Monthly Archives: May 2015

Addressing Corseting Back Aches, Possible Causes, and Relation if any, to the Kidneys

The Ache and The Concern About Kidneys Graphic for research project on aches (c) ROMANTASY 2015

Those who wear corsets and who may waist train continuously or from time to time, have occasionally reported specific aches located near or at the waistline in back, more to the sides of their torso. The area I am discussing is pictured  left in four white squares.

Incidentally, if you might like to be involved in a research project regarding aches in these locations, please let me know via email to: inquiry@romantasy.com, and I’ll send you a followup questionnaire for more details about your experience.

Only a handful of our corset clients over 25-plus years have infrequently called those kinds of aches to my attention. However, I have personally noted them from rare time to rare time (details below), one of my team members has noted them once or twice after long hours (about 10) of wearing a corset she made, and my present waist-training coaching program client just noted them. That client has recently reached a 3.5″ reduction from her natural waistline of 34″, and is corseting from 10 to 12 hours daily  with a wasp-silhouetted Edwardian corset. She is pictured here at the beginning of her program  with 3″ reduction in her pretty corset. Before these many hours of continuous corseting, she had not encountered the issue.April training student 2015

Early in the 2000s I had investigated the matter of the kidneys and what happens to them in corseting and training.  I looked at graphics of the anatomy of the body and kidneys and asked questions of a few doctor consultants (some corseted and some did not) when I was first writing this book from 1999 to 2003. I decided not to comment in detail in my book at the time because my consultants were of the opinion that the kidneys are located so far inside the trunk of the torso, and are protected at the back by the spine, that it was highly unlikely they would be affected by moderate corseting practices.

I decided to investigate this matter again in some length because concern about this ache and its possible relation to the kidneys seems to recently appear and re-appear in social media comments. In sum, my recent research  supported my original view. As an educated layperson but without medical training to be sure, I still don’t believe there is any relation between the kidneys and sideback waistline, or other, aches while corseting.

I have, however, now become concerned  that vague or ambiguous comments repeated in social media relating kidneys to corseting may contribute unnecessarily and unfairly to prejudices and stereotypes  against well-made custom corsets and against reasonable waist training pursuits.

For those interested, the facts and reasoning to my conclusion are set forth below in detail and I welcome your comments and input to further my research and learning.

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What motivated my recent research was a brief online comment in April, 2015 by an experienced corset maker, that almost certainly the kidneys are asking for relief if you develop an ache at the lower back on the sides when you are corseting. Many followers of her commentary thanked her for this notice.

I asked about the source of her information to learn more. If I understood correctly from what she replied, the basis for her concern was a doctor’s unspecified advisory about corseting and the kidneys some years ago given to her former partner, and her former partner’s present concerns from her recent practice as a chiropractor. She was  concerned because she said the kidneys were somewhat out of the protection of the rest of the abdomen being retroperitoneal, and mentioned the kidney punch (more below on that matter).  The corset maker was also concerned about possible extreme corseting in the BDSM community.  She remembered some long-ago concern about the kidneys expressed to her from a corset “trainer.”  No further details were provided.

I then found another website mentioning “the kidney feeling” related to sweats and a slightly nauseated feeling when corseting, but when I contacted that writer in my research efforts, she said her information came from the first commentator corset maker and I should contact her, which I had already done. It reminded me of the importance of asking for the factual basis of anyone’s brief opinion which may not be well founded but nonetheless can be rather quickly expressed, easily repeated,  and widely spread on the internet today.

My Personal Experience

I’ve personally noted just that particular location and ache when wearing a corset, but only in two circumstances: first, when wearing an ice-cream cone silhouetted corset, and second, when wearing it for over an hour or more. Sometimes when this ache comes on, it can become quite noticeable and unpleasant. However, I do not get that ache every time I wear this silhouetted corset, and the ache always subsides within a few minutes, perhaps half an hour at the very most, after removing the corset. It has not caused me to stop wearing this corset and I’ve never had any kidney problems diagnosed or noted.

Basic Anatomy

Cross section of torso Gray's           I re-confirmed the location of the kidneys in my trusty Gray’s Anatomy (15th English Ed.) Page numbers below refer to this book. The graphic here is a transverse section  across the body of peritoneum showing the kidneys, found on page 901 of Gray’s, and the vertical orientation of the kidneys below is found on page 924.

Of course the descriptions in this medical tome are far more detailed than any general discussion here can entail, thus I recommend this seminal and famous text to any layperson with a dedicated curiosity about anatomy.

