So what we don't want to do is turn people like a refrigerator when we're trying to reestablish movement. Good morning. Happy Monday. I have neural coffee in hand and it is perfect. All right. This is going to be a busy week. The intense 14 starts this week. It's actually on Thursday. So I'm looking forward to that. So let's dig right into today's Q&A. This is with Charlie. Charlie's fairly new. I saw him sneaking in on one of the coffee and coaches kind of what's called last week. So he's had a few exposures and he's figuring some stuff out on his own, which is great. But he asked some really good foundational questions in this Q&A that I think a lot of people are going to benefit from. We touched on foundational archetypes. We touched on rate oblique orientation, dirty measures on the table. So we talked a little about that, about how these things can change using the table as your constraint and point of reference. So very important call probably for a lot of people. I think you'll benefit. If you'd like to participate in a 15-minute consultation, please go to askbillhartman at gmail.com, askbillhartman at gmail.com, put 15-minute consultation in the subject line, and please include your question in the email. And we will arrange that at our mutual convenience. Everybody have an outstanding Monday, happy intensive week, and I'll see you tomorrow. All right, Charlie, we got the video rolling. The clock has started. What is your question?

Bill, I don't know if you have that chessboard that I emailed through.

I do.

I do.

And I'll put it up here in the video for everybody to see.

Okay. I was wondering if I could just go through what my interpretation was and you could maybe guide me and see if I was on the right track.

Yeah, let's go.

So it's starting off with a wide infraternal angle. The axial skeleton is exhaled, with reductions in flexion, abduction, and external rotation across the limbs. Looking at the pelvis, we've also got a restriction in internal rotation. I think I understand that the common compensation is a concentric orientation of the posterior lower musculature at the pelvis. That's how I understand that.

That's going to limit the early flexion measures. It's actually representative of the posterior lower compression limits the ER and the flexion in front of you. It moves extra rotation from in front of you out to the side. That's what that posterior lower represents.

Okay, yeah, so you're getting more ER space and you're using up the IR space that you have.

It's actually less ER space so you don't have any ER space in front of you it's moved out to the side so it's moved away from midline. That's what you want to understand about that. It's the anterior compressive strategy that's going to limit the internal rotation. So what it's showing you is that you've got a tremendous amount of A to P. So when you get that posterior lower compressive strategy, the thing that happened just prior to that is the anterior compressive strategy. That's why we talk about these things in a little bit of a sequence because it allows us to see how these superficial strategies are layered upon the axial skeleton. So don't misrepresent what they're showing you. When you have posterior lower compressive strategy, you lose early traditional hip flexion. If we want to call it that, you're going to lose the straight leg raise is going to be limited. And then you're going to lose IR not because of the posterior compressive strategy, but because of what just happened prior to that, which would be the anterior compression. There's a sequence of events that those things represent, but it tells us where you are in space. That's the important thing.

Yep.

So when you have a posterior lower compressive strategy, you lose early traditional hip flexion. If we want to call it that, you're going to lose the straight leg raise is going to be limited. And then you're going to lose IR not because of the posterior compressive strategy, but because of what just happened prior to that, which would be the anterior compression. Okay. There's a sequence of events that those things represent, but it tells us where you are in space. That's the important thing.

Okay. So is that an extra step between the inhalation bias strategy that comes with the exhalation bias on the

It's not extra. It's just part of the sequential layering of superficial strategies on top of the axial skeleton. There's a typical representation of the archetypes. I think you understand that. What you have to understand is that the superficial strategies are going to appear in a relative specific sequence of events based on where your center of gravity is over your feet. When you see posterior lower compression, so your early flexion measures, if you look at the chessboard, the early flexion measures are very limited. So your hip flexion is limited, your straight leg raise is limited. So right away you go, 'uh-oh, we got a posterior lower compressive strategy.' If you have a posterior lower compressive strategy, you have all the other superficial strategies in play already because the last one to get layered on is posterior lower. So that's what I want you to understand about this. Your assumption, so in your email, your assumption that this chessboard represents a right oblique representation is correct. So this is somebody that's tipping on a much more oblique axis as they are turning. And that would be represented by your ER measures. So when you see the deficit of ER on the right side, greater than the left side, you can make the assumption that you're on the right oblique. When you see the limitation of straight leg raise and early hip flexion, that means you're pushed forward. Tipped on the right oblique first. Tipped on the right oblique first and then got pushed farther forward. So the center of gravity is way over to the right and way forward.

