So, Adam, I like your thinking, but let me give you an alternative explanation for this, because I think that the way you described it hints at something that is really, really common and a very, very common misunderstanding as to what's actually happening during the squat. So let's talk about what would normally occur as we descend into the squat. So we talk about the way that the hip is oriented and the pelvis is oriented as we move through space. And so this early phase of hip flexion, so as you're descending in the squat, this early phase would be external rotation. We pass through internal rotation, where we get a reorientation of the acetabulum, and then we finish into this deep position. And chances are, and I'm not picking on you, brother, but chances are, if you're wide ISA and you're squatting the way you say, you're not hitting that range flexion, so we're not going to be worried about that part. But what I do want to talk about is what's potentially going on with the orientation of the pelvis and then what you're actually seeing at the hip. What you're seeing is extra rotation is actually internal rotation. So let's talk about that for a second.

If you're a wide ISA, you're going to be biased towards an internal rotation of the ilium and a nutation of the sacrum, which would put you in a position that looks something like that, but with the nutation, I'm exaggerating for effect, of course. But chances are, again, based on the way that you're describing it, you're going to be anteriorly oriented and you're going to be compressed in the posterior aspect. So as you try to descend, you're not even starting in this normal ER position. You're probably not able to capture that. So you're going to hit IR pretty hard and pretty fast. So as you descend, what you're going to try to do is you're going to see this hip going out. And a lot of people perceive that as being extra external rotation. However, if the knee is going out and you're still descending, I want you to see this really, really closely. If the knee goes out and you descend, that actually turns you into internal rotation. So as the knee goes out, you're actually capturing the internal rotation at the hip, but you can't capture it in an arc that is reasonably close to what we would perceive as traditional flexion. You've got to deviate outward and try to capture it there. So what that's going to do, it's going to drive your knee outward, but your foot is grounded and you still need a propulsive foot to push off of when you're squatting. And so what's going to happen is the tibia is going to be forward on the ankle. So that's going to move you towards a late propulsive strategy in the foot. But if you use relative motion at the subtalar joint in that position, you're going to collapse towards the floor and you're probably not going to be able to get about your squat. And so what you're doing is you're locking up this position in this late propulsive strategy and it's going to drive you that way towards that visual representation of pronation, which is actually this late propulsive foot strategy. So I think that's what you're seeing more than anything else. So from a strategy wise then, what we probably want to do is let's move you to something that gives you a little bit more of that ER strategy at the beginning of the squat. So if I elevate your heel, I move this tibia backwards relative to the foot, and that puts us in an earlier phase of propulsion. So this is where you can actually capture some of your external rotation in that early phase of the descent of the squat, and then as you move towards your internal rotation, chances are the squat's going to get a little bit prettier that way because you're not able to access this early phase of external rotation in your descent because you've given it up with your anterior orientation.

in that early phase of the descent of the squat, and then as you move towards your internal rotation, chances are the squat's going to get a little bit prettier that way because you're not able to access this early phase of external rotation in your descent because you've given it up with your anterior orientation. Now, in addition to that, what you're going to want to start to do is you're going to work on your split stance activities with your front foot, with the front heel elevated as well, because now it's going to keep you in that early phase of that propulsive strategy. Allow the knee to track over the foot as you descend into your split squats, but with the heel elevated again, you're going to start to capture that early phase of your propulsive strategy at your ankle and foot. That's going to allow you to access the external rotation of the hip, and you're going to start to move through this full excursion of the hip. Throw in some Heels Elevated Camperini deadlifts and now you're going to be able to capture some of the internal rotation with that early propulsive foot as well. And eventually dropping that heel back to the ground in your single leg hinge type of activities. So we have this full external rotation, full internal rotation kind of a strategy as you move through your squat.

