Good morning. Happy Monday. I have neuro-coffee in hand and it is perfect. All right, happy National Batman Day. So I think DC Comics celebrated on the 19th over the weekend. But, excuse me, but I think I also have some information that today is the official National Batman Day. So we're gonna celebrate that today if it's okay with you. And then again, it's an everyday Batman day. So in celebration, let's do a Q&A. It appears to be a very simple question, but we're gonna dig into it a little bit and maybe get a little bit more depth of understanding about a couple of concepts. So this comes from Mihail, and Mihail says, could you please explain how to improve hip abduction, so ABduction for wide ISA with very tight adductors? Okay, so right away, you kinda hit on one of my pet peeves there, Mihail. and this concept of tight. So tight is a sensation. We need to recognize it as such. So it's not a representative property of muscle. So when somebody says that something is tight, we don't know if it's eccentrically oriented and producing tension or concentrically oriented and producing tension. Unless we want to fall into the traps of the stretching and strengthening crowd, we have to be very, very careful when we use a representation or a concept like tight. What we want to do is we want to look at it from the concentric to eccentric orientation. That represents the position. and is much more useful. So based on your description, if we have limited hip ABduction, we're gonna have constant augmentation of the musculature that is limiting that abduction. So let's start using these concepts a little bit more effectively. Now, you also mentioned wide ISA. So when I put together the concepts of the wide and narrow archetypes, people looked at ISAs forever, they looked at structure. But what I did is I followed one very simple rule and that is that the structure is going to determine the strategy. So when we have a wide ISA with limited extremity ranges of motion, then I know in the midst of a compensatory strategy and because of the wide ISA, I know that the bias is going to be an exhalation bias. Now, assuming my client or patient is still alive, then they're still breathing, which means that they have to use a compensatory strategy. So under these circumstances, if I need to restore range of motion and I have a bias towards exhalation, which is the bias of the wide ISA, then the simplest answer that could possibly give you to restore hip abduction is that I need to restore a non-compensatory inhalation, but we might have to construct that. So there's a couple of things that we want to recognize about or wide ISAs, okay?

If I grab Fred here, Fred actually has a pretty wide ISA, so his infraternal angle's gonna be right there. One of the properties when I have an exhalation bias is I have to look at the pelvis because we're talking about hips. With the bias of the wide ISA, I'm gonna have a nutated sacrum, a concentrically oriented pelvic outlet, and a wide IPA as well. So my goal to restore the hip abduction—which is actually an external rotation measure—is to be able to close this IPA, which is representative of a non-compensatory inhalation. Right away, what I should recognize about the first compensatory strategy, which is a diaphragm compensation in the wide ISA, is that I have a diaphragm that's going to move against the axial skeleton to allow me to breathe in. I get this wide IPA, which means I'm going to have a limitation in abduction right off the bat, because I'm going to increase the concentric orientation of that musculature, which promotes internal rotation of the hip. Remember, my wide ISAs are biased towards internal rotation, which for those traditionalists is going to also allow that adduction to occur. The one thing you're going to have to pay attention to is if I have any other compensatory strategies superimposed. So if I get a posterior compression at the base of the sacrum, if I have any anterior orientation, I'm going to pick up even more concentric orientation of the musculature that's going to limit my external rotation measures. And so you're going to have to pay attention to that. So if I do have an anterior orientation, a dead giveaway is going to be a loss of ER at the hip as well. What I have to do is reorient that pelvis first. So I got to recapture the ability to posturally orient. That's going to be hip extension activities because I got to bring that ischial tuberosity closer to the femur. So I got to bring it this way. The way I'm going to do that, again, is with hip extension activities. So my preference would be to do something unilateral under these circumstances. Because if we do bilateral hip extension activities, there's a concern that we're going to create that posterior lower compressive strategy, and then that we just created more interference for our ability to try to recapture a normal movement. So it could be something as simple as some form of glute bridging. And as we advance people through these hip extension type activities, we can look at arm bar variations that are going to promote this hip extension as we get people to standing up. Then we're looking at some variations of like a sprinter step up or a crossover step up at the much more advanced level.

