We have a patient case study for Monday. Let's check it out. Good morning. Happy Monday. I have neuro coffee in hand and it is perfect. Busy Monday. I fast you folk we have a live Q&A at 2 p.m. Eastern the link is on the website if you're not signed up for I fast you you better do it quickly and we will see you early this afternoon. Last couple Q&As have been pretty killer so so we've had a good time. I want to dig right into Monday's Q&A because I got a dentist appointment today braces so this comes from Carmine. And Carmine has a case study for it, so this is going to be kind of fun. He says, I appreciate you sharing your model and the content you consistently put out where you are most welcome, Carmine. I have a client who often experiences right SI joint pain. He is biased towards an aero ISA with a straight leg raise. So pay attention to these numbers, folks. Straight leg raise of 85 on the left, 75 on the right. Hip flexion on the right is 130, 110 on the left. He has about 30 degrees of IR on the left, 20 on the right. ER on the left is 60, 50 on the right. What would be the orientation of the pelvis and what do you believe is producing the pain experience on the right side? Would these measures, would this be a pelvis tipped on an oblique axis to the right with an answer or post to your compression on the right. What activities would you recommend for this individual? What activities would I recommend? Well, Carmine, you can just send your consultation check to me in care of IFAST, and we'll take care of that. Kidding. Let's go through this. Okay. So first and foremost, let's figure out why we would see this representation in the first place of Carmine. And so let me tell you what's going on here. You got somebody that's looking for right internal rotation. And so they're orienting their body in a position as a substitute for the inability to internally rotate. So you're gonna have to find internal rotation somewhere. We're gonna go after the hip here, because I think that's gonna be the first place that if you recapture this, it'll be money. But let's break down what the pelvis looks like. So when in doubt, You always want to go back to your archetypes to start. So we got somebody that's going to be biased towards the narrow ISA. Okay. So we know we don't have normal extremity motion. So we don't have full breathing excursion. So we're going to have somebody that's going to be in our, our plastic model representation of that. Okay. So right away on the backside. We've got an outlet that is in a position that's biased towards inhalation.

We have a biased towards increased ER, decreased IR, which is what you're kind of representing. Now, your hip ER measures look like they're in the normal range. But remember, we're biased towards the narrow ISA. So what we should get is a magnification of ER and a reduction of IR. But you're kind of sitting really close to normal. So that's going to be indicative of the fact that you probably lost a little bit of that ER. Some answer orientation that we're dealing with. Now, you are absolutely correct. Because of your ER measures, that's going to be your tell as far as being tipped on this oblique. So we got a little bit of an oblique tilt going this way, and that's why you've got the deficit in your ER. So now we've got a representation of what we're looking at. So your key performance indicator is going to be this right hip IR measure, but you're going to need to get the ER back first. Then we can superimpose the internal rotation on top of that. So we're going to monitor ER first, but we're going to go after this right hip IR. You only gave me a partial chest board, but I think we got enough to work with here. But let me offer you this, that if you complete your chest board, you're going to be a lot more clear on what you're going to need to do. Chances are this person is going to have a limitation, a right hip abduction. You're going to have limited hip extension on both sides. And I would suggest that you do this in sideline. Don't use a Thomas test. Hate the test. It's never been terribly useful. Use your upper extremity measures as a confirmation. Remember we've got iterations in the thorax. So just little hints here. A couple other things. You get some outlier measures here that are a little bit off. So your hip flexion and your straight leg raise are a little bit magnified. Now that's not unusual for a narrow ISA, but when you've got the right end, when we've got the anterior orientation around there, we want to be really careful about how we measure these things. So if there's one thing that I've evolved over the last, oh, five years or so is getting very particular about how we measure. So I got a couple videos up on YouTube on shoulder flexion, hip flexion, on how to go about those things. Chances are you're getting a little bit of a roll on the table as you're doing these measures. So it's magnifying your straight leg raise a little bit. It's magnifying your hip flexion quite a bit. So you're getting some rollback on your hip flexion. So please pay attention to how you're doing that.

