The Bill Hartman Podcast for The 16% Season 4 Number 3 Podcast
I have an opinion about this. At some point in time, the anatomists that named these structures were staring at an anatomical chart on the wall. They threw a dart at the hip and it landed on the piriformis. They decided that the piriformis is the muscle they're going to pick on. It gets a lot of attention. It's a cool muscle, of course, but it gets way too much attention. So let's not pick on a particular structure. Let's just say that we have some posterior hip pain under these circumstances because there's a lot of stuff back there. It's a very busy area. To pick on one thing, I think, is unnecessary and distracting. It makes us think about things like we start calling these things by a name and it distracts us from what the real problem is under these circumstances. In most cases, when we have this type of a presentation, what we're dealing with is somebody that cannot capture sufficient internal rotation during maximum propulsion. And so what they're doing is they're trying to create an orientation that allows them to do that, which is why we see some of these cool measures. Now, Javi, you didn't give me much to work with. Good thing we got Batman on today because we got to play detective. And so we're going to put some pieces together.
piriformis syndromeposterior hip painhip internal rotationpropulsionmovement diagnosis
I'm going to talk you through a sequence here, and then I'm going to throw you a couple of measures that will help guide you that you might need to do, but hopefully give you something that's useful. So let's go through this scenario a little bit. I'm going to grab the pelvis so we have it in hand as we go through this. Okay. So we're starting with a narrow ISA. So we know that we're going to have an outlet that looks something like that that immediately biases towards greater external rotation, less internal rotation. So that kind of fits your bill so far because we had the right hip IR in deficit. I'm assuming it's a she. She has palms to the floor touch, which means that you probably got an anterior orientation and we have an eccentric orientation of this posterior lower musculature that allows the pelvis to move through this full excursion. The straight leg raise of 100 degrees is going to be useful. That is excessive to a slight degree. Again, we're making an assumption that's going to be the right straight leg raise. So here's what we're going to do. We're going to use the straight leg raise to guide what this pelvic orientation means to us. And then once we understand that, now we can define a strategy. So I got 100 degrees straight leg raise on the right. What I want you to do is I want you to take that straight leg raise and I want you to compare it to the left. So if the right straight leg raise at 100 degrees is greater than the left straight leg raise, you most likely have a posterior compression on the left side that is turning the pelvis to the right. And that's going to result in a reduction in left hip external rotation. So that's going to be a flatter turn into this right hip. When you do the straight leg raise, what's happening while you get the excessive straight leg raise is as you bring it up, it's allowing the pelvis to turn away and that's why you get 100 degrees on that side. Now if you compare straight leg raises again and you get a left straight leg raise that is greater than the right, what you've got is a pelvis that's tipped on an oblique axis so it's actually tipped up like that, so it's tipped over in that direction, which means that you have greater eccentric orientation on this posterior left lower side than you do on the right side and it tips it up. So when you do this straight leg raise, you're not actually raising it up in flexion, you're raising it up closer to an abducted position.