We want to achieve an effective exhalation. So first and foremost, we've got to get the ISA to move. We need a dynamic ISA. So that means that the diaphragm is now able to move from its compensatory concentric orientation to a normal eccentric orientation. So that's what an effective exhalation is. And this is representative of an ISA that will move. And so when we do our ISA test, just look at the YouTube video that I have posted. When you do your ISA test we should restore dynamic movement of that and then you should also see a restoration of some of your extremity motion. If we need shape change to promote this dynamic ISA, so Fred here is a really good representation because he's pretty wide and he's also flat front to back, so if you got somebody that looks like that, you might need to do some form of axial rolling. So again, arm bars come back onto the table, sideline activities to help promote this anterior posterior expansion. So we're going to take advantage of gravity to help us expand this thorax anterior to posterior. If we're assuming that we don't have this posterior lower compression that I was talking about before, so this would be concentric orientation below the level of trochanter, we've immediately got that 0 to 60 range that's available to us in the thorax and in the pelvis. So we can start to do reaches within that range. We can work on dorsal rostral expansion activities within that range. We can even go into the gym. We can do some staggered stance high to low cable pressing and some limited range chopping variations that will allow us to create the posterior expansion to achieve the normal non-compensatory inhalation strategy. We've got oblique sitting that we can use. So that's a nice unilateral activity that's going to help promote the shape change through the thorax. And then we can even move forward towards like a heels elevated split squat variation. Again, as we get into higher level activities. Now, if we have normal internal rotations, that immediately buys us 60 more degrees of activity. So now we've got reaches up to 120 degrees and we've got full depth almost on all of our split stance activity. So now we have upward reaches. So we have pullover variations that are on the table. We've got straight arm cable pulldown variations and even a downward dog if you can get to that. We've got full range chops now available to us, and we can add the cable lifts back in without worrying about having a compensatory strategy. So again, when you think about strategies, we need a dynamic ISA to make sure that we've got our availability of that full diaphragm excursion so we can now get an effective exhalation and a normal inhalation without any compensatory strategies.

So, Mihail, I hope that gives you a little bit of strategy, a little bit of understanding. Just make sure that as you go through these activities that you can breathe through the entire activity. If there's a breath hold involved, you're going to have to use some form of compensatory strategy.

When we have an intact nervous system, we have to take a different perspective. The traditionalist view is that we have weak muscles, which would imply an intrinsic quality within a muscle that there's a problem with a muscle, and they would call it weak. However, I think this is just a bad interpretation based on a flawed model. Let's use an example: if we were to perform a hip flexion test in the sideline position, I would have you raise your leg in what is traditionally called hip abduction, which is actually external rotation. If I push down on it and it gives way, and I say, 'Oh, you have a weak gluteus medius,' here is the problem with that. We know that if I have an anterior orientation of the pelvis, the musculature above the trochanter changes its direction of pull. Traditionally, in 'dead guy' anatomy, we would call these muscles external rotators, but if I anteriorly rotate the pelvis, their angle of pull changes; they become internal rotators. This is why, even though this traditional hip abduction is an external rotation movement, if the muscles are oriented to pull in internal rotation, the test will show weakness, but it's not an intrinsic problem with the muscle itself. It's just the orientation of the pelvis. So, how can I use this test? Perhaps I can use it as a test-retest assessment. If I identify an inability to produce force in a certain direction, and then I recapture the ability to fully anteriorly and posteriorly orient the pelvis, the test might then become useful. Additionally, you must consider that all our movement is based on shape change. If I measure something in one context, such as on the table, and I say I've recaptured range of motion with full excursion of internal and external rotation and full inhalation to exhalation, and then I stand the person up, I've changed the context. Now, my isolated measurement becomes less useful because we're dealing with a much more complex situation involving the interaction of the entire body in space. Therefore, in complex movement, like a split squat, for me to access 90 degrees of hip flexion, I know I need to be able to access hip internal rotation under those circumstances; otherwise, I'll have to use a compensatory strategy. These situations are not dependent under most circumstances, as most people who come to see me are neurologically intact. So again, just wouldn't use manual muscle testing in those circumstances. I don't think it's totally useless out of respect to Florence Kendall and those who came before us; I appreciate their work. I just don't think it's a good representative model and isn't based on a good model, so its use becomes very limited.