I also recommend highly an even better anatomy text with astoundingly detailed colored illustrations by Dr. Frank H. Netter called “Atlas of Human Anatomy.” I have the 6th edition.

In general I learned that the kidneys are situated in the back part of the abdomen, one on either side of the vertebral column behind the peritoneum and surrounded and “mainly held in position” by a “large quantity of loose fatty tissue, hence rupture of this organ is not nearly so serious an accident as rupture of the liver or spleen… occasionally the kidney may be bruised by blows in the loin or by being compressed between the lower ribs and the ilium when the body is violently  bent forward. This is followed by a little transient hematuria which, however, speedily passes off.” (page 994).Graphic kidneys and spine Grays p 924 In these graphics you can see how the spine is closer to the outside of the skin in back with kidneys tucked farther inside the body. It makes sense that the spine serves to protect in part against direct blows to the kidney.

“Kidneys cannot be felt (Ed. note: I assume Gray means by the doctor examining a patient) unless enlarged or misplaced.” (Page 993) The right kidney is slightly lower than the left. Each kidney is four inches in length and two to two and a half in breadth with one inch of thickness. The left is somewhat longer though narrower than the right. The kidneys are considered “fixed” but can be floating as a congenital condition.

This confirms information I was first given back in 2003 by my medical consultants at the time.

The front surface is partially covered by the peritoneum and partly uncovered. The posterior surface is not covered by the peritoneum but is embedded in aerolar and fatty tissue and rests on the eleventh (right kidney) or eleventh and twelfth ribs (left kidney). The main structures passing in and out of the kidney include the vein, the artery in the middle and the duct or ureter behind and toward the lower part.“The kidney is dense in texture, but is easily lacerable by mechanical force.” (See page 986)

To complete here our brief review of what’s involved, Gray says the abdomen is the largest cavity of the body bounded in large part by muscles and fasciae. It contains the kidneys among other organs and those organs are covered by an extensive membrane, the peritoneum. (Page 895). Dr. Netter’s book at Plates 309 and 315 shows that behind the kidneys toward the skin’s surface  in a person who is standing and toward the back are the Psoas and the Quadratus Laborum muscles. In addition part of the obliques and the transverse abdominus muscles end close to the same vertical height as and behind the kidneys also toward the back of the torso. The peritoneum is the largest serous membrane in the body. In the male it is a closed sac and in the female the fallopian tubes open directly into the peritoneal cavity. The viscera inside (the peritoneum) can glide freely against he wall of the abdominal cavity or upon one another with the least possible amount of friction because of serious fluid. (Page 898).

Comments from Physicians

One of my clients and gracious periodic advisers on medical and anatomical matters is a physician who has worn corsets since 1963, Dr. Milt Simmons. Dr. Simmons practiced medicine for 43 years and is Board Certified in Family Practice. He also was on the faculty at Wayne State University School of Medicine in the Department of Family Practice for 27 years. He served as Preceptor and Clinical Assistant Professor until retiring in 2005.

Dr. Simmons also wears back braces, including medical corsets as well as modern-day custom corsets. In mid-April of 2015 he told me that he once wore an orthopedic corset 24 hours a day for six days straight before he started to get relief from back pain. He also wore another one called a “Bob’s special” which was all plastic and 1/8- inch thick. “There is no movement with this one as four heavy straps keeps one well encased from below the breasts to the groin.” For the past ten years or so Dr. Simmons has worn custom corsets formerly by Amy of Wasp Creations, and more recently by ROMANTASY’s Sharon. He wears them approximately four days a week for up to 14 hours each day.

He reports that his corsets  “are a welcome relief compared to those prior types, but one gets used to them to get pain relief.” Sharon’s custom corset designed and produced to specifications from Dr. Simmons is called the “Golf Corset.” It enables him to play golf without injuring his back or causing pain. We tell more of his story on our website’s FAQ page under the question about health and corseting, if you are interested.

In telephone conversations in late April, Dr. Simmons confirmed my understanding that the kidney is not a floating organ in the abdomen. “It is in it’s own retroperitoneal space separated from the larger peritoneum which contains the major organs of the body such as liver, spleen, pancreas, stomach, intestines and in the female, the reproductive organs. “Both kidneys have non-connecting spaces with adrenal glands attached to the upper pole of the kidney. There is a thick membrane called Gerod’s fashia protecting both kidneys. The ureters coming off the kidneys and renal arteries coming off the aorta and the veins going to the inferior Vena Cava, are all well protected in the retroperitoneal area. “Basically there are three peritoneums, with the lesser peritoneum coming off the main peritoneum then ducking behind the stomach toward the pancreas. It would take a lot of constant pressure to get to the kidney.”

