For those of you living under a rock, the ISA is this little angle right here. at the bottom of the rib cage that we use as a proxy measure for the design and structure of your skeleton and then certain behaviors that are associated with that and then certain consequences that are associated with training or rehabilitation. And so with the ISA strategy, so this is our exhaled axial skeleton with a compensatory inhalation strategy that's superimposed on top of it, thus this physical presentation. But because we are dealing with a bias towards exhalation, as we try to drive performance, we are actually reinforcing what these people are genetically pre-designed to be good at. And so we always have to be careful because we can take things too far, too quickly, and then we sacrifice something else. And so what we wanna make sure is that when we're talking about performance, we have a well-defined intention when we're talking about it. So I want this person to be able to do such and such for my performance standpoint and then what activities are gonna be supportive of that. And so again, In most cases, in most cases of force production, we're going to be talking about exhalation based activities. So there's always a forceful exhalation strategy that is superimposed on top of that activity, the stronger the exhalation strategy, the greater my force production. And again, because of the bias, As we move towards higher and higher levels of performance, if we don't monitor things that we would associate with health or skill level, then obviously we're going to have detrimental secondary consequences for that. So we always want to determine what our key performance indicators are going to be. So what are the things that we cannot sacrifice? in regards to performance and so if we were talking about say a golfer and we want to increase his long drive capabilities well obviously that's a force production issue but we also don't want to sacrifice his ability to turn adjust his swing based on any number of influence that are associated with things from uneven ground to obstacles and such. If we're talking about a baseball pitcher obviously we want to increase their their velocity which again is a force producing need but I don't want to sacrifice ranges of motion that that may be

So these people have great bodyweight squatting capabilities, but they might not be terribly strong because the requirements to get into this deeper squat pattern in this relative motion that occurs require a lot of eccentric orientation to capture these deeper squat patterns. And so if you don't develop this concentric capability to overcome the loads that you may want to actually lift if you're one of those people that are chasing numbers, you might find that you're just not meant to be that strong, but you do have a pretty squat, so people will be jealous of you for that reason alone. But let's talk about the two other ends. Okay, so we've got an early propulsive foot with the high arch, and then we've got this late propulsive foot, which actually has a much lower arch but different force producing capabilities. So those people that are biased towards this early propulsive strategy with the higher arch and the plantar flexed first ray will tend to have a squat and a deadlift that are very comparable in their force producing capabilities. So let's just say you got a 300 pound squat, you probably got a deadlift that's probably in the same general vicinity. Okay, if you're biased towards the other end of the extreme, so you're in the late propulsive capabilities, you're gonna have an amazing deadlift and a pretty parochial squat, relatively speaking. So maybe you can deadlift 500 pounds, but your squat's only like three. So there's a big gap there. And so now what we want to think about is, okay, how do I sort of even this out to some degree? What are the ways that I can take this big differential between my squat and my deadlift and sort of bring my squat up? Because you're always going to be a good deadlifter when you're in this late propulsive strategy. And so we can use our box squatting as a point of reference or an exercise of reference as to how we want to modify training to sort of even this thing out. So we talk about the people that have this huge differential between squatting and deadlifting. They are concentric overcomers all day every day. They're very, very high force producers. Their center of gravity is always forward. And so what we need to teach them to do is to capture some measure of a yielding strategy. And so the way that we're going to do this is we're going to use the box squat. And so this is going to be very much like a traditional powerlifting style box squat. So if you've ever read anything from Louis Simmons or West Side where they talk about deloading their body weight onto the box, that's going to be your number one strategy to help bring up your squatting capabilities to your deadlift. Because what deloading on the box does, this allows you to create this yielding strategy.

So you're actually distributing the load through your skeleton and through your connective tissues. And that allows you to actually capture the appropriate depth and then spring back up off the box. Because typically what you're running into when you have this huge differential between your squat and your deadlift is that you just can't capture this yielding strategy, which makes it so difficult. What you may find is that over time, as the load increases that your squat gets a little prettier, but you're still not being able to create that return on investment as you descend. It's still you're a grinder; you're trying to push through this thing because you just don't have the yielding strategy. So deloading onto the box is going to be your number one strategy if we go to the other extreme where we have this person with the high arch, plantar flex first ray, tibia tends to be behind, we can still use the box squat, but in this circumstance this is going to be one of those situations where you do not want to spend too much time on the box. You're going to try to get off the box fairly quickly; it'll eventually turn into a touch and go. And that's gonna start to bring your squat numbers up as well, but you're always gonna be this guy that has a squat and a deadlift that are very, very comparable. Sorry, you picked the wrong parents if you're trying to create the big deadlift. You're just not gonna be the best deadlifter in the room. However, one of the little compensation strategies you can use is to go sumo. That's gonna get you a little bit bigger numbers on your deadlift by the way.

