I also threw up on Instagram some propulsive strategies, some late propulsive strategies, using an old classic, I think it was Charles Poliquin that probably made it popular at one point, using the Peterson step up and also a low box rear foot elevated step up. So check that out. And then I threw up a Instagram story this week on a bunch of activities that I've been doing to reestablish some eccentric orientation with load. So that's an interesting little twist on that video. So check those out. And let's dive into this week's Q&A. I got a ton of questions. I tried to narrow it down as much as I could. So just remember that askbillhartman at gmail.com. And then put in the subject line, ask Bill Hartman question. So I know that you're really asking me a question and not trying to sell me something. So let's get started with those. So this is TS training systems. Bill, can you give a quick overview about the propulsion phases? Yes, I can. So you didn't ask me an open-ended question. So there's the answer. Kidding, of course. So when we talk about the propulsive phase, let's first of all talk about the difference between load and propulsion. So load is what pre-exists based on gravity, the internal forces that you produce yourself, and then the external forces applied to you based on all the physics that are around you. So if I put a barbell on your back, I've just altered the loading parameters. If I move laterally, I've altered the loading parameters. So those are all those three things combined. The propulsive strategy is what I use against those to produce the desired intent or movement. So when we talk about propulsive phases, we can break these down to make it a little bit simpler into something we would consider an early propulsive phase, sort of a mid or maximal propulsive phase, and then an end propulsion. So at either ends of the propulsive spectrum, we're moving through a compressive internally rotated pronated strategy towards a more supinated. So I land in supination, I move through my propulsive phases as I move to internal rotation, pronation, exhalation. And then at the end of that phase, I resupinate, I move back towards external rotation and inhalation. And so the two ends of the propulsive spectrum kind of look the same, but they're not the same. While one's moving from a more inhaled to an exhaled, the other one's moving from more of an exhaled to an inhaled strategy, They end up looking similar, but the orientation of the pelvis is just slightly different. As we go through the mid propulsive phase, that is where the maximum concentric strategy would be as I move against all of the external forces that are applied to me and the internal forces that I produce. And so, again, if we use gate, we're landing in supination. We'll move towards pronation, which is my propulsive phase. And I will resupinate the foot at end range. So I will have activities and exercises and elements of performance that will emphasize one of these phases or another. So if I can identify where the limiting factor is in performance, I can then select the appropriate activities with the appropriate positions to emphasize each of those propulsive phases. And so we have this endless array of exercises. And once we can identify where these limitations are in our propulsive capabilities, the exercise programs kind of write themselves. And so this is a really huge topic that we cover at the intensive, especially during the practical component, because a lot of people think that there's some sort of standardized exercise progressions when the reality is, is the progression needs to be individualized towards the client or the athlete that we're working with in regards to what do they do well, what do they not do well, and then what is our intent? Are we trying to emphasize something that they're already good at, or are we trying to work on a weakness or a limitation? And so again, as we look at this from the beginning of the propulsion to the end of the propulsion, there's definitely things that we need to emphasize. But just to wrap that up, Remember that early propulsion is moving from an inhaled state towards an exhaled state. The maximum propulsion is where I am maximally pronated through ground contact and I move again towards the inhaled state towards the end and I can again self-select the activities that would be most appropriate for each of those phases. So hopefully that gives you a little taste of what we're talking about and I'd be happy to expand on those if you have a very specific question on that. from looks like kina mac d can you explain eccentric and concentric orientation once again that's yes you got to ask me an open-ended question my friend Is it different than short or long? I don't really care if you use short or long. I just think you need to understand what's really going on. So traditionally, we've talked about eccentric and concentric contractions, and I don't think it's a very good descriptor. And so when I use eccentric or concentric orientation, so orientation makes reference to position. So if I have a muscle that is positioned at length greater than its perceived midline, wherever that may be, and we can use that sort of as our imaginary middle point. If it's positioned eccentrically, then it would be positioned in the long position, and if it's positioned concentrically, the big position is short. The reason I use eccentric and concentric orientation because there's certain properties that are associated with those positions. So if I am concentrically oriented, it is much easier for me to recruit that muscle during activity. If I'm eccentrically oriented, it is much more difficult. So there are properties within the muscle itself in regards to how I sense that position and then how I am able to recruit that muscle that I think makes the eccentric and concentric orientation better descriptors. I also don't particularly like the fact that concentric and eccentric contractions are kind of vague. And so I tend to use an overcoming contraction versus a yielding contraction rather than calling them concentric or eccentric contractions. Because again, I just think it's a better descriptor. So for instance, I could have a muscle that is eccentrically oriented, so it's longer than its midline, and it could be using an overcoming contraction. what someone might recognize as they might actually call that an eccentric contraction, even though the force is going in the opposite direction of the lengthening of the muscle. And so again, I think there's some vagueness to the way we've used those terms in the past. So what I'm trying to do is clarify what's really going on in regards to position, concentric or eccentric orientation, and to contraction with an overcoming contraction or yielding contraction, just because I think they're better descriptors. And maybe I'm wrong. I'm willing to be wrong on that because I'm not a big fan of useless jargon. But again, as we've had discussions at IFAST and through the intensive, these terms have evolved into something that has become a lot more useful. The next question, rather, comes from Tanner Batten. How do you approach rehabbing a core muscle injury or sports hernia? So this brings up an interesting concept. I'm not a big fan of treating by diagnoses. So I don't think it really influences me all that much other than maybe having to provide an element of protection to certain tissues that may actually have a change in their constraint. So we do have an area that may be affected in the lower abdomen or the groin area by its diagnoses. But as far as the treatment goes, I treat the human being in regards to its ability to recapture this spectrum of breathing capabilities, full movement from external rotation to internal rotation. the loading and propulsive strategy. So that's how I look at things from this global perspective. So whether we call it a sports hernia or whether we had a shoulder injury or a toe injury or whatever it may be, that just simply guides me into an element where I might need to protect something, but I wouldn't change my treatment strategy all that much in regards to any specific diagnosis. So I know you're looking for something specific here. As far as what exercises I would do, I have no idea. until I would evaluate this person. Other than, like I said, this might just guide you in an element of protection. So we don't want to negatively influence this by allowing a great deal of discomfort to be associated with the treatment itself.

