The Bill Hartman Podcast for The 16% - Season 10 - Number 5 Podcast
Dan's always been kind of quiet on the coffee and coaches conference call. He's been on a few times and then asked a killer question when he did open up a little bit this past week and asked a great question for your foundational question in regards to why everything is an ER or an IR and how do we even get rid of these straight planes that were so ingrained in us in school. And what we have to recognize is that all joints move on helical angles, and therefore, if they're all helical, they are all ERs and IRs. And this is the tough part to understand, but once you can get rid of those straight planes, a lot of solutions arise that you would have ignored previously.
joint mechanicsER/IR terminologyhelical movementstraight planes
Last follow-up question, more of a model question about describing movements as ER and IR only. How would I better conceptualize that with traditional abduction or flexion? I kind of think about the Chinese handcuffs where it's like a tube and then if you widen it, it kind of expands. And then if you elongate it, I'm not sure if I'm off on that basis.
joint motionshoulder mechanicsER/IR conceptualization
That's exactly how it works. So make a big Y shape with both arms. So like a Y. So like turn your hands and all that kind of stuff. Your thumb should be pointing backwards, right? What position is that?
shoulder mechanicsexternal rotationinternal rotation
Your.
It is absolutely you are. But by tradition, the stuff that they taught you in school, what position is that in? Of the shoulders. Yes, sir. Some school. You're just ER, like when they, when they taught you in school and they said, put your arm in that position. And they said, what position is that shoulder in? And you go, well, it's this, it's this, it's three things, right?
shoulder mechanicsexternal rotationanatomical terminology
Oh, I see what you're saying.
So what three things is it?
shoulder mechanicsanatomical terminologyplanes of motion
Oh, so we got flexion, a little bit of abduction, a little scaption, whatever you want to do.
shoulder movementshoulder flexionshoulder abductionscaption
No, there's no scaption. That's incorrect. But I think so. Going to traditional school, three planes of motion, right? The old three planes of motion thing that don't exist. If my arm is in this position, what position is it in? Give me all three.
scaptionplanes of motionshoulder movement
Okay.
Okay. The old three planes of motion thing that don't exist, right? Okay. If you're, if my arm is in this position, what position is it in? Like, give me all three.
three planes of motionshoulder movementanatomical position
Flexion, abduction and ER.
shoulder biomechanicsplanes of motionjoint movements
Okay. But it's not in any of them to the maximum, is it? They're all ER measures, so they're all ER. I had to create an expansion to get into that position. Now take your right hand and put it in your left front pocket. You went across and put it in the opposite pocket. Just talking about the right arm. Right hand in your left hand pocket. What position is that arm in?
shoulder mechanicsplanes of motionjoint position terminology
No.
planes of motionjoint positioningshoulder movement
But they're all ER measures, so they're all ER, right? I had to create an expansion to get into that position. Now take your right hand and put it in your left front pocket. You went across and put it in the opposite pocket. You can put the other arm down. We're just talking about the right arm. Right hand in your left pocket. What position is that arm in?
shoulder mechanicsinternal rotationexternal rotationPNF diagonalsshoulder position assessment
Adduction, relatively more extension in IR.
shoulder mechanicsjoint movementinternal rotationadduction
Well, it's in a relative position of extension, internal rotation, and adduction by tradition, right? All of those are IRs. So now you just did a PNF diagonal, correct? Now you understand why PNF does what it does. It's just ER to IR, ER to IR, ER to IR. You get it? Yep. All turns. See, it was all turns to get there. Did you understand that? Yes. All turns. It's all turns. Then who cares about straight lines?
PNF (Proprioceptive Neuromuscular Facilitation)joint movement mechanicsinternal rotation (IR)external rotation (ER)
Okay.
There's not a joint. All joints move on a helical angle. Every single joint moves on a helical angle. If it moves on a helix, there is no straight plane.
joint mechanicsbiomechanicshelical movement
Any illustrations of that? What do you mean with visual references?
joint movement mechanicskinematic chainsproprioception
A visual reference, like other than the one you just demonstrated for everybody on this call.
joint mechanicshelical movement
Yes, it's just, I don't know, conceptualizing it is definitely a roadblock sometimes for me.
joint mechanicsmovement patternshelical motion
Okay, hold your arm up in a traditionally flexed position. Like, okay, how did you get your hand into that space, bro? Did you move in a straight plane?
shoulder mechanicsjoint movementbiomechanics
No.
joint mechanicsmovement patterns
No. So I'm going to exaggerate a piece of this to help you. Okay. So hold your arm up there again, boss. Now turn your palm so it faces backwards. Your thumb's going to point out to the right. Cool. Did you feel the turn? So that's a turn. There's no straight plane. Like literally you turned, you literally turned everything in sequence to get your hand into a position in space.
shoulder mechanicsjoint movementbiomechanics
Yeah.
So that's a turn. There's no straight plane. Like literally you turned, you literally turned everything in sequence to get your hand into a position in space.
shoulder mechanicsjoint mobilitymovement sequencing
All right. Do you see it? Yeah. Like the true shoulder flexion test, like I can appreciate that rotation. No, that makes sense. But for some other reason, like, I don't know, other plans, I guess more challenging for me, but.
shoulder flexionshoulder rotationshoulder mechanics
Okay. Do you understand, uh, Cotman's paradox?
shoulder mechanicskinetic chainmovement assessment
No.