I do.

We're limiting it. Yes. We want to limit it.

Well, good luck with appropriate, right? When you're talking about high performers.

Very busy Monday. We're going to dig straight into today's Q&A. This question comes from Alex, and Alex's question was in regard to selecting the appropriate position for patient intervention. This is more of a rehab kind of a question, but it does apply to gym activities as well. One of the things we have to consider is how our patients or clients are managing internal and external forces. We're talking about gravity and then the internal forces that we produce through the internal movement of our bodies. This is why we see the superficial strategies that we talk about that can create interference with movement. So if we can better select interventions in patient positions, we can be much more effective with those interventions and then progressively teach our clients to manage these forces and have much more successful outcomes. And so that's kind of where this question took us. One of the things that I want you to walk away with is understanding that number one, always have an intention, a very specific intention, and therefore you're going to need a key performance indicator. You're going to need something that you're measuring as you intervene to assure that you are being successful. So take that time, intervene and always re-measure so you know that you're being successful. If you would like to participate in a 15-minute consultation, please go to askbillhartman at gmail.com, askbillhartman at gmail.com, and we'll arrange that at our mutual convenience. Everybody have an outstanding Monday, and I'll see you later.

Yeah. So think about the inertia that's required to break the bar off the floor. That's going to require the orientation of the tibia relative to the foot, so the tibia is over the foot. Okay, so if they were moving forward, they would literally be at max P. And so what happens is they are going into max P to break the weight off the floor, but they're not going to go forward because that would be a mislift by a long shot. So what has to happen is that's why the tibia goes backwards as they're bringing the weight off the ground to the knee. That's max P, but it's max P with a heel on the ground. If I don't have the capacity to produce the downforce, so that's in high internal pressure, concentrically oriented outlet, nutated position of the sacrum. If I don't have that, I've got to go find a way to get to max P. So how do you do that? Well, if I lift my butt up, I can create more downforce by keeping my center of gravity over my forefoot. That's what you're looking at. They're just using an alternate, and again, a less effective strategy, obviously. Do you know what they typically blame for this? Like a typical Olympic coach would blame a muscle for this problem, right?

And then don't forget you've got other superficial compressive strategies that you're probably going to have to deal with. So hopefully Brady that answers some of your questions, give you some alternatives that you can utilize to restore your movement capabilities. If you would like to participate in a 15-minute consultation, please give it to askbillhartman at gmail.com, askbillhartman at gmail.com, and put 15-minute consultation in the subject line so I don't delete it, and we'll arrange that at our mutual convenience.

Okay, so we have to look at space time.

Move them back on the right first, then try to make the orientation to the left by applying pressure to the right sacral base. Don't forget your foot contacts, don't forget your line of pull, and remember to exhale on the exertion so the breathing mechanics match the axial skeletal mechanics.

Yeah.

Correct. So you're actually creating a shape that creates a downhill force, so to speak, for the internal organs to fall down and to the left to initiate the force in that direction.

Sir, before it gets to 103 degrees with 99% humidity. I have a basketball player transitioning from high school to college, but he's very recreational in his basketball. Basically, he goes to the park every day and spends two to three hours playing basketball with his friends. I've been trying to avoid a lot of the low amplitude plyometrics and ballistics due to the connective tissue considerations we discussed, focusing more on magnitude rather than frequency and rate of force production. I've been focusing on heavier weight training, helping him transition from yielding to overcoming actions, like we did with the reverse bandit a couple months back—which worked really well for him to prevent the double bounce in the box jump. I'm unsure how much further to push him given his current activity level. I'd appreciate any research or book recommendations to help me understand the recovery process of connective tissues, so I can better program his training frequency and magnitude. Do you test him at all? Well, I don't have a jump pad, so I just use video analysis in slow motion to evaluate his jumps.

And I'll put it up here in the video for everybody to see.

Diastasis.