So these people can keep showing up for what they do for a living. I wanted to talk a little bit about that so we can talk about some training strategies because I'm sure there's many of you out there that are dealing with kind of the same issue is you want to do really, really well in the gym, you want to perform well in your sport. And so there's always the consequence that's associated with trying to raise performance. And so let's talk about how we're going to structure things and how we're going to do that. For those of you living under a rock, the ISA is this little angle right here at the bottom of the rib cage that we use as a proxy measure for the design and structure of your skeleton and then certain behaviors that are associated with that and then certain consequences that are associated with training or rehabilitation. And so with the ISA strategy, so this is our exhaled axial skeleton with a compensatory inhalation strategy that's superimposed on top of it, thus this physical presentation. But because we are dealing with a bias towards exhalation, as we try to drive performance, we are actually reinforcing what these people are genetically pre-designed to be good at. And so we always have to be careful because we can take things too far, too quickly, and then we sacrifice something else. And so what we wanna make sure is that when we're talking about performance, we have a well-defined intention when we're talking about it. So I want this person to be able to do such and such for my performance standpoint and then what activities are gonna be supportive of that. And so again, in most cases, in most cases of force production, we're going to be talking about exhalation based activities. So there's always a forceful exhalation strategy that is superimposed on top of that activity, the stronger the exhalation strategy, the greater my force production. And again, because of the bias, as we move towards higher and higher levels of performance, if we don't monitor things that we would associate with health or skill level, then obviously we're going to have detrimental secondary consequences for that. So we always want to determine what our key performance indicators are going to be. So what are the things that we cannot sacrifice? in regards to performance and so if we were talking about say a golfer and we want to increase his long drive capabilities well obviously that's a force production issue but we also don't want to sacrifice his ability to turn adjust his swing based on any number of influence that are associated with things from uneven ground to obstacles and such. If we're talking about a baseball pitcher obviously we want to increase their their velocity which again is a force producing need but I don't want to sacrifice ranges of motion that that may be essential for him to be able to perform without a compensatory strategy that would eventually load a tissue and result in an injury as well. We also consider things that we think about like normal behaviors. Okay, how's your sleep? How's your ability to focus? Are you making progress in the gym or are you plateaued or stagnated? So again, it's not just skill. It's not just ranges of motion. It's all of these behaviors that underlie this.

When we talk about the reinforcement of the exhalation strategy of force production at high levels of performance, we're going to move towards things that produce the compressive strategy. So in the gym, the easy things to identify that will do this are the things where both sides of your body are doing the same thing at the same time. So these are going to be your barbell-based exercises. So deadlifts, squats, presses of all kinds, whether they be bench press or overhead pressing. Or if I'm pulling myself up or pulling something down with both hands, under those circumstances, I am activating the superficial musculature that increases this compressive stretch, so right away I'm superimposing greater force production on top of this axial skeleton. If I'm trying to offset the negative secondary consequences under those circumstances, now I got to start thinking about my accessory lifts and my supplementary activities that are going to support my ability to reshape my body in the opposing direction. So the cool thing about my little skeleton guy here is that he is very, very wide, but he is also very, very narrow anterior to posterior. As you can see, that type of a structure is going to be associated with a limited ability to turn. So a loss of rotational ranges of motion in the hips and shoulders. So this could be your monitor for those of you that are training yourselves in the gym and don't have somebody that can help you out. You can actually monitor your shoulder and hip range of motion as your KPIs. The way you would overcome these compressive strategies then is to think about what activities will shape my body in the opposing direction. So if I take a front to back kind of an orientation, so I'm getting squished this way by high levels of performance, high levels of force output, high levels of muscle hypertrophy, I have to think about the things that would actually expand me anterior to posterior. So right away we go to unilateral strategies because we get a compressive strategy on one side, we will get the expansive strategy on the other side and so we get this kind of a reciprocal expansion-compression which will actually help us maintain our ability to turn and also our ability to expand certain areas of the thorax and the pelvis that will help us maintain ranges of motion.