pelvic orientationstraight leg raisehip rotationnarrow ISAposterior compression
So if we have a difference in the straight leg raise, then we have a difference in the problem. So again, the right straight leg raise greater would be a posterior lower compression on the left, a left straight leg raise greater, and you got a right oblique tilt. Okay? So if the right straight leg raise is greater, what you need to do is delay the left propulsion, but you're going to start. If you're in sort of like a rehab-ish mode, you're going to start in right-side-lying activities or an offset quadruped. It's going to be a great place for you to start because you've got to delay this propulsive strategy on the left side. When you go into the gym, then what I want you to do is I want you to start with a left foot forward split squat orientation. So we've got to get relative motions and we have to delay the propulsive strategy. So we're going to use a hip shift. So we're going to push this left hip backwards in that split stance position. You can then go into a right to left half kneeling cable chop with the right knee down. As far as carry activities, you could do a left rack carry, which is going to help delay that left propulsive strategy. Then you want to use a backward sled drag as conditioning, which will allow you to emphasize this posterior hip shift. Now, if the left straight leg raise is greater, so remember the left straight leg is greater, you got an oblique tilt, so we got to use the right side to push back and to the left to reorient this pelvis. So now, left side, side-lying activities with a right propulsive strategy are where you're going to want to go from a rehab standpoint and then when you go to the gym, we're going to do half kneeling activities or a split stance activity with the right knee up, left knee down. I like to use like a, like a Palov split squat or something like that. You're going to do a right to left, a split stance, side split stance, cable chop, left suitcase carry under these circumstances. Again, because what we need to do is we have to create this a stronger right propulsive phase and the suitcase carry on the left is going to do that. And then you're gonna use a crossover sled drag instead of the straight posterior sled drag, because again, we wanna create this stronger, right propulsive strategy to offset the oblique axis. So Javi, I hope that gives you some ideas about what you're looking at and a way to diagnose what you're looking at, and then some strategies in the gym.
straight leg raiseoblique pelvic tiltpropulsive strategyhip shiftcable chop
First things first. There are many representations that get labeled as anterior pelvic tilt, and I believe this stems from some of the methods used to identify it, with people chasing an ideal static orientation. We must always think dynamically rather than statically. We are not trying to capture an ideal posture. There is no such thing as a neutral spine or similar concepts; we need to discard these ideas and start viewing humans as movers rather than as static postures or ideals. I think one of the methods used to identify what's optimal is comparing the ASIS to PSIS orientation. Whenever we see the PSIS higher than the ASIS, it gets branded as an anterior pelvic tilt, but this doesn't account for the relative motions that occur between the sacrum and the ilium. It's just an assumption about the entire orientation of the pelvis. We have a better way to identify this than relying on most palpation tests, which have been shown to be quite unreliable in most situations. But let's discuss why this might occur in the first place to understand the entire orientation of the pelvis. A few factors are at play. Some structural issues may be an influence. We discuss our archetypes: the wide and the narrow. These present in various ways, from a foundational representation to superimposed superficial strategies, and we will build on that. Structure is definitely an influence. You must consider everything you do from a movement perspective. How much or how little you move is an influence. There are training influences; when we chase certain adaptations, they will have an impact. However, the thing we must stop immediately is blaming muscles as if they are separate from everything else. It's like saying, 'You have tight hip flexors and weak glutes.' Let's abandon that line of thinking; it's not helpful. What you start to recognize is that the end result of what you observe and the limitations you have are the predominant adaptations associated with everything you do. Now, let's discuss representations. I have my archetypes: the wides and the narrows. One thing we want to represent is that with a narrow representation, you will have a counter-nutated sacrum relative to the ilium. If you are a motion palpation person, you would immediately say this person has an anterior pelvic tilt, even though the sacrum is counter-nutated. It would be better to look at the hip rotation representations. Under normal circumstances for our narrow ISA archetype, if they are biased towards inhalation, they will have about 100 degrees of total hip excursion, but they will be biased toward more external rotation and less internal rotation. According to textbooks, normal hip rotation is 60 degrees ER and 40 degrees IR, but these individuals will be biased toward a bit more external rotation and a bit less internal rotation. Let's say they are biased toward 80 degrees of external rotation and 20 degrees of internal rotation. You would conclude this person likely represents the narrow ISA archetype. The goal in this scenario is to take an inhaled pelvic representation and teach them to capture an exhaled pelvic position, which will help reorient the ilium into internal rotation and capture some nutation. You will do this using a series of 90-degree angles: the hip at 90, the knee at 90, and the ankle at about 90 degrees. This is the easiest method because, considering how the hip moves through space and the associated movement of the ilium, it's around these 90-degree angles where we begin to recapture the exhaled position of the pelvis. This is where you will train these individuals and perform any rehab-style exercises. Now, for our wide archetype, we see a pelvis that looks like an exhaled representation. We want to move them toward an inhale representation. The easiest way to do this is with early propulsive strategies, such as heel-elevated activities with the hip closer to traditional extension. This will help expand the posterior aspect, creating a yielding strategy posteriorly and helping us recapture the hip extension we are likely missing. Remember that for your wide ISA individuals, as a standard representation, they will be biased slightly toward internal rotation and slightly less external rotation, but as long as they achieve about 100 degrees of hip excursion, they are only showing their structural bias. If we have an anterior orientation where the entire pelvis, including the sacrum and ilium, moves forward together, you will experience a loss of total hip excursion. Instead of the combined 60-40 split of ER and IR, we will likely see less than 100 degrees. With this anterior orientation, due to the reorientation of the musculature above the greater trochanter, we will see a loss of external rotation measures. These are the key indicators of an anterior orientation: less than 100 degrees of total excursion and likely an external rotation deficit.
