That makes perfect sense. That's great. Thank you, Bill. I'll definitely take that stuff into consideration. I think I feel much more comfortable about the direction we're heading in, just making sure that we're doing things the right way.

What would be a really good self-test for them to identify whether they're capturing the internal rotation superimposed on the ER as their body's passing over the foot and the hip would move back into the IR representation into the ground? There's an exercise.

Gotcha.

That is, I suppose it's a myth.

The number of cricket bowlers that I've actually measured are very few. So let's make it two. It's not a big sport here. I relate a lot to baseball pitchers, and it's similar. It's different, but it's more like a javelin throw. It's much more similar to a javelin throw than a baseball pitch, just because I'm far enough in the foot position. And I was a javelin thrower, so I can't speak with reasonable intelligence about that. But I wasn't very smart when I was throwing the javelin, to be honest. I was kind of an idiot. But I understand it a little more. I would say look at your right foot positions first. Do you have video of these guys? Yes, I have. So good. Start there. I would start looking at the video and start looking at the foot contact of the right foot before you start looking at the left foot, because again, if you don't get the right side orientation correct, the chances of you getting the left side orientation are pretty slim.

Because you're coming into it with more momentum, so if you're loading the tissues at a higher rate, there's not gonna be as much movement.

Right.

You have 30 seconds. Do you have something to ask me in 30 seconds?

Yes. No, but you're out. Yeah. Like, your representation in my estimation is absolutely correct. It's like they don't have the normal pronation capabilities and that's why they're not capturing that right foot position. So they have to hop off of it.

If they were of a more flat representation, how would that look in the hip pinch?

Correct. And they gave you a little bit of a clue. So the first athlete was complaining about some left-sided lower back pain. So quite often, if you have a compressive strategy there, so a compressive strategy would be that side pushed forward more. So we have more of the internal rotation represented in the spine. So we have a correlation there. And so now we can say, well, maybe that's why they're complaining about this left side low back pain because they're just turned more to the right by getting pushed forward more on the left side. But this is why you want to take people through activities. And if you're the type of person that does tests on the table in situations where maybe you're working with somebody with pain, this is why you do those measures is because you can't just make a blanket statement based on a visual representation. Yeah, having said that, it doesn't mean that visual representations aren't helpful. It just means that they can't be absolute. Okay, we still had to have confirmation by watching people move and determining what behaviors we're actually observing. Okay. But again, that's why you do this. That's why you have people go through movement, complex movements like squats and toe touches and turns and anything else that you find valuable. You can use any movement as a representation to track over time for change. You just have to understand a little bit more about what you're observing.

So, and like I would do that by engaging the hamstrings and the ICA vector and things like that. How do I get them back?

Have you seen the karate kid yet?

You see what I'm getting at? It's like you just got to push him that way and then he'll start to make his turn and the turn is where the relative motion is. But you first have to get him into a place where he can actually capture relative motion because right now you've got an AP compression and you've got a pretty hard push to the right. It's like just reverse engineer.

That would have these four. Yeah. So my approach is that most people I'm working with don't really have enough range of motion to get into good positions to accelerate or change direction. So I'm getting away from heavier training. But I'm still trying to figure out when I can still use it, like when it's still useful.

Yes, yes.

So I can roll them onto it?

Well, it would be represented by, so depending on what environment that you work in. So people come to see me, they have painful conditions. And so in many cases, what we do is we'll measure ranges of motion and that determines the orientations, then the shape, if you will, of the body. So that's what creates the representations of early versus late. Certain measures will drop off to a more significant degree if somebody is in a late representation of propulsion. For instance, if somebody is late on one side, you will tend to see a reduction in early, what would be termed as hip flexion. So early hip flexion disappears, straight leg raises affected. And then because of the loss of the extra rotation measures, I'll experience a loss of internal rotation measures as well. So the later you are in the propulsive phase, the less you're gonna see in those early phases of measurements.