Now the cool thing is that you still got some deficit in your measures that are going to point us in the right direction. Just make sure you're getting more reliable with yourself. So let's go through this step-wise. We've got some anterior rotation. Gotta take care of that first. Bringing that back is going to help us recapture our external rotation measures. Now, just a quick reminder, because we're dealing with a narrow ISA: if you try to reorient the pelvis from an anterior orientation to posterior orientation, chances are you're going to have somebody that's going to try to clinch that lower aspect of the posterior lower part of the pelvis. They're going to try to concentrate on that as they posteriorly orient. So what you're gonna wanna do is induce a little bit of internal rotation with that. And because of the orientation on the oblique axis, we have to push back into the left at the same time. So what we need is a right overcoming action on that right side. So we're going to drive right propulsion as we reorient the pelvis and try to kill two birds with one stone. So it's going to look like this. I like to put people in hook lying and then drive the right propulsive strategy again at the same time. That's very rehab-ish. So ultimately what we want to be able to do is get this person standing up and into a split squat with the right foot forward orientation to help push back into the left. But we might have to construct this. Again, you're dealing with somebody in pain. They may not be able to manage gravity all that well, but we can start to look at this from that perspective of the split squat, but we can put them on our left side. So we want to be left side heavy under all of these circumstances. So you can hear me say that a lot as we organize the exercises. So we put them on left side heavy and we start to put them in the split squat orientation so we can drive that right propulsive strategy and start to recapture the hip rotations that we've lost. As we drive that right propulsion, it's going to help us push back into the left with the right side, we capture ER, and then we lower them into the split squat orientation which is going to capture the IR. Again, start them on the left side line, or as we would say, left side heavy, right foot pushing back. Once we recapture our hip ER and IR on the table, we want to go ahead and stand them up. So we're going to have that same orientation, right foot forward, split squat orientation, and be pushing back into the left with that right side. We'll start with an ipsolateral loaded split squat. What the ipsolateral load is going to allow us to do is make it easier for us to come out and maintain that ER orientation because if we lose the ER in that right hip, we have no place to superimpose our IR. Once you can consistently recapture your external rotation of that right hip, we're going to move to the contralaterally loaded split squat which is going to push us into the split squat in IR. So now we're going to capture the IR there and then we're going to have to push out against the resistance and maintain our ability to control the pelvis and hang on to our externally rotated position. You can also use a right foot front foot elevated right propulsive split squat. Here, you're actually reaching forward with the right side, creating an overcoming action on the right side by biasing that right side lead. What that does is teach us to go through the middle propulsive phase, hanging onto the ER, and then we can superimpose the IR on top of it. Once we can become more dynamic, we can shift to a backwards sled drag with a left handle only stepping back with the left foot only. Again, it's teaching us to push backwards and to the left with that right foot. Once we do that we can move to playing in this middle propulsive area so we get normal middle propulsive capabilities, and then the sled drag becomes the crossover sled drag because that's playing in middle propulsion all day every day. We can go right suitcase carries to help us maintain some measure of IR, and then hopefully we can just restore all of our normal dynamics and build out variations from there. You might have to consistently apply a little bit of this in the early phases of training just to make sure that they're maintaining their capabilities of hanging on to that extra rotation and pelvic orientation on the right side, but in general, this should move you towards a solution.

We're going to be pushing back into the left with that right side. We're going to start with an ipsolateral loaded split squat. The ipsolateral load is going to allow us to come out and maintain that ER orientation because if we lose the ER in that right hip, we have no place to superimpose our IR. Once you can consistently recapture your external rotation of that right hip, now we're going to move to the contralaterally loaded split squat which is going to push us into the split squat in IR. So now we're going to capture the IR there and then we're going to have to push out against the resistance and maintain our ability to control the pelvis and hang on to our externally rotated position. You can also use a right foot front foot elevated right propulsive split squat. Here's a representation up here should be if my technology is good. And what you're doing here is you're actually reaching forward with the right side. And so again, we're creating an overcoming action on the right side by biasing that right side lead. And what that does is it teaches us to go through the middle propulsive phase, hanging onto the ER, and then we can superimpose the IR on top of it. Once we can become more dynamic, we can shift to a backwards sled drag with a left handle only stepping back with the left foot only. So again, it's teaching us to push backwards and to the left with that right foot. Once we do that we can move to playing in this middle propulsive area so we get normal middle propulsive capabilities and so then the sled drag becomes the crossover sled drag because that's playing in middle propulsion all day every day. We can go right suitcase carries to help us maintain some measure of IR and then hopefully we can just restore all of our normal dynamics and build out variations from there. You might have to consistently apply a little bit of this in the early phases of training just to make sure that they're maintaining their capabilities of hanging on to that extra rotation and pelvic orientation on the right side, but in general, this should move you towards a solution.

