But seriously, like you were working your PhD and you literally were already a businessman. You refurbished an entire home and then gave birth to twins.

And we've been buddies. Yeah.

And so an easy test to determine whether we have a down maneuvering is actually the old school aptly scratch test. So this is where you reach behind your back. You can try to touch the opposite shoulder blade. And this is intro rotation behind the back. And actually access this range of motion. We have to be able to eccentrically orient some of this anterior musculature. So if we think about if we're going to pick on a muscle, clavicular pack for instance would have to be able to eccentrically orient force to reach behind our back and touch that opposite shoulder blade. So if it's concentrally oriented and creating a compressive strategy that's pulling the miniburm down, you're not going to be able to reach behind your back. When we think about another potential influence on the neck position, especially the lower cervical spine, we have to have dorsal rostral expansion to have normal rotation through the lower cervical spine. So our big test for that would be end range shoulder flexion. And so now we have two really powerful tests to let us know whether we're getting this anterior posterior expansion especially in the upper rib cage. Now from a strategy standpoint, we wanna monitor these tests as we're intervening to make sure that we're on the right track. But the first thing that we wanna look at is we're gonna have differences in our y's and in our narrows. And so when we think about the compensatory sequence and how they arise, so if we're looking at a narrow, we may still have some upper dorsal rostral expansion in many cases. So their in range shoulder flexion might still be good, but they're not going to be able to reach behind their back. So in this case, We're still going to have some lower cervical rotation, but upper cervical rotation is going to be restricted. And so what you'll typically see is that typical forward head posture. We have the upper cervical extension, lower cervical flexion by traditional representations, higher bone will be depressed. If we're looking at a wide under the same situation, you're probably going to have dorsal rostrum compression, again based on the way that these compensatory sequences arise. So in this case, we're going to have a limited amount of lower cervical rotation, but we're probably still going to have upper cervical rotation available to us, but this is going to be a more military-style posture where you're going to see the mandible pulled backward actively, which is going to pull the hyoid bone up. As far as the treatment training strategy goes, first step, let's not do anything that interferes. So we want to eliminate that. So bilateral symmetrical pressing activities tends to be a bad idea because it's just going to emphasize the compressive strategy that we may have that's pulling that manubrium down. If we have the dorsal rostral compression as well, then we want to take away

Yeah. So you start there. Um, and then, you know, there's a lot of stuff that you can be doing. It's like UDR. Yeah. When they're in the protective phase, it's like people don't recognize all this other stuff that you could be doing that is supportive. Like, you know, people coming off a rotary cup repair or something like that. When they're in the protective phase, people think that, oh, you just do like this little bit of passive range of motion or whatever, whatever. And then that's all you can do. It's like, hey, you got like three other limbs there that are going to be influencing the capacity of the body to be moving around volumes and pressures and changing shapes and stuff. And all that was an influence that probably perpetuated the need for the repair in the first place. So again, you always evaluate the person, not the diagnosis. So my concern here, and again, you look at it as radius. And if you measure the pronation just from the rest, and that's your representation of pronation, I don't know that's going to be terribly accurate because it's going to be limited, but I think it's limited by the fact that you've got to twist in the radius itself. But again, it's like, every time you see an adaptation that you perceive as favorable, recognize the fact that something else had to change for that to occur too. And so if I direct resources towards an adaptation, that means that something else is sacrificed. And it might not be impactful at all. But then again, maybe it is. And so this is why, but again, this is why we always evaluate the human and not a body part or not a single representation or adaptation. We have to look at them as a whole all the time.

Well, here's how it impacts everything. And we can talk about your context as well. So think about the behaviors that you're trying to influence. You're trying to get people to actually change the way that they behave, right? And so that requires a little bit of output from your brain because you're making decisions all day long. So if you put a piece of chocolate chip cheesecake down in front of somebody that's restricting their food intake, that takes energy to say, 'I'm not going to eat that.' And so the foundation then is: do I even have the energy to make that decision? Because every decision that you make during the day, even the smallest ones, requires energy. And have you heard about concepts like decision fatigue and things like that? Is it David Rock? I think he has the book 'Your Brain at Work' or something like that? He talks about that type of concept. So you have to appreciate that. So if they're starting from a deficit, if you're trying to lose weight and you don't have some other factor that's going to influence your behavior favorably towards the goal, you're going to be in trouble. So I think, you know, from your standpoint, obviously it's very, very impactful. It is impactful from my standpoint because pain is a decision. It's just a decision that they don't make consciously, right? And so if they are defensive, a lot of people will come to me and their physical behavior, their motor output is a defensive behavior. And again, if they don't have enough energy, then they're going to default to the easiest thing, which is the negative. Everybody defaults towards the negative. It's one of our little protective elements that we're born with. So if you're dealing with a painful situation and I don't have enough energy and I default to the closest thing, yeah, they're going to feel crappier.