anterior pelvic tiltnarrow ISAwide ISAhip rotationpelvic orientation
And so right away, if you're a motion palpation person, you're going to say, oh, this person's in the anterior pelvic tilt, even though they have the counterneutation of the sacrum. It would be better though if we would look at the hip rotation representations of this. So under normal circumstances for our narrow ISI narrow ISA archetype, if they are biased towards inhalation under those circumstances, they'll have 100 degrees of total hip excursion give or take a little bit, but they'll be biased towards more extra rotation and less intro rotation. So if you look at the textbook and the textbook says you have 60 ER 40 IR, they're going to be biased towards a little bit more Extra rotation a little bit less in rotation. So let's just say that they are biased towards 80 degrees of extra rotation and 20 degrees of internal rotation. You would say, oh, this person is probably going to be this representation of a narrow ISA. The goal here under those circumstances is we have an inhaled pelvic representation. We want to teach them to capture an exhaled pelvic position, which will help reorient this ilium into internal rotation. We'll capture some mutation. You're gonna do this with a series of 90 degree angles. So the hips gonna be at 90, the knees gonna be at 90, and the ankles gonna be at about 90 degrees. So that's gonna be the easiest way because if you think about how our hip moves through space and we get the movement of the ilium that's associated with that hip range of motion, right at about that 90 degree angles where we're gonna start to recapture that exhale position of the pelvis. So that's where you're gonna wanna train these people. And this is where you're gonna do any sort of your rehab-ish exercises in this 90 degrees of hip flexion, 90 degrees of knee flexion, and then that neutral dorsiflexion where the ankle's at 90 degrees. Now, let's go to my wide archetype. And so we're going to see a pelvis that looks like that. So this is the exhale representation. So obviously we want to move them towards an inhale representation. The easiest place to do this is with early propulsive strategies. So this is your heels elevated type of activities with the hip closer to traditional extension. And this is going to help us to expand posteriorly; we create the yielding strategy posteriorly, and this is going to help us recapture that hip extension that we're probably missing. So remember that your wide ISA people, as a standard representation, they're going to be biased a little bit more towards internal rotation, a little less external rotation, but as long as they get a hip excursion of about 100 degrees, that they're only showing their structural bias.