I received a question from Johnny that we answered recently, and he posed another excellent question that prompted me to move him to the front of the queue. We will address Johnny's new question today. Johnny says, 'Thanks for answering my questions recently.' You're welcome. He continues, 'I'm curious, why is inhalation needed when lifting something heavy? For instance, prior to a 1RM squat. Since you've expressed that internal rotation (IR) is force production, but inhalation would be external rotation (ER), is the reason along the lines of needing ER expansion so that we can compress IR?' Johnny, I love your thinking process, and you are on the right track. Let's break this down further for a clearer understanding of the mechanics and our use of breath, especially during high-force production and in specific exercises like the squat. This concept applies to numerous activities, particularly those involving high-force production. First, we must discuss our evolutionary origins. We evolved from swimmers, who were biased toward external rotation. Upon moving to land, we had to work intensely against gravity, developing our internal rotation capabilities. It's crucial to understand that internal rotation is superimposed on an external rotation foundation. This is where we generate force. The heavier the load, the greater the force required. During an exercise's movement, we need to access range of motion. Consider the squat: I descend and then ascend, superimposing internal rotation and force production upon my expansion bias, which provides external rotation. The degree of inflation is determined by the required force production and the needed range of motion. Olympic weightlifters exemplify this well. Observe them during lifts like the clean and jerk. As they stand with the clean, you'll see them managing their breath, inhaling and exhaling to optimize internal pressure, accessing specific ranges, creating optimal body shapes, and maintaining sufficient force production under the bar. This is fundamentally what we all do during lifts. You may have experienced this yourself during squats: you need a precise volume of air in your rib cage and a certain level of muscle tension to perform the squat. Without sufficient expansion, you cannot access the range of motion required. This is why, as weight is added, squat form changes. You might see shallower squats, increased lordosis, more forward lean, or altered knee positioning. The lifter is trying to achieve positions but must alter their body's shape based on the load, their expansion capabilities, and their compressive strategy. If you inhale too much, you create excessive expansion, leading to too much ER and an inability to generate sufficient compression, resulting in a missed lift. Conversely, if you don't inhale enough, you'll face a force production deficit. Without sufficient inhalation, your ER excursion narrows, limiting the available internal rotation range. For example, your sticking point might be around 90 degrees of hip flexion. If your internal rotation excursion is insufficient due to inadequate expansion, you lack the necessary range to apply force, causing a missed lift. Johnny, we can analyze this through multiple factors: expansion capabilities to access external rotation, creating internal pressure with a compressive strategy, and maintaining body shape for force production directly under the bar. Think about the front squat; many lifters fail by dumping the weight forward because they cannot maintain the anterior expansion required. This is another critical shape change to consider. Johnny, I hope this answers your question. It's a fascinating topic. If not, please ask another question at askbillhartman@gmail.com. I'll see you all tomorrow.

That's essentially what we all do when we're performing our lifts, and you probably have some experience yourself when you're doing your own squats: you sort of have to have this optimized amount of air volume in your rib cage. You have to have a certain amount of muscle tension available to you so you can perform the squat, because if you don't have enough expansion, then you're not going to be able to access the range of motion that you're trying to access during the squat itself. And so this is one of the reasons why, as people slowly put weight on the bar during a workout, you'll see their squat sort of change. In some cases, what you're going to see is a shallower and shallower representation of the squat, or you're going to see a bigger lordosis, or you're going to see more forward lean, or you're going to see changes in knee position. So what these people are doing is trying to access certain positions, but because of the context of the lift—the amount of load, the amount of expansion capabilities that they do have, the amount of compressive strategy that they do have—they have to actually change the shape of their body. If you inhale too much, what you may end up doing is creating too much expansion; you have too much ER, and then you can't squeeze enough. So you're gonna end up missing a lift. If I don't inhale enough, then you may have a force production issue as well. So think about if I don't inhale: I won't have my full ER excursion, which is going to immediately narrow the excursion I have available for internal rotation. So my sticking point is somewhere around 90 degrees of hip flexion, plus or minus 30 on either end. So I might have a 30 to 60 degree range of motion where I need to produce high force through internal rotation. But if my excursion of internal rotation is insufficient because I didn't expand enough, I don't have enough time to apply force. And so I'm going to miss the lift under those circumstances as well. So we can break this down into multiple factors: we can look at it from the expansion capabilities to access external rotation. I have to have internal rotation available to me; I have to create enough internal pressure and a compressive strategy, but I have to have enough inhalation so I can squeeze against that to create the pressure. And then I need to actually maintain the shape of my body so I have enough force production directly underneath the bar to lift it. Think about a front squat under certain situations. You'll see a lot of people dump front squats forward because they cannot maintain the anterior expansion of the bar.