I have a lot of butt in there, okay? All right, so here's the deal. He's on the right oblique, you're absolutely right, okay? But there's a little extra addition here, okay? When you look at the hip IR measures, so typically on a right oblique, if you didn't have anything else added on, you would see a lot of internal rotation on the right hip, okay? You don't have any. Which means that he went on the right oblique and then he went forward. So if you try to push him back on the left, as you would say for a typical right oblique, what's going to happen is he's going to orient everything at the same time. So he is basically locked into one piece. He doesn't have his relative motions available to him. So if you look at the HIPPR measures especially, So you know, you've got an anti-orientation on both sides, you know, it's more on the right, that's the right oblique representation, and then you lost the hip internal rotation. Okay. So, one of the things that you're going to see here is a lot of orientation into external rotation. This is why your flexion measures got magnified because he shouldn't even have that much flexion based on the fact that he has almost no internal rotation. So you've got a proximal hip that's in external rotation and then he's internally rotating as he goes down towards the floor. So step one is you've got to bring him straight back first, recapture some of the external rotation and the internal rotation superimposed, then make your turn. Okay? Because like I said, if you make the turn too soon, all he does is everything just faces the other way. It's not the relative motions that you're trying to recapture. Does that make sense?

So, under those circumstances, we actually use a very relaxed, casual type of breathing with very slow, methodical movements. Very, very low tension, very, very low effort. Because again, if we have this really, really strong, wide ISA, superficial, concentric orientation, you're never gonna get your way out of that by trying to use more effort. Because again, you just reinforce the strategy. So again, I would caution you against thinking that there's only a way or there's only two ways. What we have to do is we have to consider what this person that we're working with is bringing to us. And then we have to reason our way through the strategies to alleviate whatever we're trying to change or reinforce what we're trying to reinforce. So from a performance standpoint, if I do have somebody that has to drive a lot of high force, then I do want to use a concentric strategy. I do want to use this aggressive exhalation. So always taking the individual into consideration is where we go. It's always N equals one. It's always in a gray. Everybody wants a black and white answer when it comes to all of these concerns. But the reality is that we have to adapt our treatment strategy or training strategy to the individual. So it's not as black and white as everybody makes it seem to be.

So it doesn't mean they're bad vertical jumpers, it just means that as a representation of where they perform the best, they are better at horizontal projection because they are so much closer to maximum propulsion than another athlete would be. And so they'll have the quicker for a step. They'll have great acceleration. But what you're going to measure, to throw them on the table, they're going to be biased more towards external rotation. So remember, as I break that foot, I get this concentric orientation that's going to move me quicker towards the ER. So what happens is they have a reduced yielding strategy, which again, that dampens their ability to produce a vertical jump, but it also improves their horizontal projection. They're going to have limited hip flexion. They'll probably have a limited straight leg raise, et cetera, that's associated with this extra rotation bias and a reduced yielding strategy. If I move you back just slightly from max propulsion, I have now just increased the amount of time that you have between where you are as a representation of your center of gravity and maximum propulsion. So in doing so now, I've actually increased the time that you have to produce a yielding strategy. These are the people that will have a better vertical jump than broad jump as a representation. But they're going to be a little bit slower in regards to change of direction. But they're going to have better top speed because their vertical projections are better. They're going to have slightly less external rotation bias. So they're going to have a little bit more of an internal rotation capability than, say, our guys that are better horizontal projectors. And so they'll have a little bit better hip flexion, a little bit better straight leg raise. So if we look at a couple representations of feet, I'll try to show you the subtle little difference. So what we have right there is a pair of feet that can run a 4-4-40. So he is very, very good at acceleration. He is very, very good at change of direction. So this is a Division I football player, and he played four years of high level Division I football. this other representation right here it looks very very similar but this is a better vertical jumper than a horizontal projector and so this is actually a very very high level basketball player and so he's got a better vertical jump than horizontal projection and and so again subtle differences as to how close these guys are to to their maximum propulsion phase. Now, let me show you another pair of feet that don't jump very well and not very fast, but also on a very high level basketball player. So this individual has a much higher arch. He has positioned much more into an earlier phase, so he's a little bit slower. He doesn't jump as high and he's not as fast.

So my question was regarding foot force production we talked about before, but I was confused when it comes to sprinting, where they tell you that your toes are always on the ground and your heel never touches, but that seems like you're still producing max force.