narrow ISAwide ISApelvic orientationhip rotationexhalation position
If we have an anterior orientation, anterior orientation, the entire pelvis that is orienting forward, so the sacrum and the ilium are moving together, you're going to experience a loss of total hip excursion. So where we have to combine 60-40 of ER and IR, now we're going to see less than 100 degrees, most likely under those circumstances. And when we have this anterior orientation, because of the reorientation of the musculature above the trochanter, we're going to see a loss of external rotation measures. And so that's going to be your giveaways as to whether you have this anterior orientation to begin with. So it's going to be less than 100 degrees total excursion, and you're probably going to be in an ER deficit. OK, now. Let's talk about strategies here, Bradley, because I know that's what you really wanted to listen to. Step number one under all circumstances is to eliminate the interference. Anything that creates the posterior compressive strategy that's going to push that pelvis forward has to be eliminated. So now we're going to take things off. off the list like Romanian deadlifts. Most of your deadlift variations are probably going to be off the table for a short period of time. Back squats also creates that upper dorsal rostral compression which is going to be duplicated at that circle base under most circumstances, so we want to eliminate those. Kettlebell swings. Anything that is very, very hingey and propulsive probably needs to be taken off the table for a while until you can recapture enough adaptability through the pelvis. Now, let's talk about activities which are going to bring the pelvis back, promote some yielding and posterior expansion of that pelvis, and then recapture the hip extension. If we think about activities that are on the ground, so we've got supine arm bars, promoting the hip extension element on the extended extremity. Anything that delays this propulsive strategy is going to be heavy on the heel, heavy on hip extension, so like a cross connect step up is still a viable choice for your exercise programming. If we talk about trunk related activities, we could do a TRX mountain climber. That's going to move us towards the two ends of the early and late propulsive strategies, which will help us create the inhaled position, especially for your wives. Along the same lines, like a Swiss ball jackknife with a reciprocal leg movement, if we need to drive more hip extension, we might have to do some activities in hook lines. So these become your glute bridging activities. We can progress those to say an alternating hip lift with your back supported on a bench. And then any number of, again, activities that represent the two ends of the propulsive base when we capture this hip extension. So you can even consider like a high step cable chop.
anterior pelvic tilthip excursionposterior compressive strategypropulsive strategiesrehabilitation exercise
The thing that I want you to understand here, Bradley, number one is you have to look at your programming and start to eliminate the interference and then understand what you're looking at. So take your archetypes into consideration and then capture the posteriorly oriented position. It's not about trying to find this one ideal. It is about moving people back and forth between these full excursions so we have full adaptability through the pelvis and the hips. I hope that's helpful for you, Bradley. Have a great day everybody. I will see you tomorrow.
pelvic orientationarchetypesprogrammingadaptabilitypelvis
Okay, we've talked about this before, but it's worth going over again. Some of these things get really confusing, and then we've got layers of competitive strategy to talk about. So if we're going to talk about a wide ISA, so we've got a wide IPA to go with it, we've got a mutation to the sacrum, so we've got an expansion to this posterior lower aspect. So under these circumstances, this would antivert the acetabulum, which would give us plenty of IR. However, because of the expansion posteriorly, we've got a center of gravity issue that's going to knock me backwards. And so my first strategy from our wide ISA is to create that compressive strategy near the base of the syndrome. So I'm going to push the top of the pelvis forward, which is going to take me in that direction. And so now I have a center of gravity issue that's going to push me forward. So I will compress from the front side under those circumstances. So I'll compress the front side of the pelvis. I get a shape change in the SEM which picks up the external rotation concentric orientation and so right away I start to lose my IR capabilities. Now very very late in these compensatory strategies I got to think about post-year lower so when this initiates its concentric orientation very very late where I'm going to bring the sacrum I'm going to bend that sacrum underneath. That will also pick up some of that ER concerted orientation at least initially until we get another shape change in the pelvis. And so late in the compensatory strategy, I'm going to lose some IR under those circumstances. So there's a couple of ways that we can influence this. And it just depends on how far and how deep into these compensatory strategies we actually are. But again, another really good question.