I also posted on Instagram some propulsive strategies, specifically late propulsive strategies, using an old classic—though I think Charles Poliquin probably popularized it at one point—the Peterson step up and also a low box rear foot elevated step up. So check those out. And then I posted an Instagram story this week on a bunch of activities I've been doing to reestablish some eccentric orientation with load. So that's an interesting little twist on that. So check those out and let's dive into this week's Q&A. I got a ton of questions. I tried to narrow it down as much as I could. Just remember that askbillhartman at gmail.com, and put in the subject line, 'Ask Bill Hartman question.' So I know that you're really asking me a question and not trying to sell me something. So let's get started with those. This is TS training systems. Bill, can you give a quick overview about the propulsion phases? Yes, I can. So you didn't ask me an open-ended question. So there's the answer. Kidding, of course. When we talk about the propulsive phase, let's first talk about the difference between load and propulsion. Load is what pre-exists based on gravity, the internal forces you produce yourself, and the external forces applied to you based on all the physics around you. So if I put a barbell on your back, I've just altered the loading parameters. If I move laterally, I've altered the loading parameters. So those are all three things combined. The propulsive strategy is what I use against those to produce the desired intent or movement. When we talk about propulsive phases, we can break these down to make it a little simpler into something we would consider an early propulsive phase, sort of a mid or maximal propulsive phase, and then an end propulsion. At either ends of the propulsive spectrum, we're moving through a compressive, internally rotated, pronated strategy towards a more supinated one. I land in supination, I move through my propulsive phases as I move to internal rotation, pronation, exhalation. And then at the end of that phase, I resupinate, I move back towards external rotation and inhalation. So the two ends of the propulsive spectrum kind of look the same, but they're not the same. While one's moving from a more inhaled to an exhaled strategy, the other's moving from more of an exhaled to an inhaled strategy. They end up looking similar, but the orientation of the pelvis is just slightly different. As we go through the mid propulsive phase, that is where the maximum concentric strategy would be as I move against all of the external forces that are applied to me and the internal forces that I produce. Again, if we use gait, we're landing in supination, we'll move towards pronation, which is my propulsive phase, and I will resupinate the foot at end range. So I will have activities, exercises, and elements of performance that will emphasize one of these phases or another. If I can identify where the limiting factor is in performance, I can then select the appropriate activities with the appropriate positions to emphasize each of those propulsive phases. So we have this endless array of exercises. Once we can identify where these limitations are in our propulsive capabilities, the exercise programs kind of write themselves. This is a really huge topic that we cover at the intensive, especially during the practical component, because a lot of people think that there's some sort of standardized exercise progressions when the reality is the progression needs to be individualized towards the client or the athlete that we're working with. What do they do well, what do they not do well, and what is our intent? Are we trying to emphasize something that they're already good at, or are we trying to work on a weakness or a limitation? Again, as we look at this from the beginning of the propulsion to the end of the propulsion, there are definitely things that we need to emphasize. But just to wrap that up, remember that early propulsion is moving from an inhaled state towards an exhaled state. The maximum propulsion is where I am maximally pronated through ground contact and I move again towards the inhaled state towards the end. And I can again self-select the activities that would be most appropriate for each of those phases. So hopefully that gives you a little taste of what we're talking about, and I'd be happy to expand on those if you have a very specific question on that.

