So under that circumstance, the muscle in question is oriented to produce force in IR and we're asking them to try to produce force in ER.

I've always got a bunch of questions, but I'll pick one that might be of some general interest. It's a bit of a complaint that I've got because I work with a lot of clients who go and see more conventional practitioners. So I'm faced with the stretch and strength and crowd discussion on a pretty regular basis. Just to give you an example, I have a client at the moment who has a significant interior orientation. He's an older guy, probably around 50, but he can still pull 500 pounds off the ground pretty much every week. He goes to an exercise physiologist or physiotherapist and they tell him he's got weak hamstrings because he's got an interior orientation. I'm just thinking there must be something they've based this on. I never went to PT school like you guys did, so where does this come from? Where is the notion? Where are the studies? When you look at EMG studies on standing posture, hamstring activity is almost nothing. So where does this notion come from—that I can pull 200 kilos off the floor, but I can't straighten my pelvis because my hamstrings are too weak? It doesn't make any sense.

All right. Question. All right. If I have an anti-orientation of the pelvis, yes. You understand that the musculature above the trochanter is reorienting into an IRD position. OK.

Yes.

Yes. OK. Awesome. Yeah.

OK.

In the physio world, when testing a muscle like the glute medius, they use a straight plane representation. They think glute medius performs hip abduction because they're using an old school dead guy straight plane representation of what a muscle can do. Now, what we know is that if you move the extremity away from midline in a lateral representation, you're producing a late ER position of the hip. Under that circumstance, the muscle in question is oriented to produce force in IR, and we're asking them to produce force in ER. When they push down on the leg, it collapses, and they conclude the glute is weak. But it's not that the muscle is weak; it's in a position where it cannot produce force in the direction being tested due to its orientation. The test itself is fine, but the interpretation is wrong. They're looking at structural reductionist representations, viewing muscles as separate entities that behave separately. In reality, everything works together in a positional representation. They might say you have an unstable hip, pelvic instability, or weak hamstrings, but essentially it's about a muscle being incapable of producing force in a specific position. For example, if you anteriorly orient the pelvis sufficiently, it's difficult to put the hamstrings in a position to produce force. This derives from historical manual muscle testing approaches, like Florence Kendall's, which graded muscle activity on a five-point scale and used isolated representations of muscles in certain positions. Additionally, they often test in these ER-like weaker positions, making it inherently difficult to produce force regardless.

Even if you went with a client sort of mentality, surely the notion that if you're going to test a hamstring in this case for its ability to reorient a pelvis to pull the ischium down, you would think that they would have to have some sort of measure to determine how strong that needs to be. And the second question that went along with that is if they don't have a measure or some sort of baseline indication to go, 'Well, this is determined to be weak in that specific position,' then how are they establishing that it's weak? It doesn't make sense.

Well, okay. Thank you. You're asking the very good questions here, right? That they refuse to, they can't answer it because they don't really have a great response to that. You trap them in supine and you just trap an arm sort of like in this, like it was a PNF D2 flexion, right? You trap them there and you take your other hand and you put it below their chest so it's on the lower rib cage. So like I think ribs seven, eight, nine, 10. And you just start, rocking them, right? And so what you're doing is you're just creating these waveforms, right? And then you play with the rhythm. And then what happens is, if you get it right, and you can feel it, you can feel them tense up or you can feel them like, oh, so you know, like increase, decrease kind of thing. But literally, so they're just rolling from side to side, basically, but you're controlling this pulsation of rhythm. Right? It's like, uh, it's like manually induced lazy rolling in supine. Basically is what it's like. Yeah. Yeah. Works great. Like it's underappreciated. Something that's underappreciated because everybody wants to pull, stretch, lift, squeeze, you know? And it's just like, no, just chill. You know? Yeah. It's like, uh, uh, the, the, the harmonic technique you ever been in, uh, on a floaty, like on a raft on a lake that just has like this kind of like general rhythm thingy going, yeah, that's why that stuff is so soothing because it just sort of restores this this really relaxed kind of rhythmic passage of energy through your body. It's kind of cool.

So we said that, would it be wise to restrict the rib flare in the other side? For example, like if the rectus strategy is on the right, very strong, restricting the lower ribs in the left, not allowing them to flare, would this help to open to

Well, so when you're doing that activity, typically you are creating the compressive strategy on the other side. So you're correct, yes. Because you're inducing part of a turn, and so it would have to turn and open on the other side. It's kind of like you were talking about: if it's late on the right, is it early on the left kind of a thing? That's what you're trying to create. We're trying to restore the ability to turn on the helical axis.

So if you're holding their left arm up, you'd be compressing on the right ribs. Doing what? It depends on what you're doing. But the stuff you're doing, like the harmonic method, trying to get that pulsation.

So think about the recoil. It's hard for me to get on the other side of the body if I'm holding the arm where we're talking. If I'm holding the arm on this side, I have to push over here. So I'm pushing you away from the arm and then you're going to recoil back towards it.

Right. Yeah.

Okay. So I'm pushing you away from the arm and then you're going to recoil back towards it.

Let's see.

I see it.

Okay.

Yeah, that's, but see, that's why you have to find a rhythm that's comfortable for them because it's the recoil that creates the expanded representation on your side. Remember, you can only create the compressive strategy. See it? Yeah. So, you kick a wave away from you and the wave kicks back. Okay. Yeah. Um, have you ever seen Olympic swimmers? Like in the Olympics. So they get up on the box and they're shaking and trying to swing up. Why do you think they do that?

Cause they're nervous.

Was trying to get like the right, the right tension set. Right.