I just said beer can. So you take a full beer, right? Don't pop the top on it. I know you have to buy canned beer because you're a student, you have no money. But you can stand on a full beer can because you're compressing it, because the fluid inside holds you up. You chug your beer, put it down on the ground, and it crushes like a grape. So there's the difference. What the muscles do is they squeeze, they contain the fluid in a shape that allows you to stack weight on top of it.

Thank you. I really appreciate it.

Yeah. That makes sense.

Okay, so here's what we gotta do. We gotta talk about this for a second because there's something that's unique about the fake throws and I'm gonna give credit to my buddy Lee Taft for the fake throws because I think that he's the guy that's been well-known for that. You have to understand what's happening during a fake throw, okay? Because I know that I'm not going to release the medicine ball as I am moving into the position. So let's just say that I'm doing a fake throw down into the right. I know I'm not gonna let go of that ball, which means that the velocity with which I'm moving into that position is decreasing. So I have a negative acceleration under those circumstances and I'm slowing down, okay? If I'm slowing down, that's going to provide me a way to distribute and dampen the forces that are going into that movement. Does that make sense? I'm slowing down. So I'm increasing the amount of time that all of those tissues are going to be loaded. So I'm creating more of a yielding action than I am creating this stiffness at the turnaround. So I'm dampening that load, right? So I'm not going to get the high impulse response under those circumstances. So I'm dampening as I am moving into that internally rotated position.

Okay. So that's the principle that we want to talk about that. And so what we would say is, is what activities now support that intention? If we're talking about anything in a split stance orientation, that orientation is specifically designed to create relative motions within the axial skeleton at some points in time, and within the relationship between the extremity and the axial skeleton. So let me clarify. When we're in the top position, legs split front to back. I have two points of contact on the floor, which I need to create relative motions within the axial skeleton. So for me to get the interaction between the bones, let me grab my pulse for a sec. So we're talking about getting relative motion within the axial skeleton itself. So I'm using the sacrum relative to the ilia here. That's my representation. To create that type of a turn, I need two points of contact on the ground. Because the minute I pick up one foot, the pelvis tends to solidify into a single segment. There's a limited amount of relative motion there. That's just a normal behavior of how I would distribute force and try to hold my position. If I pick up my foot and I don't want to collapse into the ground, I have to compress things into a single segment. Now I have relative motion between the femur and the pelvis as a unit. So that's the distinguishing characteristic between two points of contact and one point of contact on the floor. So when people classify a split stance activity as a single leg exercise, that is absolutely wrong. In every way. Okay. We can bias back and forth between one leg and the other, which will change elements of how much relative motion we have available to us. But the reality is if I get the two points of contact, it's totally different than being in a single leg stance. As I'm moving through space in that split stance orientation, at the top of the exercise where I'm at my highest level of elevation. Under those circumstances, that's where I'm establishing a position of relative motion in what would be external rotation representations. That establishes the field within which I can move. So the space within which I can move, I now have relative motions available to me within the axial skeleton itself. So the sacrum can turn, the spine can move, the ribs move, etc. as I descend into the split squat and I start to approach a position where I'm superimposing more and more internal rotation, more and more force into the ground, I actually have to reduce the amount of relative motion available because the higher the force output, the less relative motion I can demonstrate. Because what would happen is if I try to produce force, where I have lots of relative motion available to me, I dissipate the force. So I don't really produce a high level force. It gets so distributed that there's no increase in the force output. And this can be risky because if I accidentally load a structure that is trying to distribute force, I may take it to its end constraint. And now I have a situation on my hands that I don't want to have. Because if I can't control it, And we've been going back and forth on email that a lot of people don't know. It's like, you asked me about injury potential. There you go. That's a situation that we really don't want to have, right? I don't want a massive amount of relative motion when the force output is very, very high, unless I have the capacity to distribute that safely and effectively. And that goes, that's a byproduct of exposures, experience and training. Okay. So do I want a situation? Do I want a situation for somebody that I'm trying to improve their capabilities of relative motions and then some measure of force production so they can remain effective in whatever activity that they want? Absolutely. But the rule is not, you have to do split squats or you have to do split stance. The rule is, is I need to create the environment that allows relative motion under certain circumstances and I need to produce force under certain circumstances. The great thing about the split squat is that it gives me an element of both under certain circumstances. I can tweak that split squat in any number of ways, asymmetrical loads. We talk about offset loading on contralateral, ipsilateral sides. We talk about bilateral symmetrical loading. I can put a bar on your back. There's any number of ways that I can tweak this thing to bias me more towards force production or bias me more towards relative motions. So your rule of thumb is not, I need to do split squats. Your rule of thumb is I need to select exercises that fulfill my intent of am I restoring relative motion or am I producing force? Do you see it? Yes. So now it's just a matter of understanding, it's like which exercises fulfill that need. Man, so let me give you another scenario since we're talking about lower body. What if I got somebody that has, they come in with a constraint that limits my exercise selection? So somebody comes in and they say, Andrew, my left knee has been a problem for the last 15 years. I don't want you to aggravate that, but I'm trusting you with my health. And you go, oh, can you do a split squat? And they go, I don't know. It kind of hurts when I go up the stairs. Now going up the stairs is not a split squat. It's not always a double foot contact. So now you're thinking it's like, okay, the single leg thing might be a question mark. We'll see. Okay. Let's see what happens when you do two feet on the ground and you test them and you say, oh, that's either a good thing or it's either a bad thing. Okay. And then you might need, what you might find is a bilateral symmetrical activity is not painful. A split stance activity is painful. And so what that might mean is if I reduce the amount of rotation, that's what happens when I make my stance symmetrical, I'm reducing the amount of rotation available. Okay, I can, I can fulfill my desire of creating some measure of relative motions. Okay. I can also induce from the top down some other way to create a turn. So I don't have to offset my feet like I would in the split squat. I could keep it bilateral and symmetrical, but I can do some turning in some other way shape or form. You understand? It's like cable activities, chopping, lifting, presses, turns, et cetera, et cetera. So I might be able to create my relative motion in that respect. And now I am protecting that person from the activities that were offending for their constraint when they came in the door. So far so good?