Like a split squat for me to access 90 degrees of hip flexion in a split squat I know I need to be able to access hip internal rotation under those circumstances Otherwise, I'm going to have to use a compensatory strategy and so These situations are not dependent under most circumstances because most of the people that come to see me are typically neurologically intact. And so again, I just wouldn't use it under those circumstances.

But point being, if I've got limited shoulder flexion, the typical compensatory strategy for limited shoulder flexion, especially in the early range of shoulder flexion, which you would be exposed to in a bench press, is to turn away from it. So again, so he's actually turning his rib cage on the bench, and so this arm looks like it's far away, and this one looks like it's tucked in. Now, here's the problem with that. Because what you've actually done is you've actually turned the right shoulder towards greater internal rotation. So I need internal rotation for bench press. I need internal rotation for my compressive strategy, constant regrain rotation and propulsive activities. And then I need to move through a space that demands I have internal rotation so we got a triple whammy there as you get a ton of compression in that right shoulder under these circumstances and so that may be why your client is experiencing right shoulder pain. This is actually really cool little little competitor strategy and it's probably not that uncommon. So, probably what I'll do, as soon as I get a little bit of time, Ben, I'm gonna go into the gym, I'll probably grab Eric, and we'll go through how this is actually happening. So, if I don't do that soon, please send me a reminder. Alright, so what's our solution here? Step number one, because you're dealing with a painful situation, you're going to have to clear this client for any structural issues. And so if you don't have the capacity to do that, I suggest you get them to somebody that can. Let's rule out anything that may be important under these circumstances. Because whenever we're dealing with pain, we've got to clear those structural issues. Number two, take a break from a bench press. You basically got two options here. Either take the bench press away because it is problematic or you keep training the heck out of it as hard as you possibly can until it breaks and then you have to take a break from the bench press. Either way you're gonna have to take a break. I suggest you do the the first option there, much safer and much more caring for that client. In fact, what I would do then is I would remove all barbell exercises from his program at this point. You're basically fixing the extremities under any circumstance, whether we're talking about a squat, a deadlift, a row, or any kind of pressing, you're fixing the extremities in a position that are going to promote more internal rotation. From a rehab standpoint, again, if you don't do manual therapies yourself, you're probably going to want to find somebody that does. If this person has any level of hypertrophy or is actually a very, very strong human being, you're probably going to need some help getting this rib cage to move. So you've got to get a dynamic, infrasturnal angle. So that might require some manual therapy. We need sternal movement because if you're missing internal rotation, you don't have pump handle movement in the anterior thorax so we need to recapture that. Clavicles are going to be limited in the ability to rotate. When you've got to get the ribs to move more effectively, you're going to have to decompress the scapula from the dorsal rostral space. So that's a manual technique, by the way. I have a video of that on YouTube. I also have one for the scapular elevation. So look at those two. And again, if you don't do manual therapies, get somebody that can apply those techniques. You may have to have somebody that's good with their hands. to help reduce some of the concentric orientation as well. Basically, you've got a guy that's really, really compressed and you've got to get a whole bunch of expansion here to restore His ability to move freely through space. Okay, from a rehab exercise standpoint, I got a couple videos on YouTube specifically for dorsal rostral expansion. So there's a seated variation, and then there's a better band pull apart video that is also really effective for dorsal rostral expansion, one seated, one standing. You can immediately go to some sort of high oblique sit activity. which is going to help start to reshape the the thorax a little bit get some of that anterior posterior expansion and and as you can move into a lower obliques type of an activity which would be closer to what looks like a side plank variation you'll start to get some some pump handle activity from that you can do supine cross-connect so they should be in a non-provocative position based on the upper extremity and then a sideline propulsive activity will also be helpful. Again, sideline is a great way especially for these wide people to get some of that anterior posterior expansion because we're taking advantage of gravity. Once you can capture 90 degrees of shoulder reflection without pain, supine arm bars are now on the table. You can throw in a screwdriver on top of that. to promote some internalized storm rotation and then you can eventually move to a prone propulsive activity which is going to get you a ton of that posterior expansion and yielding strategy that your client is lacking. If you want to take you into the gym, we've got suitcase carries that are probably on the table right now. Eventually, you can play turn it into a rat carry so we can get some ER and IR out of that. Backward sled drags with two handles to promote the unilink strategy posteriorly. So you get some expansion, you get some pump handle action. You're also going to get some hip mobility out of that as well. High rep tricep push downs with a band. Also, it's going to keep you close to that transition. between internal and external rotation and give you some of the yielding strategy posteriorly in that dorsal rostral space. Again, you're going to need that. So dumbbell curl variations. There's a bunch of videos on my YouTube channel for that that you can also use to help keep that dorsal rostral space expanded. The key element with any of the resistive activities that I've just mentioned is that you can breathe through it. The minute you have a breath-holding strategy under any circumstance during these activities, you are promoting the limitation that you are trying to alleviate. So keep that in mind. So in a nutshell, what you got is you got something that's very, very compressed. They're using compensatory strategies during the activities in question. So in the bench press, maybe they're carrying them around. I don't know, but either way, when they're bench pressing, this is what they're using. So you have to reduce the compressive strategies and eliminate the interference through all of the activities that you're doing. So you might have to restructure some programming. Unilateral activities are going to be much more effective than bilateral symmetrical activities and take the barbell out of their hands. So Ben, I hope that gives you something to work with. If it doesn't, if you need more, go to askbillhardman.gmail.com and we will provide you another solution if you have another question. Everybody have a great Wednesday and I will see you. Oh, coaches, come to the Coffee and Coaches Conference Call tomorrow morning, 6am. It's going to be Thursday. It's Chips and Salsa Day tomorrow. Have a great day. Happy Thursday. I have neuro coffee in hand and it is perfect.