Don't you think that's going to move the bone?

You want to talk about that?

There you go.

You know, you read a book like Spark. Have you ever read Spark? It's a quick read, great book. And it's all about neurotrophic factors. So neurotrophic factors include brain-derived neurotrophic factor in it. The book Spark is by John Ratey, I believe. Anyway, they did a lot of research. It was in a school system in Chicago or outside of Chicago. Maybe Naperville. They brought in kids that were having trouble with grades and such, and they gave them a special gym class focused on driving up their fitness levels. They had significant improvement in their ability to raise their grades, especially within the first three hours after exercise exposure. They even narrowed it down that far. So they're looking at, well, why is that? And then they look at the elements associated with exercise. So you have brain-derived neurotrophic factors, which makes neurons. And then you have vascular endothelial growth factor, which contributes to blood flow. And fibroblast growth factor, which is another cellular—it's like they call it 'Miracle-Gro for the brain.' So exercise would be that would be the first thing I would do would be movement-based. And then you grade it not on some generalized standard, but to that person. So each individual has goals they have to meet as an individual. Like, when we went to gym class, you had to show up so many times. If you forgot your gym clothes on so many days, you got a reduced letter grade or something ridiculous like that. That's the standard. So you have to have a fitness standard of some sort, but it's got to be individualized. Okay. So that would be the foundation of everything because movement promotes creativity and problem solving. So right away, you already have a kid that's primed for learning. And I think that's the first and foremost thing. I realize there are some things they have to learn beyond foundational math. Yeah. Some basic foundational math, foundational sciences, things like that. I think you have to have those in there. But then I would say that you probably want to have something derived from that again to promote creativity and life skills.

I was reading a few days ago where mitochondria is extremely important for helping to regulate shape change at the local level. That was eye-opening to me, just trying to further include aerobic-based work and activities for some people who are now coming off of rehab and trying to generate some gym stuff and even some of the recommendations I might make. This is speculation, but say they have compression in their posterior thorax and those muscles might now potentially have a decrease in mitochondria. If I want to increase mitochondrial density in those areas to help improve that shape change, it's almost like a double-edged sword where now if I'm doing more rowing or pulling-based activities that might close off that area, but it might help facilitate further peripheral adaptation. I'm just thinking how I might mitigate one consequence for the sake of another adaptation.

You know, these are the people that you really, really, really want to help a lot.

We must see Michelle. As far as description goes, it's better. It's better. So it's a nice place to start to develop your framework reference. OK.

Right, right. Okay. And the other question is, I was trying to help a buddy of mine who lives across the country in Atlanta, though he's in Chicago right now. We were on a Zoom call, and he was talking about how he has pain in his neck and shoulder area after prolonged sitting. This was due to his job—he sits a lot and reaches forward while taking notes. When he does this, he experiences pain. I was wondering if you could help me through my thought process here. I realized if he were to come in, I would do a range of motion assessment, which I was able to do. But he gets pain after prolonged sitting or in that same posture, so it wasn't something I could replicate at the time. Some of the objective measures I thought I needed, like a manual muscle test or something to test his muscle strength—I would have done that. Why? Well, I figured it's more of an endurance issue because if he's just in the same static position for a long time, his muscles might be getting stuck or fatiguing after too long. That was my thought process. I didn't know what else to do.

