You're taking a two-dimensional representation. You're saying these two people are the same. And then the reason that they measure differently is because you're measuring it in a minimum of three dimensions. This is with Pradesh. We've talked to Pradesh before. He had an interesting question in regards to two athletes that came with the same general physical appearance. So he was looking at posture as a representation of what he thought they should measure and they did measure differently. And so this takes us in the direction of understanding why I don't like to talk about the imaginary planes too much because if we start thinking in planes then we assume that we should see these same representations or if we get similar measures that we would have the same thing happening on both sides of the body and that's not necessarily true. What we need to understand is that as we're measuring, we have movement on the table. If we're doing table tests, or as people move through space, they're going to use compensatory strategies to compensate for limitations in movement. And so this is what we're talking about as we go through this Q&A.

You too.

You do something.

Okay. And then as far as the difference as far as I understand between like a squat or a deadlift or a sled push is that you're not as—during the push-through, you're not stopping the movement right—you're pushing all the way through and then your foot comes off the ground. So is that anywhere, for example, we're talking about like running, sprinting, or jumping? Is the sled a little bit more transferable to those kind of dynamic movements than a deadlift or squat, or is it still all the same if you're going heavy?

All right, so the question would be about one of my problems. I used to powerlift, but I had to stop it because I got a leg length issue, a leg length discrepancy. I used to overtrain my right side because when I started training, I just never fed my right side as well as my left side. So I did really weird things like retracting and pressing during bench pressing, and I did everything like this. And I trained for years, doing squats and things like that. And I became aware of it and stopped doing it. And it's still like some internal rotation, but left me with a rotated pelvis. So my right leg is buckling all the time while I'm walking. The question would be how you would approach to fix this leg length problem. I think my left pelvis, the left ilium, is rotated forward, and my right leg is caving all the time inwards. I got a left hip shift in the squat. Then I watched your 'how to fix the left hip shift in the squat' video when you elevate your heel and do squats. But the problem is that my left leg is so much stronger than my right. I feel balanced on my right leg, but the left quad just takes over and it cramps all day. One of the things I just became aware of is that my right leg, the shorter leg, has less external rotation. It can't external rotate. It's weak. And the VMO is so much smaller on the left side. The left side is always externally rotating, even when I'm sitting.

Because the advantage that the wide ISAs have is that the angles at which the musculature associated with their skeleton, like their ribcage and their pelvis, is generally more horizontal. This provides a tremendous advantage for force output.

Correct.

No. All right. No, muscles can't do anything. They can squeeze things really, really tight, right? So hang on. Let's empty your guts. Your gut is now hollow. OK. And I'm going to put that 500 pound barbell on your back. What do you think is going to happen?

OK. So differentiating. Cable chops, like I've been playing around and I love that. And I always think of that for wide ISAs or unloading them, right? For expansion and a little bit of rotation. But you used it in a narrow position. What's the thought process? Is it the same? Is the goal different, or is it the same?

Under those circumstances. And that's the loss of IR. So the anterior orientation tells you via loss of ER, the forward displacement of your center of gravity tells you by the loss of IR. All right.

See you.

We are rolling and the clock has started. Andrew, what is your question?

Yeah. So I was like, that really emotional. It's like, I remember that very, very clearly. But it is, we got about a minute. So let's try to wrap this up. Is there anything else that you wanted to bring up?

Which one?

Okay.

Every time you do an intervention, you got to retest her. That's how you that's how you know you're doing the right stuff.

Okay. So if you measured somebody and you did an overhead flexion test with external rotation, that shoulder blade would be wrapped around away from the spine, just a little bit, right? So it's going to be a little bit this way, and then it kind of does this upward rotation. And so the abduction test would be measuring a little bit more in the center, right? Because the shoulder blade is wrapping around this way towards my center.

Okay, so they're trying to find stability in the upper cervical spine by clenching.

So I appreciate your enthusiasm. You're just going to scare people away.