So they're trying to literally self-induce these vibrations to create an optimization of muscle activity that they feel is optimal for performance. Because they've done this a bunch of times, and so they're literally tuning themselves as they're standing. Because they know if they relax too much to mushy, if they're too tense, they can't swim. And so they're constantly trying to feel like they use the vibration for sensation to feel how much muscle activity and what position they can get into. But they do it—they're probably thinking about it to do that, but that's what they do.

Yeah. If it sounds like the golf waggle, like when a golfer goes to put their club down and then they do the sort of wiggle their hands back and forth.

It is a similar effect, but part of the waggle is the pressure. They're trying to optimize the pressurization before they take the club back. What does the club head do when you waggle? What does the club head do when you waggle, Cameron? When they waggle, they do the up, down, up, down. So what they're doing is swaying their guts back and forth and then unwading them, swaying them back and forth, unwading them, swaying them back and forth, unwading them. So they can feel where everything's going to go when they take the club away. He's got to learn strategy to produce a lot of force down into the ground so he can lift the weight off the ground. He's trying to get as much internal rotation downforce as he possibly can, which requires that you anteriorly orient the pelvis to do so. They're going to use standardized positions. If you're going to test a hamstring, you put somebody in prone, you bend their knee and you push against it, and you go strong, weak. Then they're going to make a comparative measure. So they're going to do a pre-measure, an intervention, a post-measure. In many cases, they'll get the favorable response that they want because they can't reproduce it. Even if you've got one of those little dynamometers on your hand to tell you how much pressure you use, you're still not going to be able to reproduce it. The person's not in the same position that they were before. Maybe you accidentally did something that's favorable, and you actually created the position that you needed to in the pelvis to create the higher pressure strategy so you can produce more force. It's exceptionally difficult to determine whether you have the optimal position or not. This is why when we talk about table tests and chess board measures and then representations of what that would translate to dynamically, that becomes so important for somebody like you. You're going to use step-ups, split squats, squats, and things like that to determine position. You understand, you recognize where the internal rotations and external rotations are supposed to show up during those activities. And then to what degree, you determine what is acceptable, optimal under the context.

I mean, it's gonna lose.

It goes sideways. Are you a golfer? Or you work with golfers probably, right at Pepperdine? Yes, I work with golfers. So when they waggle, right, they do the up, down, up, down. So what they're doing is they're swaying their guts back and forth and then unswaying them, swaying them back and forth, unswaying them. So they can feel where everything's going to go when they take the club away. He's got to learn strategy to produce a lot of force down into the ground so he can lift the weight off the ground, right? So he's trying to get as much IR downforce as he possibly can, which requires that you anteriorly orient the pelvis to do so. And so they're going to try to use standardized positions. Like I said, if you're going to test a hamstring, you put somebody in prone, you bend their knee and you push against it, right? And you go strong, weak, right? And then they're going to make a comparative measure. So they're going to do a pre-measure. They're going to do an intervention. They're going to do a post-measure. And in many cases, they'll get the favorable response that they want, because number one, they can't reproduce it, even if you've got one of those little dynamometers on your hand to tell you how much pressure you use, and you're still not going to be able to reproduce it. The person's not in the same position that they were before. Maybe you accidentally did something that's favorable, and you actually created the position that you needed to in the pelvis to create the higher pressure strategy so you can produce more force. But you're right. It's exceptionally difficult to determine whether you have the optimal position or not. But this is why when we talk about table tests and chess board measures and then representations of what that would translate to dynamically, that's why that becomes so important for somebody like you. It's like, because you're going to use step-ups, split squats, squats, and things like that to determine position. You understand, you recognize where the ERs and IRs are supposed to show up during those activities. And then to what degree, you determine what is acceptable, optimal under the context.

So there's no magic set of tests. There's no magic studies that I haven't found somewhere on the internet that demonstrate some baseline recommendation for hamstring strength relative to quad strength that is supposed to keep and maintain a level pelvis. Oh, great.

Not in that case. You'll find it in regards to a knee. Yeah, you'll find stuff in like, and I don't remember what the ratios are now, they usually give you like a ratio it's like one to 1.25 or something like that for me, anybody know what those stats are anymore I haven't looked at them in decades. But they'll talk about that for the knee. I don't know that you have the same relationship for the hip. Keep in mind, Matt, that they're looking at these things in straight planes. And so you're going to hear pelvic orientation described as a force couple, which is inaccurate to be kind. But you'll see it described like that because they're looking at it in a traditional sagittal plane kind of a representation, which is where some of this hamstring stuff comes from as well. But again, you don't have a great measure. Now, there is literature that they'll use x-rays in some positional stuff to give you an idea of what the pelvic inclination angle is. So that's the relationship of the sacrum relative to the spine. There is a pelvic tilt measurement that will also be used. And then they will have like established norms under those circumstances, but it's not helpful clinically because I can't x-ray everybody in every position that they would be in and determine whether they fall within some average range.

So now you're back with that, that would differ in your model in respect to now as it was that would that would differ.

There's definitely differences. And again, pelvic inclination, not clinically, but from the research standpoint, when you look at the pelvic inclination, that is a representation of the degree of orientation that we're talking about. That is measurable, but again, it's not reasonable to use that clinically. And it informs us of things that helps us determine what we're actually looking at clinically, but the degree of which is almost impossible to tell. But there is a little way to kind of, there's some detective work that you can do in regards to the way that the sacrum shape changes, especially some of your really compressed sacrums. You'll get an idea of the degree of pelvic incidence. The greater the incidence, the more bend you have in the sacrum. Like that's just an absolute, as far as we can tell. So your question. Go ahead.