We'll move towards pronation, which is my propulsive phase. And I will resupinate the foot at end range. So I will have activities and exercises and elements of performance that will emphasize one of these phases or another. If I can identify where the limiting factor is in performance, I can then select the appropriate activities with the appropriate positions to emphasize each of those propulsive phases. And so we have this endless array of exercises. And once we can identify where these limitations are in our propulsive capabilities, the exercise programs kind of write themselves. And so this is a really huge topic that we cover at the intensive, especially during the practical component, because a lot of people think that there's some sort of standardized exercise progressions when the reality is, is the progression needs to be individualized towards the client or the athlete that we're working with in regards to what do they do well, what do they not do well, and then what is our intent? Are we trying to emphasize something that they're already good at, or are we trying to work on a weakness or a limitation? And so again, as we look at this from the beginning of the propulsion to the end of the propulsion, there's definitely things that we need to emphasize. But just to wrap that up, remember that early propulsion is moving from an inhaled state towards an exhaled state. The maximum propulsion is where I am maximally pronated through ground contact and I move again towards the inhaled state towards the end and I can again self-select the activities that would be most appropriate for each of those phases. So hopefully that gives you a little taste of what we're talking about and I'd be happy to expand on those if you have a very specific question on that.

So there are properties within the muscle itself in regards to how I sense that position and then how I am able to recruit that muscle that I think makes the eccentric and concentric orientation better descriptors. I also don't particularly like the fact that concentric and eccentric contractions are kind of vague. And so I tend to use an overcoming contraction versus a yielding contraction rather than calling them concentric or eccentric contractions. Because again, I just think it's a better descriptor. So for instance, I could have a muscle that is eccentrically oriented, so it's longer than its midline, and it could be using an overcoming contraction, what someone might recognize as they might actually call that an eccentric contraction, even though the force is going in the opposite direction of the lengthening of the muscle. And so again, I think there's some vagueness to the way we've used those terms in the past. So what I'm trying to do is clarify what's really going on in regards to position, concentric or eccentric orientation, and to contraction with an overcoming contraction or yielding contraction, just because I think they're better descriptors. And maybe I'm wrong. I'm willing to be wrong on that because I'm not a big fan of useless jargon. But again, as we've had discussions at IFAST and through the intensive, these terms have evolved into something that has become a lot more useful.

I would caution you against trying to say, oh, this is a sports hernia protocol. I don't think those things exist. I think we have to treat the humans. I can't pronounce this name; it looks like A F H O O G S. So however you pronounce that. This is a student question. So this is exciting. Do you have any advice on handling the current DPT education knowing that much of it is no longer best practices? So that's a really, really strong question. I like this a lot. First, let me throw this out: in physical therapy, there is no such thing as best practices. It's impossible. We're dealing with complexity. At best, what we have are what's called emergent practices. So we don't know what will be the best choice. What we have to do in a complex situation is intervene, then reassess. So you have what is presented—that's our evaluation. We provide an intervention and then we reevaluate for the outcome, and that guides our practice. So that is an emergent type of practice, and so there are no best practices. So right away that's in favor of the PT curriculum in a way, and that they're doing the best that they can. They're trying to provide you with elements of education that they think are reasonable and necessary. Most of the curriculums have to teach a certain way because there's a board's exam that they have to support, which is unfortunate. But I would also default to Max Planck's quote in regards to science progressing one funeral at a time. And so there are people in charge who are driving these curricula. I don't know; my Latin is kind of weak. So they're driving these curricula and they have to do the best they can. I get to talk to some of these academic people regularly just because I have a student every semester, and they are going to pickle too. There are things they have to teach that they don't want to, but I think it's going to be a matter of practitioners like yourselves who will eventually take power. And rather than doing it as we have always done, I would hope that you would start to try to change those things. As a consumer, as a student who is paying for an education, it is also your responsibility to ask questions. And I think that's something that unfortunately gets squelched in academia: that the instructors understand there are things that don't necessarily apply in the real world anymore, but they have to teach them. And so they encourage students not to ask the difficult questions or they're incapable of answering them, just because of the environment they're teaching in, which is unfortunate, because I think when the student is paying an absorbent sum of money, they deserve to get what they pay for. So what I would offer you as a piece of advice is to continue to educate yourself outside of your curriculum. Take continuing education courses as you're allowed to, and you get discounts, which is really nice. But I would also encourage you to try to learn as much as you can with the understanding that there will be information in conflict. And so what this does provide is a very powerful concept called an earned opinion. So when you can argue multiple sides of anything, that allows you to have an informed and earned opinion, which gives you the capacity to see things from multiple sides and allows you to problem solve much more effectively. So let's not look at this as a negative that you're stuck in this curriculum. Let's look at the curriculum as one viewpoint and then this expansive amount of information and education available to you, which will provide you with this earned opinion that eventually will again give you great power in regards to how you intervene with your patients.

