So let me just standing, take a breath, counter-nutation, and then you get an ER of the ilium. Wouldn't that create a concentric orientation on the front and then eccentric orientation on the back? Fluid shift would be able to go backwards.

Would the iteration for that in the pelvis be above the trochanter?

So I made some recommendations to Alex on there and I thought it would be a great way to sort of wrap up the week here because we really get to talk about program and I think it's kind of one of those things that's fun to talk about but let me practice this by saying that I don't think there's any magical program. I don't think there's a right way to do everything but I do think that there are some principles that need to be appreciated, that some people don't attend to enough, and that might be why they're frustrated, aside from the fact that you may just not be genetically programmed to be great at some of this stuff. So step one is probably pick better parents, and then the rest of the stuff gets kind of easy. But I think that if we think about this on a principled basis, one of the things you probably need to recognize is that there's a learning and a coordination effect of every exercise you do. And what that means is that if you do it more, then theoretically you should get better at it. So people who are program hoppers or they're looking for the next best thing or they're desperate for improvement, and their desire is to think that there's one program that's going to be the one that's going to make the biggest difference. In reality, there isn't one. But if you're constantly changing, then you have to relearn the exercises every time. So what I would say is if you're going to try to bring your box squat up or any form of a big lift, continue to execute that lift. Keep it in the program for an extended period of time. It would be like an Olympic weightlifter that didn't keep squats in his program, knowing full well that it is supportive of his Olympic lifts. So let's appreciate the learning and the coordination effect here on a very large scale. Don't change your exercises as frequently. Secondly, one of the ways I program from a repetition standpoint is I tend to recommend that people train with a buffer at higher intensities. So if I say you're going to train with your five-repetition maximum load today, what I would say is come in and do your 5 RM load but only do three repetitions with it. So we're not training to a maximum force output every set. But what this does is allows you to accumulate volume at a very high intensity. So from a coordination standpoint, we're still recruiting those high-threshold motor units that we need for the lift. So we maintain that aspect of it. But we're also accumulating volume. So from a cross-sectional area, there's going to be a benefit there from a hypertrophy standpoint.

Where we're out of a specific context, there's some broader questions that you may want to ask. So it's like, why did other models demonstrate success? Because again, it's all about perspective. When we think about comparing what we do with our model to other perspectives, things like we talked earlier this week about rotator cuff strengthening versus recapturing relative motion site. So some of those things actually do work in the clinic, but it's just a matter of perspective where you say 'oh you're strengthening a rotator cuff' and I say 'oh you're just restoring the relative motion in those relationships that allow us to move more effectively.' So again, both models will work, but the perspectives are different. So which one of those can I apply consistently and demonstrate greater levels of success in more context? Stretching versus each other orientation might be another one that we would consider to have different perspectives. So again, I want you to start to think about evolving your process and looking at these things the same regardless of the outcome whether it is favorable or unfavorable. This is how you're going to get better is to continue to question things. And it is a struggle. It is work because when you're successful, you want to kind of pat yourself on the back and say 'yeah I did great. I was awesome today.' But the reality is if we really want to get better, we have to continue to question everything that we do because we're never seeing reality, but we can start to close that gap with knowing that the gap is always going to be there.

I'll take a video if you don't mind and send it to you.

I think it goes back to what you're saying, Bill. I think there needs to be more emphasis on movement and just like, you know, I do it all the time for my kids is like taking them on a walk. I'm like, all right, we got 70 minutes of class. Let's do history stuff. And then we're going to go for a walk for like 10 minutes and just get outside.

You had an exhale?

