Reconsider... with Bill Hartman RECONsider... Infrasternal Angle Confusion — Solved with Bill Hartman
Nov 18, 2025
They unpack why treating the infrasternal angle as a fixed number misleads assessments. They explore how rib cage behavior, compensation, and test positioning change what that angle actually signals. They discuss sensing movement with hands, archetypes like narrow versus wide rib shapes, and why responses to interventions matter more than a single measurement.
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ISA Is A Behavioral Measure Not A Number
- The infrasternal angle (ISA) is best treated as a behavior not a fixed number, because structural estimates reveal themselves through intervention responses.
- Bill Hartman emphasizes using process and repeated exposures to refine judgments rather than relying on a single measurement.
Use Interventions To Test Your ISA Call
- Do use interventions as experiments and track the response to guide whether your ISA estimate was useful.
- Hartman recommends safe-to-fail interventions, chessboard measures, and KPIs to course-correct when initial calls are wrong.
Stop Measuring ISA With A Goniometer
- Avoid treating ISA as a goniometer number; instead use hands-on sensing to observe rib cage external/internal rotation during breathing.
- Bill instructs to feel for expansion (ER) on inhalation and compression (IR) on exhalation while noting constraints.