wide ISAhip internal rotationcompensatory strategiessacrum mechanics
We want to restore, especially in return to play issues or late off-season, where we're really trying to drive up force production to prepare them for the season, we have to implement these activities. So one of the things that I like to do, especially when we're starting to restore these bilateral symmetrical activities to the programming, is to start with activities that reduce the influence of that posterior compressive strategy, especially. So when you think about a back squat and the scapular retraction that's required there, you're going to close off that dorsal rostrum, we're going to lose some rotation in the shoulder, we're going to potentially compress that posterior pelvis. And again, so we're going to lose some of those movement capabilities. But if we implement something like say a front squat, well, we can maintain the yielding strategy. Now we've actually reduced the influence that would restrict our ability to turn, especially for a change of direction type of things that a lot of our field and court athletes have to do. I like snatch grip RDLs to re-initiate hinging activities because moving the arms away from the sides actually moves us from a more internal rotation position to a little bit more external rotation, so again I get some of that posterior expansion. And so there are activities that we can utilize that will help maintain our ability to yield posteriorly, especially when we need that for turning. Another strategy in this regard is when we know that we're going to have to utilize an activity that is very high compression. So think about power cleans and back squats, pulls from the floor. Anything along those lines is going to be a very compressive type activity. What we might do is we might make that primary exercise for that day number one. And then everything after that is structured so that we start to restore some of these movement capabilities. So think about the highest possible intensity, highest force output, highest speed activity coming first because we have to use these compensatory compressive strategies for that type of force production. And then, like I said, we construct the rest of the program to help them maintain many of their movement capabilities.
bilateral symmetrical exercisesposterior compressive strategyhip rotationscapular mechanicsprogramming strategy
How do we like teeter this boundary of what it means to desire competence and then how would we define success not go after perfection and yet not in the same space settle and leave things on the table that could be gathered?
competenceperfectionsuccess definitionboundary setting
The first thing you need to do is to have a representation of what your intent would be, right? So you have to qualify that. You have to decide it's like, okay, what would be favorable under these circumstances? What is my goal with this person? So if that's ill-defined, then you're in the dark already. I mean, you really have no rhyme or reason as to whether you're successful or not. So that has to be defined first and foremost. Then it's just a matter of, okay, that's point B, and then you have to be able to identify point A. And that's been a problem because the representative models that we're taught in school are structural reductionist models. They're based on anatomy representations that were defined 2300 years ago by the most archaic of methods. But it's just a matter of first and foremost, knowing what you're trying to accomplish. And I don't know that anybody, I mean, I can't say that now. I've been working on this for a while, but I don't know if that's ever been very well-defined as to what the real intent is because of the emphasis on this limited representation of what's actually going on. If you think in levers and pulleys, then that structural reductionist model works really, really well, but it has so many limitations on it. And so again, my goal is just to, I'm not trying to redefine anything. I'm just trying to actually create a more realistic representation of what's happening. And therefore my intent seems different. I mean, it's the same stuff that everybody's been doing, but with a better representative model, I think that our approach can become better defined.
clinical intentstructural reductionismrepresentative modelsassessment methodologyanatomical foundations
I'm now becoming aware of new perspective changes. I think it's indicative that my assessment and the information I'm taking in and then integrating to form a goal or a conclusion needs to change because it's not sufficient at this point. And so I'm wondering now as your career has developed, what has it been like to have a significant change in perspective?
perspective changeclinical assessmentprofessional development
Yeah. There's a lot of cognitive dissonance in the beginning. And I kind of disagree, Bill. You have defined quite a few things, and you have a language for those principles. And because there is a language for it, you're doing exactly what people did 2,300 years ago. And that is, it's a good thing though, because I say it's a good thing because the cognitive dissonance, it really turns things upside down. And now you have a new model and it's not just a model, there's principles behind it. And those principles support your model. And the language used to support the principles is what really drives this and it's what makes things challenging.
cognitive dissonancemodel developmentlanguage in coaching
I feel like I've been operating from like outside in rather than inside out. And so in some ways that's felt difficult and left me discouraged at times.