However, if we get this upper dorsal rostral compressive strategy, we're going to see concerted orientation in the posterior scalene. We'll see it in the elevator scapulae. We'll see it in the upper trapezius. We're not going to see this normal counter rotation mechanism occurring. And so we want to make sure that we can restore this. So what we have to do is we have to capture eccentric orientations again in all of this posterior musculature. There's some easy ways to do it. And there's also some tells to let you know that you do have this compressive strategy going on. So let's go over those tells first. So as we look at Alfred here on the table, one of the things that we can actually look at from a structural standpoint is this angle between the spine of the scapula and the clavicle. And we refer to that affectionately as the Campereen angle named after the late great Mike Camperein. One of the things that we want to look at is we want to make sure that that angle is about 60 degrees. That would be a normal representation. More often than not though, when we have this upper dorsal rostral compression, this angle is actually going to be less than 60 degrees. So right away we have a visual representation of this compression and what's happening here basically is we have the narrowing of the angle and so the scapula actually just rides up this posterior rib cage as the upper trapezius will pick up its concentric orientation. Now it can certainly try to assess the lower cervical spine manually to determine whether it can turn or not, but actually a better test is looking at end range shoulder flexion. So as I flex the shoulder, what I should see as a posterior tilt of the scapula is that upper dorsal rostral expands. But what I should also see is that ipsilateral or same side lower cervical rotation. So if my shoulder flexion is limited, I kind of know that I've got this upper dorsal rostral compressive strategy in play. If you've got some manual therapy skills, I've got a couple videos on YouTube that will show you how you can manually restore the expansion of this Campereen angle by depressing the scapula and rotating the cervical spine. If you don't, then you're going to have to use some exercise related strategies which we can cover out in the gym. Now before we head out into the gym, I want to go through a couple mechanical issues that we might need to attend to as we go through some of these exercises. So let me give you an example for someone that might have a wide infrastructural angle that would have a representation in the neck of lower cervical extension, upper cervical flexion. So under those circumstances, I'll have a lot of upper cervical rotation available to me with very limited lower cervical rotation.

Is you want to have all movement options available to you. So if he is static, right, and then becomes uncomfortable, have you ever sat on a hard chair for a long time? And if you sit on the hard chair long enough, your butt starts to hurt.

Yeah, this kind of brings to mind athletic development in general. That's not quite as straightforward as, hey, I'm a powerlifter and I want to put 200 pounds on my squat. There are a lot more variables, and it's hard to know if training with you the last six months actually improved their performance.

I kind of did a full academic assessment because it's kind of lacking in the academic kind of things. You know, I just, I think in general it, I find it silly to exclude food groups for no reason. Right. Right. And so, you know, like when people say like, Oh, I like, I don't eat this. And you're like, Oh, why? And they're like, Oh, it's not good for you. And it's like, you know, but like for no given reason, they're just decided it was magically not good for them. So with the carnivore diet to say like, you just eat meat. And, you know, so what's the difference between a carnivore diet and a ketogenic diet. So if we added seven spears of asparagus each day, right, and three mushrooms, like all of a sudden you lose all these magical effects of said carnivore diet. So those kind of huge like chasms of logic when those are missing, I find it really difficult to have conversations about should or shouldn't you do that. There's no good There's no good biological mechanism really behind it. You know, I think really if we look at time, the closest thing you'd liken to would be a ketogenic diet. And if you look at the data behind ketogenic diet, which from a sports performance perspective is really lacking. I actually did a webinar yesterday on it. And I did a review last fall on it as well, like an academic review. And it just, there is a lot of good data on sports performance and ketogenic diet. And so at best, it's just as good as a regular dietary approach. potentially better at endurance, but likely insufficient at high intensities, right, even after keto adaptation. So if you kind of apply all those same things to the carnivore diet, I mean, you know, that's kind of what you're left with. I think there are a lot easier dietary patterns for people to follow. I mean, I love your advice. So it's like, I think that, you know, but I also think that when you start excluding whole food groups, you know, your personal biology and physiology doesn't change because you've decided to eat or not to eat certain things. So this is a conversation I always have with people if they follow a vegetarian diet, like that's fine. But like the biology of your protein metabolism is still the thing. Like your body still needs two to three grams of leucine at every eating occasion to maximize muscle protein synthesis. Just because you're choosing not to eat, foods that are high in these essential amino acids doesn't change your body's need for it. And so when you look at these other extreme dietary approaches, you're like, okay, that's fine, but what are we doing to account for now all the things that we're not getting that we generally would have otherwise that your body needs?

You step off into a box, like a depth drop. If you could drop down deeper in space and manage that position, and that was like, a deeper squat? Yes. And then that was a representation of, oh, you managed Golgi tendon inhibition to such a degree that it allowed you to get into that position.

And I like changing people's perspectives on what PT is. Yeah. That's the biggest thing. I love that. Excellent. So we did that. And we did eight reps of eight sets of one to have her really focus on the control and working through breath and not reverting to their high tension, breath holding strategies. And then we just finished it off with some supine rocking. I had her lie on her back, grab her thighs behind her knees and back and forth, making sure she kept like in zone of apposition. making sure she kept ribs down, hips tucked under, and then stood up. And keep in mind, Bill, we're retesting every single time we make a change.