But here's the problem that you're going to run into when you see somebody with this magnified hip internal rotation. Chances are when you lay them on the table, what you would typically see is a loss of hip external rotation associated with the anterior orientation. So your expectation is that the same side shoulder would have a loss of external rotation, but that rarely shows up in this circumstance. Because of the extreme orientation, because of the traditional extension and internal rotation of the lumbar spine, what happens is I get a thorax that would normally be tilted forward, but it falls backwards on the table. This actually magnifies the external rotation measures in traditional external rotation and flexion. So it can be a little bit confusing if you don't have the awareness that the thorax can actually move as you lay them down on the table. So keep that in mind when you're making your comparisons of same side hip to same side shoulder. So Brian in a nutshell, your strategy is to create the reorientation under these circumstances and not go to blaming laxity. Unless you have some scenario where it's going to be very, very clear that they have some form of condition that would actually promote this laxity. Use your comparative measures. Understand that all your measurements are dirty, and we have to account for the position on the table. Ryan, I hope that answers your question for you. If it doesn't, please ask another question at askbillharmanngmail.com, and I will see you guys. So we can't look at this guy as an average human being because he is not. The gods, as they say in the movie, turned his arm into a thunderbolt.

So when to seek help is actually kind of an easy one because at some point in time, you're not going to be able to answer the questions all by yourself. It's important though that you make the attempt first because in many cases and because of the prolific nature of information and the instantaneous access, a lot of these questions can be answered in some way, shape or form, because again, like I said, information is essentially free. Everything is available. What you run into though is because you may not have the vocabulary, so to speak, to understand everything that you might need some expertise in someone that can explain it to you in some language that you may be familiar with. And so that's when I see, so I have a, I have a, I have a friend that, that like he's got a background in astrophysics. So that's great. You know, I just like, Hey, I got a question. And he's like, Oh, and then he, he dumps it down for me. So we talk about like, when we talk about curve space time and things like that, he uses free throws as an example, which is like this brilliant analogy. It's important that you do establish your own understanding first so you have a comparison so you're not not flying in in blindly because we we tend to learn things by analogy and so if if I can acquire new information or a different understanding I I because of the effort that I put in beforehand I have that comparator and so now I can say okay so here's where I was here's the distance that we that we had to to cover. This is the actual representation. Now I can see where it comes from or it just gets me further towards some way that I can understand something that might even be a little beyond my grasp. So the struggle, the struggle is important. Like I said, because number one, there's gotta be an emotional attachment to anything that you learn. Otherwise you won't retain it. It's sort of like when you were in school and they club you over the head with gross anatomy. and physiology and they say, okay, just spit this back out on the test. And you do pretty well. And then it's like you go out into the clinicals and then you have a CI that goes, oh, where's the tibialis posterior attached? And you're going to go, well, it's kind of in this area and it kind of does this because it just wasn't meaningful to you when you were first exposed to that. And it was basically like I said, just spit it on the test. Whereas now, through the discussions that we've had and the interactions on IFAST, you and all of the calls and things. And now you start to see, oh, when you do these things in context, it's a totally different representation. You make it more meaningful. And then the retention is just that much easier because now it's like there's an emotional attachment to it. It's like you have a reason for retaining that information. As far as deciding on when to move on, That's always an interesting question because I think that there's definitely two perspectives. So you've got the mentor and the mentee that both influence the relationship and there's points in time where the mentor has a pretty clear perspective that okay this it's time for you to you know leave the nest and move on and go seek something else like they understand it's like I have topped out I've given you everything that I can it's now up to you to evolve this and then there's also the mentees perspective that says I've had my fill And I want to do something else. And so I don't think there's one way ever to do this. And then I think that that's a discussion that you have too, because there's been a lot of bad representations in the history of mentor and mentee relationships where it eventually turns into butting heads at that point I think that that is pretty clear that it's probably time for somebody to move on because you never wanted to degenerate into that kind of a situation that there's no there's no reason for it because the the whole premise of that relationship in the in the in the first place was for both people to get better right and if it turns into a conflict like that that doesn't make sense to me Like the mentors should never be insulted when the mentee moves on. It's like, okay, that's entirely up to you. And then the mentee shouldn't be hurt when the mentor says, it's time for you to go. Because again, there's emotional investment on both sides. So I understand being human and the emotions involved in it. But there should also be the understanding that this is not a forever relationship. This is not a husband and a wife situation. right? When we reach a point where we feel like we're in the land of diminishing returns, then it's probably time for us to seek other information. Because the more filters you have, the better you're going to be. Because again, most people They get stuck in a system and the system fails. Every system fails. And that's the thing you also want to understand. It's like the minute you marry yourself to a system, you have just, you have just capped your, your capabilities and you don't want to do that. You don't ever grow in.