So we need to make sure we include split stance activities, single leg activities that will also allow us to support ourselves through one side and again creating this reciprocal compression and expansion. When we think about just sort of trunk activities that many people will do, if we are biased towards this wide ISA increased compressive strategy, the difference between a cable chopping activity on a diagonal versus a cable lifting activity on a diagonal, we would want to use a strategy that actually reduces the influence of gravity, which would be our chopping element, which will actually promote a greater ability to expand ourselves anterior to posterior and overcome this compressive strategy. The simple way to look at what I'm talking about, if you would compare say a prone plank where you're on both forearms to a side plank where you're on one side, in the prone situation you're actually reinforcing the compressive strategy. So I rarely put these wide people in what would typically be utilized commonly in that prone plank because it does reinforce exactly what we've already done from our performance level. So these will be more people that you put in their side planks, which actually increases your ability to expand front to back. And so now we can start to throw in some creativity where we're doing some single arm supported activities through the ground. So things like your sit-throughs, kettlebell get-ups, and things like that are actually excellent choices to help maintain the ability to turn and expand. So I hope this gives you a couple of ideas as to what we're talking about when we're talking about strategies that you reinforce. The archetype can actually enhance performance, but again, we don't want to sacrifice those things that we use from a skill level perspective or a health level perspective.

