Good morning. Happy Monday. I have no coffee in hand and It is perfect. All right, a typical busy Monday. For those of you on IFAST University, we have a call at 1 p.m. Eastern Standard Time. If you're not at IFAST University, please go to IFASTUniversity.com. Get yourself signed up so you can join us for the conference call at 1 p.m. All right, digging into today's Q&A. This came through email from BradyS and he says, hi, Bill. I have severely rounded shoulders. And I'm working hard to strengthen my upper back to pull my shoulders back. I'm making little if any progress. Any suggestions would be helpful. Thanks. Okay, so let's redefine what we're actually looking at. So what we're actually looking at under these circumstances is not a rounded shoulder problem per se. What we have is a rounded shoulder result. And so at minimum you're looking at a sternal compressive strategy that is pushing the sternum down and back. The resultant is a response of the shoulder girdle in its behavior relative to this down pump handle situation. The way you're going to know this Brady is you're going to lose a lot of shoulder internal rotation under these circumstances. Depending on the other compressive strategies you're going to see some other things occurring as the shoulder protracts, you're going to see a scapular elevation that's going to be associated with this. So if we can take a baby step back, the biggest problem that we have here is calling this thing a rounded shoulder because it implies that your shoulder is going to get pulled forward. by so-called tight muscles. So we will say, well, you have tight pecs and that's pulling your shoulders forward. And then you have weak scapular muscles. And so we end up with this scenario of the stretch and strengthen crowd where people are going to try to pull on pec muscles that are actually contracted and they're going to try to pull back on scapular muscles and you can end up with what looks like the before picture on the Terry project because Terry had a down pump handle. He had the rounded shoulder appearance and tried to fix it by constantly pulling back the scapula in a retracted state and therefore created a secondary postural issue as you can see in the picture. So we have a wrong model therefore a wrong solution. So the positioning more importantly the movement of the shoulder girdle is very dependent on the shape of the thorax and so this is going to be dependent on your ability to compress and expand appropriately which means that we've got to get airflow into the upper portion of the thorax to restore a normal anterior posterior expansion, normal shoulder girdle representation and therefore normal relative motions. And so if we think about people that are at this end game strategy.

So this is going to be somebody that's gone through all of these superficial strategies and they're actually pulling the sternum downward with rectus abdominis. That has to be resolved first and foremost. So activities that are going to help us resolve this and sort of free up the sternum so we can get the normal up pump handle situation. Actually, your developmental postures work really, really well under these circumstances because we've also got the iterative effect of this increase in concentric orientation in the cervical spine as well. And so we're going to kill two birds with one stone. We're also going to be able to move the shoulder girdle into a position that does not require us to use a compensatory strategy. Our ERs move out and away from midline, and so we can actually use that space to our advantage to start to expand that space by reducing the concentric orientation of rectus abdominis and allowing the pump handle to come up. Now, chances are, because we're so far into these superficial strategies, you're going to be dealing with some anterior orientation of the pelvis and the thorax that's going to need to be addressed as well. So rectus abdominis has to be resolved first, then go after your reorientation of the pelvis and the thorax. Once you're able to reorient the pelvis, we can start to worry about building the expansion back up into the thorax. Remember, the lungs fill from the bottom up, just like a glass of water. So we're going to reduce the posterior lower compressive strategy. We're going to start to expand the dorsal rostrum. So activities like the seated Better Band pull apart, standing version of Better Band pull apart is going to be useful as well as you start to gain shoulder range of motion and we can get the shoulder above the horizontal without compensation. Now we've got activities that we can do in quadruped and some of our horizontal reaching activities are going to fit the bill here and this is where we're really going to start to see the pump handle start to come upward. Chances are if we want to restore full excursion of the scapula, we're going to work towards a position where the upper extremity is above shoulder level. And so this is where your inverted lazy bears are going to come into play. Some of your overhead reaching activities, some of your pull down activities actually will be useful under these circumstances. So Brady, what I want you to think about though is that you're going to deconstruct what you're looking at as far as the rounded shoulder posture is concerned. The shoulder is the result of the lack of expansion especially in regards to the sternum. So thoracic shape becomes your highest priority. Avoid interference. The intentional retraction activities in an attempt to fix the shoulder girdle posture is not going to be an appropriate strategy under most circumstances.

And then don't forget you've got other superficial compressive strategies that you're probably going to have to deal with. So hopefully Brady that answers some of your questions, give you some alternatives that you can utilize to restore your movement capabilities. If you would like to participate in a 15-minute consultation, please give it to askbillhartman at gmail.com, askbillhartman at gmail.com, and put 15-minute consultation in the subject line so I don't delete it, and we'll arrange that at our mutual convenience.

