Does it look like elephant ears going in?

So if somebody walks into your gym and has this issue, would you look at their ISA? Would you measure that first and then go from there? Or would you just still just go with the lockouts?

Everybody thinks they're in the 16%, but they're not, right? But the reality is, that's why I prefaced those videos, because I recognize the fact that there's 84% of the people that don't give a rat's patuity about it. So number one is I only speak to certain audiences, which is good. That way I don't have to change me too much. I do alter communication styles a little bit because you do have to adapt to the people that you're talking to. But typically what I don't do anymore is I don't censor myself. I don't try to talk down as much. Because mostly I don't care, because if you don't understand me or you don't want to understand me, go somewhere else. I'm fine with that. But generally speaking, it's like, don't try to talk to everybody and then it gets a whole lot easier. Right. So the language that I just started using my language from my model. Right? And then people have sort of, they either hop on the bandwagon, they go, tell me more about this, or they just go, I think that the biceps is a class two lever. Is that right? Is the biceps supposed to a class two lever? I can't remember it was in school. It was like 400 years ago for me. But anyway. So that's the simple answer, Alex. It's like just decide who you're going to be talking to, and then that determines the language that you will use or the method that you will use.

And those changes that you get in probably rotation due to compensations, that's probably, you know, for bone takes many, many, many years, whereas muscle you can know. How long does it take?

So what would that be? The first one would be like a Dr. Longus and Brevis.

So it's kind of keeping them from falling forward.

So Vikram says, can you explain why some people go into what looks like cervical flexion at the bottom of a bench press? Yes, I can. And actually, it is flexion to a degree. So let's talk about this for a second. So go back and watch the arching video that we did on the bench press earlier this week, and you'll get kind of the same representation in the neck. So when we're talking about bench pressing, power lifting, et cetera, if we don't want any turning, we want high compressive strategies, we want lots of concentric orientation on the outside squeezing in. So in a bench press, the way that most people are going to try to stabilize their neck and their head against the bench is they're going to create an upper cervical flexion if you will. Okay, so it's a rotation of the cranium of your skull on top of C1. What that does is it pulls the high-end bone upwards as if you were swallowing. The great thing about that is it takes your airway, which is normally kind of roundish, and it compresses it into a flattened state just like when you're flattening the rib cage with your pecs and your upper back and your lats and things to create this strong exhalation compressor strategy for strength purposes. And so now we've got a very, very stable neck. As people lower the bar to their chest, they maintain this position. And so just like kind of doing a sit-up for your neck, the musculature on the front side that is pulling the high-eyed bone up and compressing your airway and making your neck go from a cylinder to this compressed sort of wide-looking neck will actually lift the head up. And so you'll see people that have never done breathing activities before or reaching activities and you'll see a tremendous amount of this sort of rectus abdominis effort as they try to use it as an exhalation strategy. You're seeing the exact same thing in a bench press. And so again, from a performance standpoint, it creates high levels of compression. It prevents air from escaping the body, so now you're squeezing this compressed air and it contributes to force output. So bench pressing is your thing and you want to maximize that, then you better be able to compress your neck. Now, secondary consequences—always secondary consequences—is something that seems good. You're going to lose lower cervical rotation. You're going to lose dorsal rostral expansion, which is going to affect your ability to move your shoulders and your lower cervical spine. You may also create eccentric orientation in the suboccipital area. So now you're going to get a little bit of extra upper cervical rotation as a compensatory strategy. And again, if you're willing to live with that, if you're okay with that, you're the adult—you get to make that choice.

Okay. So let's take that one off the table.

In regard to the actual positions and orientations, you'll see why you get the crazy straight leg raise, and then we have to clarify what you mean by sufficient ER, because you might not have as much as you think you do. Okay, so if I'm talking about narrow IPA, I'm gonna have this kind of a presentation. And so under those circumstances, I'm gonna have a compressive strategy in this lower posterior region. And I've got a couple of possibilities. So if I would move forward, under those circumstances with the inhaled pelvis, I'll have somebody that has like this 35, 45, maybe a 50 degree straight leg raise. If I have an anterior orientation, however, I'm gonna get a little bit more of an eccentric orientation on some of this lower posterior musculature because of the orientation that takes place. It's still biased towards ER. That's the thing we have to recognize. However, when you take somebody like this and you lay them on the table in an anterior orientation, they're actually laying in hip flexion right away. And so what you've done is you've taken the normal relationship of external rotation to internal rotation to external rotation, and you've tipped it forward. So they're actually able to internally rotate. It's just way down here where you're gonna see the internal rotation. So if you doubt me, you just confirm it on the table. This is down here. So they're gonna get their internal rotation here. Their sticking point because they're laying in hip flexion their sticking point is just off the table and then they're moving back into external rotation. Now as you move somebody like this through their excursion as you're moving them into the straight leg raise they're also going to turn a little bit this way. So what happens is what it looks like on the table is that it's perpendicular to the table and straight up. So you're implying that the movement is happening in the imaginary sagittal plane. It is not. They're actually turning more into external rotation at the top. So they're passing through the internal rotation and moving back into external rotation. So most people call that hip abduction under the circumstance, and so that's where their straight leg raise is actually going because when you restore some of the adaptability so if I capture some of the exhalation strategy without the compensatory strategy like I intend to in many cases what you'll see is you'll see the loss of the straight leg raise. So these are not muscular adaptations. These are orientations of the skeletal position and then the associated muscle positions that allow those crazy straight leg raises to occur. So you have to appreciate the starting conditions from where you're measuring and then looking at the relative position of the hip, not just looking at the table and saying that straight up is 90 degrees, because they're 90 degrees this way down.

