Good morning. Happy Wednesday. I have neuro coffee in hand as usual and it is perfect. Okay. Big day. If you're on the mentorship list, a little FYI. I'm going to be sending an email today with a huge monster announcement for you. Something we've been working on for a little while that actually includes my business partner, Mike Robertson. So you're going to be wanting to look for that because there's going to be something that's very, very special for you guys that are on the mentorship list. So if you're not on that list, I would suggest you get signed up very, very quickly. Also, it is Wednesday, which means that tomorrow is Thursday, so tomorrow is Chips and Souls today. So I'm really looking forward to that. Now, two, the Q&A. Today's gonna be all about the wide ISA, if that's okay with you because I got a question from a couple people that have gone through the intensive, Monica and Justin, and they had a question about some wide ISA strategies. And so I wanted to go through a few things that I think might be helpful for you, from like a self-diagnosis standpoint and from a training standpoint. And so first and foremost though, let's kind of look at what we're up against here with the wide ISAs. And so I got out my little thorax thingy here that I'm going to show you down the line. So what we're typically looking at with the wide ISA is the expansion from the medial to lateral. And then so we're narrower from anterior to posterior. And so under these circumstances, we don't get a lot of turn. We'll see a lot of compressive strategies. The initial bias with the Y is towards increased internal rotation and a loss of external rotation. But Justin and Monica had questions about what about when you lose the internal rotation. So let me grab the pelvis here and I'll show you. like a nice little representation of the pelvis. So under most circumstances with the wide ISAs, and if they don't have full breathing excursion, then I'm going to be looking at a situation like that where I'm going to have the nutated sacrum, the IR ilium, and that would normally point the acetabulum forward and into an anterior position of the acetabulum, which gives you lots of IR. However, if I'm losing that IR, that means I've got a compressive strategy anteriorly. So the front of the pelvis is getting pushed backwards, much like the sternum getting pushed down, so the pump handle would probably be down as well. So that means I'm going to start to lose shoulder internal rotation, and I'm going to start to lose this hip internal rotation. And so when we think about lines and we think about training strategies and such, We want to consider this shape first and foremost.

So what we need to do is create a strategy that creates anterior expansion. It brings the pump handle back up, moves the pubis forward. One of the things we can do is flip people onto their side. We'll do more sideline activities. For someone who might typically do a prone plank in the gym, which would be symmetrical and reinforce this compressive strategy, a side plank would not be recommended. Instead, moving into a side plank position is beneficial because the internal organs fall toward the ground due to gravity, creating nice anterior-posterior expansion. If we're talking about planks for a wide ISA, I would use side planks all day, every day. Gravity provides a mechanical advantage with the gut position. We also need to recognize that wide ISAs don't have good turn capability. Bilateral symmetrical exercises are typically not advantageous when trying to create anterior-posterior expansion and restore turn. An exception might be recapturing hip internal rotation with a modified deadlift followed by a wide stance, heels elevated deep squat. This can restore internal rotation for those wides showing limited straight leg raises, probably below 70 degrees, but more limited than that. You'll see a return on investment in hip internal rotation because the musculature below the trochanter is concentrically oriented and limiting internal rotation. This is one exception to the bilateral symmetrical rule. Typically, we want to emphasize split stance orientations and single arm pressing and pulling. When pushing and pulling with a single arm, we get a compressive strategy on one side and an expansive strategy on the other, helping restore the turn element. When thinking about the sternum, you have a right and left. Compressing on one side compresses the pump handle on that side, allowing expansion on the other. On the thorax's backside, you get reciprocal expansion and compression. Use unilateral strategies when trying to create expansion for wide ISAs.