So it actually was before we moved in. This is awesome. So imagine a 2200 square foot rectangle, right? And it's very deep, kind of narrow, but in the front it was unique because mostly it's just like open space at the back, but at the front it's like this very distinct like office area and it looks professional. And so we walk in there, but there's like these like cut off like closed circuit cameras. Like what's going on here? And the landlord is like, oh yeah, this used to be an underground casino. So until they got raided and kicked out. So our luck.

But you don't want to let that run rampant. Which it very could with my conversation. Yeah, everything seems all fine and wonderful until it doesn't seem all fine and wonderful, right? And if you don't pay attention, you don't see it coming because all you're seeing is the good stuff and you're not monitoring for the things that you've taken away. And let me offer you this, the fact that you and I can speak the same language because we're part robot, you know is that we didn't see it coming until it came. Right.

Yeah, actually, I refer to this direction. What can we do in our daily life to promote an environment that encourages the yielding? And also, what is the difference between yielding, true yielding, and collapsing into ourselves?

Okay, why does she have symptoms?

Yeah, they're moving away from each other.

All I have to do is approximate the ilium towards the femur and I will start losing external rotation.

I would like us to talk about going into and out of the cat, focusing on the yielding and overcoming actions and more specifically the rate in which they increase or decrease. The rate, yeah, rate. All right. And also at which points we would expect to see the biggest or lowest amount of one action relative to the other. So just before we begin, I understand, I think, that it's the posterior outlet that influences the movement of the gods, right, when we're moving in and out.

Any time that stuff needs to be constructed, so when we're talking about muscle mass or mitochondrial development, there's this tendency to look at it as a four to six week period where you're going to see a decent amount of adaptation. And then there's about a four to six week period where it's going to decline.

Gotcha. Yeah, I know. Not the answer that you wanted to hear. You can try to reduce it. There may be enough yield that you'll get some measure of favorable expansion, but you run that test. You just have to run the test and say, 'OK, this is not going to, or it is going to work.' And then from the remainder, it's like that's where you've got to make your decisions as to whether you're going to apply hands to promote it's just elsewhere. Do I need to reduce muscle activity? And then can I fill the available space that I do have? Yeah, it's just like your question is more about process really, right?

If I was saying that, in this example, the practitioner said that you have very strong hamstrings relative to your quads, and that's why your pelvic position is the way that it is. That would mean that the hamstrings would have to be outpulled by the quads. The muscle activity must be at maximal effort for that to happen. Why wouldn't the hamstrings just pull a bit harder and level it out? Do you get what I mean? I'm with you. There shouldn't be very much activity at all.

OK, and you're a paper and pen guy?

With the toe touch, does that go, like as you're able to descend further into it, does that follow like a similar arc as like what you talk about with a squat where like there is like an early representation?

Yes, I have neural coffee in hand. Perfect.

Well, OK. And you're trying to be like a horizontal abduction kind of thing.

I don't have a lot of time. So how much time do you have to get to force production in that circumstance? It's already a force-producing representation—a higher force-producing representation—whereas the other one is like, 'I get to land early and I get to roll into it.' So storage and release of energy: this one has a shorter timeframe for getting to whatever peak force would be under the circumstance. So that's the difference between the two representations. Okay. Let's associate this with Alex's question. When we talk about how much time you've got on your foot: if I can move the foot through that full excursion with good relative timing where I don't overproduce the IR representation, meaning I'm not orienting where I have some relative motions where everything's moving in a really nice sequence—that's a good choice. If I can't do that—if I have an orientation problem—now I need to shorten the amount of time the foot is exposed to the IR. So I'm going to choose this representation. I can't remember if it's the first or second one, but it's the one where the foot's not moving a whole lot and it's still a representation. It's like you're closer to the middle and on the backside of the middle—you're in that late representation of the foot and middle.

But if they're deloading to the box, you're already getting that. The concern that I would have if you're picking their feet up is what are they going to do when you do that? You still got to consider that they might collapse. It's like you take somebody's base of support away. The only base of support you have are your tuberosities on the box. It's a balancing act. So I don't think you need to physically lift their feet off the floor because as soon as the center of gravity goes behind the feet, you've just deloaded the foot. If they deload to the box, you took more pressure off the feet. Now they have to create the impulse to come off the box anyway. You're going to get the same effect and it's probably a little easier to execute and probably relatively safer.

Who had the bigger IR space, the girl with the ACL or the girl with the Achilles thing?