So here we go. First question comes from Alex and Alex wrote me this synopsis of his presentation as a foundation for his question, but basically what he wants to know is in regards to the foot types, in my experience, the measures that you see further up the chain. Do certain ISAs mirror certain foot types? Can the foot type detail explain the compensations expected outside of the tibia, the talus, and the calcaneus? So is the foot representation going to give us any information as to what we should expect to see above the foot? And I think this is a great question, Alex. But let me clarify one thing for Alex. Alex, you don't have a late propulsive foot. You've got an early propulsive foot, early propulsive foot to be behind and externally rotated. I got a really high arch and I got a plantar flexed first right. So you're early, bud. Anyway. That was for him. So regardless of the foot type, however, what we want to recognize is that the foot is our main ground contact. It's supporting all the load from above. And it stands to reason that if I have an orientation or a presentation above the foot that alters the position of the center of gravity, then I have to have a foot that is going to adjust to that. And so Alex, your question is actually right on point. Unfortunately, this is a really long conversation. So if we're at the intensive and you ask me this question at the intensive, we are going to have about an hour long talk about this. So let me just give you a little quickie kind of a representation here. So we think about all the possibilities as far as the orientations and positions that the pelvis could be in. And we have to recognize the fact that I have to control my center of gravity. I don't want to fall. And so the way that I would do that is I would make adjustments in the foot. And so let's just say that I have some sort of concentric strategy that I'm utilizing the pelvis pushing me in the direction, I would also have to have some form of concentric strategy in the foot that's going to help me maintain my balance. And so yes, these things do become very predictable. Let me give you a case in point. So I'm talking to Mr. Camparini last night and I sent him a little foot thing and I always test him. I don't know why, maybe it's because he's a former powerlifter but I always want to challenge him and make sure he's on point. And so I said, hey, what do you predict above the pelvis? And he was really accurate because he has really dug into the model rather deeply and so I think you make a really, really good point here, Alex, is that we should recognize the fact that this foot is connected to everything else. There are relationships that are associated with the orientations above the foot. And yes, it is very, very predictable. It's probably something that we probably need to expand upon at some point in time. But I'm going to have to do it in some other form. And unfortunately, I think it's going to be more of an intensive oriented kind of a thing where we have plenty of time to break these things down. So this short form video kind of thing just doesn't do it justice because it is rather detailed but once you get it, it's incredibly powerful because just like we use iterations above and below in the axial skeleton to confirm our suspicions, we can use the foot in the same way where we would expect to see a presentation in the foot that we would see up in the pelvis as well. So thanks Alex, I appreciate that. Second question. So fellow Austin also threw me a really good question because of what he's observing in the purple room. He's got some sequencing questions. And so Austin's question is, when you're a patient with a narrow, inferior angle that is limited both ER and IR, how do you prioritize interventions to emphasize expansion where this need is so? So let's break this down first and foremost. So we've got some information, and let's just kind of see where we're starting from. And then that's going to tell us how we're going to intervene. So if we've got a narrow, inferior angle, we're going to assume that we have limited breathing excursion because we've lost ERs and IRs. So that tells us what we're looking at. So we've got an ER, Ilium. We've got a counter-neutated sacrum. We're just going to say that this person is symmetrical in that regard. So we can see this counter-neutation and ER. So I got my narrow ISA. I've got, like I said, the counter-neutation here, which is going to bias my acetabulum back towards external rotation. If I have my full internal external rotation available to me, my total physiological range of 100 degrees will be intact. So let's just say at the extreme of this. Let's just say I have 80 degrees of external rotation, 20 degrees of internal rotation. I know that I don't have any superficial strategies that are negatively influencing the position of the pelvis. However, Austin says, what if he lost ERs and IRs? Okay. So now we've got to think about sequencing, about how a narrow would lose their ranges of motion based on these superficial strategies. So because of the orientation of the sacrum relative to the ilium, I'm going to see an anterior compressive strategy coming on first. That's going to steal my IR. Then I'm going to see an orientation, most likely that's going to steal my ER. So now we know what comes first. So we got anterior compression first, and then we got the posterior orientation that is driving the loss of ER. One other thing that I know is I also have some posterior lower compression that's associated early on with the narrow ISA presentation. So I also have that to be concerned with. But because I have an orientation problem, that's going to prevent me from recapturing relative motions. So whenever I have the orientation situation in play, that's going to be strategy number one. I got to go after that. So my first intervention is going to be to try to reorient that entire pelvis. So as a unit, so we're not talking relative motion here, we're just talking about an absolute position of going from an anterior orientation to posterior orientation. There's any number of ways to do that. It's going to be a hip extension based type of an activity. You get your choice in that regard. Now because my next strategy would be the anterior compression, I want to go address that as well so that's going to be the next thing I'm going to do. One of the great ways to do this for narrows and get a big bang out of this because if I put you in a 90 degree angle, I'm going to get the expansion anteriorly. And so I got to think, okay, if I have this strategy in the pelvis, I'm going to have that strategy in the upper thorax as well. So quadruped works great under these circumstances for a lot of reasons. Not only does it going to get me the anterior expansion that I need here, but it's also going to help me reduce some of the compressive strategy in the posterior lower pelvis, posterior lower rib cage. So again, very, very useful to go quadruped under those circumstances. Last thing I'm going to do with my narrow ISA person is I'm going to try to restore the normal relative motion of that sacrum. So I'm going to try to bring the sacrum base back into counter-mutation. That's going to be more of your dorsal, rostral stuff in the upper thorax. And so it's going to mirror that. So again, from a sequencing standpoint, if we were to back up just a little bit, we're going to go orientation, then expansion, then posterior expansion for your narrow ISA client that has lost ER and IR because that's going to strip away those strategies in the sequence in which they occurred. So it's really, really simple. So I hope that's useful for you guys. Happy Wednesday. Have a great day. Don't forget to call tomorrow morning, 6 a.m. Join us for coffee and coaches. Chips and salsa day is tomorrow too. Have a great Wednesday and I'll see you tomorrow.

You make a really good point here, Alex, is that we should recognize the fact that this foot is connected to everything else. There are relationships that are associated with the orientations above the foot. And yes, it is very, very predictable. It's probably something that we probably need to expand upon at some point in time. But I'm going to have to do it in some other form. And unfortunately, I think that it's going to be more of an intensive oriented kind of a thing where we have plenty of time to break these things down. So this short form video kind of thing just doesn't do it justice because it is rather detailed but once you get it it's incredibly powerful because just like we use iterations above and below in the axial skeleton to confirm our suspicions we can use the foot in the same way where we would expect to see a presentation in the foot that we would see up in the pelvis as well. So thanks Alex I appreciate that.