We want to create the yielding strategy, which is actually going to start to turn our sacrum to the left. So we're going to initiate this in an early propulsive activity. And so we could just use simply in the gym we go to a supine arm bar and we're going to start to recapture that ability to turn the sacrum. This can then move into a left rolling pattern. So we're going to start with an early propulsive strategy in the roll, and then we want to move towards middle in this rolling activity. This can eventually become then the right arm bar that will approximate this same position. So again, we don't have to lay anything on the table. We don't have to do any measurements. We don't have to treat this person like a rehab client. We have one scenario to deal with here, and that's all we're going to chase. Now because of the orientation of the pelvis she's going to have probably a situation where she's going to have an eccentrically oriented pelvic outlet and we want to make sure that she can capture concentric orientation. Now the cool thing you mentioned in your question is that she can squat without pain awesome so we can already start to work on that. So what we want to do is we want to start to work on maybe a touch and go box squat so we can capture the concentric orientation of that pelvic outlet and start to work on the shape change of the pelvis so we can capture this internal rotation. From there we can use an overcoming a squat in a static position that will also teach her the concentric overcoming strategy in the public outlet. So that gives us our pressure management that we're going to need in the bottom of the split squat to hang on to this internally rotated position. Now we can start to move into split stance activities. So the first thing I like to do is just to do some sort of static representation of this. And what we want to do is we want to create a situation where we're actually pulling ourselves towards this overcoming action through the thorax. So we can actually use the thorax to help us start to build from the top down. So if we pull the thorax into the overcoming and we resist that, we're actually going to start to teach ourselves to keep the pelvis turned to the left in a stressful situation, so in a loaded situation. So again, that's why we're going to use this cable representation. Now, from here, we're going to move this into a dynamic situation where we're going to move back into the split squat, but we're going to use an offset load.

So for me to perform a squat with a heavy barbell, I have to have enough relative motion. So my femur and my knee, right? Or my femur and my tibia have to be able to bend for me to squat down. Well, that's relative motion there. So I have to be able to do that. So what that means is, I have now increased the coordination of my system to produce the upward force or the force into the ground that's gonna allow me to push upward and still capture enough eccentric orientation to move. Just enough, just enough. The stronger I get, the more concentric orientation I need, and I still need enough eccentric orientation. That's how, so that's when your strength starts to top out. You can't get any stronger because I need so much upward force that I give up my eccentric orientation and I can't move anymore. What if your plantar fasciitis isn't just a foot problem? I think in most cases, especially with the people that come to me with these insidious onset of plantar foot pain, I don't think it's going to be an ideal situation. And if you look at some of the soft tissue research, especially leaning towards tendinopathy, you're going to see that we're seeing people in these later stages of tendinopathy where there is no inflammatory situation. These are degenerative situations that occur. And most likely, in my opinion, I think there's going to be a blood flow issue that's associated with that too. There's the tight calf, tight plantar fascia hypothesis, which leads people towards these rather aggressive stretching protocols in many situations that I don't think are terribly helpful. However, having said that, I think there might be a situation where some of that may actually be beneficial by accident. The bottom of the foot's a very busy place. There's a lot of muscle that's attached to the calcaneus, not just the aponeurosis of the plantar fascia and the thinner medial and lateral plantar fascia. So I think that there's not a specific foot type per se that's going to result in these situations, but I do think that there might be a little bit of a bias in one direction. And I think that this has to do with the way that the connective tissues behave in regards to overcoming and yielding because we do have a situation when we're moving through propulsion where we have yielding actions versus overcoming actions. And I think that those people that are predisposed to a prolonged or maintained overcoming action are those that are probably going to be more predisposed towards the symptoms that are typically thrown into the diagnosis of plantar fasciitis. It's this reason that I think that some of these stretching protocols may accidentally help because if we can create any yielding action at all through some form of tension, then maybe you do get some relief. But I think in many situations, because this is not just a foot problem, this is a center of gravity issue, I don't think that it's necessarily going to be a great solution. So let's real quick go through our phases of the propulsive foot. So as you recall, we're going to have three rockers. We have our ankle rocker, which is the heel contact to where that first metatarsal head comes down to the surface. I've got a tibia that's behind the ankle, that's an ER. This is going to translate over the foot. And so this is going to be our middle propulsive phase. And this is where we're going to see the reduction of the arch. So we see the supinated foot with the arch. We're going to move towards traditional pronation, which is the lowering of the arch. And then I'm going to see the resupination of the foot and the re-ER under those situations. Now, I think that those that are going to be more predisposed towards this diagnosis are going to be those that are going to be in the later stages of middle propulsion or they're going to be trying to acquire this early propulsive strategy at the end of middle propulsion where we're going to hit that maximum propulsion. So this is maximum pronation right at the point where that heel starts to break off the ground. I have to create this overcoming situation. And so this is the connective tissue behavior. So the tissues are behaving very, very stiff at this point. I think that this is where we're going to see most of our people that are dealing with heel pain situations because this is the overcoming. And so I'd rate this very high rate of loading into the connective tissues. They become very, very stiff. Now, if you have somebody that is in later propulsion, just as a reminder, if their heel is still on the ground, what you're going to see is you're going to see a decent arch, but you're going to see the toes curl under. So we're going to see the distal phalanges there are going to get pulled under. So we're going to see a flexed toe representation under those circumstances. So you can differentiate between somebody that is biased towards their max propulsion versus the later because we're going to change the strategies a little bit in regards to which presentation you're seeing. Let's go back to center of gravity real quick. If I am anteriorly oriented, I'm going to see those people that are going to have a center of gravity that is biased forward. If I have, say, a narrow ISA and I have that posterior lower compression, I'm also going to see somebody with that center of gravity forward. And in both cases, I'm going to be pushing that tibia forward. So what we want to talk about now is this rate of tibial translation across the foot. So if I see somebody with a lower arch, what I have is a situation where the arch is low. So that allows the tibia to translate very, very quickly. That increases my rate of loading. So under those situations, my first layer of strategy is number one, I got to reorient the pelvis and not need to recapture my non-compensatory hip external rotation and internal rotation. That's going to help me manage this center of gravity situation. Number two, I got to restore the arch. So in this case, there may be an orthotic solution that we need to utilize or perhaps a shoe selection that's going to allow us to manage this arch. If I can bring the arch a little, I can slow the translation of the tibia and then that reduces the rate of loading on the connective tissues on the bottom of my foot. So again, we want to slow the tibia from moving forward. After that, what I want to do is I want to start to train people through this middle propulsive phase. I'm going to start with gradual loading. So I'm going to do front foot elevated activities under these situations where I am translating the tibia. But again, I'm managing that arch position. If I have somebody that is farther into propulsion, so they're in late propulsive foot, so this is where the arch returns. And I'm starting to see some of that toe flexion that you'll typically see. So this is a concentric overcoming situation. So what we want to do here is, we're going to take advantage of the concentric orientation, but we want to recapture the yielding action. So we're going to take them all the way back to early propulsion. So this is all of your heels elevated activities after you reorient the pelvis and recapture non-compensatory external rotation, right? So again, so heels elevated front squats, heels elevated squats. And then what I want to do is then I want to rebuild middle propulsion just like I did for those folks with the lower arch.