They encourage students not to ask the difficult questions or they're incapable of answering them just because of the environment that they're teaching in which is unfortunate because I think that when the student is paying an absorbent sum of money they deserve to get what they pay for. So what I would offer you though as a piece of advice is continue to educate yourself outside of your curriculum. So 10 continue education courses as you're allowed to and you get discounts, which is really nice. But I would also encourage you to try to learn as much as you can with the understanding that there will be information in conflict. And so What this does provide, though, is a very powerful concept called an earned opinion. So when you can argue multiple sides of anything, that allows you to have an informed and earned opinion which gives you the capacity to see things from multiple sides and allows you to problem solve much more effectively.

And again, if we understand how to reduce that compressive strategy and restore the open airway, which is as simple as a head tilt chin lift—all of CPR—then we can reinforce those positions during the activities that we have selected. So your second half of your question is: is there any case where you would try to cue a position or action from the neck up, along with biasing internal rotation, pronation, or external rotation, supination? Absolutely. And so what we have to understand is the entire system is behaving under every circumstance. So it may be as subtle as an orientation of the cranium on top of the cervical spine in regards to that last piece of an activity. It's like, how do I want you to manage your head and neck position as you're doing a half-kneeling cable chop or something under those circumstances that will reinforce the ability to restore that variability without having to create some sort of special exercise. So again, to do a quick review on this, it's like: yes, you do see those representations; yes, they do follow what the remainder of the system is doing; and yes, we can influence that under every circumstance of activities, whether we're trying to reinforce the capability or restore variability to that system. So hopefully that answers your question.

The people that are better hinges tend to have a more nutated or an exhaled position of the sacrum which tilts the sacrum forward and now the pelvic axis is no longer vertical; it's actually tilted posteriorly and so of course the pelvis is going to follow that axis. And so again, we have a rudder basically that the sacrum represents that controls the fluid shift that goes down into the pelvis. And then that's what directs the direction that the hips and pelvis will go. So again, if your inhalation bias, you'll tend to be a better squatter. If your exhalation bias, you'll tend to be a better deadlifter.

Take a day and do a whole bunch of different carries and then give yourself some sort of self-assessment or reevaluation in regards to how you respond to those activities. You will find that you will be favorably responding to certain types, and there will be other types of activities that actually may steal some of your movement capabilities. So those will be the activities that you would want to stay away from if the goal is to restore maximum variability or to actually enhance your ability to do certain things. So if I can create a better compressive strategy under certain circumstances, my force production goes up. So maybe I actually help my bench press by doing a certain type of carry or maybe I improve my ability to deep squat or reach overhead by restoring some eccentric capabilities. So again, keep in mind that this goes in both directions, depending on whether I'm trying to reinforce something good in regards to performance or whether I'm trying to restore something for a more favorable movement-based outcome.