perspective shiftassessment methodologyclinical reasoning
Pick the emotion part out of it and just look at the outcome. And then that defines the next step. So I always talk about taking the next logical step. What is the next logical step? Take your ego out of it. And that's really difficult to do because we do invest so much. You know, if you're really intent on being good at what you're doing, you're investing yourself in it. There's no question about that. But the thing that you can't do is invest so much emotion in it because there are dips and valleys within the process. And so again, we just have to look at it. It's like, okay, what is my decision-making process? And then it becomes this, I don't want to say robotic, but it just becomes execution. It's like, okay, I measure. I determine what those measures mean to me. And then I intervene and then I determine what the outcome was. Based on that outcome, I know what my next intervention should be and so on and so forth. That's how we have to look at this. Knowing full well we do not see the reality. We can't see what the patient sees or our client sees. We can't feel what they feel. And there is always the gray area and the unknown because everything that we do is based off of a probability. Let's just say that we're intervening: there's a 76% chance you're going to be successful and a 24% chance you're going to fail. And you fail. Does that mean you made a bad decision? No. It just means there was a probability of failure. So everything that you do has a probability of success or failure, assuming that you're within some reasonable accuracy, like I said, if we can ever get there. And we have to accept the fact that there are things that we cannot impact, things that we may be able to impact—or we may not be able to identify them. And so it makes people uncomfortable to live in a world where this probability is so obvious. Because in school, they said, 'it's this.' They gave you the black and white answer. And we don't work in black and white. There's a constant state of unknowns. You have no idea how someone would respond. Getting back to the whole language concept, that's why you have to be aware of how you speak to people. Because that's part of the influence, right? And so their state, based on how they respond to you, is another element that influences the outcome, whether you're going to be successful or not. So if they don't like Notre Dame, guess what? You have a problem. It's okay. Your failure is not a failure in the negative sense. Your failure is just the outcome that told you that that was not successful this time. But my process told me that that's what I should have been trying to do. So maybe I said something differently. Maybe they wore their lucky underwear that day. It could be any number of things that turn out to be an influence. Doesn't that make you happy to know that you just have so little control over things? Just the recognition of this sort of perspective, I think it helps us because we stop punishing ourselves as much. You're always going to, like I said, I always talk about the scar on my forehead from banging my head on the steering wheel on the way home—every day where you think, 'I said the wrong thing. I did the wrong exercise. I could have done this instead of that.' We always have those thought processes, but that's good to have those because the people that don't have those thoughts on the way home... good morning, happy Friday, I have neuro coffee in hand and it is perfect. All right, very solid week. We're wrapping it up. We're gonna go into a stellar weekend, which I'm looking forward to. Hope you are too. Hope everything's going well for you. So let's wrap this up with a really good Q&A for Friday. So this comes from Jason and Jason says, it's a common sentiment that we hear in the industry: a certain muscle is tight because it's weak, particularly in reference to hamstrings, hip flexors, and external rotators. How does this concept fit within the orientations and strategies of your model? Well, let's talk a little bit about the concept that you're asking about first and foremost and let's kind of figure out where that sort of comes from. And I think it's based on what would be the typical structural reductionist model where people are taking physical properties in the world around us and then trying to apply them to humans. For instance, if you pull on a rope or stretch a leather belt or a rubber band, you feel the tension. And if your model of the world is based on these physical properties and you apply them to humans, then my perceptions are going to follow. So it's like we compare muscles to tension in rubber bands, even though that's not remotely true. That might be where this kind of thing comes from. 'Nuts' and muscles is another one that stands out in my mind. Muscles don't actually have nuts in them. They might have contracted areas that become sensitive. But somebody called them nuts at some point in time. It caught on. It's a great metaphor. It's very useful for a descriptor to describe a sensation. It's just not much of a reality. Doesn't mean we don't feel tension in tissues.
clinical decision-makingprobability-based outcomespsychological influencestructural reductionismmuscle sensation metaphor
Your failure is just the outcome that told you that was not successful this time. But my process told me that's what I should be trying to do. So maybe I said something differently. Maybe they wore their lucky underwear that day. It could be any number of things that turn out to be this influence. Doesn't that make you happy to know that you just have so little control over things? Just the recognition of this sort of perspective helps us because we stop punishing ourselves as much. You're always gonna have that thought process on the way home: I said the wrong thing, I did the wrong exercise, I could have done this instead of that. But that's good to have those thoughts because the people that don't have those thoughts on the way home don't reflect on their work.