Because the behavior of synovial joints is really important to understand, especially with any exercise prescription, but especially with things like these. When this type of activity is useful, it does have utility, and it's usually because of the exact reason that you state: we're actually capturing relative motions. So I think it's been misguided that there's strengthening going on. And I won't deny that there's potential for hypertrophy and force production and things like that. But I don't think that these activities are remotely important for such things because from a load perspective, there's not a whole lot of overloading going on here. But what there is is a lot of coordinated activity that becomes incredibly useful to recapture normal synovial joint function. So we need to start thinking about how that works. So let's just touch on that briefly. When we talk about any synovial joint, they are filled with synovial fluid. So we're just going to call that water for the sake of argument. And that water is incompressible. And so for a synovial joint to move through its normal excursion, I have to be able to create pressure in certain areas so the volume will shift in certain directions to allow movement to occur. So let's use an elbow as an example. If I compress the front side of my elbow, I create pressure here, the volume moves to the backside of the elbow, and that allows me to bend the elbow. If I put pressure here, I extend the elbow, the volume goes this way, and I can extend the elbow. So all synovial joints behave the same way. And so the muscles that are the closest to the joint, and they're actually attached to the joint capsules, they are the pressure manipulators. So they are the ones that are moving the fluid volumes that allows all of this motion to occur. So if we're doing rotator cuff strengthening exercises—and I have to throw the air quotes in there because again, I'm not looking at it from that perspective at all—what we're actually doing is restoring the ability to move the humerus relative to the scapula and the scapula relative to the humerus and the scapula relative to the thorax and any number of things that we have to talk about. So if we look at this from a load perspective, if you look at the typical prescriptions for retraining the rotator cuff as it is in the literature, everything is based on a very, very low load and for very good reason because if we use higher loads, we tend to reduce the relative motion capabilities.

So anytime I have to increase force production to a significant degree, that's exactly what's going to happen. Now, if my intent is to restore normal movement, I'm actually going to restrict that with using higher loads. I also have to consider the position of the joint. So if you look at the, again, we'll use rotator cuff literature because it's prolific. The position of the humerus relative to the body matters in regards to what they would say would be EMG activity in the rotator cuff musculoskeletal, what we're going to make reference to is that we have to have this humerus in an appropriate position to restore expansion where we need expansion. So for external rotation capabilities, I need to make sure that I can expand dorsal rotator cuff. So if I pin my arm to my side, I've immediately restricted my ability to expand that area. So I'm going to move it away from my side. And typically what you'll see is they'll have some sort of bolster or roll underneath the arm as they're doing these activities. They say, oh, wow, the EMG activity ramps up when the reality is Oh, I just created more concentric orientation to allow that relative motion to occur. So that's how we want to start to think about this. We think about muscle positions. So concentric to eccentric orientation, where do I need the concentric orientation to be to allow the fluid volume to shift? So once again, if I'm trying to create more external rotation, I have to create compression on the posterior side of the shoulder. So the volume shifts forward and allows that external rotation to occur. Axial position is going to matter. So where do I position the thorax to maximize these internal and external rotation capabilities? So if I am allowing someone to perform these activities in a compensatory strategy, so let's just say that I retracted both scapulae and I was performing external rotations, I've actually just compressed the area that I need to expand to allow that external rotation to occur. So I have now failed miserably based on my intent. And so again, we have to take these positions into consideration. Finally, let's superimpose breathing on top of that. So if I hold my breath, I'm going to reduce my relative motions. If I can't breathe through the exercise, I'm not going to be able to create the expansion and compression strategies that I may need to restore the ability to turn or rotate. And so again, we have to take all of these things into consideration. So again, I would caution everyone to look at these things as strengthening. I would look at more for the ability to restore the capacity to execute relative motions, because that's what's gonna be most important when we're talking about restoring health. Later on, we can superimpose force production on top of anything, which is actually going to reduce those relative motions.

