So when you say use it appropriately, the thing that we have to have in place is the context in which it's going to be applied. So if we were just talking about walking versus throwing a baseball, very similar in regards to the phases of propulsion, but how you would produce that might be different because of physical structure and because of how they're producing internal rotation. So when you say internal rotation, it's like, okay, is this relative motion at the hip, or is it a compensatory strategy to drive force into the ground to a greater degree, which I might use an anterior orientation, because that increases the amount of force that I can apply into the ground. So again, we have to be very contextual with this and progressive. So if you think about, so you just acquired, let's just say you acquired relative motion of internal rotation on the table.

Alright, so I'm just curious on your operation on when somebody has gained, let's say, hip internal rotation. How do you, in general, go about superimposing force production on that newly acquired range of motion? I can't imagine that just because they have the range of motion that they'll use it appropriately, not sure. So I just want to hear you clear that up.

So when you say use it appropriately, the thing that we have to have in place is the context in which it's going to be applied. So if we were just talking about walking versus throwing a baseball, the phases of propulsion are very similar, but how you would produce that might be different because of physical structure and because of how they're producing internal rotation. So when you say internal rotation, is this relative motion at the hip, or is it a compensatory strategy to drive force into the ground to a greater degree? I might use an anterior orientation because that increases the amount of force that I can apply into the ground. So again, we have to be very contextual with this and progressive. If you think about acquiring relative motion of internal rotation on the table, as soon as I take you out of that context, I've just changed everything about the strategy that you would have to use because I have reoriented gravity and increased the force demands upon you. And then I'm going to move you into a context where we now have seven components of force to deal with. The magnitude of the force matters, and the rate of force application matters. Again, we have multiple influences that we have to account for regarding what strategy you will utilize. As you move into higher and higher force production, you will lose relative motion because it is inevitable—you cannot produce a higher peak force with relative motion. Motion has to actually stop for you to apply that force into the ground. Over what duration do we need to apply this force? For example, in a max effort squat with 400 pounds on your back, the duration of your peak force output is going to increase because it takes longer to get through that phase. If you were using half of that weight, it would be a much smaller representation based on time because you can move the weight more quickly and the acceleration is higher, resulting in a shorter duration where you would be exposed to that peak force. This requires a very specific context. Many people might not recognize this because they make an assumption like, 'Oh, you have internal rotation now, so you have the capacity to do this.' Not necessarily. This becomes problematic when you're working in the athletic realm because physical structure is going to determine how you apply forces to the ground and what durations you have available to you. For example, a narrow-stance individual has a very small window of opportunity to apply force into the ground because they don't have the shape change that produces maximum force into the ground.

Okay.

As soon as I take you out of that context, I've just changed everything about the strategy that you would have to use because I have reoriented gravity. I have actually increased the force demands upon you. And then I'm going to move you into a context where we now have seven components of force to deal with, right? So the magnitude of the force matters, the rate of force application matters. So again, we have multiple influences now that we have to account for as to what strategy you will utilize because as you move into higher and higher force production, you will lose relative motion. It is inevitable because you cannot produce a higher peak force with relative motion. Motion has to actually stop for you to apply that force into the ground. Over what duration do we need to apply this force? For comparison, consider a max effort squat. So I put 400 pounds on your back and you perform a squat. The duration of your peak force output is going to increase because it takes a little longer to get through that phase of peak force. If you were using half of that weight performing the same activity, it would be a much smaller representation based on time. Because you can move that weight much more quickly. You can still be very, very forceful, but because the acceleration is higher, it's a shorter duration where you would be exposed to that peak force. So it requires a very specific context. This might be something that a lot of people might not recognize is because they just make an assumption like oh, you have internal rotation now, so now you have the capacity to do this. Not necessarily. And this becomes problematic when you're working in the athletic realm because physical structure is going to determine how you apply forces to the ground, what durations you have available to you. For example, a narrow ISA individual has a very small window of opportunity to apply force into the ground because they don't have the shape change that produces maximum force into the ground. So take a high jumper, like a really good high jumper. If they apply force into the ground too long, they dampen.