          Dr. Simmons was then courteous enough on April 23 to consult a nephrologist colleague with a specialty in kidneys. He presented the question about corsetry and the kidney. The answer was “that the kidney is generally so well protected by bone, location, geriod fachia, fat, and its retroperitoneum coverage that the corset does not become a problem here.” (Emphasis added)

I then located a detailed but undated paper by a resident physician at Doctors Hospital in Columbus, Ohio, entitled “Boxing and Kidney Damage.” For anyone concerned about this matter it is worth a read at: http://www.sportsci.org/encyc/drafts/Boxing_kidney_damage.doc The latest source for the paper was from 1993 so this might be an older document to be sure. This physician confirmed the above-stated information that: “The kidneys are well protected by virtue of their retroperitoneal location.” The physician also confirmed that: “The kidneys are located in a paravertebral gutter on either side of the vertebral column through the lower thoracic and upper lumbar levels. Each kidney is suspended in a shock absorbing fat and fibrous connective tissue capsure. Anteriorly, the kidneys are protected by the abdominal viscera and the internal and external obliquus muscles and the transversus abdominis muscles. Posteriorly, the kidneys are protected by the lower ribs and the vertebral column and by the quadratus lumborum, the sacrospinalis and the latissimus dorsi muscles. Laterally, the rib cage surrounds the upper third of the right kidney and the upper half of the left kidney. The kidneys are not rigidly fixed. They are held in position by the renal fascia and the large renal arteries and veins. Their attachment affords the kidneys an ability to move.”

A corseting physician with a specialty in the heart and coronary health, one who has ordered and worn about six corsets from ROMANTASY over the past 15 years, also confirmed that “the kidneys are so deep within the abdominal cavity that they are protected from the squeezing.”

Other Information

As with most any question on the impact of corseting on the body, there is little to no research and not many comments about actual or possible kidney damage caused by or contributed to by corseting.

And once more I make my point: just because something moves inside us does not necessarily and automatically equate with damage (think pregnancy)–so let’s stop thinking in that nonsensical way.

Likely the best modern pronouncement on the topic of organ movement was called to my attention by Lucy Williams, our Canadian corset educator colleague. It is the video presentation from an October 2014 Quiz How of the MRI of a corset wearer, the burlesque dancer Eden Berlin. German medical doctor and TV sensation Dr. Eckhart von Hirschhausen studied how a well-shaped and apparently custom  corset moves organs in a tightlacer on his October 2nd episode of his gameshow, Hirschhausens Quiz Des Menschen (“Hirschhausen’s Quiz of the Human [body]”). Of course the corset was not boned with metal as that would have been quite dangerous (the magnet might have torn the metal thru the soft body tissue!). You should certainly visit Lucy’s article on the program (she had it translated from German) here: http://lucycorsetry.com/2014/10/08/corset-organs-mri/

As the principle result of his MRI Dr. Ekhart concluded that the intestine is “trapped and digestion slowed”. Lucy also notes from her review of the video that “While it might not have been explicitly mentioned, from the image we also now have confirmation that the liver and stomach move upwards (and the liver remains pretty much in the same shape) and they are not forced down below the waist like some horrendous illustrations once claimed.”

          Dr. X is a retired coroner with over 30 years of medical practice in a major urban area and a present day forensic expert in crush injuries. He has been a ROMANTASY resource on the anatomy and various medical issues since publication of this book. He reminded me that MRI’s likely do not produce a 100 percent correct orientation of the organ position when corseted, because they are taken lying down and we tend to wear corsets while standing. Organs may therefore show on an MRI as in a slightly higher position in the body.

From my own experience wearing corsets I’ve noted some rib as well as organ movement, some differences in my body’s functions, and variations in comfort level when I wear different styles or different silhouettes of corsets. I was initially curious as to why the underbust Victorian style and often the hourglass- silhouetted corset always seemed best for training purposes. I discuss these differences in some detail in my book, but let’s return to the kidney.

The German MRI showed that the kidneys weren’t much affected either in position or in function, but how the doctor could determine anything about function relying on only one MRI without a longitudinal study is not clear to me!