Austin, thank you so much for this question. I think it's a very useful question. Hope it's useful for you guys as well. Have a great Tuesday, and I will see you tomorrow. Good morning. Happy Wednesday. I have neuro coffee in hand and it is perfect. Okay. It's Wednesday. Very exciting. Tomorrow's Trips and Salsa Day, so that's always something to look forward to. Also looking forward to the 6 a.m. Coffee and Coaches Conference call. Please join us for that. Push your coffee prep on Instagram and your story. Tag me. I'll share that for you and we'll all have a great time talking about whatever we talk about on the conference call. Sometimes it's very technical. Sometimes we're just blowing off some steam, but it's always a great time, always great people. So join us for that. On the Q&A today, I got a question from my buddy Charlie Reed. He has the perfect hair and amazing guitar playing ability, but also one of the better coaches around. So if you're in Charlie's area, it's R-E-I-D, track him down and do some work with him. Great question, though. That's gonna require a bit of a demo that I'm not gonna do today. And then we'll probably follow this up with something a little more accurate, but I wanted to talk about rotation because that's what Charlie's question is about because I think there's some misunderstandings about how rotation is actually produced, especially in sporting movements. Charlie says I had a question regarding improving and restoring trunk rotation. He did a nice video on improving shoulder term for sports that require a lot of rotational ability like tennis, golf, and baseball. My question is, do you have any suggestions for improving trunk rotation in the gym or at home that require new equipment? Absolutely. And so there's a lot of things we can do to actually enhance the ability to rotate with our athletes and our regular clients because they have lost that ability in many cases as well. But the thing that I want you to understand is how this rotation is actually produced. Because I think it is grossly misunderstood. People think that the two sides of the body are doing something different. And they think that the top and the bottom is doing something different. So when we talk about the bottom, we're talking about pelvis. When we're talking about the top, we're talking about thorax. People seem to think that they're rotating in opposite directions. If that was actually occurring, it would be one, very, very uncomfortable. Number two, it would not look very fluid. And number three, it would be very, very difficult to breathe. And so when you do have people that are producing sort of this counter rotation between the pelvis and the thorax, you're going to hear them do some form of this salve or a breath hold to get there because you have to use superficial compressive strategies to produce that type of movement. And it's not very fluid. So when we're talking about athletics, especially in producing rotation, Let's talk about how this is actually done. So let me grab my incredibly high-tech homemade thorax here. So we got a representation of a thorax and a spine. It might be looked down the line here. And so if I turn my spine, You'll start to see the shape change here where I get this expansion on this right side and I get a compressive strategy on the left side. If I turn it in the opposite direction, you'll see that sort of flip-flop. And I think this is one of the reasons why people seem to think that these expansion and compressive elements are creating an opposing strategy. The reality is from a muscle orientation standpoint in a rotational sport like golf or tennis or baseball, more often than not, if they're not using a compensatory strategy which some people will do then, if they're not using a compensatory strategy and they're creating this nice fluid rotation, both sides of the body are doing the same thing at the same time. The difference is going to be the use of an overcoming versus a yielding strategy. So let me give you a for instance, so if I am if I am swinging a golf club because I'm translating my weight shift from one foot to the other, it's actually representative of of gait. And so I don't have this pure turn where one side of body is going forward, one side is going back. I'm actually translating. And so as I rotate, both sides, if we talk about the posterior aspect of the body, both sides are constantly going to push me towards the one side. So if I'm a right handed golfer and I'm taking my backswing towards my right side, the constant of orientation on both sides posteriorly is pushing me to the right. The way that I produce the turn is actually have a yielding strategy. on the side to which I'm turning and an overcoming strategy on the side that's pushing me towards that turn and that's what produces the turn. So if I was coming straight at you, it would look like this. Both hands are still coming forward. One is on the delay and so that produces what appears to be the turn. I would just reverse gears and I would go through that to my follow-through if I was a right handed golfer as I translate to my left leg. And so again, so what we have are these alternating yielding and overcoming strategies, which is what produces the turn. On the front side, obviously I have an eccentric orientation and I still have the yielding and overcoming elements that again produce the turn. So if we were looking at a pelvis, And I look at the two ends of the golf swing. So again, back swing to this side, follow through to this side. Those are both inhalation strategies. They're both going to produce external rotation through the pelvis. And so if I was just to ER both sides of the pelvis equally, what I would see is this. But to produce the shift, I create a yielding strategy on the side to which I am turning. And so it looks more like that. So both sides are ER. Now what I'm not doing is I'm not showing you the IR element in the middle. So here's exactly what happened. So I go ER with the yielding strategy on the right side. If I'm taking my club into my right-handed backswing, as I come towards the middle, I will IR. This is where I produce my maximum force. So force is always produced. in an internally rotated manner, and then I would shift back to my ER strategy where I have the yielding strategy on the lead leg there. Now, if I'm turning, obviously I have a foot position that's coming up from the ground, I've got a knee position that's coming up from the ground, I've got a hip, I've got a femur turning into the acetalement that also contributes to my production of rotation, so I'm not ignoring that. I just want you to see the representation of what's going on in the axial skeleton because it is both sides of the body doing the same thing from a muscle orientation standpoint. The difference is the delay that's produced by the yielding and overcoming strategies. So right away we have elements of PNF that are in play to help us produce rotation. So those are your chopping and lifting patterns. Because what they're doing is that they're actually producing the concentric orientation on one side of the body, the eccentric orientation on the other side of the body. And then as you move through space, you're producing these yielding and overcoming strategies. And so that's why those contribute to rotation. Any number of rolling patterns are going to be contributors to this ability to create rotation. all of your arm bar progressions, the simple log rolling that we're doing, the unilateral shoulder rolls, et cetera, all contribute to these compressive and expansive strategies that we're going to use to produce training. If we think about the pelvis as something as simple as working through our split stance activities will actually help us produce this rotation. So again, we have a lot of things that we can utilize in the gym. I promise I'll produce a video that will demo some of these things so we do have a visual representation of how we would utilize these things. But I just wanted to throw that out there and let you see that rotation is probably not what you think it is. And again, both sides of the butter are doing the same thing at the same time. We just have a little bit of delay between one side and the other, and that's why we see the rotation. So hopefully that's helpful for you. Have a great Wednesday, and I'll see you guys tomorrow. It is Thursday. Happy Thursday to everyone. I have my neural coffee in hand and Dr. Mike, I think it's the best batch ever. It is perfect. Dr. Mike, how are you this morning? I'm doing wonderful. Yeah, you look good. You look good. You need a t-shirt hoodie, apparently.