Okay.

So take a high jumper, like a really good high jumper. If they apply force into the ground too long, they dampen. Because their window by their physical structure alone. So this is a physical structure thing. It's like, you look at the best high jumpers in the world, they all kind of look the same.

Right.

Because their window by their physical structure alone. So this is a physical structure thing. It's like, you look at the best high jumpers in the world, they all kind of look the same. Like, what the Olympics are like one of the greatest representations of the influence of physical structure. You take the best high jumper and then have him stand next to the best shot putter. Totally different worlds. Both human, both same body parts, different physical structures, and therefore the way that they apply forces into the ground are going to be different. The outcomes are obviously going to be different. Their connective tissue behaviors are going to be different and so then you have to account for this. It's like, so I got a high jumper that has a need for a tremendous amount of internal rotation into the ground over a very short period of time, but he needs to access that internal rotation directly, well, slightly in front of his center of gravity. Now take the center of gravity of the shot putter. He's going to use a lot more orientation to apply that force into the ground because he's got a longer period of time that he can apply that force to the ground. His peak force is going to be probably very, very high because he's got to move and implement. You see the differences. When you say how do you progress somebody with a black and white answer, unfortunately, it's rarely that, but it is principle based. You just have to recognize what the principles are. Again, this is why the generic program concept doesn't work. You apply the same program to two different people, why do you get two different outcomes? Because the starting conditions were different, and therefore the outcomes will be different. And that's the thing you have to kind of recognize. So you fall back on basic principles. We could use the two extremes. So what kind of an archetype are we looking at? What kind of configuration do they have in the relationships between the thorax and the pelvis in regards to circumference because that determines how easily they're able to move their center of gravity upward and downward? It's going to tell you how long they spend on the ground. It's going to tell you how big their middle propulsive representation is. A wide ISA individual has a much broader duration and physical space to apply forces to the ground, and Nero does not. That's why when you see the tall slender folks that come into the clinic with painful situations, they're trying to apply forces into the ground in an ER representation because they spend more time in that space because their physical structure says you're going to spend more time in that space no matter what you do. And so that becomes the difficulty.

Right.

The Olympics are one of the greatest representations of the influence of physical structure. You take the best high jumper and have him stand next to the best shot putter—totally different worlds. Both human, both with the same body parts, but different physical structures. Therefore, the way they apply forces into the ground are going to be different. The outcomes are obviously going to be different, their connective tissue behaviors are going to be different, and so you have to account for this. It's like, 'I've got a high jumper who needs a tremendous amount of internal rotation into the ground over a very short period of time, but he needs to access that internal rotation slightly in front of his center of gravity.' Now take the center of gravity of the shot putter: he's going to use a lot more orientation to apply that force into the ground because he's got a longer period of time to apply that force to the ground. His force needs to be a lot—his peak force is going to be very, very high. You see the differences when you say, 'How do you progress somebody?' You know, with a black and white answer, Bill. Unfortunately, it's rarely that. But it is principle-based. You just have to recognize what the principles are. Again, this is why the generic program concept doesn't work—you apply the same program to two different people, why do you get two different outcomes? Because the starting conditions were different, and therefore the outcomes will be different. That's the thing you have to recognize. So you fall back on basic principles. We can use the two extremes: what kind of an archetype are we looking at? What kind of configuration do they have in the relationships between the thorax and the pelvis in regards to circumference? Because that determines how easily they're able to move their center of gravity upward and downward. It's going to tell you how long they spend on the ground, how big their medio-lateral propulsive representation is. A wide ISA individual has a much broader duration and physical space to apply forces to the ground, whereas a narrow individual does not. That's why when you see tall, slender folks come into the clinic with painful situations, they're trying to apply forces into the ground in an external rotation representation because they spend more time in that space—because their physical structure says, 'Guess what, you're going to spend more time in that space no matter what you do.' And so that becomes the difficulty.