On February 12, 2015 Dr. Oz hosted a television show on “Waist Training – Is it Safe?” He had an MRI done of a “corseted” guest, however the guest was not wearing a custom steel-boned corset, but merely a latex, stretchy and wrinkled cincher of an undetermined kind and brand. What he found was that his guest’s waistline was reduced by two inches, and the kidneys, liver, diaphragm and intestines were all “squeezed up.” He also noted a rippling effect in the sides of the liver which he attributed to the ribs pressing in on that maleable organ.

When Dr. Simmons reviewed the tv segment he noted that the “corset” was not a boned corset and that it appears that the guest’s waistline was indented or brought in about one or two inches more on one side than on the other, from a front view. The “corset” did not appear to have a graded or even pressure around the torso.

Dr. Simmons also noted that the ripple effect Dr. Oz noted on the MRI in the liver, was not that unusual or concerning, since the liver normally fits into the 9th and 10th ribs and evidences at least two indentations therefore, more or less the same thing that Dr. Oz noted.

As noted in Grays at page 933 the liver’s “consistence is that of a soft solid; it is, however friable and easily lacerated.” However, I did not see any measurement of how high the organs moved in Grays, and Dr. Oz did not describe any kind of damage just from the fact of kidney or organ movement, although he indicated some concern. He said he “has an issue” with what he found from the MRI, but what issue is that? Perhaps he will explain in a further show on corsets.

You can read an excellent point-by-point response to Dr. Oz by Lucy Williams on her blog at: http://lucycorsetry.com/2015/02/26/dr-oz-investigates-waist-training-response/ The Kidney Shot–A Related Advisory for Corset Wearers? Graphic - Petit's Triangle

The corset maker who motivated my present research to be sure I had up-to-date medical information and thinking, mentioned the kidney shot issue. That is certainly worth a look.

Dr. Simmons had already advised me that “there is a possibility that small triangle which is formed by two muscles (the lattisimum dorsi and the internal oblique), and the bone structure of the superior iliac rim at its base, could be weakened and allow pressure placed in the area to be felt.”

The area is described by Gray as an interval is called Petit’s Triangle. You will see the area labeled on the graphic from page 338 of Gray’s. In boxing one refers to it as the “kidney punch area.” I’ve also seen it called “the kidney shot” area; see https://answers.yahoo.com/question/index?qid=20100626162316AAI3q72, http://www.ask.com/sports-active-lifestyle/kidney-punch-5ef3f532b50b289b I’ve both read that it is and is not illegal, and that it is illegal if it is “purposeful.”

Livestrong.com says that it is illegal, at: :http://www.livestrong.com/article/432817-are-kidney-punches-allowed-in-boxing/ “Kidney punches are illegal in boxing. A hard blow to a kidney can bruise or cut the organ, or even tear it loose from the blood vessels that supply it. Damage can range from mild pain to blood in the urine to anemia, kidney failure, shock and even death. That’s why the rules of boxing, which generally prohibit any punch to the back, pay special attention to the kidney area.” Ask.com says: “A punch to a kidney can severely bruise and cut the kidney. An especially strong kidney punch can cause a kidney to tear loose from blood vessels. Damage from a kidney punch ranges in severity from very mild pain to bloody urine, anemia, shock, kidney failure and, in the worst cases, death. A person punched in the kidney who experiences lasting pain or bloody urine should seek immediate medical attention.”

Remember that Dr. Gray noted that the kidney “is easily lacerable by mechanical force” and: “occasionally the kidney may be bruised by blows in the loin or by being compressed between the lower ribs and the ilium when the body is violently bent forward.” (emphasis added).”

As for other effects on the kidney in the case of boxers, the doctor mentioned above in his paper noted that “there is little information to support proposals that changes in the urine of boxers is related to direct trauma to the kidneys.” Other possibilities mentioned are the crouched position of the boxer, the “grunt reflex,” and trauma to the bladder. He said that many possibilities exist for changes in urine and kidney damage. For example, it can be related to sudden acceleration or deceleration injury and other. The doctor also concluded that there is little research on sports injuries and that more research is needed.

          Sound familiar?

The fact is, in boxing the punch would be sharp, quick, and hard. The punch could be fairly characterized as a “blow” and it’s not hard to imagine a boxer violently bending forward from such, or grunting. But let’s get a grip here. Did you hear me talking anywhere in this blog or my Corset Magic book about a punch or a focused violent blow to your kidney area, or anything other than very gradual, not-very-restrictive initial lacing on of a well-fitting, double steel-boned custom corset? I didn’t think so.