Also posted today on Instagram, a little strategy to maintain posterior expansion on the backside for those of you that perform a lot of bilateral symmetrical exercises and are probably biased towards a wide ISA. Very useful strategy as well. Another great self-test is the back to wall flexion test. That's also up on YouTube so you can actually get to see that. If you are limited to such a degree that when you put your fingertips against the wall with the elbow pointing straight ahead and you can't get past 90 degrees of shoulder flexion without the deviation of the elbow outward, then you know that you are compressed below the level of the scapula and you need to go to the most recent Instagram post and get that posterior expansion. where I show you bending over the glute ham to expand the lower posterior ribcage because that's going to be your first step. I would also do the heels elevated bilateral squat under those circumstances to try to reestablish expansion in that area first because if you don't have expansion there you'll never get the pump handle to come up because ultimately we've got to get the pump handle to come up to get the internal rotations to come back. So expand the posterior lower rib cage first, then go after pump handle. The way you go after pump handle is through the unilateral pressing and pulling activities. So make sure you're addressing the reciprocal strategy. And again, when you're trying to create that AP expansion. So hopefully that gives you a little bit. You got a couple of tests. You got the back to wall shoulder flexion test. You got a straight leg raise test that are going to help guide what your priority should be. And then you've got this unilateral reciprocal strategy in regards to your training. So apply those.

Pete asked a bunch of questions and I hope you don't mind Pete, but I want to paraphrase this stuff a little bit just to make it a little bit more digestible. But basically, Pete's first question is, how are you dissociating sacral movements to pelvic orientations and how do they show up in testing? So this is actually a really, really good question because it allows us to differentiate the difference between relative motion within the pelvis and then an absolute orientation of the pelvis. Let me grab my pelvis for a sec to show you what I mean. So if we're talking about normal stuff here, right, we're going to talk about normal range of motion first. So if we look at your typical average norms, we get about 60 degrees of hip ER and 40 degrees of hip IR by dead guy anatomy. So what that requires though is that I have this normal nutation counter-nutation element of relative position change in the pelvis. So when I am nutated and I have that IR ileum that allows me to capture my normal IR motion. When I have the counter-nutation and the ER ileum that allows me to capture my ER motion. Now if I would have measures, let's just say 75 degrees of ER, 25 degrees of IR, that still demonstrates the relative motion within the pelvis. It just means that I'm biased towards my inhalation strategies because I've got 75 degrees of ER. What that does is it just means that I've retroverted the acetabulum to allow that 75 to show up. If I still have 25 degrees, that means I still have some relative motion here. It's just that I'm biased way back towards my inhalation strategy. So keep that in mind. When I have orientations take place, what that means is I'm going to start to lose my physiological motion. So if I would anteriorly orient the pelvis, what you're gonna see over time because of the compressive strategy that takes place on the posterior aspect of the pelvis that starts to drive this orientation is I'm gonna start to lose my ER measure. Because the musculature above the level of the trochanter is compressing the posterior pelvis. It's going to create this orientation and I'm going to start to lose my ER measure because these muscles reorient and become IRs and they start to bring myself into that hip IR position. So that's a great way to distinguish between the orientations and the relative motions because when I have relative motion of the pelvis, I still have this full physiological range. When I lose my physiological range, then you can pretty much guarantee that I've got an orientation problem going on. Okay, so Pete's second question.

