Closing the ISA Isn't Always the Answer: Change the Pressure Gradient First
diaphragm diastasis infrasternal angle pelvic floor postpartum pressure management prolapse Oct 17, 2026
There's a lot of emphasis in the postpartum and pelvic floor world on closing the ISA (the infrasternal angle, by getting the lower ribs down) and on learning to lengthen and activate the core and pelvic floor. That's amazing, but...
A question worth asking
What if this is sometimes creating a situation where we're constantly having to use those strategies, because we aren't addressing why the pressure is pushing down in the first place?
Closing the ISA isn't the same as the thoracic floor lifting
Closing the ISA doesn't necessarily mean the thoracic floor is able to ascend. Often, exhaling hard and getting the external obliques to turn on creates more straightening of the ribs and a thoracic floor that struggles to lift.
Change the pressure gradient
We need to change the pressure gradient and make it easier to push the guts back up.
If you have pelvic floor issues, or you're a human on earth, this is helpful, because we all want to be able to manage the forces of gravity.
Watch more
Should you exhale from the bottom up? Part 2
No More Kegels: 5 things that improve pelvic floor performance without the pelvic floor
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