So that might require some manual therapy. We need sternal movement because if you're missing internal rotation, you don't have pump handle movement in the anterior thorax, so we need to recapture that. Clavicles are going to be limited in their ability to rotate. When you've got to get the ribs to move more effectively, you're going to have to decompress the scapula from the dorsal rostral space. So that's a manual technique, by the way. I have a video of that on YouTube. I also have one for the scapular elevation. So look at those two. And again, if you don't do manual therapies, get somebody that can apply those techniques. You may have to have somebody that's good with their hands to help reduce some of the concentric orientation as well. Basically, you've got a guy that's really, really compressed, and you've got to get a whole bunch of expansion here to restore his ability to move freely through space. From a rehab exercise standpoint, I've got a couple videos on YouTube specifically for dorsal rostral expansion. So there's a seated variation, and then there's a better band pull apart video that is also really effective for dorsal rostral expansion, one seated, one standing. You can immediately go to some sort of high oblique sit activity, which is going to help start to reshape the thorax a little bit and get some of that anterior-posterior expansion. And as you can move into a lower obliques type of an activity, which would be closer to what looks like a side plank variation, you'll start to get some pump handle activity from that. You can do supine cross-connect, so they should be in a non-provocative position based on the upper extremity, and then a sideline propulsive activity will also be helpful. Again, sideline is a great way, especially for these wide people, to get some of that anterior-posterior expansion because we're taking advantage of gravity. Once you can capture 90 degrees of shoulder flexion without pain, supine arm bars are now on the table. You can throw in a screwdriver on top of that to promote some internal rotation and then you can eventually move to a prone propulsive activity, which is going to get you a ton of that posterior expansion and yielding strategy that your client is lacking. If you want to take them into the gym, we've got suitcase carries that are probably on the table right now. Eventually, you can play and turn it into a farmer carry, so we can get some ER and IR out of that. Backward sled drags with two handles to promote the uni-lateral strategy posteriorly, so you get some expansion, you get some pump handle action, and you're also going to get some hip mobility out of that as well. High-rep tricep push-downs with a band also are going to keep you close to that transition between internal and external rotation and give you some of the yielding strategy posteriorly in that dorsal rostral space. Again, you're going to need that. So dumbbell curl variations; there's a bunch of videos on my YouTube channel for that that you can also use to help keep that dorsal rostral space expanded. The key element with any of the resistive activities that I've just mentioned is that you can breathe through it. The minute you have a breath-holding strategy under any circumstance during these activities, you are promoting the limitation that you are trying to alleviate.