And so when you do have people that are producing sort of this counter rotation between the pelvis and the thorax, you're going to hear them do some form of this salve or a breath hold to get there because you have to use superficial compressive strategies to produce that type of movement and it's not very fluid. So when we're talking about athletics, especially in producing rotation, let's talk about how this is actually done. So let me grab my incredibly high-tech homemade thorax here. So we got a representation of a thorax and a spine. It might be looked down the line here. And so if I turn my spine, you'll start to see the shape change here where I get this expansion on this right side and I get a compressive strategy on the left side. If I turn it in the opposite direction, you'll see that sort of flip-flop. And I think this is one of the reasons why people seem to think that these expansion and compressive elements are creating an opposing strategy. The reality is from a muscle orientation standpoint in a rotational sport like golf or tennis or baseball, more often than not, if they're not using a compensatory strategy which some people will do then, if they're not using a compensatory strategy and they're creating this nice fluid rotation, both sides of the body are doing the same thing at the same time. The difference is going to be the use of an overcoming versus a yielding strategy. So let me give you a for instance, so if I am if I am swinging a golf club because I'm translating my weight shift from one foot to the other, it's actually representative of of gait. And so I don't have this pure turn where one side of body is going forward, one side is going back. I'm actually translating. And so as I rotate, both sides, if we talk about the posterior aspect of the body, both sides are constantly going to push me towards the one side. So if I'm a right handed golfer and I'm taking my backswing towards my right side, the constant of orientation on both sides posteriorly is pushing me to the right. The way that I produce the turn is actually have a yielding strategy on the side to which I'm turning and an overcoming strategy on the side that's pushing me towards that turn and that's what produces the turn. So if I was coming straight at you, it would look like this. Both hands are still coming forward. One is on the delay and so that produces what appears to be the turn. I would just reverse gears and I would go through that to my follow-through if I was a right handed golfer as I translate to my left leg. And so again, so what we have are these alternating yielding and overcoming strategies, which is what produces the turn. On the front side, obviously I have an eccentric orientation and I still have the yielding and overcoming elements that again produce the turn.

On the front side, I have an eccentric orientation and I still have the yielding and overcoming elements that again produce the turn. So if we were looking at a pelvis, and I look at the two ends of the golf swing. So again, backswing to this side, follow-through to this side. Those are both inhalation strategies. They're both going to produce external rotation through the pelvis. So if I was just to ER both sides of the pelvis equally, what I would see is this. But to produce the shift, I create a yielding strategy on the side to which I am turning. And so it looks more like that. So both sides are ER. Now what I'm not doing is I'm not showing you the IR element in the middle. So here's exactly what happened. So I go ER with the yielding strategy on the right side. If I'm taking my club into my right-handed backswing, as I come towards the middle, I will IR. This is where I produce my maximum force. So force is always produced in an internally rotated manner, and then I would shift back to my ER strategy where I have the yielding strategy on the lead leg there. Now, if I'm turning, obviously I have a foot position that's coming up from the ground, I've got a knee position that's coming up from the ground, I've got a hip, I've got a femur turning into the acetabulum that also contributes to my production of rotation, so I'm not ignoring that. I just want you to see the representation of what's going on in the axial skeleton because it is both sides of the body doing the same thing from a muscle orientation standpoint. The difference is the delay that's produced by the yielding and overcoming strategies. So right away we have elements of PNF that are in play to help us produce rotation. So those are your chopping and lifting patterns. Because what they're doing is that they're actually producing the concentric orientation on one side of the body, the eccentric orientation on the other side of the body. And then as you move through space, you're producing these yielding and overcoming strategies. And so that's why those contribute to rotation. Any number of rolling patterns are going to be contributors to this ability to create rotation. All of your arm bar progressions, the simple log rolling that we're doing, the unilateral shoulder rolls, et cetera, all contribute to these compressive and expansive strategies that we're going to use to produce rotation. If we think about the pelvis as something as simple as working through our split stance activities will actually help us produce this rotation. So again, we have a lot of things that we can utilize in the gym. I promise I'll produce a video that will demo some of these things so we do have a visual representation of how we would utilize these things.