So that's another shape change that we have to consider as well. Johnny, I hope I answered your question for you. This is a really, really interesting topic. So if I didn't, please ask another question at askbillharman.gmail.com and I will see you guys tomorrow. So let's talk about three different shoulder impingements, three strategies, and three solutions. Good morning. Happy Wednesday. I have neuro coffee in hand and it is perfect. All right. It's Wednesday, so that means tomorrow's Thursday, which means that we have the Coffee and Coaches Conference call at 6 a.m. Eastern Time. Go to my professional Facebook page. If you would like to join us, we've had amazing groups the last three or four calls, so please join us. Discussion is getting really deep. Everybody's getting smart, so I really like this. Let's dig in. I got a really, really good lead-in question. That's going to take us in a little bit different direction, which will be kind of cool. So this is from Mihail. Mihail says, hey Bill, hey Mihail. He said, during shoulder flexion test, when measuring it the right way. So he's making reference to my YouTube video on how to measure shoulder flexion. He says, what's happening when the elbow starts to move laterally? Is there a normal motion available at the shoulder girdle? And the only way to get the arm overhead is through shoulder internal rotation. So if you keep raising the arm overhead while allowing the internal rotation to happen, is movement happening only at the shoulder joint with no movement, the scap, clavicle, et cetera. Mihail, you are on point. So this is a very, very specific situation where we've got a posterior compressive strategy that is going to limit shoulder elevation because it's going to eliminate the external rotation, of elevation. The minute you steal that you're diving right into interrotation and you're moving towards interrotation but we got a scapula that can't move and so we have a very specific limitation and you start banging into the compressive strategy at about 90 degrees of shoulder flexion which would typically be one of our impingement tests so What I would like to do, Mihail, is I would like to take this situation and let us look at three different impingements because I think a lot of impingement gets packaged into one thing and I think the current strategies for most PTs is to try to look at They're calling it subacromial pain syndrome rather than subacromial impingement. We don't want to look at these impingements the same because the source of the limitation that is creating the compressive strategy in the shoulder that results in pain is not the same. So we're going to look at three different situations here and We get to use old school PT school orthopedic textbook impingement tests because this is why those impingement tests were valuable at one point in time. They just didn't know why.

So we're going to tell you why here. So we're going to look at Hawkins Kennedy. We're going to look at the near test and then we'll look at a painful arc. Okay. Now I don't use these tests because my table tests will tell me exactly where these compressive strategies are. Just because somebody doesn't have pain with these positions, it doesn't mean that there's not a compressive strategy there. It just means that it's not sensitized. So everybody kind of ignores it. And then when somebody does have pain, they tend to blame the poor little rotary cuff. It's not his fault. He's just the result. And so let's talk about where this compressive stuff comes from, okay?

This might not be the first exercise of choice, but it might be something we can go to because there's a turn associated with this. So once we drive something with a reach below shoulder level or a supported activity below shoulder level, we may be able to access a higher level of flexion without any symptoms whatsoever. And especially in this deep squat where we're going to get some of that posterior lower expansion in that position and then we can superimpose a turn. So we're actually going to use the compensatory strategy that Mihail was talking about to our advantage, and we create that turn and we create a reciprocal expansion as we move one arm through the pull down at a time, and that's going to give us the expansion that we want.