clinical decision-makingprobability-based interventionsemotional detachment
Under circumstances of yielding actions, we do feel tension because load is always distributed into the connective tissues, and that's a large part of what we perceive based on my model. So whether we have a concentrically oriented muscle or an eccentrically oriented muscle, and we get to some end of excursion that is allowed under those circumstances where we do have the yielding action, that is definitely what we are going to feel. So if you have done a static stretch and you get that discomfort at the end of the stretch, that is the distribution of tension through the connective tissues that, of course, we are going to sense. So again, that's what we are talking about. When we talk about tight, we are talking about a sensation, not necessarily a useful representation for decision making until we identify joint position, muscle position, etc., and then we can determine what an intervention is. So this is a common mistake where people will say, 'Oh, you feel tight, you need to stretch,' when the reality is, if the tissue is already under tension under some circumstances—especially if I've got an eccentrically oriented muscle and a yielding action—it's like all you are trying to do is just pull on something even harder than it's already getting pulled on. It's already in an eccentrically oriented position, so it just becomes an exercise in futility. The reality is what we need to do under those circumstances is just restore the full excursion of movement under those circumstances, and then we feel nothing because under situations where we have full concentric or eccentric orientation of muscles—which would be representative of a full breathing excursion or full joint motion, however you want to perceive this—we feel nothing. We don't pay any attention to it because we don't have those sensations of tension or tightness. When we talk about weakness, we are also talking about a similar situation. I'm going to bring in the little skeletons here. Since you brought up external rotators, I'm assuming you're talking about the external rotators of the shoulders. If we get sort of a concentric orientation where we get a compressive strategy in the dorsal rostral thorax, what's going to happen under those circumstances? We are going to get an orientation of the scapula that will position—if we are talking about muscles—the subscapularis would be concentrically oriented, and then the external rotators, and we will just say infraspinatus under these circumstances, would be eccentrically oriented. So under those circumstances, because of the position of the joint, the movement of synovial fluid, and the orientation of the muscles, we have an eccentrically oriented muscle that cannot recapture its concentric orientation, which means that it can't produce force. An eccentrically oriented muscle has a much greater difficulty producing force; in fact, it doesn't really produce a whole heck of a lot of force. It's always concentric orientation that is going to produce force. So if I have a muscle that is positioned eccentrically and cannot produce force, then people are going to blame it for being weak. Then they say, 'Well, you just need to strengthen it,' and they do some sort of activity that supposedly strengthens a muscle. So you do your little rubber band external rotations under these circumstances, and if you can recapture concentric orientation of that muscle, guess what? It tests strong, which means that all you did was create an orientation in that joint that allowed that muscle to capture its concentric orientation and produce force again. And so again, this is why breathing excursion matters. This is why restoring full movement options matters because that's what allows us to continue to produce the appropriate force, move comfortably, and move without this tension.
connective tissue tensionmuscle orientation concentric eccentricjoint position and movement excursionshoulder external rotatorsbreathing excursion
It's always concentric orientation that's going to produce force. And so if I have a muscle that is positioned eccentrically, it cannot produce force, then guess what? People are going to blame it for being weak. And then they say, well, you just need to strengthen it. And then they do some sort of activity that supposedly strengthens a muscle. So you do your little rubber bandy extra rotations under these circumstances. And if you can recapture concentric orientation of that muscle, guess what? It tests strong, which means that all you did is you just created an orientation in that joint that allowed that muscle to capture its concentric orientation and produce force again. And so again, this is why breathing excursion matters. This is why restoring full movement options matters is because that's what allows us to continue to produce the appropriate force move comfortably and move without this tension. So Jason I hope this gives you a little bit of an explanation of my perspective of how this stuff actually works and then everybody have a great weekend and I will see you guys next week.
muscle orientationeccentric vs concentric contractionmovement restoration