So again, two resources for you there. But this is a great question for team as we covered a lot of ground in a very short period of time as far as understanding how this herniation would arise in the first place and then what to do about it. So I hope you find it useful. If you would like to participate in a 15-minute consultation, please go to askbillhardman at gmail.com, askbillhardman at gmail.com, put 15-minute consultation in the subject line, and we will arrange that at our mutual convenience. Everyone have an outstanding Tuesday, and I'll see you later.

So in one of your videos, you spoke about disc prolapses being a yield in the disc. So you're trying to pick up the yield somewhere and then somehow you get the disk and then you get the yield through it. And I was wondering what, theoretically speaking, there are people that have the superficial compressive strategy of the lumbar spine, and are people that create that flexion orientation through the lumbar spine. Which ones are more likely to get that prolapse through the disk? Are the ones that allow the yield to go all the way through and sort of yield even to a superficial musculature, or those who yield until the disk but hit the constraint of the superficial musculature?

Yes.

So in one of your videos, you spoke about disc prolapses being a yield in the disc. So you're trying to pick up the yield somewhere and then somehow you get the disk and then you get the yield through it. Yes, sir. And I was wondering what, so theoretically speaking, there are people that have the superficial compressive strategy of the lumbar spine, right? And there are people that create that flexion orientation, let's say through lumbar spine, right? Yes. Which ones are more likely to get that prolapse through the disk? Are the ones that allow the yield to go all the way through and sort of yield even to a superficial musculature or those who yield until the disk but hit the constraint of the superficial mass culture?

Okay, so what we have to do is talk about the sequence of events that leads to the potential to create the yield strategy in the disc, okay? The way this works is you have to have a progressive weakening of the posterior elements of the disc first, okay? That would be associated with a reduction in blood flow to the vertebra, where the greatest pressure is in the spine, which is typically so what are the two most commonly herniated discs in the lumbar spine?

Okay.

So the way this works is you have to have a progressive weakening of the posterior elements of the disc first. That would be associated with a reduction in blood flow to the vertebra where the greatest pressure is in the spine, which is typically in the two most commonly herniated discs in the lumbar spine—L5S1 and L4L5.

L5 is one.

L5S1, L4, 5, right?

L5S1, L4, 5.

Recent injury is because there's greater pressure on the posterior aspect of the disc under those circumstances. If I magnify that pressure, I reduce the blood flow to the vertebra. The blood flow, the nutrition for a disc, diffuses from the bone to the disc. So it's a bony side supply, right? If I reduce that, then I start to see a breakdown of the disc. So you'll see the proteoglycan content of a disc start to break down. That's the stuff that holds the disc together, right? And so you get the wearing away of that. So that would precede the prolapsing because I have to have a reason to have to create the delay strategy. So if I'm shoving the spine forward first, I'm increasing that posterior compressive strategy, aren't I?

Yes.

So that precedes the disc, but I'm still trying to create a yielding action somewhere to slow that side down. If the disc is weak enough, I can use the disc now as the delay strategy. You see it?

Yeah.

So you can't just say that, oh, the disc is the delay. It's like, well, wait a minute. Why did I suddenly have to use the disc in the first place? Because everything else is getting shoved forward. And I had the progressive destruction of the disc material itself that made it weak enough to become the yield strategy.

OK.

Does that help?

Yes, that actually is really helpful. I had another talk in mind. Correct me on this one or tell me if that makes any sense. The potential mechanism of that would be the difficult biomechanical levers that we sort of cover in school, where potentially if you have posterior compression and you're starting to bend and then this stops the motion, you get that effect on the disc where you create a very strong compressive force. If you create a compression and expansion and you sort of just let the pressure go through the disc rather than accumulating in the disc, would that be also something that plays a role in this problem?

Well, that's exactly what we just talked about. So that's the yield, right? So the yield is post-year expansion. Well, how do you create, post your expansion of discs? Well, you have to have compression on the opposite side.

Yes, yes.

Well, how do you create posterior expansion of discs? Well, you have to have compression on the opposite side.

Yeah, yeah.

Does that make sense?

And in that case, how likely are you to speed up the healing process of herniation? If you create a nice heal that the posterior superficial musculature.

Okay. So here's the really cool thing about this. So this is process. All right. First and foremost, herniation will represent a focal yielding action. You understand that?

Okay.

Next, I have to create a distributed yielding action, which would be early propulsion.