Then I'm going to see an orientation, most likely that's going to steal my ER. So now we know what comes first. So we got anterior compression first, and then we got the posterior orientation that is driving the loss of ER. One other thing that I know is I also have some posterior lower compression that's associated early on with the narrow ISA presentation. So I also have that to be concerned with. But because I have an orientation problem, that's going to prevent me from recapturing relative motions. So whenever I have the orientation situation in play, that's going to be strategy number one. I got to go after that. So my first intervention is going to be to try to reorient that entire pelvis. So as a unit, so we're not talking relative motion here, we're just talking about an absolute position of going from an anterior orientation to posterior orientation. There's any number of ways to do that. It's going to be a hip extension based type of an activity. You get your choice in that regard. Now because my next strategy would be the anterior compression I want to go address that as well so that's going to be the next thing I'm going to do. One of the great ways to do this for narrows and get a big bang out of this because if I put you in a 90 degree angle I'm going to get the expansion anteriorly And so I got to think, okay, if I have this strategy in the pelvis, I'm going to have that strategy in the upper thorax as well. So quadruped works great under these circumstances for a lot of reasons. Not only does it going to get me the anterior expansion that I need here, but it's also going to help me reduce some of the compressive strategy in the posterior lower pelvis, posterior lower rib cage. So again, very, very useful to go quadruped under those circumstances. Last thing I'm going to do with my narrow ISA person is I'm going to try to restore the normal relative motion of that sacrum. So I'm going to try to bring the sacrum base back into counter-mutation. That's going to be more of your dorsal, rostral stuff in the upper thorax. And so it's going to mirror that. So again, from a sequencing standpoint, if we were to back up just a little bit, we're going to go orientation. and to your expansion, posterior expansion for your narrow ISA client that has lost ER and IR because that's gonna strip away those strategies in the sequence in which they occurred. So it's really, really simple. So I hope that's useful for you guys. Happy Wednesday. Have a great day. Don't forget to call tomorrow morning, 6 a.m. Join us for coffee and coaches. Chips and salsa day is tomorrow too. Have a great Wednesday and I'll see you tomorrow.

Rock and roll.

It is a Thursday. Happy Thursday. I have neural coffee in hand. And it is perfect, even though Dr. Mike Roussel is not on the call this morning. But you have to consider that I can demonstrate this concept on top of a femur. Each of these twists and orientations affects what I measure on the table. You also have to appreciate that as I move them, their weight shifts on the table. So not only do I have movement that I'm creating in my perceived perfect measurement style, but I must also account for their movement underneath my measurements based on where their weight shifts. And again, that's something they don't teach us in school because when we learn how to measure in school, the patient is perfectly centered and we are moving exactly what we think we're moving. So we have to appreciate that there's a lot happening as we move. Now, regarding the case you just described, I had a patient who was very similar. She had one measurement showing 80 degrees of external rotation and then everything else was zero or negative. But it was only on one side. What you start to recognize is that this represents a significant orientation issue. It's the whole pelvis being tipped on an oblique axis, which creates extreme measurements like that. Whenever you're unsure about what you're seeing, take all your measurements into consideration. Identify what you think you're observing, then intervene, perform a correction, and remeasure. Often we don't figure these things out until after we act—we can say this was the initial presentation, here's what I did with the intention of correction, and here's what happened. Then you look back and understand, oh, she was tipped up like this, this was turned that way, and that was turned this way. Or you realize, as I was measuring, the pelvis was actually turning toward me, which skewed my measurements. This is difficult to grasp because it adds another layer of complexity when looking at and measuring things. It makes everything very gray instead of black and white. Another thing you can do is apply a manual technique to induce some form of sensation and see what happens. For example, if you have extreme external rotation but no internal rotation, what manual technique would you use to recapture internal rotation? Try it and observe the results. The patient I was working with had exactly that—80 degrees of right hip external rotation and minus 10 degrees for internal rotation. I simply mobilized her hip to recapture internal rotation, and wonderful things happened. That's acceptable because these things are complex. We don't always know exactly what our representation will be, and there's nothing wrong with experimenting in this situation. We only figure these things out in hindsight.

I see that a lot too.

