It's easier if you turn his toes out. Yeah.

All right. So I think it would just be easier. I do have two chessboards. Well, a chessboard and a half. The full one is on this post. And no, I don't know if you can see it clearly or not.

High tech. OK. Hang on. What measures are looking at?

Got it. The trouble is, so he's a basketball player, trouble with getting into an athletic position with his feet facing forward. It's easier if he turns his toes out.

So his feet are really, really wide and then he still can't get to parallel, right? But he can get lower. Am I correct?

Yes, I know.

OK.

Oh, that's not tall. That's not. Well, taller than me. So, but it's not really tall. Like when we talk about like the six foot nine, six foot 10 guys. Gotcha.

I'm pretty tall.

They have some other center of gravity issues, so this guy probably won't do too badly, but chances are he's still going to orient to try to get that just because of his physical structure and then his bias towards this type of behavior because this is a performance-related behavior. Right.

Yeah. Go ahead.

No, no, you go. You go.

The other thing I was considering was the rate of connective tissue loading as he's moving. It's one thing to have him breathe in a static position, all these things, but as soon as he's moving quickly, it obviously increases stiffness, like you've mentioned multiple times.

Yeah. And the only way to know, I already mentioned this before, like if you give somebody like that who uses compressive strategies for performance benefit, if you give somebody too much range of motion, there's only one, I would imagine the only way to find out if it's too much for that person is to give them a range of motion, retest whatever you're testing and then go there.

you know because I've had like one or two patients like that like during treatment I'm like you're gonna fall asleep on the table here no nervous system I guess okay oh cool um Okay, so move him left and then back.

So when you see this end game representation and you can see it in the numbers, you can see that he got pushed forward first. So he's on a very, very flat turn and then he just kept going forward. He hit an anterior constraint where he couldn't go forward anymore, so he had to slide over top of his right leg. So that's the direction that he went. So he went, boom, boom. So you got to reverse gears, you go, boom, boom.

Gotcha. Okay. You see it?

You see it?

Okay.

Depending on what he can recapture on his feet, you might have to take him to the ground in an arm bar series or something like that. Depending on how far back you need to go, then it becomes a cross connect or something like that. It's like starting him at the high level. He's a performer. If he's not broken, then I would treat him like an athlete first and see what you can recapture that way, and then just regress as much as you need to to capture what you think you need to recapture.

It's not a turn because his center of gravity went forward and to the right. So you have to bring the center of gravity back to the left. He's pushing right to left. It could be something as simple as a left crossover step with a sled drag. That might be enough to do it.

You see what I'm getting at? It's like you just got to push him that way and then he'll start to make his turn and the turn is where the relative motion is. But you first have to get him into a place where he can actually capture relative motion because right now you've got an AP compression and you've got a pretty hard push to the right. It's like just reverse engineer.

Gotcha. Okay. I appreciate that one next. This is not a chessboard. I'm going to give you like general qualities of this person. I think I've seen videos of you provide solutions in those scenarios. So 70 year old male, wide ISA. He has pain around both sacral ala, like on the lateral aspect of both, worse on the left. He has a lumbar fusion from L3 to L5, absolutely zero hip interrotation, hip flexion stopped at maybe 80 degrees, SLR was at 45 degrees. Not much hip abduction or hip ER on both sides, actually wasn't too bad I like if I remember correctly between 60 and 70, but just like overall stiff and just pretty crippling pain in the sacrum. And I imagine that was just kind of his last compressive strategy in your line.

70?

70? Yes.

The entire pelvis rolling.

Yeah. So, when you measure hip ER, where do you think that's coming from?

Yeah.

And so when you're measuring hip ER, like first of all, he's a wide ISA. So right away, you're thinking I should have a deficit in hip ER. He doesn't have a deficit in hip ER, which means that you've got a lot of stuff that's moving together. Okay, so you've got a compensatory strategy with the pelvis. The pelvis is a single unit. So jam them together, lock them and then lock the lumbar spine. So he's probably rotating there. So he's probably rotating there when you're measuring hip ER. So you're right. It's like all he's got is a sacrum that's just getting compressed between the two ilia at this point. Right? So the pressure just builds, builds and builds. Right? He pushes forward, forward, forward. Right? So now you got to start thinking it's like, okay, where can I make space? Can't use lumbar spine compensatory strategies. Not moving the sacrum at all. Right? So you're going to have to create some form of AP expansion. Right? So he's a side lunge guy. He's going to be a guy that you can usually get a lot of manual therapy on to get the rib cage to move, to get the pelvis to move.

Yeah, I've been having the treatment I've been doing with him so far. Yeah, sideline, just taking the foam roller between the thighs and just trying to roll the femurs back and forth. He's at 90 degrees of hip flexion, which probably as we were talking is obviously is compensatory if he's in a range of motion.