The first thing we want to do is let's deconstruct what we're actually looking at and then we can actually come up with a viable and useful strategy. So, Dory, you give me some really good cues here in regards to a couple things. So the left shift in the squat gives us a little bit of a clue that we've got a sacrum that is going to be oriented into a right-facing position. Now the question mark is why is that? And so the limitation in hip flexion gives us a little bit of a clue along with the straight leg raises. So the straight leg raise is a little bit more than normal, so chances are we don't have this posterior or lower compressive strategy. So the concentric orientation here in this lower part of the pelvis below the level of the trochanter is probably not there. So we're probably still eccentrically oriented there. But we do have a posterior compression at the sacral base. And so the giveaway there is the limited end range hip flexion. And so to have normal hip flexion, that full end range hip flexion, the lumbar spine has to be able to turn towards the hip flexing side and that sacral base needs to be able to come back on that side. So chances are you've got a compression here. And so we've got something that kind of looks like that. So we're pushing the sacrum. So it's pushing and facing the right, which is why she squats and shifts backwards and to the left. And so what we're going to have to do is we're going to have to alleviate this compression. So the lack of ER on this left side also reinforces the fact that you've got this compressive strategy and that's bringing the orientation of the pelvis forward more so on the left than it is on the right. So we have kind of a unilateral issue here. Both sides are affected obviously as they always are, but we're going to focus in on this left side.

The lack of ER on this left side also reinforces the fact that you've got this compressive strategy and that's bringing the orientation of the pelvis forward more so on the left than it is on the right. So we have kind of a unilateral issue here. Both sides are affected obviously as they always are, but we're going to focus in on this left side. So the first thing that we're going to want to do is we're going to reduce this anterior orientation. Now, your client complains of left hamstrings, which is not a shocker because she's got an eccentrically oriented hamstring on this side. So when the pelvis gets pushed forward, it's oriented forward. This ischial tuberosity moves further from the femur, which means I've got an eccentric orientation here. And then I've got, like I said, the eccentrically oriented hamstring. So every time that you put it into a hinging scenario, you've got a lot of eccentric orientation there, which is going to increase that load on the hamstrings, probably why she gets sore. So what we're going to have to do is we're going to bring the orientation back by grabbing all of this ischial tuberosity. Now, how do you do that? Well, we have to consider that we really want the proximal musculature of the hip to control the position of the pelvis relative to the femur. But the further forward you go and the further away from the femur, the ischial tuberosity, the more we're going to use the hamstring as an assist. Because if we look at this from a geometric standpoint, we lose the glute max moment arm as we flex the hip and then the hamstring moment arm actually increases. So we're going to use the hamstring to help us pull this back. So now we're talking about hook lying activities. We're looking at just your classic glute bridge progression. A couple of things that you may want to consider under these circumstances is that if you do find that as she performs her glute bridge, her knees separate, we want to put something between her knees like a yoga block or a ball or a band or something like that that we can keep the knees together. So we don't move into this externally rotated position because what we're trying to do is we're trying to recapture this hip extension and as close as we get the hip extension, that's more of our hip IR moment. And so we don't want the knees to be separating under those circumstances. But like I said, you work from this hip extension progression to where you can get the hip fully extended. So I would refer you to an arm bar video that I did a while back where you can actually see the progression to the fully extended hip with the foot on the wall during an arm bar.