Yeah, but it was only on one side. Okay. Right? But what you start to recognize is that, oh, okay, so what I have is this really big, and it's an orientation. So it's the whole, take the whole pelvis and tip it on an oblique axis. And that's how you get crazy measures like that. Okay. Whenever you're in doubt as to what you're looking at, take all your measures into consideration. Identify what you think you're looking at and then intervene and then do something right and then remeasure. Because a lot of times we don't figure these things out until after we do something where we can say, okay, this was the initial representation that I had, here's what I did with the intention of something right, and then what happened. And then you look back and go, oh, now I get it. She was tipped up like this and this was turned this way and this was turned this way. Or you say, oh, as I was measuring what was happening was that the pelvis was actually turning towards me, and then that's what skewed my measurements. Because again, and this is a really difficult thing to grasp because it's just another layer of complexity when we're looking at things and measuring things. We have to consider and it makes it very gray, right? Instead of like, oh, I know exactly where this person is. I have to say, maybe, right? Another thing that you can do is you can do something manually to induce some form of sensation, right? And then see what happens under those circumstances. So let's just say that you've got the crazy external rotation, no internal rotation. What would be a manual technique that you would use to recapture internal rotation? Do that and see what happens, right? Because the lady that I was working with, that's exactly what I did. It's like, I had this crazy, like a right hip external rotation of 80 degrees and then like minus 10 for her internal rotation, right? So I just mobilized her hip to recapture the internal rotation. And then lo and behold, wonderful things happened. That's acceptable because, again, these things are hard. We don't always know exactly what our representation is going to be. And there's nothing wrong with experimenting in this situation because it is in a complex domain. We only figure things out in hindsight.

Yes. Didn't have video. Sorry. That's why I joined right back.

That's all right. So I want you to see, you know, all this.

That's why I joined right back.

This is the best I look all day and it just gets worse.

Trust me. I was going to use that line. So in that situation, I'm picturing that the obliquity could be right or left and whichever orientation or actually whichever representation of that one pelvis or ilium where she did not have flexion and internal rotation was externally rotated and tilted.

Yes, that would be my best guess. So you've got to think about, when you're lacking flexion, and you think about the musculature that would have to be concentrically oriented to limit that, like to bring the hip towards flexion. It's got to be down low on the posterior aspect of the pelvis, right? Correct. And then you say, OK, well, if this is concentrically oriented, what is that going to do as far as the position is relative to the femur? It's going to shove it forward, right?

Sure.

It's got to be down low on the posterior aspect of the pelvis, right? Correct. And then you say, OK, well, if this is concentrically oriented, what is that going to do as far as the position is relative to the femur? It's going to shove it forward, right?

I'm trying to continually learn and visualize the obliquities that you just described and also what not regarding the ilium or you have an orientation where both are internally rotated, externally rotated, or even tilted or twisted. Because you can have all those. That's where it gets really hard.

But see, this takes a little bit of thinking, but if you've got one of these to play with, literally just set it up. And you break out Kappanji. And then just start playing with orientations. And say, okay, so if I tilt the pelvis like that, what picks up concentric orientation? What is now eccentrically oriented? And that's going to give you what movements you have available. And every time I bring this forward, and this is one of those underappreciated things. And this is why the dead guy anatomy is really frustrating because—and the brilliance of the people that came before us that got to name everything—they screwed it up for everybody. Because they called these muscles up here external rotators. Even though when I go like that, they become internal rotators. So they get misnamed, and right away it's like everybody gets lost. I think there are two articles you got to look for in the JOSPT where literally they went through and used Euclidean geometry—which is okay to get the grasp on the thing—but literally they took the moment arms of each of the muscles of the hip as it moves through space. Which becomes very valuable because now you start to see, oh my gosh, it's like your gluteus maximus starts out as an external rotator from dead guy position. And then literally as you lower yourself into a split stance, now it becomes an internal rotator. Oh wait a minute—that changes the whole perspective on how I want to approach this. It changes the perspective on what's going to happen to the shape of the pelvis as I move through space. And it's like they tell you, okay, flexor hallucis longus bends the big toe. No—it lifts your heel off the ground when you're walking. Wait a minute—that's a totally different perspective now, isn't it? Yes? Right? So it's like, they named it when they were pulling on the little, you know, the pulleys on the dead guy and they pull on it and go, look, it bends this big toe. Let's call that something Latin that means bend your big toe. And I screwed everybody up because now the perspective is 'bend your big toe' not what it really does. Right? Like they don't say, oh, this twists your tibia. You see these broad attachments of the musculature in the lower leg, like the broad attachments on the bone?