So the patient typically comes to you to alleviate the pain. But we can use that to assist us in making some decisions, but it can't be the ultimate decision maker as to what we can influence because pain is the decision that their system is making. So while we have an influence, it can't be the end result. Because again, we don't get to make the final decision on that. The thing that we can do is to restore or offer the greatest adaptability to whatever system that we can impact. And so that's why restoration of relative motions as we would measure them as a therapist is sort of our guide as to what's going on. And so you always have to keep that in mind. As much as we want to help people and to alleviate the reasoning for them to be coming to see us in the first place, it can't be our guide. That's the patient's guide. And so when it comes to our outcome, we have to accomplish everything that we possibly can from our perspective and then whatever happens happens because there's people that you will be able to help and then there's people that you will not be able to help. And then maybe you're not the solution and you have to accept that fact too, which is, you know, you want to be their solution, right? I mean, you want to be the guy that gets to help them, because we want them to feel good, we make ourselves feel good when we do good things. But ultimately, the stuff that we have is the stuff that we can measure and the things that the patient can accomplish in those circumstances, but we don't control the pain. And maybe there's something else wrong that is allowing that symptom to perpetuate that we have no control over. The example I typically use, so let's say you have 12 subsystems in your body. And the treatment that you provide addresses seven of those. So you restore adaptability to seven out of 12 systems. But what if one of the remaining five is the causal system? So you did a great job in making a change. It's something that you could probably measure in regards to an outcome, but it didn't touch the system that's the limiting factor. So therefore, the treatment appears to fail, even though you made a successful change. Maybe it's something that you can't change. But again, sometimes you just have to invest. Always remember that there's a disconnect between what you understand and what you want to see for an outcome and then the patient's understanding. They're not coming in educated in regards to the perspective that you have. All you have to do is instruct a patient on how to execute an exercise and then ask them to send you a video three days later of them doing it without any instruction at all.