So you can actually progress them towards those type of activities and then eventually bring them up to stand and start driving some hip extension that way. So something as simple as say a right foot step up will promote the left hip extension on the support side leg as you're stepping up. So things like that will be a great diagnostic for you to pay attention to as your as your client progresses now. So let's take away some of the interference that's going on here as well. So this person is not going to be a back squatter and you're going to take away hinging activities temporarily because the chances of recapturing that ischial tuberosity position during a hinge is going to be very, very difficult because she's already having trouble. She's demonstrating trouble with that already. The back squats going to just increase the amount of posterior compression you've got. So we want to eliminate that. Now, what we can do, though, is start to use some front-loaded squatting activities, like exert your squats on the table, goblet squats on the table, but what I would do is elevate the heels. What we want to do is we want to move her back. towards this early propulsive strategy where we're going to reduce the pressure on the sacral base. When you put it into split activities, I would elevate the front leg. Again, I want to reduce the amount of load on that front leg and I want to promote that posterior expansion and the front foot elevates split squat is a great way to do that. I would also refer you to the offset squatting activity with the heel elevated. I got a video on YouTube for the left shift, so that is also on the table. Once you start to see the straight leg raise normalize and hip external rotation starts to improve, now you can start to reintroduce some hinging activities, but I would start with a camper and you'd then live with the heel elevated. Again, what I want to do is I want to reintroduce these activities where she has to now control that ischial tuberosity relative to the femur, but I want to keep her back towards a position that will reduce the sacral base compression. When it comes time to reintroduce the bilateral symmetrical activities like those like a Romanian deadlift or anything that falls into that category. Doria would use a snatch grip RDL as a reintroducing activity. The starting position, because of the snatch grip, actually reduces the likelihood of getting that sick work-based pressure that you would typically have used, like something that would bring the hands in. and create a compression in the upper dorsal, rostral area.

So again, we just want to think about eliminating interference as much as we can, but that should give you an idea of one, what you're looking at and some strategy that you can use to bring this person out of this. I hope it's helpful. If you have any other questions, please let me know. Everybody have a great Monday. Let's kick off a great week and I'll see you tomorrow. Good morning, happy Tuesday. I have neural coffee in hand and it is perfect. Great Tuesday, clinic day, very, very busy. We're gonna dig right into Q&A. Alex was on YouTube, apparently yesterday. He saw the commentary about the left shift and some of the sequel compression that we were talking about. And so Alex's question basically plays off of yesterday's video, where he said, would you use the same strategies to apply for a right shift? Or would it be somewhat different? And he also mentioned that, yes, we've shown a number of different approaches on how to address these things. But let's go ahead and talk our way through this because I don't know if I've actually laid out much strategy for the right shift. We've shown some exercises for it, but let's talk a little bit about strategy. But let's build this thing from how we get from this left shifted orientation to the right shifted orientation because it does tend to be a little bit of a progressive kind of a thing. So when we talk about the left shift, like we talked about yesterday. Remember that we're going to start with a left sick world-based compression. So we're going to be compressed here. It's going to push the sacrum. So it's going to be oriented to the right. Now we're still going to have some expansion in this left posterior area. So these will be typically people that will have a decent straight leg raise. But what happens, because we get this sacral base compression here, we're going to get the irritative effect in the dorsal rostral area and the thorax, and so we get this orientation of the entire axial skeleton to the left, so as they squat, they shift back to the left. Now, if we superimpose the anterior compression on top of this, what's going to happen? We get the shape change in the left posterior aspect of the pelvis. So we're actually going to turn this issue a little bit. And what that's going to do, it's going to externally rotate. The hip a little bit, it's going to approximate our sacrum to the femur. And so we're going to start to get this oblique tilt. We get the same iterative effect in the posterior lower rib cage, which is going to push forward. And so now we've got a pelvis that's tilted on a right oblique axis. OK, so if that happens, we're going to lose the extra rotation on this right side.

So as we move through the squat and as we approach our internally rotated position here, we get the interrotation of the hip. We get an expansion on the right side. So we're going to get this expansion between the sacrum and the ischium here. We're going to follow that expansion. So now we've got a squat with a right shift. So that's how we get to the right shift. Now we've got to start thinking strategy here. So we've got a couple of issues. We've got a two-sided problem. We've got this late propulsive strategy on the left side that's pushing us forward. We've got to shift back into the right hip that we also need to address. So the first thing we have to do is we've got to get everything reoriented. And so I would have you go back and take a look at the Camperini deadlift variations from about two weeks ago. I think it was about two weeks ago that we talked about that. So what you're going to do is you're going to use a comfortable lateral load. You're going to elevate the left heel. We're going to try to get you back to that early propulsive strategy on the left side. So we've got to get the sacrum and the pelvis to reorient to the left number one. Once you recapture your hip internal rotation and your straight leg raise on that left side, then you're going to want to switch and you're going to use the ipsilateral load because now what you got to do is we're going to address this right side stuff. So we got to use the right side to push back into the left side to hold back that propulsive strategy. So this is right foot forward stuff. So your Camp Rainy dead left is going to be right foot forward with the load on the left. We can move into some split stance variations at this point as well. Again, right foot forward. So if we want to do, say a split squat with an Ipsilateral load. So when I say Ipsilateral will be a right hand load with the right foot forward. So this is somebody that is working their way out of a cut, if you will. So by loading on the right side, we're going to emphasize the right hip external rotation to push us back into the left, maintain that left internal rotation and delay that left propulsive strategy. We can also use a right foot forward split squat with a left cable load and what this is going to do if we maintain the expansion on the left posterior side with that left cable load we're going to be pushing again with that right foot to push us back into the left side, maintain our left hip internal rotation, delay that propulsive strategy.