Yes.

Don't you think that's going to move the bone?

Sure.

Of course it does. But they got distracted by sharp shiny objects when they started to pull on the tendons and the distal stuff that doesn't weigh anything, right? it starts to bend and so then it gets misnamed. So instead of calling it something Latin that means, oh, it lifts your heel when you walk, they said, oh, it's a big toe bender.

That's what makes it so difficult to explain this to other people or when people visit the gym and see that I have a large demographic of high school volleyball girls who all fit the same shape and movement category. They're all doing some variation of box squat on Monday or Wednesday. The interns see that and label everyone as doing the same thing, but different breathing is recommended for each, along with different tempos. They see band squats and box squats as the same thing, but a box squat is a hard stop that provides force to push off, while a band squat is a soft squat. There are many variations that people just see as the same thing applied across the board for everyone in that shape category, but it's not. You have many options there.

But this is why these programs, like our apprenticeship, mentorship style programs have to exist. It's because people just don't know what the options are. They don't even know what they are. And you have all of these superimpositions on top of the exercise. If you talk to, like say, a powerlifter, because their intent is basically the same in powerlifting, it sort of gets mixed down to this limited number of options, right? There's only a couple of things that you can do. There is a way for you to do this. Right. And then when you start to branch out and we get into these dynamics that we're trying to support from a sporting aspect, it's like, oh wait a minute, that's actually going to be detrimental if I do it that way, whereas if I just tweak it in one respect. The duration of time on the box, the touch and go, the foot position, all of these things can be manipulated to create just a point of emphasis that will support this individual's capacity. And again, it's like the only way that you're going to get that kind of understanding is this experiential type of an environment, right? It's like if I can't access it at the quote unquote normal place in a joint, I'm going to get it somewhere. I need something that re-orients me to go forward when I want to walk forward. Knowing full well that people are going to be biased back towards external rotation under most circumstances. ER is our home, so to speak. From an evolutionary standpoint, external rotation came first, internal rotation came second. Because we were swimmers before we were walkers. And swimmers are externally rotated. Walkers have to internally rotate against gravity because the propulsive phase is different on land than it is in the water. I appreciate you all for being here. Have a great week. Hang in there. Keep doing good work and I will see you next time.

So I made some recommendations to Alex on there and I thought it would be a great way to sort of wrap up the week here because we really get to talk about program and I think it's kind of one of those things that's fun to talk about but let me practice this by saying that I don't think there's any magical program. I don't think there's a right way to do everything but I do think that there are some principles that need to be appreciated, that some people don't attend to enough, and that might be why they're frustrated, aside from the fact that you may just not be genetically programmed to be great at some of this stuff. So step one is probably pick better parents, and then the rest of the stuff gets kind of easy. But I think that if we think about this on a principled basis, one of the things you probably need to recognize is that there's a learning and a coordination effect of every exercise you do. And what that means is that if you do it more, then theoretically you should get better at it. So people who are program hoppers or they're looking for the next best thing or they're desperate for improvement, and their desire is to think that there's one program that's going to be the one that's going to make the biggest difference. In reality, there isn't one. But if you're constantly changing, then you have to relearn the exercises every time. So what I would say is if you're going to try to bring your box squat up or any form of a big lift, continue to execute that lift. Keep it in the program for an extended period of time. It would be like an Olympic weightlifter that didn't keep squats in his program, knowing full well that it is supportive of his Olympic lifts. So let's appreciate the learning and the coordination effect here on a very large scale. Don't change your exercises as frequently. Secondly, one of the ways I program from a repetition standpoint is I tend to recommend that people train with a buffer at higher intensities. So if I say you're going to train with your five-repetition maximum load today, what I would say is come in and do your 5 RM load but only do three repetitions with it. So we're not training to a maximum force output every set. But what this does is allows you to accumulate volume at a very high intensity. So from a coordination standpoint, we're still recruiting those high-threshold motor units that we need for the lift. So we maintain that aspect of it. But we're also accumulating volume. So from a cross-sectional area, there's going to be a benefit there from a hypertrophy standpoint.