Apart from a squat, what are the other key expansive movement patterns? Well, that would be really nice if we could just make an exhaustive list. But the reality is, is that every activity that you choose will have elements of an expansive strategy or a compressive strategy depending on what your goal is. So we could take a split squat, and we could make it very very compressive depending on what we're trying to do or we're going to make it very very expansive. The nice thing about split stance orientation in regards to an exercise is that I can bias one side of the body and so if I'm restoring rotations this element becomes very very important because wherever the expansion occurs will allow rotation to occur. So when we talk about baseball, golf, tennis or other rotational sports these split stance orientations and establishing these eccentric or expansive inhalation biases become very, very important regards to strategy because the people with high compressive strategies cannot turn, which is why you start to see these deficits occur in these athletes that overuse strength training as an element of their performance enhancement, especially when they have to turn or rotate. So again, hopefully that addresses some of that for you. If you have a particular question about a specific exercise in regards to its capabilities, that might be a better question to ask next time, Drew.

So what you need to do then is you have to create a position and use a strategy that will take all of that concentric orientation on the backside of the body and eccentrically oriented. So again, you might have to eliminate gravity, so maybe we have to lay somebody on their back or we have to lay them on their side and allow them to capture that eccentric orientation because when they move against gravity, they tend to be biased towards this compressive, exhaled concentric strategy. There's any number of exercises that can do that. Something as simple as putting yourself in prone in what approximates a fetal position and then driving respiration in that position promotes expansion on the posterior aspect of the body. So something that could be that simple. It could be a heel's elevated goblet squat could do that for you. There's any number. We do forwards and backwards rolls as an element of this to restore those eccentric capabilities on the posterior side of the body. so there's any number of activities that you could use it depends on the environment that you work in it depends on the individual that you're working with you know so if you had somebody that was you know uh worked behind a desk for 40 years and was non-athletic and a non-exerciser you might have to use a totally different strategy than someone that is an athlete that's trying to to recapture this eccentric orientation so whereas one might be very very active and we take them over to an area and it looks like a fourth grade gym class with a lot of rolling pattern and such versus somebody that might be on their back on a table and trying to recapture this eccentric orientation. So again for me to give you an absolute as to what would be the first exercise it depends on the person and so you have to take that into consideration. The thing that we don't want to do that I encourage people not to do is don't turn people that are active and athletic into rehab clients. There's been a lot of influence of dragging rehab into the performance realm and it does not need to happen. They are two different environments and should be treated as such.

Encourage people to do it just helps with self-regulation and self-awareness when self-awareness is the greatest superpower you could possibly have. There's a lot of ways to break into philosophy. Probably the simplest answer to this would be to look at the books of Ryan Holiday. He and a couple of the people like Kim Ferris, the people that are popular on the internet and that preach the stoic philosophies, tends to be a really good place to start because it's understandable and it's somewhat useful; it's easier to implement. If you go with 'Obstacles Are the Way', 'Ego Is the Enemy', and then whatever, what's Ryan's new book? I don't know if I have it out. That's something stillness, I can't remember, but you'll see it. So if you get those three books, you'll be able to buzz through those in three or four days if you take some time to read. Those are great places to start. There's tremendous amounts of information for free on the internet, just Google Stoicism. But once you start to read that, and then you start to break into some other variations, so there's some Buddhist philosophy that is very, very useful, there's some meditative stuff that is associated with that that I find useful. If you want to go the stoic route and you want to get past some of the commercially, when I look at some of the more traditional stuff, so what do I got here? 'The Practicing Stoic: A Philosophical User's Manual', so there's one right there. I'm a big fan of Marcus Aurelius when it comes to the stoic-based influences. I'm not a big fan of Seneca. It seemed like Marcus Aurelius, and again I'm just going by my own opinions here, that he actually tried to live the philosophy where some of it that you get from Epictetus or Seneca seems to be like a 'do as I say not as I do' kind of a thing. This is a great book that you could probably read in a weekend. It's a great little story but it's a great way to lay out philosophy and this is 'The Courage to Be Disliked'. And then again another one of the beginner's guide for Stoicism is 'A Guide to the Good Life'. But again, those are some decent recommendations to get just started. And then I would say, like I said, read Ryan Holiday's books in regard to the sort of an updated version, readable, stoic element, if you will.

I buzzed through this quickly because I have a hot date with a blonde, so I apologize. However, if there are any other questions, you can list them below in the comments or contact me through Instagram at Bill Hartman PT. You can also ask Bill Hartman at gmail.com, but remember to use the subject line 'Ask Bill Hartman Question' so I know you're not trying to sell me something, as I'll automatically delete it otherwise. I hope you have a great week coming up, and we'll be answering questions and posting content throughout the week. I'll see you later.