And then this is going to help us learn to restore that much more symmetrical presentation in your squat. I think that I also have a video up here on one of the two simple videos where we used the offset left heel elevated left cable loaded squat variation. So this is going to get you into the deeper aspects of your squat and also help you maintain the ability to offset that left propulsive strategy that you're going to need to delay. to make sure that you can maintain your symmetrical squat and not shift to the right. So Alex, I hope this gives you some strategy in regards to the right shift.

You've got anterior compression, which is stealing some IR. You've got posterior compression, which is going to anteriorly orient you. So you're going to lose some ER there. So you've got a lot of compressive strategy in your pelvis, but that's advantageous when we're talking about lifting things that are really, really heavy and moving under load. If you're missing ER and IR, and as you move through this sticking point, you're gonna have to find some IR somewhere to break parallel. And so under those circumstances, what you can do is actually, if you deviate your knee laterally, so a lot of people are gonna say, well, you're actually rotating the hip through this excursion you are, but as you move through the squat, and I'm gonna try to show this on the camera here, so if I fix the foot to the ground, versus the way we would measure in an old-school open-chain measurement. When I fix the foot to the ground and the pelvis is lowering, I'm actually moving into internal rotation at the hip. So if I fix this, the knee is going to rotate and I'm going to internally rotate that hip. So when you deviate out, Tony, what you're actually doing is you're recapturing some internal rotation of the hip which is allowing you to break parallel. This is a common misconception and so it drives a lot of ineffective strategies to try to recapture hip ranges of motion. So what I would do Tony is I would start to work on one restoring your ability to move the pelvis through its full excursion. So you're probably anteriorly oriented. You probably need to learn how to capture the posterior orientation. We've got plenty of videos on YouTube to address that. And then I would start to work on some of this internal rotation that you're going to need, and it'll give you some more variability in your squat if that's your goal. When we're talking about force production, remember that we're trying to reduce the relative motion to allow us to produce a lot of force. And so there's going to be some give and take here. So if your goal is to increase the range of motion, you need relative movement between the segments, so between the sacrum and the ilium and the ilium and the hip and so on and so forth. Again, it's all going to depend on what your goal is. If you want to lift heavy things, you've got to reduce the relative movement to allow you to produce higher force. If you're trying to recapture relative motions, you might have to sacrifice a little bit of force production in the process, but you also might feel a little better as you're moving around during normal activity.

So Tony, I hope that gives you an idea of where this range of motion is coming from. If you have any questions about this, please go to askbillharman@gmail.com and submit another question and I will see you guys tomorrow. Coffee and coach's conference call—don't forget that. And we've got some new stuff coming up on iFastU as well. So if you're not on iFastU, get there. I'll see you guys tomorrow. Happy Thursday everybody. I had neuro coffee in hand and it is perfect.

All right. She had diastasis recti, but over the winter, she decided to have surgery and, assuming yes. Sorry. Yes. Abdominal plastic. And she started to get where she was going to the physical therapist for is like radiating pain in her neck and down into her arms and back.

Yeah.

Abdominal plastic. And she started to get where she was going to the physical therapist for radiating pain in her neck and down into her arms and back.