between internal and external rotation and give you some of the yielding strategy posteriorly in that dorsal rostral space. Again, you're going to need that. So dumbbell curl variations. There's a bunch of videos on my YouTube channel for that that you can also use to help keep that dorsal rostral space expanded. The key element with any of the resistive activities that I've just mentioned is that you can breathe through it. The minute you have a breath-holding strategy under any circumstance during these activities, you are promoting the limitation that you are trying to alleviate. So keep that in mind. So in a nutshell, what you got is you got something that's very, very compressed. They're using compensatory strategies during the activities in question. So in the bench press, maybe they're carrying them around. I don't know, but either way, when they're bench pressing, this is what they're using. So you have to reduce the compressive strategies and eliminate the interference through all of the activities that you're doing. So you might have to restructure some programming. Unilateral activities are going to be much more effective than bilateral symmetrical activities and take the barbell out of their hands. So Ben, I hope that gives you something to work with. If it doesn't, if you need more, go to askbillhardman.gmail.com and we will provide you another solution if you have another question. Everybody have a great Wednesday and I will see you. Oh, coaches, come to the Coffee and Coaches Conference Call tomorrow morning, 6am. It's going to be Thursday. It's Chips and Salsa Day tomorrow. Have a great day. Happy Thursday. I have neuro coffee in hand and it is perfect.

Previously in a video, I heard you say that lateral loads delay propulsion. That makes sense to me from a forward-backward locomotion perspective, but it doesn't make sense to me from a cut perspective. Because in my eyes and mind, the contralateral load would push you further into the cut, and then the ipsilateral load would push you out of the cut. Can you go over the cut sequence or what's going on in a cut from an ipsolateral and contralateral load?

I'm standing behind you, and we're both mirroring each other. You're going to cut off of your left foot. As you go into the cut, I'm going to shove you from the right into your left leg. Then, as you try to come out of the cut, I'm going to grab your left wrist and yank it towards the floor. Which one delayed you? It's an ipsilateral load. The contralateral load is going to get you there, and the ipsilateral load is going to keep you there and make you want to stay there. It gives you something to push against, and doing so creates the delay.

No, it's water. I already drank two cups of coffee this size. I'm moving. I'm going.

All right. Just want to be sure. Hi, Dr. Mike. Come on, guys. You have your hold your cup up. Let me see. You got it? There he is, ladies and gentlemen. There's your neuro coffee guy. I would be nothing without this guy. By the way, Dr. Mike, my coffee is perfect. I did not expect any difference.

Come on, guys.

Hold your cup up. Let me see. You got it? There he is, ladies and gentlemen. There's your neuro coffee guy. I would be nothing without this guy. By the way, Dr. Mike, my coffee is perfect.

I did not expect any difference.

I've got a client who is very wide, very compressed anteroposteriorly. And, fascinatingly enough, whenever I put him in a supine or inverted position, he can't breathe. His nose gets congested.

How are you inverting him?

Elevating knees, going forearms to the floor.

So butt's up in the air, head's down. Okay, he's wide, flip him over on the other side, first and foremost, okay? Because you're dumping his guts into a position of the diaphragm that's not going to allow you to flip flop this space, okay? But he still may not be able to breathe in that circumstance, just an FYI if he is really compressed. So this is one of these really neat little things about the iterative effects of squishing a pile and squishing a thorax and then squishing a skull. So if you look at, get a cross-section of a pharynx, okay? So you can see where the tube goes, so to speak, posteriorly. And so if you're compressed AP, the pharynx is going to be narrowed, A to P. So in certain positions, just the position alone is going to cause the mandible to retreat and the tongue comes with the mandible. And so that immediately narrows that space. If he's got like a soft palate that is also interfering. So you've got some musculature that's attached there as well. And so if that area collapses or is just narrow to such a degree, you can't breathe through your nose. So people will talk to you like they're stuffy. Right, so you're going to have to actually you're going to be a little bit more creative you're not going to be able to put them in those position. Right, but you can still. Maybe use like an like a low oblique position we're going to prop down an elbow. Okay, that's still sideline. So you still, you still get some advantage there. And then he's a little bit more upright. And so you'll be able to get, get some, some airway opening.