So eventually what we're going to do is we're going to be able to work towards an inverted position in many of these cases to reintroduce the higher reaching and to make sure we've got the ability to close the ISA. I really like a reciprocal alternate pull down activity and standing that hopefully you can see right here. This is a nice little activity to reintroduce some of the resisted stuff. It's very similar to the squat variation I talked about with the Hawkins Kennedy impingement problem, but this is a nice way to reintroduce that. We can also superimpose some cervical rotation on top of that, which will actually improve our ability to expand the upper dorsal rostrum area and finish off that flexion without the compressive strategy. Okay, impingement number three. So this is the classic painful art test. This would be traditional shoulder abduction at 90 degrees and plus or minus about 30 or so and this is dorsal rostral compression from start to finish. And so this is from about the spine of the scapula downward. And so number one, we want to avoid anything that's going to compress that dorsal rostral layer. So bilateral compressive exercises like rowing, bilateral eyes, tees and y's, bilateral face pulls off the table. Now you may be able to perform these unilaterally if you can maintain a yielding strategy on the non-concentric overcoming side. So as I pull towards me this way, that's going to be the concentric overcoming. I got to capture yielding strategy on this side. If you can do that, then you can do these activities unilaterally. But to do them bilaterally, it's a bad idea because all you're doing is compressing that area. OK? Now, we still have all of our posterior yielding exercises that we can do. So again, we've got some of those prone variations, but one of my favorite things to do in this situation is go to my Better Band Pull Apart video on YouTube or anything that couples the yielding strategy in the dorsal rostral area with shoulder extra rotation. What happens under these circumstances is you're actually turning the scapula into what would be, I believe, traditional internal rotation of the scapula which actually bands, that dorsal rostral space to even a greater degree. Love those exercises for this situation. So this would be your typical painful arc strategy. So there you go. You've got three impingements, three strategies, three solutions.

We got prominent activities to bring the pump handle up, but here's the kicker. This is when you get to use your bilateral rows, your bilateral face pulls and your bilateral eyes, T's and Y's because I have expansion there. And if I compress that area a little bit, I can push the pump handle up even more. So that's a really cool strategy first to wrap up with. Awesome question. If I did not answer your question sufficiently, please let me know at askbillhartman at gmail.com and We'll see you tomorrow morning on the coffee and coaches conference call. Have a fabulous Wednesday, and I'll see you tomorrow morning Good morning. Happy Thursday. I have no coffee in hand and It is perfect.

Let's take the heels elevated squat, for example. I see people use varying degrees of heel elevation. With a super aggressive heel elevation, you're almost blocked from getting into a deep position or from achieving inhalation at the pelvis. It's almost like a scenario where you're so inclined that you can't achieve passive central orientation. Can you comment and reflect on what might potentially be going on with a super high heel elevation?

Right, so you're playing with center of gravity. So it stands to reason that there's going to be a sweet spot where you're going to, wherever your capabilities will be at that point in time, depending on what you're trying to maximize, there's going to be a sweet spot. So we have all the variations of platforms and stuff. And, you know, we can go from I think what is the lowest 10, 10, highest is 30. If you get on the 30, you can kind of tell if you were walking downhill and didn't want to fall face first down the hill, you have to lean backwards depending on the inclination of the hill. So the steeper I put you on a platform, it is likely that at some point in time, I'm going to actually get the opposing response of what I might be chasing if posterior expansion is my goal. Because again, it's just pure center of gravity issues, and you are absolutely correct. And so more is not better, better is better.

That makes sense. It just looked funny to me and I didn't even feel like, and I've kind of played around with it and I've seen people like, hey, if I'm trying to get quad hypertrophy for, with like a cyclist squat, like I've seen people justify that. But to me for like the goal of like movement restoration that didn't seem to like make a lot of sense.

Yeah.

But to me for like the goal of like movement restoration that didn't seem to like make a lot of sense.

Right. I think the 'look funny test' is a very useful test because something catches your eye and you realize that's not really what you were shooting for. I think it's fair to make that judgment as long as you're making a safe-to-fail experiment. You never want to compromise anybody and put them in a situation where they're going to get hurt. But I think the eyeball test works. Have you read the book Outliers?

A while ago on audiobook.

Okay, probably one of the better ways to actually consume that information. I always tell folks to read the first chapter of Outliers and then throw the book away because it's all in the first chapter as to what he's talking about. There's a story about this guy watching a tennis match, I think he's a tennis coach. It's been a long time since I read it. He's watching this guy serve and his predictive capability of when this guy is going to double fault is ridiculous. Like his accuracy is ridiculously high. He's just watching the match and he can't figure out what it is that he's seeing that tells him when this guy is going to double fault, but he sees it. And so we all have this to a certain degree once we start to capture some experience where we'll see things and we'll go, that's not really what I wanted to see, but I'm not really sure what to do. Then it's just about layering experience on top of that to allow you to identify when you see these things and then to figure out what that is. And that's essentially what we all do. I mean, the longer you're in this, I mean, I've been doing this for more than 30 years now. So it's like, people say, well, how did you see all that? It's like, well, because I've been staring at people for 30 years. Like, get more reps and you get better at it. So again, I think that what you're seeing is right on, right? So hang on.