Pete's second question had to do with, I'm just going to go to the end of it. What do you commonly refer to when you say someone is in exhalation versus inhalation? So now, Pete, we're going to talk about the two archetypes. We're going to talk about your wide ISAs and your narrow ISAs so that everybody just loves to talk about. But in general, what we're looking at is different physiological structures. And so if you looked at my Instagram over the weekend, I've stood outside one of the shops nearby IFEST. had the wacky wavy tube guy out front. And I just love the wacky wavy tube guy for so many reasons. But one, because it is demonstrative of one of the strategies that we utilize against gravity. So we only have two. We can either expand or we can compress. And so what the two archetypes are representative of is that ability to expand or compress, because we will be biased at the extreme. So we're talking about the extremes. We're not talking about anybody that's in the middle range. So because of the helical angles, so the angles of if you look at the abdominal muscles, that's a great representation of the helical angles, but the ISA is representative of those helical angles. So the narrow ISA has a more vertical helical angle and what that means is that person's physical structure cannot elongate anymore so their strategy against gravity is to try to expand themselves so they will be inhalation biased based on their physical structure. In the opposing strategy where I have a wide ISA I can't get any wider so I try to squeeze myself and compress myself upward against gravity to maintain my position. Well, if one is expanding, then that creates negative pressure. So that's a bias towards inhalation. If the other is compressing, that's a bias towards exhalation. So that's how we know the difference between these two archetypes is one is a compressor and one is an expander. So the compressor is an exhalation bias and the expander is the inhalation bias. the ISA represents the compensatory strategy against their axial skeletal bias that we just discussed. And so that's what allows me to determine what their strategy may be against gravity. So when we talk about inhalation or exhalation, it's based on your physical structures. So I hope that clarifies that for you, Pete. I hope everybody has a fabulous Monday. I got stuff to do, including finishing up my neuro coffee, which is delicious as usual. Everybody have a great day and I'll see you later. Good morning. Happy Tuesday. It is a great day. I had to come in to the purple room for a little bit today. So I thought I would just shoot the video from here. So I brought the travel edition of neuro coffee and it is perfect.

I've been going back and forth on email with Eddie from Germany, Eddie's an osteopath in Germany. We've been discussing how we would utilize half kneeling positions or split stance positions and how it would affect the orientation and behavior of the pelvis. I thought I would shoot a video and sort of break down the half kneeling position a little bit more in detail than what we've been used to and hopefully it will answer some questions that you may have as to how you're going to implement this in half kneeling or split stance activities to achieve the outcomes that you've been seeking. So I have my pelvis set up here on the stool in sort of a split stance orientation or half kneeling orientation so we can manipulate it a little bit easier and show you some of the positions that are very common in regards to execution of certain activities in half kneeling or split stance or some of the things that you're going to see in your athletes or clients. And one of the most common things you're probably going to see is you're going to see people assume this half kneeling or split stance orientation with one hip higher than the other. And what I want you to recognize is that what you're typically seeing under these circumstances is that the pelvis is actually going to be oriented towards the downside leg, but it's also going to be positioned in a position of inhalation. So you're going to get extra rotation of both ilia and you're going to get counter-nutation of the sacrum. Now, what this does is it creates a descent of the pelvic diaphragm. So this is a very low pressure situation inside the pelvic diaphragm, which pushes some of the effort towards the extremity musculature, which is one of the reasons why you'll see people complain of quad tightness in a split stance or half kneeling position, or they'll complain about tightness in the front of the hip, or they'll complain about anterior knee pain, because they're placing more demand on the extremity musculature. This increases pressure and tension at the joints and so that might be what they're actually sensing. If we want to create a more stable structure through the pelvis, we have to create a concentrically oriented pelvic diaphragm. So we need an overcoming contraction and concentric orientation of that pelvic diaphragm. And the way we do that is by leveling the pelvis actively. So for those people that are presenting with that one hip higher than the other, So they're in extra rotation. What we need to do is actually push the front side hip downward. In doing so, we actually create an internal rotation of that front side hip, which moves the ilium into internal rotation, which immediately nutates the sacrum and starts to bring the pelvic diaphragm upward towards concentric orientation.