So yeah, the Boy Scout sign is what you do. On the DVA, you hit the barrier, which becomes the abductor pollicis longest tendon. When you release it, it should go a little farther into radial deviation. That would be normal. If you go all the way over, release it, and it stays in that position, you've passed what would be the relative normal. You already have more space here and less space to begin with, so it doesn't go any farther. That's how you distinguish whether you have that eccentric orientation. That's been money as far as exercise selection—intervention is obviously the most important. If I do have that eccentric orientation, did you see the video I did yesterday with the curl? A lot of people miss the thumb part, which is where the key is. Why do you scoot over on the dumbbell? You're literally pushing your thumb against the inside of the dumbbell because people think they're just driving hardest for flexion, but I'm also reorienting the hand relative to the rep.

Yeah. And so, so we haven't been doing any travel, but there's actually been some other really stressful things happening in his life currently, but the weight is like gone. And it was so interesting to see how there could be an intense life stressor, but not this physical travel stressor where there's like extreme time zone change on a consistent basis. Like how the body is responding to different kinds of stress. And, um, and it's been really interesting. So yeah, Nick, I think you're right. Like, people are experiencing, not that, you know, everybody's living a stress free life, but they're experiencing different kinds of stress, maybe. And, um, and it's interesting for me to see the kinds of stresses that are permissive for weight loss and not permissive for weight loss.

I've pictured it as well, too, just since we're on narrow ISA. Is that going to influence the elasticity of the lungs? I mean, obviously, the chest wall, but I mean, the lungs as well. Do you feel that structure actually genuinely gets stretched so compliance changes laterally when picturing, when queuing with doing some of the respiratory interventions that they think about from an inhalation perspective above and beyond the opening, that it needs time for it to open, that you have to kind of go slow to create the lateral expansion in whatever position they're putting them in.

Exactly right. Exactly right. Yeah.

Well, it's a lot of reps though. So think about that. It's like, yeah, you hate every minute of that. Getting up at 6 AM on a Saturday morning is a really horrible thing to do for 16 years. But you certainly get a lot of reps, and you get a lot of learning. Talk about paying your dues, kind of a thing. Yes. And it's always about the reps as long as they're good reps and you're paying attention. Absolutely. And so we sort of hit a critical mass at the same time when we started having this conversation. It's like, you know what, we gotta do something.

So I love that. And I remember us having a conversation before about like hypertrophy in my lower body is important to me, right? Listen, I could never gain any more muscle in my upper body. And I think I'd be okay. Like when I'm lean, I feel I like the way I look. Maybe a little more trap, a little more neck. I could always use a little more of that yoke. If I'm being honest, but everything else I'm cool. But you mentioned one point I believe about like old-school single joint like bodybuilding type activities and like I'm so biased towards these big compound movements. The only reason I'm doing them outside understanding that they're fundamental patterns of movement is because I want to grow. I want hamstrings. I want more glutes. I want more quads. So I might need to consider like a secondary workout at another gym with some of these single joint leg extension type exercises and curls that like I really had like I haven't touched in 15 years, you know? It's like just very scared of those activities in a very irrational way. You know, so that might be a return to that type of style of training. You think that has any value?

You see it? Your honorable intentions had the right idea. Just the execution in context was incorrect. So the result that you got created interference instead of supporting the desired outcome. Good morning. Happy Monday. I have neural coffee in hand and It is perfect. All right. We are back at it after a little bit of a rest over the weekend with the holiday. A quick housekeeping item, IFAST University members. We have called today at 1 p.m. Eastern Standard Time. If you are not on IFAST University, please go to IFASTUniversity.com. Get yourself signed up and please join us for that call at 1 p.m. Eastern Standard Time. Digging straight into today's Q&A, though, this is with Annette. Annette is fairly new to the Coffee Coaches Conference call and to the model, so she asked a foundational question about yielding inside what interferes with our yielding capabilities. What yield is the expanded representation of connected tissue behavior so anything that would interfere with that that doesn't allow us to achieve a gradient of the yielding representation and the overcoming representation of connected tissues will create interference so anything that would be associated with a learned behavior that would create a compressive strategy so anything any of our compensatory strategies that we would see superficially, concentric orientation of musculature, et cetera, that would keep or maintain tension on these connected tissues and not allow that gradient to occur will interfere with yielding. And so we covered that. This is also influenced by the water content of the tissue. So as we age and dehydrate, we tend to see a loss of this yielding capability. We'll see this in tenonopathy as well. So there's a number of representations that we may see where yielding is interfered with. And if we can appreciate this, I think we can be a little bit more effective with our treatment strategies and some of our training strategies. And we actually covered that a little bit at the end of the conversation. Nat's got a background in martial arts, and so we talked about how we can actually use that as a favorable influence to restoring or maintaining our yielding capabilities. So thank you, Nat, for your question. Everybody have an outstanding Monday, and I'll see you tomorrow.