No.

OK. So Matt's got a hat on, Nate's got a hat on, and Vinny's got a hat on. I am the guy that invented the backwards hat just for the record. I was born before all of you. I just want to make this very, very clear. I was eight. I started the trend, and it just spread like wildfire. Grace, break out your notebook. We need a question. Come on. Help me out.

I have a client who has been hip shifting out of his heavy squats, but it is only when he's on the ace end and he's shifting all the way over to the right.

Like his butt goes right?

Yes. Is there a curve? Curve meaning what? Like, does it look like a side bend through his trunk and his butt kind of skews to the right? Yes, and his chest rotates to the left. Yes, yes, yes. And if he like loses, he has no shoulder here.

No, I am in the right shoulder at all, right? You know why? Because he has no internal rotation on the right hip either, okay? So what he's doing is he's trying to find a part of his body that will allow him to turn the force down into the ground. And so we see a side bend or a hip hike. Those are substitutions for internal rotation or they're demonstrating their lack of internal rotation. And so they're just getting it somewhere else. That's what you're seeing right there. So if you were to try to do this, like, let's just say you did it bilaterally, right? Simultaneously bilaterally, what you would see would be knees tracking inward and an increased arch in the lower back. Those were all substitutions for internal rotation. And so that's all you're seeing. Like in the big picture, the solution might be a little bit more complex than that, but that's why you're seeing that.

Because I'm wondering if he'll then kind of reach a threshold at this point with this limitation and no access to that IR shape on the left.

Right. And so then he starts topping out, right? So now no more progress. And then all you're going to get is you're going to get a stress related load that might turn into something bad. Right, because every time you compress in that strategy, what do you think the load's going to go because he's looking for internal rotation instead of distributing the internal rotation throughout his whole body. He's putting it in one big place. Right. Every what like the, the, the cute curve of that side bend and that hip shift. That's where the load's going. That's why we don't want to see that kind of stuff, because that's what's going to lead towards bad stuff. It's not just bad technique. It's focal load that can change things. And we don't want to constraint change, because those tend to be undesirable for many reasons.

Was anything particular, like near elbow pain? I definitely feel less confident treating that. So particularly like anterior knee pain where it's not, you know, medial or laterally focused. If they have like decent hip range of motion, where are you going from there?

Okay, wait a minute. Are we talking about elbow? Are we talking about knee? Just knee for right now. The two big tests that I use for knees is extension inflection. where the pain is, is initially less of a concern. Like the location can kind of tell you a little bit about the knee. So if I have like a medial knee pain, I tend to have a femur that's internally rotated on an externally rotated tibia. If I have lateral knee pain, I tend to have a tibia that is so far externally rotated that it dragged the femur with it. So they're both kind of turned outward, right? So under those circumstances, you can tell the medial lateral stuff. when you have an anterior, like just kind of like that broad generalized kind of anterior knee pain kind of a thing. So think about it's like I'm driving force through the knee from posterior to anterior under most circumstances, which means that I don't have turns available to me, right? So I'm gonna load it straight through the knee. And so when you think about, you understand what a screw home is, right? Okay, so do they have screw home, which means that I should have some representation of if we talk about traditional extension measures you're probably going to get five to 10 degrees of hyperextension in a knee passively, and then I should have healed to butt flexion. Okay. Those are the two biggies for me. It's like, can I extend the knee and can I flex the knee fully? And so if I can't, that means I have a rotational problem. So when you say decent hip range of motion, not really sure what that represents, but let's just say that you've cleaned up the hip and the pelvis and the actual skeleton and so everything looks all fine and wonderful there and then you go to the knee and you go, oh, they're like four or five inches from heel to butt. And so that would be indicative of somebody that probably can't internally rotate the tip enough to bend the knee to normal range. And so that's where I would spend my time.

Just knee for right now.