No, this happens. I don't know what else to say. So yeah, so what they did is they took the end game compensatory strategy and they built it. So they tightened up her rectus abdominis basically. So they pulled the pubis and the sternum closer together by accident. So typically, so picture this for a sec. When you have a diastasis recti, the abdominals are going to behave very much like a wide ISA. So the pregnancies will spread the diastasis, right? And chances are it was probably more cosmetic than anything else under most circumstances. But if you can get the finger measurement, are you familiar? where they take their fingers and they say, how many fingers wide is your diastasis? And if you get to like three, they go, ah, you may want to tighten that up. And so chances are that they pulled everything in and they pulled it down and in as they closed the diastasis, right? And so you took your wide person and then you pulled the sternum down at the same time. So they tried to close the ISA surgically, okay? And then they pulled it down. So you have to treat this person as such. You're going to have to slowly work them back out of it, and you're going to have to recap. So here's an interesting little twist of day. You're probably going to have to drive them into some form of old school traditional extension. OK. Getting flexion. with an exhalation. So what's going on is she cannot fill the upper ribcage right now at all. So she's getting pulled down, right? So her flexion is gonna be limited. And so that's probably gonna be your primary KPI as far as how you're gonna follow this, okay? But that's the goal. You're gonna have to get air up. Because she's not actively closing the ISA, which is a requirement for reflection. They created an AP compression. So she's getting squished and pulled down. She'll have some form of inversion in her program. Eventually, you're going to want to get her to hang maybe one arm at a time or something like that. to try to create the expansion upward, but again, monitoring her ability to close the ISN. But stuff like sideline becomes important for her, because you can expand one side. So you remember the slinky that I had in the purple room? So you're going to side bend her like a slinky from side to side.

Yeah.

But if you can get the finger measurement, are you familiar? Where they take their fingers and they say how many fingers wide is your diastasis? And if you get to like three, they go ah, you may want to tighten that up. And so chances are that they pulled everything in and they pulled it down and in as they closed the diastasis, right? And so you took your wide person and then you pulled the sternum down at the same time. So they tried to close the ISA surgically, okay? And then they pulled it down. So you have to treat this person as such. You're going to have to slowly work them back out of it, and you're going to have to recap. So here's an interesting little twist of day. You're probably going to have to drive them into some form of old school traditional extension. OK. Getting flexion with an exhalation. So what's going on is she cannot fill the upper ribcage right now at all. So she's getting pulled down, right? So her flexion is gonna be limited. And so that's probably gonna be your primary KPI as far as how you're gonna follow this, okay? But that's the goal. You're gonna have to get air up. Because she's not actively closing the ISA, which is a requirement for reflection. They created an AP compression. So she's getting squished and pulled down. She'll have some form of inversion in her program. Eventually, you're going to want to get her to hang maybe one arm at a time or something like that to try to create the expansion upward, but again, monitoring her ability to close the ISA. But stuff like sideline becomes important for her, because you can expand one side. So you remember the slinky that I had in the purple room? So you're going to side bend her like a slinky from side to side.

Perfect. I have a GHR so she can lay to the side.

But don't put her prone because it's not going to work. She's somebody that regardless of what her ISA measurement would be, she has to be able to actively close it to get her arms overhead. Some good activities like an upper dog or was it is that is anybody a yoga person on here like it was it? It's like a sunrise asana or something something where they're looking up. Okay, but so the so the cool thing here is that is that your your arm position puts you in an ER inhaled position and you're also actively closing the ISA. And like I said, it's a little counterintuitive. And it's not about being extreme. It's literally just getting air up into the thorax while you're closing the ISA. So again, that's why you start there because she probably doesn't have shoulder flexion and then you start to work upward.

Bill, when you said that you wouldn't put this person in prone, are we talking about all prone positions, like quadruped?

Prone on elbows and okay. Is that because she's going to crunch down too much? Yes, she's going to try to bend more than expand. And again, this is a really common issue with putting people into quadruped anyway. It's that people don't recognize the difference between bending the spine forward and expanding the posterior thorax because they are not the same. So what you don't want to do is reinforce the shorter distance between sternum and pubis for her. But under most circumstances, for most people that have not had traumatic incidents and they just have movement related issues, the restrictions are just concentric orientation. And so what the table test represents are the areas that would be most compressed. So when I have a limitation on the table, I have a compressive strategy that's typically limiting that. And then you have to understand where that compressive strategy is. But if you know where that compressive strategy is, you know what movement would be limited because of that. Now you can go right into the gym. So you don't have to lay people on the table. You just have to understand how these things work. You just have to understand the relationships. And then you go to the gym and you go, oh, you can't do that. So when I ask you to take this kettlebell and press it overhead, you have to go into a side bend to get your hand into the upright position. It's like, oh, okay. So you can't reach overhead. So chances are I have a compressive strategy that's limiting that movement. Where's the compressive strategy going to be? And I say, it's going to be an X spot. And then I go into the gym and I say, well, what activity can I do that doesn't compress that? That's the strategy. That's literally what we do. And so then the exercise or the movement becomes the assessment. And the comparator, we just have to get really good at understanding the relationships in regards to the shape change that produces movement.