But I just wanted to throw that out there and let you see that rotation is probably not what you think it is. And again, both sides of the body are doing the same thing at the same time. We just have a little bit of delay between one side and the other, and that's why we see the rotation. So hopefully that's helpful for you. Have a great Wednesday, and I'll see you guys tomorrow.

I know I need a t-shirt hoodie, but I'm not going to ask for one. That would be the wrong thing to do. Rule number one, wrong thing to do. We did some training where I was really when you were emphasizing aerobic conditioning, both through circuit training and through a part of your work and how you're really using that to build aerobic bases in your athletes. And so I was just wondering how your thinking on that has evolved over time.

I am trying to become the master of simplification and so I am looking at everything from the perspective of what you need to be able to do. So from an athletic standpoint, I am just looking at what is actually where do I have to get these people to from an athletic standpoint, the game related stuff. So rather than looking at it from trying to affect one element of the energy systems as we would look at them, right? So they break it up into the three primary contributors. And I don't do that anymore. I just look at the exposure of intensity, duration, and all the factors that I can access to what an athlete may be exposed to. And I move them towards that with the full understanding that if I get a guy that comes in with a ridiculously high heart rate, like you sitting there with a resting heart rate at 75 or something like that, I know full well that he's not going to respond well to a higher intensity output right away or he will, and it will top out very, very quickly. So in those cases, you have to start farther away from where they're going to end up, because there probably is an element of adaptation in regards to the stuff that produces the energy. So I don't want to talk about mitochondria specifically, because I've never measured the number of mitochondria in anyone's muscle cells. So I really don't know. I do have that understanding that there will be enzymes that have to be produced. There is machinery that needs to be produced that may be supportive of that. There's also influences from a neural aspect that are in effect. If I do have somebody that comes in with a high resting heart rate, these are the things that I can't measure. So I have to look at this from the perspective of, okay, what do they actually need, and what do they present, and then how do I close that gap? So it's a lot like writing any other program. It's like, what is your foundational exposure? My assumption is that if somebody comes in with a high resting heart rate that they have not had any exposure to a long duration endurance type of program that would actually provide a foundation for me to build something upon. So if somebody comes in and they've been trained before, you got to teach them that one, you got to teach them to do exercises and then you have to establish one foundation of physical capacity that you can superimpose intensity upon. So it's the same rules. And so I don't change that. It's just the means would be the difference, right? Whereas somebody comes in for strength training, obviously we're going to do something that's going to get more resistance whereas somebody comes in for an endurance-based thing, obviously it's a lower intensity of output per unit of time. And so your means are different. So then we drift towards something that is less discrete of a task and more of a continuous activity. So again, that would be my perspective, whereas probably back, what, 13 years ago, I was probably thinking that, oh, I'm affecting this. Whereas I have that understanding, like I have an understanding of the energy systems, but the reality is it's like, I have no idea when you're doing using one or the other at any moment in time. And if I can't tell that, then why should I worry about it in regards to how I'm writing the program? What I want is an outcome. And so I use the same structure that I would in the purple room within a session. So within a session, I test something, I intervene, and then I retest to make sure that I'm on the right track. So with an endurance-based program or a conditioning program, I test, I intervene based on those tests, right? I structure the workout, and then I can't do it as acutely as I do in the purple room because the changes might take a little longer. Again, because if machinery has to be constructed and adaptations have to be promoted, that might take a couple of weeks to even notice any difference. And so my testing is spaced out a little more, but it's literally the same process because I can't project 12 weeks out what the outcome is going to be. But I can make sure that I'm on track to get you to where I think you need to be. So I just have to have a beginning point and an end point and close the gaps just like I do with any other aspect of the program. I don't look at it any differently than anything else that I do.