What is that?

So I've been getting so caught up in wide ISAs just because I've worked with athletes. It just so happens we've been talking a lot about wide ISA people, so I've been focusing on that. I was going back through some old stuff and switching my focus to narrow ISAs with Zach talking about his ACL patients. I just wanted to run this by you. My first question is: for your narrow ISAs, the initial presentation is going to be a lower posterior pelvic compartment compressed, correct?

Yeah, sure, absolutely. It's fairly straightforward. So both are defending against an internal force that's trying to turn you. That's the one thing that you have to recognize is that both strategies, they're going to be idiosyncratic, so it's going to be a structurally driven decision. But again, both are defending against the same force. So this is an internally driven force that's trying to knock you off your feet to your left. Again, we don't really have a choice in that regard unless your internal organs are flip-flopped and then it goes the other way. Again, it's just a bias. All right. And so when we were talking about, so I have to have some way to manage something that's trying to push me this way. The way I was describing it is if you're standing in a really strong current in a river and that river is trying to knock you off your feet to your left, what would you do? Well, you would turn into the current.

On the way down.

Yes, so I'm answering that email and asking about the bands. Essentially, how can a band be utilized to create specific adaptations? So in various ways. I'm thinking it can go horizontal, vertical, just on the muscle itself, if you will, like you're curling it or anything along those lines. How does one utilize and manipulate what we're trying to get?

So this was born after I watch your video on the evolution of your own model. And so I know you've spoken about the value of mentorship in the past. So do you think that mentorship could provide interference in the natural evolution of one's model? And do you think that there's more value, or possibly more value, in the struggle of answering your own questions as opposed to maybe a mentor nudging you in one way or the other? And I know you do a really good job of this where you try to facilitate with questions, sometimes frustrating, but it really helps with the learning. Yeah, because normally, you know, normally you ask a question and then your answer is usually with a question, but there's so much value in that.

So what do you want to start with?

Yeah, so okay, I know what an upright bass is, dude.

Let's do it.

So let's distinguish between the two first and foremost because it's very distinct. Okay. Muscle behavior is determined by eccentric versus concentric orientation. So we're looking at a moment in time and we're looking at a relative length of the muscle tissue itself. So this is the part that actually contracts based on the nervous system input. This is what determines range of motion. Yielding and overcoming is connective tissue behavior. This is a viscoelastic tissue that behaves very specifically based especially on the rate of loading. So the faster that I load a viscoelastic tissue, the more resistance it provides, the stiffer it behaves, the slower I load it. And again, we're talking relative speeds here because some things look really, really fast. But from a relative standpoint, the tissues are being actually loaded at a slower rate. So if I were to make a comparison, if I jump off of a box, so I jump off, let's just say I jump off of a 20 inch box and I land, that is actually a slower rate of loading compared to a max effort back squat because the max effort back squat load is instantaneous. It is already there. Whereas as I'm coming down from the box, I have an anticipatory concentric orientation of musculature. And then as I make my initial contact, like where I barely touched my toe. So again, we have to look at this thing in really slow motion. You look at the duration of the exposure to get to the point where the maximum load is applied based on the force production. There's a lot of time in there compared to an instantaneous load with a heavy weight. So that distinguishes the two elements of behavior. Like I said, a lot of people get confused because we talk about a yielding action when we're going into and out of a cut, which looks really, really fast. And it is visually speaking, it is very, very quick. But as far as the rate of loading on the tissues, there is a time span where I'm moving into where I make ground contact so that the tissue has to expand or elongate. It stores energy under those circumstances. And then as I change direction and I reorient, now the tissue can actually release that energy and it behaves more stiffly as I come out of the car. Does that help distinguish between the two? Yes. Okay. Now, so if you have a situation where you have a great deal of concentric orientation, that's where you're going to see the greatest movement and limitations. So goal number one then is to create greater eccentric orientation to allow more motion to occur if that's the goal.

Correct.