But that's super easy, but it's not. But it could be.

It's simple. It's not easy. The rule is very, very simple. The rule is you can only have two strategies for movement. That's it. There's only two. I can make something bigger or I can make something smaller. And based on that shape change, I produce a shape that moves me through space. That's it.

But it could be.

It's simple. It's not easy. The rule is very, very simple. The rule is you can only have two strategies for movement. That's it. There's only two. I can make something bigger or I can make something smaller. And based on that shape change, I produce a shape that moves me through space. That's it.

are only partially correct because it's the early limitation of external rotation that is a limiting factor. But it could be an internal rotation problem or an external rotation problem that ultimately limits my ability to acquire and utilize the front rack position comfortably. If you lack the up pump handle in the front, meaning you don't have enough internal rotation, what you're going to probably see is you're going to start to see the elbows flare laterally. And so this is somewhat trying to reacquire some external rotation so you have more internal rotation available to you to actually acquire and utilize the rack position. So the inability to keep the upper back expanded not only restricts my ability to hold my position, but it's also going to make it very difficult to increase the load of my front squat. So now when we think about activities that we want to utilize to reinforce our ability to expand in the appropriate areas to acquire the rack position, we want to think about, okay, what expands the posterior lower? What can give me the up pump handle? What can give me that yielding strategy in the upper back? So there's a lot of activities that actually reinforce all of these aspects of this expansion all at the same time. So this is where bear crawls really come into play. Because of the orientation of the body I'm going to emphasize that lower posterior expansion of the rib cage. I'll immediately get the yielding strategy in the upper back and because of the shoulder girdle position as I'm going through the propulsive phase of quadruped I'm also going to create the up pump handle position. Plate squats are a great way to reinforce this early propulsive strategy that we're going to utilize in the front squat as well. The heel's elevated position puts the ankle on the early propulsive phase. It's going to create a posterior expansion in the pelvis as well as that posterior expansion in the upper back. If we need to do something that's a little bit more rehab-ish or we're having trouble acquiring the position to begin with, we want to do something that's a little bit simpler. So we're going to start in maybe a child's pose, which is actually the bottom position of the front squat. We'll move into an inverted position, which is going to enter our airway and allow us to increase our ability to expand through the upper thorax. We're going to bring that pump handle up and expand the posterior upper back to challenge us a little bit more. Then we're going to bring you back to upright and we're going to do something like a backwards sled drag, which is also going to place the foot in an early propulsive strategy and teaches to expand the upper back against some resistance.

So there are a lot of activities that we can utilize rather than trying to rely on some ineffective form of stretching which might give you some sort of temporary impact in your ability to acquire the rack position but ultimately you have to re-teach yourself to expand in the appropriate areas to move the shoulder through its full excursion to get to the rack position. Now worst case scenario is we still have to train. So what are you going to be your substitutions? So right away, we elevate the heels, we get posterior expansion. So maybe that's going to be sufficient for you to acquire a better rack position and a more effective front squat. If you can't acquire the position for the shoulder, a really common substitution is to take some lifting straps, wrap them around the bar, and that's going to allow you to at least get the shoulder into a position where we can actually support the bar across the shoulders. But keep in mind, I still need to get that anterior posterior expansion in the thorax so I have a place to rest that weight. So the expansion of the thorax provides us the shelf that we're going to ultimately use to hold the rack position. Derek, hopefully that gives you some strategies and some ideas that you can allow us to improve your own front squat. If you have any questions, send them to askbillhartman at gmail.com. I will see you guys next week.