The Bill Hartman Podcast for The 16% - Season 13 - Number 3 Podcast
Good morning. Happy Tuesday. I have no coffee in hand and it is perfect. All right. We're in the midst of a very busy Tuesday. We're going to dig straight into today's Q&A. This is with Alec. Alec had a question in regards to the setup of a low oblique sit. And so we literally went step by step through this so that you do get a little representation there. And I threw up a photo so you can actually see the setup of the low oblique sit very clearly. The advantage here is that we can put people into an extra rotation space that they do have available. So as people get anteriorly, posteriorly compressed, what happens to the external rotation is it's going to move away from midline. So if we put something in an oblique set, we can actually line them up in their available space and then start to superimpose the internal rotation from distal to proximal and get the proximal change. So we start to get a shape change towards an IRD representation of the pelvis. You'll typically use this probably more often in your wide ISA individuals because if we take this wide ISA individual that's compressed A to P, lay them on their back, we don't usually get the shape changes that we're looking for. The sideline activities tend to be a better place to start with a lot of your wide ISAs. So thank you, Alec. It's going to be very, very helpful for a lot of people. Everybody have an outstanding Tuesday, and we will see you tomorrow.
low oblique sitrotation spaceinternal rotationIRD pelviswide ISA
Maybe we could expand a bit more on obliques and what makes it a more ER or IR space. I'm conceptually trying to think it's like sidelying, having a kid with seated, but I guess this is a bit of a rough around the edges representation.
obliquesinternal rotationexternal rotationbody positioning
How do you feel about getting on the floor, boss?
manual therapy demonstrationpatient positioning
Oh, anytime.
Let's just do it, because then it's easy to see. All right.
Get up, and here we are. OK. All right. I want to grab.
All right. So just lay flat on your side with your hips and knees bent 90 degrees. All right. Awesome. OK. So this is a position where there's very little rotation available. You understand that? Yes. OK, because we're biasing everything into more internal rotation represented. Therefore, there's less turn. OK. Now, I want you to sit up, OK, and face the camera. Just sit up. OK. Face the camera, if you would, please. And scoot back just a little bit if you got space so we can see your legs a little bit. There you go. Now, bend your knees and hips to 90 degrees. Awesome. So that's the same position that you were just laying in on your side, right?
hip and knee positioninginternal rotationbiomechanicsexercise demonstration
Yeah.
Okay. What I want you to do is just slowly drop your left knee out to the side. No, no, just the left knee. Awesome. Is that more ER?
hip mobilityexternal rotationpelvic position
Yeah.
hip mobilityexternal rotationassessment
Okay. Don't change the relationship at all between your hips and your pelvis and just tip over on the left side to your elbow. Stop right there. Put your left leg on the ground. No, no, no. Keep it bent. Just drop it down to the ground. So that's the same ER you just had, right?
hip rotationexternal rotationpelvic alignment
Yeah.
But I just put the leg down on the ground. So I'm going to start to superimpose internal rotation on that ER position. Can you see that?
hip rotationinternal rotationsuperimposition
Conceptually, I have a hard time understanding whether you're creating more ER or more IR.
hip rotationinternal rotationexternal rotation
The same position you were just in sitting. You dropped into ER and I just rolled you onto it. So I didn't change the hip position at all. It's still more ER. Okay. Now, so hang on. Hang on. Let me, let me, let me finish. Take your left wrist, pronate it towards the floor. So you start to feel the medial elbow. And then what you should have felt by doing that is that you shifted weight towards your left hip at the same time. Did you feel that?
hip internal/external rotationpronationweight shift
Yeah.
And then what you should have felt by doing that is that you shifted weight towards your left hip at the same time. Did you feel that?
hip mechanicsweight shiftingproprioception
I did.
Okay. And then you put pressure on the underside, which is actually the posterior aspect of the greater trochanter, didn't you?
hip mechanicsfemur rotationpelvic alignment
Yeah, I think I did that.
femur rotationpelvic mechanicsjoint mobilization
So what that does is it starts to twist the femur into internal rotation, which pushes internal rotation into the pelvis. So what I did is I put you in an external rotation space and I started to superimpose internal rotation on top of it.
femoral internal rotationpelvic motionjoint mobilization
Yeah.
femur internal rotationpelvic positionhip joint mechanics
So what I did is I put you in an ER space and I started to superimpose IR on top of it, didn't I?
hip mechanicsfemoral rotationpelvic positioning
Yes.
femoral internal rotationpelvic positionjoint movement
Okay.
You get it? Yeah. Yeah. Now I could play with the position all day long in this, in this scenario. Yeah. Yeah. So is this, as I turn, I just like, I did feel kind of my left leg want to go in a bit.
positional mechanicsbiomechanicsmovement correction
Yeah. Yeah.
Now I could play with the position all day long in this, in this scenario.
positional adjustmentsmovement variabilitytechnique refinement
Yeah. Yeah. So is this, as I turn, I just feel like my left leg wants to move in a bit. I did kind of feel that. Like I get conceptualized and visualized that I'm kind of being delayed or immobilized a bit here by my point of contact. And then at the axial skeleton, I'm turning towards it so necessarily there's unbiasing internal rotation here.
lower extremity mechanicsaxial rotationbiomechanical constraintsjoint mobility
Well, you might not have that motion. I'm just showing you.