That's going to help me produce my internal rotation. But what if I'm trying to produce more external rotation that I don't have? Because maybe I don't have that ER field. Where can I get it? Well, remember we talked about disc herniations a while back as well. I might use my disc as my yielding strategy. So I create the expansion through the disc. We call that anything from a disc bulge to a disc herniation to however you want to term it. It's going to be an expansion through the disc. So now I'm a golfer with a disc problem and I'm going to end up talking to my spinal surgeon potentially because I have been using my disc as a yielding strategy instead of producing it through the pelvis through the spine and through the hip as I would want to distribute it. So now we're right back to the beginning of your very first question. If I'm talking about not having the field of ER at the other end in follow through, and I want to superimpose internal rotation on top of that, now I might be looking at a left knee strategy to try to produce that internal rotation. If I don't have the internal rotation production at the hip the way I would want to, I'm going to tip my pelvis down or I turn that femur in to internal rotation to produce force into the ground. And now I've got ACL stress. I've got anterior knee pain because I've got a patella that's getting pulled laterally so I could have any number of maladies that are associated with the orientation and alignment that I'm using to produce internal rotation when I do not have external rotation at both ends. So, Johnny, the end game here as far as this discussion goes is, yes, I need to have this representation of internal rotation. It's going to be that nutated sacrum. It's going to be an IR at ilium. I'm going to have an internal rotation representation that's high force, high compression, concentric, pelvic outlet, internal rotation at the hip, tremendous force into the ground, hopefully. But if I don't have my field of ER first, I'm not going to capture that representation. I'm going to use substitutions. And I'm probably going to pay a little bit of the price for that.

Pick up my left knee.

No, one human being. The perfect client for Nate is who?

When you take a breath in, do you internally or externally rotate? What position represents internal rotation of the pelvis?

What would you do? Like, what's the first logical step?