Obviously it's a lower intensity of output per unit of time. And so your means are different. So then we drift towards something that is less discrete of a task and more of a continuous activity. So again, that would be my perspective, whereas probably back, what, 13 years ago, I was probably thinking that, oh, I'm affecting this. Whereas I have that understanding, like I have an understanding of the energy systems, but the reality is it's like, I have no idea when you're doing using one or the other at any moment in time. And if I can't tell that, then why should I worry about it in regards to how I'm writing the program? What I want is an outcome. And so I use the same structure that I would in the purple room within a session. So within a session, I test something, I intervene, and then I retest to make sure that I'm on the right track. So with an endurance-based program or a conditioning program, I test. I intervene based on those tests, right? I structure the workout, and then I can't do it as acutely as I do in the purple room because the changes might take a little longer. Again, because if machinery has to be constructed and adaptations have to be promoted, that might take a couple of weeks to even notice any difference. And so my testing is spaced out a little bit more, but it's literally the same process because I can't project 12 weeks out what the outcome is going to be. But I can make sure that I'm on track to get you to where I think you need to be. So I just have to have a beginning point and an end point and close the gaps just like I do with any other aspect of the program. I don't look at it any differently than anything else that I do.

Sometimes when it comes to rehab kids, I would say to Mike that there's a lot of literature now in almost every sport that looks at game analysis of physical outputs. Depending on the sport, you can see what normative data exists. While it might not apply exactly to your athlete, it can be a decent starting point. For example, when I was in soccer, GPS technology became prominent about a decade ago, allowing us to see what each league worldwide expects of each position during a 90-minute game. The same is happening now in basketball, and I know they have some data for lacrosse and football too. So even if it's not athlete-specific, it gives you a starting point for what you're trying to achieve, like Bill was saying about establishing the end goal. But if you need sport-specific terminal tasks, that's where my mind immediately goes: what sport is it, and what does the current literature say, because there's so much available now due to technological advances.

Yeah.

A lot of the field sport information falls into a very similar category. For example, you can get information on Irish hurling. We don't have work-to-risk ratios on the NFL, but we do have Irish hurling information available to us, which is useful because if you compare soccer and the hurling information, what else do we have? They have some stuff on rugby, Australian Rules football. But a lot of the field sports tend to start to look very, very similarly. I mean, they look at how long you're walking, how long you're standing, what's the longest sprint you do at such intensity. They have that kind of information now, which is really helpful to determine like, okay, here's what your needs might be.

Do you usually use like a similar type of thought process in regards to return to sport, following injury and surgery?

Once you're past that initial rehab stage, it's just a reconditioning element. It's like, okay, what's your fitness level now? What do I need to prepare you for? Adam can speak to this with great accuracy because that's what he does for a living. It's like you're in this constant state of reconstruction and restoration of fitness, right?

Once you get past that initial, which we refer to as the health and therapy phase, we really try to manage the acute injury, whatever tissue was affected. If it's an ankle sprain, you're trying to manage that acute swelling, that acute pain. We use biological timelines as a reference source, but then we also use a criterion model relative to basic strength and range of motion. And once you get through that phase, like to Bill's point, it's just training and understanding where you're at and what you have to get to. You also look at a lot of literature from Issyrin and some of the Russian literature as far as the rate of decay of athletic qualities. For example, you tend to see a quicker drop-off in high-intensity efforts, like sprinting and jump output in basketball. Because those are more CNS-like, short-lived outputs, maximal outputs, whereas true aerobic fitness that is more structural-based, more like mitochondrial and cardiac changes, takes longer because they are true structural changes. So what you're trying to understand is how long you were unable to load or challenge those systems. And then those are probably the first ones you want to hit. And if it's more of a longer-term one, maybe you try to go the aerobic route too. But once you get past that pain and health phase, it really is training at that point. There's a phrase out there: 'training equals rehab.' I agree and disagree. It is valuable in that context, but it's not the same thing early on. So they are different, but they do get to a point where, as our strength and conditioning coach says, your rehab should look like training because ultimately you have to get back to doing the things you need to get back to.

I think it's a matter of are you trying to expand adaptability for health purposes or are you narrowing capabilities, narrowing adaptations to reach a level of performance, because they are not the same. I'm actually reducing the broad scope adaptability of the system to reach a level of performance because you have finite resources that are available. I can't distribute them broadly under all circumstances. But to capture health, you do need to have that broader element intact. Because you never know how many systems are going to be affected. And so you have to try to get as many as you can.

Bill, I have a question for you. I have an answer, hopefully. We've been talking a lot about feet internally around here. Just some observations we've noticed and even let you Google, you Google some athletes feet and you see a lot of the most athletic NBA ballers, they have very, very flat feet. Toe valve is bilaterally collapsed arch. Just the whole nine.

I have an answer, hopefully.