Yes, a corset is a type of “mechanical force” but it is most typically worn in safer circumstances in general than in a violent boxing match, not to mention that tightening is done gradually over months after your first build up your hours of comfy wear– three months in the case of our recommended waist training program.

As a final point, I also always recommend to my clients and to you when you wear a corset that you not bend precipitously or continuously forward, or backward for that matter, at the waistline. The backward bend could possibly press on Petit’s Triangle. The possible result of the back bend when corseted is described next. Waistline bend in corset

Let’s also remember that back and vertebral bracing have been used for hundreds of years by the medical profession. I surmise that if untoward risk of injury to the kidneys from same existed, the braces would have lots of warnings out there or be of limited use. I can’t find one such warning on a few websites I visited, but did see some terribly uncomfy looking medical braces such as pictured for Ultralign at: http://www.deroyal.com/medicalproducts/orthopedics/product.aspx?id=pc-bracing-ultralumbsacorth

Probable Sources of Sideback Waistline Body Aches

Dr. Simmons posits that the ache we are discussing might be due to the corset as it is laced down, encroaching on the spine. It might be due to the corset pinching a nerve. It also might be due to a flimsily-boned corset that allows fabric or bones to collapse inward and focus pressure on a small area of the torso.

In the picture above of the backwards-bending bride being kissed, you can clearly see the boning bending inward at the waistline, even in a double steel-boned custom corset that she was wearing. This kind of focused pressure can develop aches and pains that I like to call “hot spots” because at their worse to me, they render a burning or pricking sensation. Whether or not the corset or bent boning actually touches the small triangle area and presses on the kidneys is not clear, but based on my investigation so far,  that seems unlikely.

Assuming a proper corset properly worn, Dr. Simmons told me that it “provides gradient pressure that supports the area covered and the organs. It does not impinge on a focused or targeted area.” In other words, a corset will typically distribute and minimize pressure from restriction about the entire torso. To illustrate what he meant Dr. Simmons added that when the custom corset is properly laced and worn, one can imagine the pressure as millions of arrows from all points on the skin where the corset is touching, pointing inward, with millions of counter arrows on the inside pointing out. In other words, when corseting there is at one and the same time pressure inward and also an opposite pressure outward by the body’s internal contents. This counter pressure helps keep the spine straight and erect. It also tends to keep organs secure even if they can or do move around in the abdomen

Thus I believe that the corset is one of the better ways to protect the organs including the kidneys. The corset applies its pressure in a gradient manner of even pressure over a large area, and I think this impedes the destruction of a given specific area (of the torso).” (Emphasis added)

This is one reason that for the beginner with all things being equal, it is possible that the best corset silhouette with which to train will be the hourglass. That is because that silhouette in my experience and in that of many of my clients and informants, seems to puts even pressure around the entire torso, rather than focus pressure on one spot such as the wasp silhouette does. The wasp might be a better silhouette choice for the advanced trainee when the ribs and pelvic bone become less covered with fat thus less, protected from pressure calling for more focused pressure right at the waistline in order to make further progress in lacing down.

Dr. Simmons is not too concerned about this ache emanating from muscles, since the muscles can adapt pretty well to pressure.

Other physicians posit that indeed, the muscles might be involved. My corseting physician Dr. RB felt that I must have been experiencing “some muscle strain perhaps along the pelvic rim or perhaps the inguinal ligament (if pain is in the front groin). At the waistline, you might feel strain along the lower ribs. Again this (type and location of ache) sounds musculo-skeletal.”corset worn too high on waistline

Dr. X pointed out that body aches at the back side of the waistline might simply result from wearing a corset a bit too high on the body, with the narrowest waistline part of the corset pressing just above the waistline. You can see pictures of that unfortunate situation to the right and left. Note that often you can tell if a well-measured custom corset is worn too high on the torso (normally measured to come just to below the bra underwire), if the top binding tends to fold or bend over, as is possibly the case in the beige corset pictured below.

Waist worn too high        Dr. X mentioned another possible cause of the sideback waistline ache, that is, a slight mismatch between the vertical proportions of the body and those of the corset, such as longer corset worn on shorter trunk. ###

          To reiterate, in sum I don’t think there is any concern about kidneys being involved in back aches or that kidneys are in danger when pursuing gentle corseting with a well-fitting custom or readymade corset.

Let me know if you find out anything different. ###

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