Mandible. Okay. So, but the hyoid is down and that opens the airway. And so if you look at the green in the upper left, you can see that her airway is a little bit more open. And then you go to the upper right and you see that the airway is more round. And again, it kind of does. So now you just got to say, okay, If I put you in this position, clearly you cannot expand sufficiently and you're creating another interference. So you just have to put them in a position where there's no interference. And it might be that you have to start upright. That's okay, right? But you learn something really valuable here is that, you know, while you can kind of follow the rules a little bit, it's like, oh yeah, you're compressed A to P up top. I'm gonna flip you upside down. Not everybody can go upside down.

Bill, if you had to give yourself business advice at 25 years old, what would you do? What would you say?

Get a job. Right.

Get a job and then work your business.

But seriously, like you were working your PhD and you literally were already a businessman. You refurbished an entire home and then gave birth to twins.

I'm taking my own advice here in that when I was in my early to mid 20s, one of the things I was able to leverage to get more experience was graduate school, and then I managed a chemistry lab for a year. There's a lot of sitting around in science. When you do science, you sit around a ton. You wait for humans, you wait for centrifuging, you wait for rotobapping. And I use that time to get the reps. As you get all those reps, you get exposed to what you like, what you don't like, what resonates with people, what doesn't resonate with people, who are the people you like resonating with, and then that allows you to kind of further hone in what you want to get after.

Bill, I have a question about orthotics. So I've heard of people saying that you should not get your orthotics made if you're pretty dysfunctional. So if someone gets their orthotics made, they're just reinforcing what they have going on and they should try to correct it first.

Okay. So I've heard of people saying that you should not get your orthotics made if you're pretty dysfunctional. So if someone gets their orthotics made, they're just reinforcing what they have going on and they should try to correct it first.

So I've heard of people saying that you should not get your orthotics made if you're pretty dysfunctional. So if someone gets their orthotics made, they're just reinforcing what they have going on and they should try to correct it first.

So what you're trying to do is you're trying to influence the output per se. I'm not trying to, one, I don't think dysfunction ever. Right, because I think that everything that we see is a normal circumstance under the context. It's like, what does this person bring to the table from a constraint standpoint, from an experience standpoint, and then this is the solution that they're offering. So at worst, I would say that people are defending themselves against something, which is very oftentimes in my world, they're fighting gravity. I just want to influence its behavior to allow the adaptability throughout that full propulsive range. Good morning. Happy Friday. I have no coffee in hand and it is perfect. All right. Friday, we are wrapping up another busy week. Got lots of calls this morning, so I'm very excited about that. We're gonna dig into a little bit of a Q&A that is sort of a combination of factors here. So we had a little bit of discussion about this on the Coffee and Coaches call yesterday morning in regards to Ipsilateral, Contralateral loads, into out of cuts things. IFAS University, we've been talking about rotation and how that's actually created and acquired, and then I got a little bit of an email thing. about some rotation. So we're going to kind of combine this into one Q&A. We're going to discuss the influence of this upper extremity loading where we use load on one side to induce rotation in regards to any kind of rotational activity, whether it be golf, tennis, baseball, cutting, or just the simple gate parameters. Give a little shout out to Eric at iFast. Eric's been playing around with a lot of this stuff on his Instagram, so go check out him. He's got a lot of demos on some creative ways to apply this. He is at eph.24 on Instagram, so check him out. But the thing that we want to talk about here is the difference between actually capturing the position that allows us to rotate versus just a pure orientation. And we can actually look at this through the pelvis a little bit. A lot of people are turning the entire pelvis as a unit, so we would consider that an orientation versus this clean rotation. They're actually using this as a substitute for hip shifting during some of their activities. What we're actually trying to induce is we're trying to create a yielding strategy, so right over here on this side, we're trying to create a yielding strategy where we get this counter-neutation at the base of the sacrum, which actually allows this nice clean turn. And this is where we can actually demonstrate a lot of the velocity that's associated with turning. And so this would actually occur after the maximum propulsive phase.