As I push this side down, I pick up activity on the inside of the downside thigh, which actually opens the outlet on this side, which also promotes a concentric pelvic diaphragm. So now I have a much more stable structure that I can perform my half kneeling exercises in or my split stance activities. And this should happen as I move actively through a split stance or as I assume a stable position in half kneeling. Once again, for those people that are presenting with that one hip higher than the other, so they're in extra rotation, what we need to do is actually push the front side hip downward. In doing so, we actually create an internal rotation of that front side hip, which moves the ilium into internal rotation, which immediately nutates the sacrum and starts to bring the pelvic diaphragm upward towards concentric orientation. If I take us to more of a side view, you can see that I probably have this potential orientation issue to deal with as well. If I have an anteriorly oriented pelvis, I have lost the relative motion and therefore I have no relative position change capabilities. To overcome the anti-orientation I have to use the proximal hip musculature to capture the position of the ischial tuberosity relative to the femur. If I can capture this position then I can restore the relative position change that's necessary for me to capture the concentric pelvic diaphragm. This is going to allow me to be stable and comfortable in half kneeling or allow me to propel through my split squat. So let's take a look at these positions in half kneeling. So as I am resting here on my left knee, I can actually feel that my right hip is now higher. So that's going to be that inhaled position. So both sides of my pelvis are actually in an inhaled position and both hips are in ER. So for me to capture an IR position of the hip in a concentrically oriented pelvic diaphragm, what I want to do is I want to cue a downward position with this hip. So I'm not sagging into the hip, I'm physically pushing it down. So think about pulling up with abdominals on the left side and pushing the right hip down. Now what I've done is I've oriented the acetabulum so they're now both facing forward into an anteverted position which captures internal rotation on both hips. Now, here's the kicker. I have to make sure that I'm maintaining the position of the ischial tuberosity relative to the femur first. If I don't do that, I don't get this relative position change and I can't capture the IRs. I'll stay in ER and those are the people that are going to complain about tightness in the front of the hip, tightness in the quad or knee pain on either knee. This is one of the reasons why this half kneeling position is so important is because it's going to transfer to all of my split stance activities. If I cannot capture the maximum propulsive position in half kneeling, the chances of me capturing in a split stance are minimal.

Keep in mind there are some clients that are not qualified to be in half kneeling, nor are they qualified for split stance activities. Your goal under those circumstances is to recapture the intentional anterior and posterior orientation of the pelvis. This assures that I can maintain the position of the ischial tuberosity relative to the femur, which gives me the capacity to restore relative positions within the pelvis.

So I'm bringing the medial heel into contact with the ground so I can pronate. That's where I'm going to start to reach my mid and max propulsive strategies. So as I hit the ground and I come over top of the foot, and as the body comes over the foot I have to create a stable pelvic orientation above the foot. So now let's grab the pelvis and now we can actually see. So as I land on here as I'm stepping over I bring the hip towards zero degrees of what we would call hip extension but this is where I'm going to get a concentric orientation of the pelvic diaphragm and so that's going to create the nutated position of the sacrum. So now I have pronation down below. I've got intro rotation of the hip. I've got a concentric pelvic diaphragm and I've got a mutated sacrum. So that's how we can relate the plantar flexion and dorsal flexion to the sacral position. So when I'm plantar flexed, which is actually supination ER inhalation, I'm going to be counter-mutated. As I'm pronated, I'm going to be IR'd, concentric pelvic diaphragm, mutation of the sacrum. So hopefully that will answer your question, Austin. And if it doesn't, please ask me another one.

However, some people walk around in that position due to their physical structures, idiosyncratic physics, and how they deal with gravity. They actually live in that position, and eventually give up the opposing rotation. We have tibiofemoral external rotation and tibiofemoral internal rotation. What we want to ensure is that our athletes have access to both, as that represents our ability to move through a full excursion of knee range of motion. For example, during a traditional knee extension activity, you get tibiofemoral external rotation, and during a traditional knee flexion, you get tibiofemoral internal rotation. To have full knee excursion, we must have both rotations available. So, Matt, I would say you want to make sure you can identify whether your athlete has given up one of those elements of tibiofemoral rotation, as that would be a risk factor. It compromises the full excursion of knee range of motion, which should be my first priority. Secondly, as they move through their maximum propulsive phase, are they capturing this knee position and then can they reverse it as they push out of it? Therefore, during early and late propulsive phases, I want to recapture the tibiofemoral position of external rotation, and as I move through that maximum propulsive phase, I want to make sure I have tibiofemoral internal rotation available.