You see it? Yeah. So even in something like a max effort bench there, go ahead. Yeah. So that's like, you need the ER field somewhere. So you got it with the grip. Sure. You could, it's part of it. It's part of it because it creates an orientation for me.

Okay. So assuming that you can capture the shoulder range of motion and the hip range of motion that is required, you're gonna slowly want to move into positions that will favorably influence the up pump handle. You want to make sure that you're maintaining that, okay? And so quadruped activities are really, really good for that, okay? Arms supported kind of activities and then working towards the inverted position. Okay, so this is going to be a situation where your behind is higher than your shoulders and you'll be propped through the arms and things like that. The great thing about that is it flip-flops the airflow. The lungs fill from the bottom up when you're standing upright like a glass of water. But if I turn you upside down, guess what? Gravity helps us fill the upper part. And so that's going to be one of those things that will be a staple for you in some of your movement activities. Eventually, what I would say is that when you do start to recapture this stuff consistently, you want to turn this into dynamic activity. So old school gym class stuff is going to be your long-term friend. Okay, bear crawls, things like that. Again, where your hips are a little bit higher than your shoulders, you're loading through the extremities and you're capturing that early propulsive position, the early propulsive position through the shoulder girdle and through the upper thorax. Does that make sense?

Exactly. So, keep in mind that she's probably trying to use her quads as a hip rotator too when her foot's on the ground. So another powerful reason to restore all of that relative motion that you can in the pelvis and in the hip, okay? Because again, it's like if she's trying to not turn or she's trying to turn, it's like what do you think she's doing on the quad tendon? It is perpetually loaded. You have to take the load away.

It's not about being able to measure exactly like someone else. It's about being reliable with yourself. But once I can do that, then I can start to use these measures if need be. Now, let me say this. You don't always have to use your table tests. In fact, if you're working with somebody in the gym, I would say that you might never need to use them once you understand what these tests represent. So if I know that certain tests are associated with expansion or compression in certain areas, I also know how you move through space during an exercise. So if I'm watching somebody doing like some sort of cable chop activity or cable lift or a press or a push or a pull or whatever it might be and I see something that seems a little off as far as that activity goes, I know what area of motion you're trying to access. So again, if I was looking at say you're watching somebody press overhead for whatever reason and you see it like they have to do this big lean to the side, they can't maintain a certain measure of shoulder position. I can actually use my understanding of tests to help me identify what the movement limitation may be that is causing this compensatory strategy that's being demonstrated. So again, this becomes very powerful because again, I don't want to have to do the table test. If I can identify these things, if I can just take you through normal activities, I can watch you squat in the gym, I can watch you do split squats, I can watch you do toe touches, I can watch you do presses, I can watch you do pulls. And from watching you do those things and understanding how the movement relates to these areas of compression and expansion, I can now identify if there's a movement restriction or if you're using a compensatory strategy that maybe I don't want you to use because some of them are very useful. But again, that's the decision that I have to make. Again, the table tests are not a necessity. They are to teach you to understand how we access these positions and movements. Once you understand them, you may not need them at all. Maybe there are confirmations at some point in time where you, because we all get confused. This is very complex. But again, once you get an understanding of where I should see expansion, where I should see compression. So my expansions are typically associated with finding that external rotation space. My internal rotations are more compressive. They're gonna give me a different representation of turning inward versus turning outward under certain circumstances. And so once I see those things, it's like I can watch somebody do a split squat across the gym and I can say, uh-oh, I got a little bit of a movement limitation over there, and I can identify what it most likely is.

Yeah.

Much more useful. Much more useful. Again, for this type of a situation. You have a limited amount of time. Show them their language. You speak their language. And then you move them towards what you want them to be interested in. And then the questions will come, and then the interest will grow, and then you become useful versus just trying to seem really smart.