Okay.

Yes, so is that oblique axis shift something that comes really early in the progression?

For a wide ISA, yes.

OK. Yeah. OK, thanks. So one thing that I've been struggling to understand is the increase of ER at the shoulder. OK. Is that from my research this afternoon, just going through videos, I got a clue that it could have been the anterior compressive strategy pulling the sternum down.

Okay, so that would be a restriction of internal rotation of the shoulder if the sternum is pushed down. Do this for me. Put your arm up in like a 90 degree angle there. Perfect. Now, don't change the shoulder orientation, just bend backwards. Did your hand go back too? Yes. So does that make it look like there's more external rotation? Yes. Okay. Was it more external rotation in the shoulder? Not relative. No, that is correct. Okay. So, when you see a magnification, your ER in your shoulder and your hip should match, which means you should know already before you even measure somebody. Unless there's a constraint problem, like a torn labrum, then the rules change. But when you're measuring somebody, if you measure an ER, you should have a similar limitation in ER in the opposite extremity. It looks like you don't. It looks like you have a lot of ER, especially on one side. But the reality is, if you're anteriorly oriented and you're laying on a table, the table becomes a constraint. So if you lay on the table and roll backwards as many people do, you don't see the restriction of ER in the table measure. The magnification tells us that chances are you lay backwards on the table, assuming all constraints are intact. There are situations where you'll have outlier measures, like cricket bowlers and baseball pitchers, who have a lot of rollback on the table, giving them a truly magnified ER representation. They get twists in the bones that magnify the ER. Typically, what you're looking at is a layback on the table, and if we saw more on the right, that's because the left side of your body is probably not touching the table relative to the right side. You're kind of measuring like this.

Uh-huh. Okay.

Get it? Yeah, I do. I do. Yeah. So it's sneaky. But if you understand what the possibilities are, then it helps you get out your chest boards, right? Okay. Yeah. As I say, all measurements are dirty, which means that the whole body is represented in each of your measures, so let me give you another for instance. So when you look at the shoulder internal rotation measure on the left side, right, which you got a pretty decent measure there compared to what your left hip was representing, right? So the left hip IR is only like five and you get 60 IR on the shoulder and you go, what the heck's going on there? Well, if you're laying on the table and you're twisted this way, guess what? My neck is turning this way, right? My lower cervical spine is going this way. That's going to magnify your internal rotation measurement of your shoulder because you're not measuring just shoulder motion. You're measuring internal rotation. Right. And so if that spine's turning away, that magnifies your internal rotation. So that's how you identify these things.

And the hip is easier. It's more of a true representation because it's harder to cheat.

What's heavier? Always remember that you're measuring in reference to the table. The arm really doesn't weigh as much as the leg does. If you had a big, gigantic arm on one side and a normal sized arm on the other side, chances are when you try to internally rotate it with a big, giant arm, it wouldn't have turned the spine nearly as much. You would have a measurement that would be more representative of a limitation. When you bring the leg up over the hip and it pushes the hip into the table, you'll get a true representation of the limitation of internal rotation. The arm being lighter, everything just kind of turns with it. You have to discern these things. Whenever you're measuring a limb, you're measuring the entire body moving. If the question is how much does the hip move, how much does one side of the pelvis move, how much does the spine move as you're performing these measures, that's how we figure this out.

I think so. So with the weight shifted forward anteriorly, is that representative of an anterior pelvic orientation?

Well, you have an anterior orientation, for sure, based on your measures, right? So your HIPPR measures give you that piece of information. So you know that you're forward. The lack of IR, the limited straight leg raise, again, that's a push forward. So you're moving towards a later representation of propulsion. So you're farther forward. You're trying to get past middle, trying to get into a late representation there. That's what this is.

So the first step would be to bring that back.

Always. Always. If you take somebody, if you take somebody that's on an oblique like on an oblique turn, okay? And then pushed forward. If you try to turn them back to the left, all you do is turn everything at the same time because you don't have relative movement available to you. So you try to push. And like I said, I always talk about, you ever move a refrigerator out of a corner?

I can imagine. Okay. Yeah.

You're not old enough to own your own refrigerator.