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Not all patients come to see me for painful conditions. Some see me because they don’t like what they see in their aging bodies, and they believe I can tell them how to fix it. I’ve shared one of those concerns previously on 1010 Park Place: why our butts get flat and wide

Moving up the body, we come to the poochy belly and muffin top. Of course, some of us get muffin tops and poochy bellies when we’re 25. Having babies and gaining weight can cause these formations. But there are many of you who stay trim your entire life, lose the baby fat quickly, trim up the tummy muscles and get back in shape. You’re amazing. 

But even if you maintain a trim adolescent body as you age, you will begin to develop a wideness in the back and belly. This is always associated with feeling fat in the lower abdomen. You’re less taught. The belly pooches, and as seen with a second mirror, we get muffin tops, love handles, and sometimes sagging skin under the shoulder blades. 

Women often complain their lower rib seems closer to the top of their pelvis (the iliac crest).

Some women see chiropractors for manipulation of their ribs and hips. They are told by some therapists that their joints are shortened and can be manipulated into their former length, so they participate in Pilates and yoga, thinking they need to adjust their posture. They do crunches, planks and bridges to build up weakening abs. Sometimes they injure themselves with an all-too aggressive exercise program, or if they do damage to their ribs…or something else. 

This phenomenon is the result of some of the same issues that cause a wider butt – the shortening of our spine. It’s the by-product of a loss of disc height in all of us, and the loss of vertebral height and deformity in those of us who suffer from osteoporosis. This in turn results in less space for organs, muscles and flesh, and the relative weakening of the abdominal muscles. It’s using the same bowstring on a shorter bow. The shortening of the spine puts the rib cage closer to the pelvis. I’ve seen some women whose ribs are essentially touching the top of their pelvis. 

Again, my point here is to underscore a natural process and encourage you to accept some of the changes to this wonderful body which has brought you so far. Of course, you can try to prevent the things which are preventable:

  • Maintain your weight, in those of us whose metabolism and gene pool allow it.
  • Do your weight-bearing, aerobic and strengthening exercises, Pilates and yoga. 
  • Take your calcium and Vitamin D. 
  • Stand up straight…as long as you can. 
  • Suck it in!

Above all, don’t hurt yourself. And ditch the rear-view mirror. We are more than our muffin tops and poochy bellies over 50.

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Dr. Barbara Bergin is a board certified Orthopedic Surgeon who has been taking care of the bones and joints of Austin, Texas, for over 30 years. She prefers prevention to treatment and takes a natural approach to both when possible. By informing her readers and patients through 1010ParkPlace and her blog,, she wants to prevent 100,000 injuries before she retires.


  1. Your blog came at a great time because my waistline isn’t as long as it used to be. Ribs not on the waist yet, but now I understand why the gap is closing. I love these posts you’re doing Dr. Bergin! Keep them coming! I know there are a lot of things like this we didn’t know about. Perhaps you do one about why high heels hurt after a certain age? I read somewhere we lose the fat pads on the bottom of our feet as we age, so we’re walking on those bones. And why can 84-year-old Nancy Pelosi still wear heels? Botox in her feet maybe? Thank you!! Brenda

  2. Thanks, Barbara! Thank God we’re more than those muffin tops! It’s appalling how fast those things can come back as we age. I never had those when younger! And it’s 10x harder to get rid of now! This at least helps me know why. I’m more and more looking forward to Heaven and a new body! Back to the gym. Argh. Best safe exercises to bust that belly? I see lots of articles and videos but now am wondering if they’ll do more harm after hearing about squats! Thanks for sharing your expertise!

  3. I never had children so I didn’t have to get the belly back in shape, but now it seems every carb is at home there and on my back!!! My back? Now I know it’s part of aging but I don’t have to like it.

  4. I’d rather eat the muffins at the top pf the page than worry about the ones on my waistline. The doctor will tell me that’s not a good idea but its the choice I’ve made.

  5. Thank you for your informative but also realistic and compassionate post. I’m sick to death of the repeated, pounding messages that we can somehow *defy* aging.

  6. Well, there comes a point when no one should wear midriff showing tops. I was kinda surprised to see Katy Perry, whom I adore, on American Idol with a midriff top (certainly, I know she’s had a baby recently, and I also know she is a big star). But her stylist made a mistake with this choice, I think. Not that she should be ASHAMED of the baby bump still showing a little, but because SHE is on TV seen by millions, and it’s not a good look for a BIG STAR. Fashion is supposed to make us more beautiful, not to feature our figure faults. And, soon, she will be back to normal with that flat stomach she has. I remember when I wore hip huggers and midriff tops loooooonnnnnnng ago, and I’m happy to see the fashion back. Maybe not bell bottoms, but the short tops look fab to me. My 11 year old granddaughter looks beautiful with them. No muffin top, her. Me, I’m way past that and LOVE THAT LONGER JACKETS ARE BACK.

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