Gotcha. And then, there may not be a perfect answer for this, but I've had discussions with her and her coach. She knows most of the other training except for this one day a week, but they do foot drills that just wear her out. So I said to her, and I think it's your opinion. It's not just about being approved for playing after surgery; it would be more about how much you want to manage the flare-ups while still progressing. In your opinion, if she's aggravating herself once a week as we continue to work through it, how detrimental do you think that is to her long-term success versus removing her from that stimulus for the time being, or is there no real way to say?

It just creates a constraint that sort of makes the bias a little bit stronger. So from a visual representation, you're going to see it a little bit more there. And then the way they, it's typically drawn. A certain way. And they certainly don't give enough credit for the diaphragmatic expansion. But it is happening. And what they'll say is, oh, it depends. They'll make reference to the changing curvature of the thoracic spine by traditional means, right? They'll use flexion extension as terms, but the reality is it's like if you look at the shape of the thorax, at the top, the segments would tip backwards, at the bottom, the segments would tip forward, the bottom, the segments would tip backwards. So which one is it? If you're defining it by traditional terms? You see why I hate traditional terms because they don't hold. But yeah, just if you took a balloon inside the thorax and blew it up, just look at it from that perspective. And then, like I said, we can use some of the traditional terminology to help us have a conversation, because the way the thorax fills up depends on or is a determining factor as to what type of a relative motion will be able to demonstrate.

Yes.

Yeah, it's so difficult to, I mean, conceptually. If I hold my arm here, or I hold my arm here, the arm's not in the same position. So the degree of relative motion changes. So if I bring my arm this way, if I want to create an ER representation of the scapula, I'm going to drive it from my hand all the way into the scapula because then the scapula is going to follow. If I'm away from here, I'm going to turn it this way because I'm going to get the relative motion of the scapula to turn in the opposite direction. You're using a left foot forward split squat offset load right. You're moving into the cut. So you're descending into the split squat.

The adductor, the inner adductor, the inner thigh muscles. They blame the adductor as the weak muscle? It is not adducting the, or

The vertical what?

It goes sideways. Are you a golfer? Or you work with golfers probably, right at Pepperdine? Yes, I work with golfers. So when they waggle, right, they do the up, down, up, down. So what they're doing is they're swaying their guts back and forth and then unswaying them, swaying them back and forth, unswaying them. So they can feel where everything's going to go when they take the club away. He's got to learn strategy to produce a lot of force down into the ground so he can lift the weight off the ground, right? So he's trying to get as much IR downforce as he possibly can, which requires that you anteriorly orient the pelvis to do so. And so they're going to try to use standardized positions. Like I said, if you're going to test a hamstring, you put somebody in prone, you bend their knee and you push against it, right? And you go strong, weak, right? And then they're going to make a comparative measure. So they're going to do a pre-measure. They're going to do an intervention. They're going to do a post-measure. And in many cases, they'll get the favorable response that they want, because number one, they can't reproduce it, even if you've got one of those little dynamometers on your hand to tell you how much pressure you use, and you're still not going to be able to reproduce it. The person's not in the same position that they were before. Maybe you accidentally did something that's favorable, and you actually created the position that you needed to in the pelvis to create the higher pressure strategy so you can produce more force. But you're right. It's exceptionally difficult to determine whether you have the optimal position or not. But this is why when we talk about table tests and chess board measures and then representations of what that would translate to dynamically, that's why that becomes so important for somebody like you. It's like, because you're going to use step-ups, split squats, squats, and things like that to determine position. You understand, you recognize where the ERs and IRs are supposed to show up during those activities. And then to what degree, you determine what is acceptable, optimal under the context.

Oh, yeah.

More internally rotated, which would be what?

So, like his step up would probably be more like a lateral step up to a box or something.