shoulder, roll your head down to the middle, then the opposite ear to your shoulder, and back up to the middle.
• Breathe slowly and evenly throughout.
• Pay attention to where you feel muscle pull. Don’t force the stretch in these areas but pause in the circle to take a full breath in and out in these areas.
• Repeat 5-10 times, alternating direction.

Chin Tuck and Neck Extension

• Without looking down or bending your neck forward, tilt your head to tuck your chin in (like you’re trying to create a double chin).
• With one or both hands, grasp the back of your head and gently pull up. You should feel a stretch right at the base of your skull.
• You can also add a bit of sideways pull.
• Hold the stretch for 5-10 seconds. Repeat 3-5 times.

Spine mobilization

Targets the thoracic (mid) spine and posterior ribs to decrease stiffness and stretch the ligaments.

For the following exercises:

• You will need a foam roller
• You will be lying on your back on a carpet or mat with your knees bent up and your feet on the floor with the foam roller horizontal under your spine.
• Only put pressure on the spine where the ribs connect to the spine, not down on the lower back or up on the neck.

Spine Rolling

• Lift your hips of the mat so the only place of contact is your feet and the roll.
• With your hands behind your head or crossed over your chest, gently roll up and down the roll by walking your feet along the floor while breathing deeply.
• Spend more time in areas that feel stiff or sore.
• Repeat 10-15 times.

Foam Roller Extension

• Place the roll just above your bottom ribs.
• Take a deep breath in, then slowly arch back over the roll as you breathe out. Only go as far as you are comfortable.
• In the arched position, take a full deep breath in and arch a bit more when you breathe out.
• Return to the start position and move the roll slightly higher on your spine. Repeat.
• It should take 4-6 repetitions in different spots to cover your spine up to the shoulder blades.
• Repeat the whole spine 3-5 times.

Shoulder mobility and mechanics

Shoulder and Arm Circles

• Roll your shoulders forward, up, back, and down. Repeat 10 times.
• Picture a clock face on your shoulder where 12 is up, 3 is forward, 9 is back, and 6 is down. Pull your shoulders into the 10:30 position. Hold them there while you raise your arms up to the sides.
• With your shoulders stable and your thumbs pointing up, move your arms in circles from big to small and back to big. Change direction and go big to small to big again. Repeat 3-5 times.

Protraction and Retraction

• Give yourself a hug, grasping your shoulders and pulling them forward to stretch your back. Take a deep breath in and out.
• Pull your arms back and squeeze your shoulder blades together, stretching your chest. Take a deep breath in and out.
• Repeat 5-10 times.

Overhead Reach with Scapular Rotation

• Raise one arm out to the side and overhead.
• Focus on rotating your shoulder blade so the point of your shoulder moves towards your ear.
• Place your other hand just below your armpit. You should feel the edge of your shoulder blade push into your hand.
• Repeat 5-10 times each side.

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Don’t feel like you have to do all of these every day. Pick a few and do what is manageable. Focus on the ones that treat the area that is causing the most pain for you. The more you do them, the better.

If you have any questions, please leave me a comment and I will clarify or provide modifications. If you have any other exercises that you have found helpful, please also share those in the comments!

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