I have a question. It should be an easy one.

I compressed the posterior aspect of the left side of the pelvis. Where does the ER go?

And they are narrow with the flat turn, so they fall. They go first forward to the left and then they go to the right. They turn to the right and then they find themselves forward on the right. So they create a rectus strategy and they pull. It's like you were talking with Jim Laird before that the force is down. So they have a strong IR. And you always answer that you first have to lengthen the right side. So what would be some effective exercise that you would give for some? So you always say that you have to create the late ER in that side.

Well, you've got a bias towards external rotation, and a sumo would be in an externally rotated representation. The question is, where can you produce the greatest degree of force down into the ground? If you're a narrow stance, your ability to capture the internal rotation position of the pelvis is reduced. Doesn't mean you don't produce internal rotation, just means that how you do it and where you do it will be different. If you were to try to lift conventional, you may not even be able to assume a position that will allow you to push down into the ground effectively because if, like, and again, you might have a representation of this. If you're to video yourself doing a conventional deadlift versus the sumo, what you'll find is that you can actually capture a better pelvic position in the wider stance just because of your, like you're more upright in a sumo than you would be in a conventional, right? And that would be advantageous for you to push down into the ground. If you have to, like, so if you sit down into a conventional deadlift and you see that, that, you know, that little rounding of your lower back, like right above your pelvis to get into that conventional position, you have not optimized your downforce. You actually have connective tissues that are in a position where they're not stiff enough and therefore you cannot push as hard into the ground. It actually dampens your ability to push down. So this requires an experiment as to what positions you can acquire most effectively. As a narrow stance, your bias is towards more of an upright type of pull from the ground, which would be more like a squat. Does that make sense? And the thing about it is, it's like, if you test both of them, you tend to gravitate towards one because you'll, number one, it'll be more comfortable. You'll feel like you can push harder to the ground. And then ultimately you just track it over time and you'll see that, okay, if I'm a sumo guy, my sumo numbers keep going up, my conventional sort of tops out and it doesn't go far enough.

I wanted to ask a question. Is it influenced the fact that it's producing a restriction in movement by a tension related restriction or the fact that they can't manage the pressure in the abdomen? Because you're going to have two scenarios here depending on like the degree. Like is it, is it pinning? Is it turning into like a rectus strategy or is it more like a narrow ISA that can't pressurize and then they got the expanded representation in the belt.

All right. Question. All right. If I have an anti-orientation of the pelvis, yes. You understand that the musculature above the trochanter is reorienting into an IRD position. OK.

Okay, one more time, sorry. Elongating bones using the late representation. Yeah. So a lot of times these bones proximal end twist to ER, distal end twist to IR and it gets screwed down. So eventually you want the differential to get in the back at IR approximately and ER distally. And when we use the late representation, that would be the opposite. And so I'm just wondering from like a, I guess, I don't know, practical or theoretical perspective. How does the late representation lengthen it while it's already too much of a differential?

Oh, fine. I feel so much better. It was laying on the ground.

So the reason he has to go wide is because there's no space front to back. He's moving into the space he does have, which is all external rotation. So it's all away from the middle. He tries to go forward into that space but can't, so he has to put internal rotation into the ground. His measures may say he doesn't have internal rotation, but he does when he goes way out. You can then put his feet down on the ground. So the little trick is to have him stand up and try to get the medial foot contacts without compensation. What you'll find is you have to keep turning the hip outward and moving the foot away from midline to eventually capture the medial foot contacts. That's where his internal rotation is—that's where he can apply internal rotation to the ground.

For those of you who don't know, it's Thanksgiving here in the United States. So I can't promise this will be a normal call. People coming in. All right, first question goes to Lalo.

And then- You talking about the right side? The left side. Okay. So we're going that way? Right to left. Okay. I'm with you. And then just by pushing off the right side, and reloading it and move the center mass to the left, that allows the right side to achieve the orientation. That allows the left side to come down lower than it.

