Good morning. Happy Monday. I have neural coffee in hand and it is perfect. That is quite good actually. All right, so we had a pretty solid weekend. Looking forward to another great week. Got lots of mentorship calls this week. So that's gonna be fun, I really enjoyed those. Which reminds me, if you would like to get on a 15 minute consultation, please send me an email at askbillhartman at gmail.com, askbillhartman at gmail.com, and we'll set that up. which leads us into today's Q&A. I got a chance to talk to Greg, and Greg has some interesting influences that I think are going to help a lot of people through this discussion. So he was kind of to share some medical history. He actually had a sternotomy where they basically slice open your sternum as a youth. And so we talked about the potential influences there. Greg is also a musician. and a physical therapist. So we have some really good thinking and we have some performance related influences that come into play in this discussion as well. And so all of these things need to be considered when we're trying to make changes in movement capabilities. So thank you, Greg, for your participation and for sharing. Like you did, it's going to help a lot of people. So enjoy today's Q&A. And remember, if you have a question, go to askbillharmonageemail.com, askbillharmonageemail.com, set up your 15-minute console, and we'll get that taken care of. And I'll see you guys tomorrow. Block is running. Go ahead. Fire away.

So a couple of months back, you talked about median sternotomy and how that might affect, depending on how things heal and how it might affect measurements. in the extremities because of what's happening internally. The first part of the question is, could you kind of talk through maybe some of that in terms of what you might want to see? And then my second, like asking for a friend kind of thing, except you know, it's me, obviously. The thing I'm trying to do is get left shoulder flexion back because I play upright bass. Um and so upright bass.

Yeah, so okay, I know what an upright bass is, dude.

You got it.

Yeah, so what do you play? What kind of music?

I play jazz.

Oh, okay.

I got you. It's awesome. Perfect. It's one of those things where it's kind of a right-behind-left stance.

Yeah. No, I'm with you. I understand. My sister's a string instrument player, so I've been exposed to that. When they fillet you open, as we would say, you have to have a union of the sternum. As it forms, it's two bones that sort of zipper together in the middle. So it behaves as two bones. You have a left sternum and a right sternum. When we talk about compression and expansion through the rib cage, you have two sides that turn together. You also have the synovial joints of the ribs attached. So we have a lot of movement around the sternum that we need for normal expansion and shape change, which is what we need for shoulder movement. When you have a sternotomy and they wire you back together, there are a couple of things that can happen. Obviously, did they talk to you about non-unions?

Not really. I was 12, so they didn't go into much detail.

Sometimes what can happen is you get what's called a non-union, which is it's either an incomplete or not even a fusion of the sternum back into its previous state. And of course, it's not going to be in its previous state, so we need to understand that too. But if you get any sort of a hingey kind of relationship now, you don't get the coordinate expansion and compression kind of thing because you got an extra hinge in the middle. And so that makes it very difficult to create internal pressure. So if you were a singer and you had the sternotomy and you had a non-union, you wouldn't be able to sing. You cannot project your voice when you don't have this normal behavior of the sternum. So there's a sweet spot between this stiffness and this mobility that we need under these circumstances. So again, you think about like a higher force exhalation kind of a strategy, like if you were trying to project your voice and you had this spot that gave way, now you've got a weak spot in the system and therefore the pressure does not ramp up under normal circumstances. Secondly, if it's stiff and it doesn't turn, now we have the limitation in our ability to change shape that's associated with that, and you're going to have some form of restriction. So just think about normal breathing. If I have to breathe in, I should have this pump handle that can move. And if I don't have that, then I'm going to have to create a substitution to breathe in. So a lot of people that have anterior compressive strategies, they're committed to people say, oh, you're breathing with your neck. So you'll see all of this extra accessory muscle activity that's associated with trying to lift the rib cage upward to create the expansion versus the anterior-posterior expansion. So the question is, is this an influence for you or is it not? That would be the step one. Based on your age that the surgery was done, it's in your favor that it's not that much of a deal because when you're as young as you were when it happened, chances are you were still mostly cartilaginous as it were under those circumstances. And so because you weren't fully calcified, the chances of it being in limitation is probably slim. Now, your physical structure lends you towards certain strategies, right?

Not that tall, like 5'10".

Okay, well, but that's above average. I'll give you that, right? But again, so now you're going to be biased towards a certain strategy as far as expansion and compression is concerned and then how do you hold yourself in space? And then that's going to be how the superficial influences affect your ability to maintain your center of gravity, turn, breathe, et cetera, okay? And then you picked an instrument that creates a structural or not a structural bias, but a coordinate bias, right? There's a certain position that you have to be in to play your instrument.

Exactly.

Okay, and my guess is that if you're playing at any level, you've practiced a bit. Am I correct? Yes, okay, so we have a really strong training influence. Just like anybody who would spend too much time in the gym relative to what they need to do for their sport, you have a certain physical influence that's going to be what we would call interference.

Yes.

Okay. So now we have to come up with a plan that offsets the negative consequences in regards to movement that your desired activity creates.

That's right.

So if we talk about limitations in what would be referred to as traditional shoulder flexion, the early phase of that movement requires that you have a posterior expansion in the area below the level of the shoulder blade to initiate that movement without any compensatory strategy or without any movement that will be required to move away from that midline, right? And that's where your struggle is, is that fair?

That's fair, yeah.

Okay. Do you notice the same thing in your hips?

Yes.

Okay.

Yeah, absolutely.

Awesome. Okay. So at least you match and that's a good thing. So the chances of us having a constraint problem, like a structural change that we can't do anything about is reduced under those circumstances. Because if your shoulder and your hip kind of match, then that would be just lending towards behavior and then physical structure. Now you're just like everybody else. You have stuff that moves on the inside, right? That you're managing. And then, like I said, you've got this superimposition of the activities. So you're going to have to offset, you know, to as much that you can, you have to offset those influences. So you have two things. You have this the normal gravitational influences, and then you have behavior. So what have you done so far that has been effective?

Okay. So I also had a string training period for about seven years. So I was going pretty hard in the gym. I grew kind of this like monster on my left side of my back. They're kind of, you grew a monster is how he said it's like a creature over there. It's just the asymmetry in the development.

Gotcha.

So I grew kind of a monster on my left side of my back. It's like a creature over there. It's just the asymmetry in development. The lat area all the way up is visible, and when that kind of kicks in—when you're holding the bar, you kind of go to it. When that kicks in, then the shoulders just can't hang because everything's just so far pushed.

Okay.

The lumbar area all the way up is, it's like visible and it's something that when that kind of kicks in, because when you're holding the brace, you kind of like go to it. Like when that kicks in, then the shoulders just, it can't, it can't hang because everything's just so far pushed.