Nobody has ever asked me to improve their intra-abdominal pressure. They ask for a flat stomach. Those are perfectly good goals — but there is a gap between the goal someone arrives with and the route that gets them there, and almost everything that goes wrong happens inside it.
Nobody has ever walked into my practice and asked me to improve their intra-abdominal pressure.
They ask for a flat stomach. Or a better backside. Or to stop their back hurting when they garden.
Those are the goals. And they are perfectly good goals — I am not going to be sniffy about someone wanting to look better in a pair of jeans. But there is a gap between the goal someone arrives with and the route that actually gets them there, and almost everything that goes wrong in this business happens inside that gap.
Someone wants a flatter abdomen. They do abdominal exercises. Crunches, sit-ups, planks, whatever is on the app. They do a lot of them, because effort feels like the variable they control.
And the muscle that responds hardest is the rectus abdominis — the six-pack muscle. It is superficial, it is strong, it is already the one they use most, and it is very good at answering when called.
Meanwhile the deep abdominal wall — the muscle that wraps the torso like a corset and draws it in — stays exactly as it was. It is not being asked. It is weak, it is underused, and it is the one that determines whether the lower abdomen sits flat or protrudes.
More effort into the wrong muscle deepens the imbalance that produced the appearance in the first place.
And because the appearance does not change, the usual conclusion is: eat less, train harder. Which is the wrong problem entirely. It is a pattern of muscle use, not a calorie balance — and you cannot fix a recruitment problem with restriction.
The reason a flat stomach is not an abdominal question is that the abdomen sits in the middle of a chain, and it is rarely where the chain starts.
Forward head position — from screens, driving, phones — pulls the upper back into rounding.
A rounded thoracic spine reduces the space in the ribcage and changes the angle the diaphragm sits at.
A compromised diaphragm cannot descend properly. The breath goes into the chest instead of the belly, the abdominal cylinder never pressurises, and the deep abdominal wall never gets its cue to engage.
Without that support, the abdominal contents sit further forward and lower than they should.
Which makes the deep abdominals harder to engage, which worsens the posture, which reinforces the whole loop.
It is a circle, and you can enter it at any point. Which is precisely why doing more sit-ups does not break it — sit-ups are an intervention aimed at one point on a loop being driven from somewhere else entirely.
Same problem, different region, and the sequence is clearer.
The gluteal muscles cannot work properly from a pelvis tipped forward. And the pelvis is usually tipped forward because the hip flexors at the front are short — from sitting — and the deep abdominals are not doing their share.
Restore the ability to tilt the pelvis back → get the deep abdominal wall engaging → lengthen the hip flexors → wake up gluteus medius for lateral stability → then gluteus maximus → and only then load the movements that build it.
Six steps. The person asked for a squat programme.
And if you skip to the squats, one of two things happens. Either the load goes into the lower back and hamstrings instead of the glutes, so the results do not come. Or something gets irritated and they stop. Both look like failure and neither was.
The clinical pathway is correct and it is a terrible sales pitch.
“I would like you to spend three weeks learning to breathe, then a fortnight lying on the floor lowering one leg at a time” is a hard sentence to say to someone who came in wanting to look better in a swimsuit. Meanwhile there is an app promising visible abs in thirty days, and it is more appealing, and it is free.
I am not going to pretend the exciting version is not more attractive. It obviously is. But the boring version works and the exciting version mostly does not, and the reason is that the exciting version keeps training the muscle that was already dominant.
The thing that changes the conversation is making the early steps visible. Not “trust me, this matters” — actually feel the difference. Most people can feel their deep abdominals engage for the first time within a couple of sessions, and once they have felt it they stop asking why we are not doing crunches.
Three things, in this order, and none of them look like abdominal training.
In and fat stomach, out and skinny stomach, drawing the belly button in. A few minutes daily. In the car, at a desk, lying in bed. Without diaphragmatic breathing the cylinder never pressurises and the deep abdominals have nothing to work against.
Breathe as above, then hold the tension — ten seconds, several times a day, breathing normally throughout. This is not training strength yet. It is building awareness of a muscle most people have never consciously used.
Lower abdominal leg lowering, where the whole exercise is keeping the pelvis tilted and the navel drawn in while a leg moves. The moment the pelvis rotates forward, the repetition stops counting. That constraint is the exercise — everything else is just leg movement.
Only after that does anything look like conventional training. And by then the pattern holds, so the loaded work actually loads what it is meant to.
Your goal is fine. Wanting a flatter stomach or a better backside is not vanity, and anyone treating it as beneath them has forgotten why most people start exercising at all.
But the goal and the route are two different conversations, and confusing them is why so much effort produces so little.
More effort into the wrong pattern deepens the pattern. The person doing two hundred crunches a day is not failing to try. They are succeeding at the wrong thing.
And appearance is often postural before it is compositional. How the abdomen sits is affected by pelvic position, breathing mechanics and deep abdominal engagement — not only by what is over the top of it. That is not a promise that posture work replaces everything else. It is an observation that the first thing people reach for is usually the last thing that needed changing.
If you have been doing abdominal work for months without much changing, the issue is more likely to be which muscles are answering than how hard you are trying.
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