So off of that, one of the things I wanted to ask was what are some of the underlying principles that you use when you teach in a bunch of different environments? You have the coach's call, you have the Facebook group, we got YouTube videos, Instagram, all this and that. Like how do you, what's kind of like the underlying principle of how you get your message across to different groups without either shooting over somebody's head, portraying the wrong message, like reading the room? Like what is someone like the best teaching strategies you've found to kind of portray to different groups of people?

And so what we're doing is actually we're inducing a very, very small amount of rotation through the pelvis through hip approximation. So an activity will look something like that that you're seeing on screen right now. And what this starts to do is it starts to actually increase the amount of eccentric orientation in this reciprocal fashion. So we're creating almost like a really tiny variation of the gate cycle through this hip approximation. In many cases we get really good results from this and then we actually pick up enough hip flexion that we can now start to move people towards some activities like maybe we do some hook lying. We continue to work on yielding and overcoming strategies in this hook lying position or we can move them into a sideline propulsive activity with an increasing degree of hip flexion and we can superimpose some reaching on top of that so you got to remember that you got this iteration that's going on in the thorax at the same time. So if we can superimpose some reaching on top of this propulsive strategy we get a much bigger bang. One of the activities that's kind of off the beaten path is actually this arming crawling that we might want to do. So when we think about the posterior lower compressive strategy that's going to limit the degree of hip flexion in the traditional imaginary sagittal plane, what we can do though is we can deviate the knee laterally and we can go get some extra rotation in that position. So that can actually help us increase the amount of eccentric orientation in this posterior lower strategy as well. So it's probably considered a developmental position for some of you depending on what your background is but we want to turn this into an army crawl. This is also great for kids with this scenario because they like to crawl around and pretend to be animals so a little FYI there. If we move to a standing position what we probably want to do because we don't have a lot of hip excursion to start with We're going to start with a very narrow stance chopping activity with a little bit of weight shift. Again, that's going to help us start to capture this little bit of rotation. Again, we're going to move them through a gate cycle. We're going to go from one chop to the other in a reciprocal fashion to recapture this eccentric orientation. Once we start to gain some hip abduction, we gain a little bit of hip rotation back. Now we can move to a bit of a staggered stance chopping activity, and then we can move into like a high low cable press. One of the things that I like to do at this point is I'll just call it sneaky arm training. So we'll actually have them do biceps and triceps activities, if you will. But what we're going to do is going to be very particular about what stance they're performing these in. And so again, we get to reinforce what we're chasing with this concentric eccentric orientation in the posterior lower aspect, while they get to do fun stuff, if you will.

With my glove side, I have to be able to internally rotate this shoulder. My left shoulder has to be able to internally rotate, but I'm rotating from distal to proximal. So what happens if we pick on pec major for a second? As I internally rotate, I'm going to start my internal rotation from distal to proximal, which means I'm going to gain concentric muscle activity at the attachment of pec major at the shoulder. As I turn, I'm going to have more concentric orientation distally than proximally, and what that's going to allow me to do as I internally rotate, I have this nice little gradient effect where I have compressive strategy that moves from distal to proximal, which keeps my pump handle up long enough for me to get my internal rotation. If I was to concentrically orient that pec, from an absolute standpoint without this gradient effect, I would get compressive strategy on the sternum, which would hold that sternum back. I get the posterior expansion, which is nice for extra rotation, but I block my internal rotation. And so you're going to see some form of compensatory strategy as I throw where I'm going to elevate the shoulder. I'm going to side bend my head as a substitution for that shoulder internal rotation. So if I break out the toothpaste tube and we can kind of look at this from the bottom up here is that what I get is I get this gradient where I have a compressive strategy distally and I get the expansion proximally. So it's a nice little representation as to how this muscle gradient influence kind of works. Now, as far as addressing these pump handle mechanics, you can do it unilaterally and you can do it bilaterally. From a narrow ISA standpoint, I do a lot of the bilateral stuff because we can immediately go to quadruped in many instances. So I might use like a bear position or eventually some form of crawling and then to a bear crawl. When I'm talking about the wide ISA people, they tend to have quite a bit of anterior compression already. It's very difficult for them to achieve the pump handle mechanics, so it's much easier to go after those people from a unilateral standpoint because I can create a much stronger compressive strategy on the backside and then create the yielding capabilities or eventually eccentric orientation on that anterior side.

I might need to start him in a very, very short staggered stance before we can actually induce a normal width stance for him because he just can't control the velocity. He can't access the ranges of motion.