So as simple as your question seems to be, there is complexity in it, but you can fall back on your principles and you say, okay, where is this person going to apply that force? In what circumstance do they apply that force? At what rate do they apply that force? Because I have a time constraint under most situations, right? What direction is that force being applied? So there are a few questions to answer, but I think they are answerable. And then you rely on process after that, where you say, OK, here's what I thought was going on. Here's what I thought we needed to do. And here was the outcome. Is that favorable? Good. Then let's amplify that and let's reinforce it and see what happens. Was it the less desired outcome? Okay. Let's dampen that. Let's try another strategy, right? And again, you have to be incremental in your process, right? Because you just don't know. I mean, we can talk on principle, but you don't know until you do something.

It was regarding how to gain ranges of shoulder flexion. But the question was whether you could do it in a quadruped position. And then you started talking that when you put someone in quadruped position, you could also get the expansion below the scapula.

Okay.

But the question was whether you could do it in a quadruped position. And then you started talking that when you put someone in quadruped position, you could also get the expansion below the scapula. So I just wanted to go over how and why and whether it would be wiser to use like low reaches to get or am I getting that wrong?

Yes.

So I just wanted to go over how and why and whether it would be wiser to use low reaches to get expansion or am I getting that wrong?

Okay, so the intention is to get the arm overhead. It was a question. We're trying to get the right moment. If you're standing upright, how do the lungs fill with air from the top down or from the bottom up? Bottom up. Excellent. So for us to move the arm through the excursion of an overhead reach, we have to have lungs that will fill from the bottom up, which means that that posterior lower aspect of the rib cage has to be able to expand. So I have to be able to put air there, right? So that would be step one for me to reach up overhead, correct?

Just to improve those and ranges of shoulder function.

The question was whether it would be wiser to use low reaches to improve shoulder function. The intention is to get the arm overhead. To move the arm through the excursion of an overhead reach, we must have lungs that fill from the bottom up. This means the posterior lower aspect of the rib cage must be able to expand. So step one is to be able to put air there to reach overhead. In quadruped, the scapula is in its traditionally referred to upward rotation position, which would create concentric orientation of the dorsal rostral space.

Yeah.

If I'm in quadruped, is the scapula in its traditionally referred to upward rotation position? It is. Would that create concentric orientation of that dorsal rostral space? What would happen to the space below it? It would expand. Okay, so relatively speaking, it would expand. So this is an IR representation, correct? So let's look at this for a second. Look at the pelvis for a sec in its IR representation, okay?

Yeah.

Excellent. What would happen to the space below it? It would expand. Okay, so relatively speaking, it would expand. So this is an IR representation, correct? So let's look at this for a second. Look at the pelvis for a second in its IR representation, okay?

Yeah.

Okay, would you have a nutated sacrum?

Mm-hmm.

Cool. Would the posterior lower aspect of that pelvis probably be in an expanded representation because of that nutated sacrum? There you go. So we created the same representation in the thorax that we just had in the pelvis. So if you look at it from that perspective, now you can kind of see like, oh, posterior lower would be expanded under those circumstances. Okay. Does that make sense?

Yeah.

As the scapula is moving through its traditionally referred to upward rotation, and if I have constant orientation of the dorsal rostral, where am I promoting expansion to allow that arm to move through internal rotation? So as you're raising the arm, the scapula, okay. Like I said, traditionally they'll say that the scapula upwardly rotates. That creates concentric orientation of dorsal rostral. You'd agree with that. OK, cool. So where would the expansion be occurring that allows me to move through this part of the reach where the scapula is actually moving? Where would I expand? Interiorly. Perfect. Okay, so that would be kind of like if I was in that quadruped position, so now I got posterior lower expansion I've got anterior expansion on the front side that gets me through that middle range, would you agree? Yeah, awesome. Okay. So to go higher. Right, to go up higher, so above this level, okay, what do I need to expand? The dorsal rostrum. Okay. If I'm going to do it in external rotation, that is correct. Okay. If I'm not able to access external rotation at the top of the overhead reach, that is what I would need. Okay. How do I get that?