We've been talking a lot about feet internally around here. Just some observations we've noticed and even let you Google, you Google some athletes feet and you see a lot of the most, the most athletic NBA ballers, they have very, very flat feet. Toe valve is bilaterally collapsed arch. Just the whole nine. They also, we see the large complete opposite spectrum, the very high arch as cave is very rigid foot. We started to notice, again, observing those that tend to be very, very flat collapse feet also tend to have a lot of bounce and are considered like your high flyers or dunkers. And then some of the rigid ones we've seen are just kind of stuck in the mud a little bit.

Yeah.

They also see the large complete opposite spectrum: the very high arch, which is a very rigid foot. We started to notice, again, observing those that tend to have very flat, collapsed feet also tend to have a lot of bounce and are considered like your high flyers or dunkers. And then some of the rigid ones we've seen are just kind of stuck in the mud a little bit.

You want to talk about that?

Yeah. This is actually really cool. I'm going to pin my screen because I want it to be big on video. Can everybody see my foot? You've got three feet to worry about. You've got early propulsive foot. So the early propulsive foot is what people would consider this supinated looking foot. The tippy toes are behind the ankle. I've got the big arch. My big toe kind of wants to touch the ground, but it's probably not really good at touching the ground. I might have to plantar flex it a little bit to get it to the ground. So that's an early propulsive foot. Under these circumstances, I've got a talus and a calcaneus that are moving together. As that heel breaks the ground, I'm producing the maximum amount of force into the ground. Then the tibia keeps going forward and it lifts up my heel and I go up over the foot. And that is again no relative motion between the calcaneus and the talus.

This is actually really cool. Hang on. Let me get my foot. Here we go. I'm going to pin my screen because I want it to be big on video. Okay. Can everybody see my foot? Okay. So you have three feet to worry about. You have the early propulsive foot. So the early propulsive foot is what people would consider a supinated looking foot, right. So the tippy is behind the ankle. And I have the big arch. Okay. And then my big toe kind of wants to touch the ground, but it's probably not really good at touching the ground. I might have to plantar flex it a little bit to get it to the ground. So that's an early propulsive foot. Okay. So under these circumstances, I have a talus and a calcaneus that are moving together. As that heel breaks the ground, I am producing the maximum amount of force into the ground. Okay. Follow so far. So that's an important point. Then the tibia keeps going forward and it lifts up my heel and I go up over the foot. And that is again, no relative motion between the calcaneus and the talus. So supinated foot and that supinated foot are not the same. So late propulsive foot is not the same as an early propulsive foot, even though they've both been termed a supinated foot.

If you really, really want to learn and really want to get better at what you do, you have to continue to question things. The reason that you want to continue to question things even when you're successful is because everything that you do and everything you see is your interpretation of reality. So it's not reality. And so there's always going to be a gap, which means that within that gap is where we can improve. And so if we can push ourselves forward to see more of what we think reality is and expand our understanding of what the possibilities are, this is what's going to help us to progress and evolve. And so one of the first things you would do, regardless of the outcome, whether you consider your outcome a success or a failure, is what relationships did I think were apparent? So what did I see? What did I think I was measuring? What did I think those relationships represented? Because I have to have a framework or an understanding of what I think is going on. And the more refined that perspective of those relationships are, the better my starting point in this process. So then based on my outcome measures and my intent when I intervene, it's like, did I interpret those measures correctly? So here's the power of hindsight. So I have a before representation and I have an after representation. And so if I intervened as I intended and I got a correct outcome or the intended favorable outcome, I can still look back and try to interpret those measures. So a lot of times you figure these things out in hindsight. So I think I have a representation, I see what I ended up with, and then I work backwards. Because maybe not everything went exactly as planned, so why not? Why didn't it go exactly as planned? So maybe it's favorable for the client. So the client feels better, they move better, they accomplish some sort of task. But the reality is that if I really, really objectively look at my measures, I can look backwards and I can say, okay, was my interpretation correct? The more often you can do that, the more you're capable of narrowing what the probabilities will be that next time. And so again, we use every opportunity of our interactions with a client or a patient or whomever it may be as an opportunity for next. Now, again, because we have this gap between our perceptions and reality, we have to ask ourselves, what else could it have been? So if I think I know something, is there something else that it could have been? What were the possibilities? Are there other possibilities? So now we have to think about, okay, as I study these things or as I'm trying to learn something new, where else can I look for possibilities? Where else can I look for understanding? And where else can I look to gain a perspective on these relationships? And so now this is where education comes in. And this is where they fail because what education has become is teaching a bunch of concepts without without a coherent model to represent things. And so, you know, when you go through PT school, for instance, they teach you embryology. Well, why do they teach you embryology? They never told you why it's important. And the reality is, it's like, that's where you came from. And so when you start to see how these relationships evolved through development, you start to see how they are represented in this fully grown human that we're interacting with. And then it becomes very, very powerful. And so that's why we have to go back and we have to start looking at those things. We look at comparative anatomy between animals because other animals behave very similarly to how we do. So how does it work for them? And then we can start to get ideas of how it might work for us. Finally, we start to say, okay, does this make sense? Is it coherent with what my understanding is? And so think about this for a second. We have universal principles that are applied everywhere. So I talk about compression and expansion a lot. The reason being is because it is a universal principle. So when I say universal, I am talking about the universe in and of itself. So we talk about compression and expansion. So that's what the universe does. It expands. So space expands and compresses. Time compresses and expands. It's light compresses and expands. So we have to follow those rules too. So wherever we have some physical principle in the universe, we need to behave within that rule as well. So is it coherent? Is it consistent with those rules? The rules are very, very simple. When we look at the complexity of a human, we can get distracted by sharp shiny objects all over the place, but the reality is, if we can start to simplify things, we look at the simplest of rules, that is how complexity evolves. So if you look at things like Conway's game of life, and you can look that up on google and then go play with it a little bit, and what you'll see is there's there's three simple rules that this game is based on, but you'll see the most amazing complex structures that evolve from those simple rules. We are the same. And so again, if I see something or I see information presented that requires that I have to learn another rule, I immediately question it because again, I think we're based on very, very simple rules, very simple processes that are just repeated. And because of the new starting conditions, that's what evolves the complexity that we see.

