The pelvis has to be able to change its shape. It has to be able to access an ER position and the IR position for me to have that full excursion. It's not just the hip joint like pivoting in the acetabulum. It's like, if you don't get the shape change that's associated approximately, you don't have that range of motion. It stops. Like literally it stops moving. And so again, that's, I think that's the question that you're asking. It's like, it's like to throw out a number at you. I don't know how valuable it would be. But you, what you would do is again, this is where the averages are actually useful. It's like, I can make a comparison, but then I have to understand it's like, where am I measuring this? Right? So if you measure hip internal rotation with the hip bent 90 degrees. And then you measure hip internal rotation with the hip at what would be traditional zero degrees of extension.

What you're seeing is the load of weight onto the box to create the yield. Okay. Good morning. Happy Tuesday. It is perfect. All right. Crazy busy Tuesday. We're going to dig straight into today's Q&A. This question is with Alec. And Alec's question led us in a really cool direction in regards to talking about how we take measures and how we perceive measures. And one of the things we always talk about is dirty measures, which means that there's a lot of movement that's taking place within our measures. And so if we were measuring someone's hip, for instance, the thing we have to recognize is that it's not just the hip joint as it's implied. As we are often taught in school. And so what we have to recognize is that we're not just measuring a hip joint even though we would call it something, so we would refer to as hip external rotation. We're not just measuring the hip joint itself. We have to take into consideration the ilium position. We have to consider the sacral relationship to the ilium. We have to consider the spinal rotation. And this is why the discussion went towards how we use language in our discussions as well. So for instance in this discussion, the word full was used, which implies that we have some sort of normal measure. And what we have to recognize right away is that what we're measuring is idiosyncratic measurements, so these are measurements that are very specific to the individual. And we make comparisons to average. That's what's in the textbook. The textbooks are average. They're not normal because the minute we start calling something normal then we imply that all of the contributors to that motion are intact, whereas in many cases, especially when we're first laying out our chessboard, which is basically just your grid of your total measurements. When we're first laying that out, we have to look at the relationships to determine what's actually happening. So even though we have a measure that appears to be equivalent to what would be considered the textbook average, we can't necessarily say that it is normal or that it is full, because then we're more likely to make a misjudgment and then intervene inappropriately. And so then our outcomes are sacrificed under those circumstances. So Alec, thank you so much for leading us in this discussion because I think it's going to be useful for a lot of people. If you'd like to participate in a 15 minute consultation, please go to askbillhartman at gmail.com. Please put 15 minute consultation in the subject line so we don't delete it and also include your question in the email. We will arrange that at our mutual convenience. Everybody have an outstanding Tuesday and I'll see you tomorrow.

Right, so you're standing in a high obliques sit, right? Okay. Flip flop your legs. Bend your knees. Bend them, bend them. Make it obvious so everybody can see. Like a split squat, like a split squat. Yeah, there you go. Awesome. Did I just reduce the constraint on the knee and give me an opportunity to go to middle?

Okay. If you give way, if you allow yourself to move in that forward direction, scapulae are going to approximate, are they not?

Yeah. Cool.

Yeah.

I guess I'm not sure why this might happen, but I'm thinking like, if the right.

Yeah.

You need axial position. You need shoulder position. You need elbow position. You need wrist and hand position.

As much as I would take credit for influence, it's been around since the beginning of humankind, my friends. So let's not give too much credit here. It's one of the reasons that babies do this so early because it's necessary. When I talk about movement, I talk about shape change and propulsion. Rolling is a representation of propulsion, which requires shape change. In fact, it's this exact same shape change we would use for any form of propulsion—moving across the ground in a forward direction. If we're talking about crawling, walking, or running, all of those things are very similar in their representations regarding the necessary shapes and force production. Again, one of the reasons babies evolve this skill is because they have to learn how to change shapes to eventually be capable of walking with proficiency. If you go back into scoliosis literature from the 1920s, you'll see rolling behaviors; in stroke rehab, you'll see rolling behaviors; in PNF from the 1940s, you'll see rolling behavior. This is nothing new. The advantage is looking at it from the perspective of shape change and propulsion, which gives us an opportunity to promote the changes necessary for people to move through space more effectively and efficiently. I see a broad spectrum—from fitness clients to professional athletes to those with pain-related issues. When people are incapable of moving effectively, efficiently, or without discomfort, we see limitations in their ability to change shapes. These people often need sensory input, pressure, and shape change. When you lay on the ground, you spread out against the ground, providing compression from the ground and expansion of your body over it. We're promoting shape change that will be useful for acquiring the appropriate shape to do something else, hopefully without discomfort, using an effective strategy that allows us to be efficient, effective, and forceful when needed. The advantage here is that as a coach—not a hands-on therapist—you can understand the principles of shape change and select appropriate rolling behaviors. Manual therapy is essentially applied sensory input, and many manual therapy strategies are compressive or expansive. By understanding how these strategies are applied—using the ground, gravity, and the body's ability to change shapes—you can influence shape. Rolling is an adjunct to what I already do. If manual therapy creates a window of opportunity for changing movement behaviors, I can use rolling to produce the input a client might struggle with on their own, creating their own window of opportunity to make other activities more effective. This accelerates the process and alleviates the limitations of isolated treatment. Clients can take this home with a similar strategy. The next step is identifying the needed behavior to determine the type of rolling—forward rolls, shoulder rolls, backward rolls, partial rolls, movements from middle propulsion outward, or from early to late.