Greetings. So that's me waking up as I say that. I've been trying to dive into some cranial stuff lately and figured out that positioning. And then I had an opinion come in the other day whose ears were very different in position during a downward forward scenario. Well, he was young. He had no particular issues, but it got me wondering what happens to a particular apparatus in different systems with different positioning like that. And how much that would affect that.

Okay. Have you ever seen a rocket takeoff? I have. Okay. So it's at a dead stop. Right? Massive explosion at the bottom of the rocket. What happens? Nothing happens. It doesn't go anywhere until the force going out of the rocket overcomes the inertia. There's your difference between pulling something off the floor and starting a squat at the top and going down. So as I go down, I am moving into a position of earlier propulsion. Am I not?

Okay, it's not a turn. It's a bend, right? Okay. It's not relative motions to get there.

Hey, Ian, who's the dork in the hat?

Yes, ma'am.

Generally speaking, the orientation that you're going to get with medial knee pain is going to be the, it's an exaggeration of the normal representation. So typically you're going to have femoral internal rotation relative to the tibial external rotation, but if I magnify that relationship, that's where you're going to start to see the potentially you're going to see the medial knee pain. That would be the orientation that would be most common.

In standing or does it matter?

So you're going to step forward with your right foot.

Here's my thought process. This is my opinion: scoliosis is produced by the forces that are internal. The way that everything is attached on the inside is going to influence the movement and the forces involved internally. What we see externally is the response to that. Research is starting to ask that question and looking at the attachment orientations associated with people with scoliosis. That research exists, though it's not extensive yet.

I can stop doing these calls. It's just getting way too complicated.

Okay. So you said narrow asset, right? Yeah. Where is the expansion on somebody that is compressed? Like, so the compression is essentially anterior, posterior, correct?

Oh, wait a minute. So hang on. So you're trying to use a foot to create AP in the pelvis?

Is this like an Alex series of questions?

Hey, Bill, I wanted to go back to the squats and to kind of review some of the mechanics that are going on between the three phases. So when we start, so we initiate, so we're in that late representation, so we're moving the ilium on the sacrum. Right. And so then as you descend, the sacrum starts to mutate. Correct. And then the ilium starts to IR as well as you get closer to the point. Then as you go into maximal depth, the sacrum is moving on the ilium and you hit depth.

Who are we talking about? But I mean, like, but who are we talking about? So, so, so that there's not a, I'll get the vertical jump cookbook out and we'll go through that, right? You can't really do that, can we? Right? We got to, we got to, we got to talk about, we got to talk about problems and solutions. We can't just say that, oh, if you want to jump higher, this is how you do it. If you want to run faster, this is how you do it. Now, here's the one thing that we can say. is that the greater the force that we can apply to the ground in the shorter period of time, that's going to impact both of those. The question mark is, is how does this individual need to do that? Is it the fact that they don't produce a high enough force? Or do they produce a high force? They just can't do it quickly.

Right, so you're talking about magnitude of load as an influence here, not just the position, right?

No, normal PT land. Well, Zach, if you have a patient that comes to you with low back pain, you just followed the low back pain protocol. Everybody knows that.

Good morning. Coming up on a very busy Tuesday, we're going to take straight into today's Q&A. This is with Taya. Taya asked a very strong foundational question that pertained to what is basically the lower extremity representations during early, middle, and late propulsion. Seems like a very basic question. The importance of this question though, it comes down to when we intervene. So if we have somebody that has a specific representation and we're trying to make a favorable change in relative motions, it behooves us to number one, understand where they are in the propulsive phase. And number two, what is the representation of the intervention? So for instance, if I had somebody that was presenting with a late propulsive strategy, say on the right side in the right lower extremity, and I perform an activity that reinforces the late representation. That's all fine and good. If that's my intention, if my intention is to alter the relative motions, then I need to understand how I need to reorganize this lower extremity to create an early representation so I can make that favorable change. So again, very, very powerful question. Thank you, Taya, for asking this question. Everybody have an outstanding Tuesday and I will see you guys tomorrow. Hi, Taya.

What's not a muscle energy technique?