Where else can I look to gain a perspective on these relationships? And so now this is where education comes in. And this is where they fail because what education has become is teaching a bunch of concepts without a coherent model to represent things. And so, you know, when you go through PT school, for instance, they teach you embryology. Well, why do they teach you embryology? They never told you why it's important. And the reality is, it's like, that's where you came from. And so when you start to see how these relationships evolved through development, you start to see how they are represented in this fully grown human that we're interacting with. And then it becomes very, very powerful. And so that's why we have to go back and we have to start looking at those things. We look at comparative anatomy between animals because other animals behave very similarly to how we do. So how does it work for them? And then we can start to get ideas of how it might work for us. Finally, we start to say, okay, does this make sense? Is it coherent with what my understanding is? And so think about this for a second. We have universal principles that are applied everywhere. So I talk about compression and expansion a lot. The reason being is because it is a universal principle. So when I say universal, I am talking about the universe in and of itself. So we talk about compression and expansion. So that's what the universe does. It expands. So space expands and compresses. Time compresses and expands. It's light compresses and expands. So we have to follow those rules too. So wherever we have some physical principle in the universe, we need to behave within that rule as well. So is it coherent? Is it consistent with those rules? The rules are very, very simple. When we look at the complexity of a human we can get distracted by sharp shiny objects all over the place but the reality is if we can start to simplify things we look at the simplest of rules that is how complexity evolves so if you look at things like Conway's game of life and you can look that up on google and then go play with it a little bit and what you'll see is there's there's three simple rules that this game is based on but you'll see the most amazing complex structures that evolve from those simple rules. We are the same. And so again, if I see something or I see information presented that requires that I have to learn another rule, I immediately question it because again, I think we're based on very, very simple rules, very simple processes that are just repeated. And because of the new starting conditions, that's what evolves the complexity that we see.

Where we're out of a specific context, there's some broader questions that you may want to ask. So it's like, why did other models demonstrate success? Because again, it's all about perspective. When we think about comparing what we do with our model to other perspectives, things like we talked earlier this week about rotator cuff strengthening versus recapturing relative motion site. So some of those things actually do work in the clinic, but it's just a matter of perspective where you say 'oh you're strengthening a rotator cuff' and I say 'oh you're just restoring the relative motion in those relationships that allow us to move more effectively.' So again, both models will work, but the perspectives are different. So which one of those can I apply consistently and demonstrate greater levels of success in more context? Stretching versus each other orientation might be another one that we would consider to have different perspectives. So again, I want you to start to think about evolving your process and looking at these things the same regardless of the outcome whether it is favorable or unfavorable. This is how you're going to get better is to continue to question things. And it is a struggle. It is work because when you're successful, you want to kind of pat yourself on the back and say 'yeah I did great. I was awesome today.' But the reality is if we really want to get better, we have to continue to question everything that we do because we're never seeing reality, but we can start to close that gap with knowing that the gap is always going to be there.