Okay.

Uh, you could say that.

And they kind of look like a jackknife, you know what I'm talking about? When they're tucking their toes?

You see the difference? The difference between early and late is the direction that the force is going.

Okay. So here you go. You do your lower cervical, upper thoracic, ART stuff to create the expansion. You're going to be targeting upper trap, rhomboid, serratus posterior superior. You get all of those, and you do your lower cervical stuff as well with the turns. So you're going to do that, then deliver your high velocity stuff and you're going to get a much better response. You'll always get a better response with a better gradient. And it's not just the cavitations I'm talking about, I'm talking about the muscle orientation change because when you manipulate, you create an IR force on one side and the ER on the other side, you will get a reorientation of muscle and you will get a bigger turn. Do you see how it works?

Okay. Well, thanks for clearing that up. So it's not that simple as I thought it was.

It was very easy. It was like one of the easier visits of all time. And then I had an older American football player in, and that was like pulling my teeth out. It was tough because again, it's like talking about two different worlds and two different levels of adaptation. So again, it's like you're not representing anything unusual, but understanding all of the potential influences is something we're never going to stand at all. You just want to get as many of those in play in our thought process because when you start thinking about tissue representations, muscle representations, and joint positions, if you can look at it through all of those lenses, it starts to present the options that will be available to you to try to influence this. You see it? That's the important thing about your question. It's like, what are my options? What do I have available? Where else can I go to create movement? If I can't create movement somewhere, where can I safely create movement elsewhere that literally they may have to use a compensatory strategy?

So by their structure, wide ISA individuals are not going to allow you to achieve as much tibial excursion as a narrow would when capturing an early foot representation. The foot position relative to the hip will differ, with less knee bend needed to achieve the early representation compared to a narrow stance. This occurs because wide stances have less tibial excursion and their ER (external rotation) representations are biased toward middle. When moving a wide individual back toward their middle representation, the tibia moves back less than with a narrow stance, resulting in the foot being positioned closer to the pelvis. This positioning captures an earlier ER representation that remains in middle P.

We've been talking about, let's go back to Grace's question. Remember how we were talking about if you put more pressure around the outside of the foot, you lose more relative motion? Yes. So when you get your center of gravity pushed way forward, your center of gravity moves up and forward. So that's moving up and out. Valgus turns everything down and in. So when you get really extreme valgus knee people, their arches are really low. And then you get the really extreme varus people and their arches are really high.

How do you manage your energy and time management? You had a post stating that energy management is more important than time management. So how do you do that? You are busy in so many aspects of life. How do you take out time to learn new things from other domains as well? How do you manage that?

And I was wondering.

Okay, hold your arm up in a traditionally flexed position. Like, okay, how did you get your hand into that space, bro? Did you move in a straight plane?

And the hip is easier. It's more of a true representation because it's harder to cheat.

So with that, if the standard reason is that perhaps the reason you would see, say, a powerlifter of a similar weight to a bodybuilder, the bodybuilder may appear physically bigger, but the powerlifter would generally be, let's just generalize it and say that they're stronger—they can move more weight in a particular activity. Would that be just more down to movement efficiency, neural pathways, things of that nature, as opposed to their individual muscle properties? So if you were to group together a bunch of muscles that might be used, you know, bench press or squat, for instance, and test each muscle in isolation, chances are the bodybuilder might have a greater capacity to use the muscles individually. But the powerlifter, because of their practice, their neural pathways, the efficiency of the movement, they can move more load with those muscles put collectively together.

Let's just, I guess, as an exercise, if we're checking all those boxes from a movement standpoint, like you just discussed, and we do want to do some direct loading of those tendons, like if you look at the research, most of the research is going to suggest that you put it in the most lengthened position possible. So like old school knee extension, put it all the way at the bottom and then you only apply pressure and hold for an isometric and so on.

If I put you in the left sideline, what should you have on the left side? I should have middle on the left side, shouldn't I? I have to be able to approach it. So that means I have to have a superimposition of internal rotation on the left side to even put you in left sideline to be successful. Exceptions to the rule, certainly. If I got somebody that's pointy and I need to go manual on somebody, I might put them there. But generally speaking, to do an activity, an intervention on the left side where they're actively participating, I would need to have some internal rotation on that side.

Well, okay. So again, it's like if everything's starting to move as a single segment. So when you get a bend versus an expansion. A bend would be later, right? Because expansion would imply that I have relative motions available. Does that make sense?

Yes, yes.

Okay. So I literally have inside a knee joint. I have one area of the knee that's IR and I have one area that's ER. So the outside edge of the knee is moving faster in this direction. This side is trying to slow down. You get it?

Why wouldn't you just need the eccentric orientation on the left to give you space to move there?