Right.

Yeah.

And that's what I was going to say. If you're going to physical therapy for three months because you think you're treating SI joint pain because that's what the doctor said, there's no analytic thought process there. And this person's presenting this way; maybe the symptoms come into play, but how are you using your tests and measures and the response to exercise to dictate your intervention instead of just relying on the physician's SI joint pain diagnosis?

Yes. The colors needed some work. Right. But yeah. And I think one of the things that happened to was really two things. So number one, we hit critical mass in that space. I remember, so you would work Saturdays because you were still in the clinic then. Yeah. So you would work Saturdays, but I would always come in and train Saturdays. And I'd have, you know, Justin and I would work out together. I just remember there was a Saturday and it's like we were stepping all over each other. Yeah. So it was close.

That's why that's why you have gray in your beard, dude. That's that's all. It's called maturity, right?

No, I've quit it.

It's not toughening her up. It is going to create a degenerative situation. All right. That's the concern. How old is she?

The compression that's happening above where expansion is happening is that it's compressed relative to the expansion.

Hashtag, one of my hashtags, right?

Yeah, yeah, yeah, yeah.

So what I would do is sort of like a litmus test. Number one, do you have any development in either direction? Like, have they ever emphasized one of those elements first, or are you trying to raise both of them at the same time? Again, that's a lower qualification or lower training age. You might just be able to run them concurrently. But what I would do is say, okay, what's the most intensive aspect of this that would provide the greatest degree of interference to both? Then say, okay, I'm going to introduce some measure of volume and just see how much competition I have. Then every couple of weeks, you have some sort of KPI that you're following to sort of direct you. And then it's like, oh, as long as we're maintaining this, raise the volume, raise the force production, right? As long as we need to maintain. That's what makes this hard.

Prone is kind of hard at first for most folks because of the head control position. Like if you're going to twist your head from one side to the other, you don't want to twist the airway. I don't want to compress something that I need to expand. Then if I was upright and using a lot of neck musculature, in what position would I put the head relative to the rest of the body to allow many of those muscles to not have to remain in concentric orientation just by position alone?

With feet. Pete. Okay, keep talking. Yes. But now like I actually have like a case that I'm kind of lost in. So I have a lady who's like a narrow ISA and she has left knee pain. According to MRIs, she has like a slight degeneration on the medial tibial plateau and like the medial side of the knee. She has a little bit of irritation or some kind of inflammation on the patella tendon on the lateral side and a Baker's cyst in the medial side of the back of the knee. So it's on point so far. Yeah. So it's great and then the other day, we worked on the posterior outlet because that was the first thing that we did with her activity wise, so that kind of got better. The next time we started, I wanted to do with her what? We did first? We solely did a basic couch stretch or like yeah, tried a couch stretch, just getting into like a half kneeling position. It gave her so much stretch on that left quad that after that she was useless for the rest of the session, like even just doing like a hinge her quads were like shaking like crazy. And she has of course a lot of like she was walking on her tippy toes like for years when she was a kid. Nobody told her not to do that until like eight or nine. And now she has a very flat foot, bunions, spreading of the forefoot just very, very wide. So I'm trying to get like both sides of the knee like I'm trying to get hip and the foot also. The hip was really I was kind of thinking that because of the femoral rotation or the twist in the femur that's why we're getting into this like shaky quad thing that the quad is not feeling comfortable working in those ranges or working with those angles but I'm kind of lost on the feet too or like what to do. Like if she can barely sense stuff. So, yeah.

Okay, so what you do is, you create categories and assign them numbers. As you acquire information, you document it somewhere and give it a number based on the category it fits into. For example, anatomy might be 1.100, and everything in that category would have a number like 1.1 something, something. That's how you build a filing system over time. That's how I do it. Right. Okay. Anytime you read something, like a paper or an author, you want to create a bibliography that is attached to your system. So then you create a bibliography catalog, and for each card, like an archetype card, you put a little reference at the bottom so you know where the information is. Just create it yourself.

Hmm.

When you see, like if he's doing like a vertical jump on the force plate, what are you seeing prior to the force application?

OK. So that's the position that his arm would be as he releases the ball. He's got to get into that position from layback, okay? You go from layback to that position. All right. But the problem is he's going to be there too long because he's got to use an orientation to get the arm into that position. That prolongs the exposure. So there's more pressure on the lateral, the posterior lateral aspect of the elbow. There's more pressure there. And then that expands the medial elbow.

Good morning. Happy Tuesday. I have neuro coffee in hand and it is perfect. All right. We're going to dig straight into today's Q&A with Zach. We're building off a question he started last week about trap bar deadlifts and narrow stance individuals, and how that can favorably or negatively influence outcomes depending on loads and how long these activities take to perform. Zach wanted to relate that question to a representation we've shown you several times before. This is based off the way a light cone would be represented, but we can use this to represent our extra rotation space and internal rotation applications of force. The way we influence this will determine how much velocity we can demonstrate in external rotation and how much force we can apply in internal rotation, as well as the duration of that force application. If we pick the wrong activities, we may increase force production but sacrifice something else—specifically, we take away time to allow us to demonstrate high velocity aspects of our activities. This is a great question for many people who don't quite understand the difference between how velocity is demonstrated in external rotation versus internal rotation. Internal rotation is a force-producing representation. Thank you Zach for asking this question. Have an outstanding Tuesday, and I'll see you tomorrow.

Yeah, yeah, yeah. But I didn't like that show, Matt. Matt, I didn't like that show because I couldn't grow up sideburns.

Yeah.

Yeah. Okay.