I am.

All right, man.

And we don't like that. The people have come to the next end with how it kind of simple it is very confusing. The rules are what is simple. It's the recognition that becomes difficult. But if you understand the rules, it's like, how is this rule being applied? Right? That's what you want to recognize. And that teaches you how the constraints behave. And if you understand the constraints, you understand the rules, then you understand how it's applied. And it just wraps. It's just exposures, exposures, exposures.

That will be for emphasizing major propulsion internal rotation. Correct. So another one. fake med ball throws, would they also emphasize the internal rotation mid propulsion?

Yes. And there's so many people like that. Yeah.

All right, so I think it was in one of the previous consultations. I forget the gentleman's name. It was the sternum one where you're talking about string instruments. Oh yeah, yeah, yeah. And one of the things I think you said in that video was like, sometimes like you could be doing all the right things, but like you just need to be doing more of it. So that kind of got me thinking, like I think there's easier scenarios to know that you're on the right track. Like some people just respond really, really quick and I'm a PG. So like, paying those a lot of time what we're going after so like they respond really quick and you kind of know you did something right and like those trickier cases where I guess like again I'm thinking of like the ACL case I've talked to you before like She's had graft site pain for five months by the time I kind of started these types of interventions. So obviously I'm not expecting that to just go away overnight. So I guess kind of like, what are some other things that you can look at, or like, what are you kind of considering to let you know that you're on the right track, besides just the restoration of relative motions? And I guess some of this might just be experience, but.

It's just moving slower relative to the extremity that I can visualize.

No, no, no, that all, that all squares.

Yeah. I mean, she still tests really weak on a dynamometer, but it seems like she does. I've got to get rid of the pain before I can actually know where the quads had.

Both tests measure aspects of external rotation, which is valuable because now I have confirmations of my capabilities. For example, if I have one test measuring in the so-called normal range—which is just an average—and two tests that are limited, chances are that the supposedly normal test is not truly normal. I need all posterior expansion on the backside for full external rotation capabilities. So I have three measures to confirm against. Now I can tell if someone is oriented in a certain position. For instance, if someone has a thorax that is anteriorly oriented but tilts backward when lying down, that could potentially magnify a traditional external rotation measure and shoulder flexion. So my abduction test, external rotation test by traditional measures, and shoulder flexion all help confirm whether I have that posterior expansion capability. If not, it tells me where to target and can reveal if someone has fallen backward on the table, which would magnify shoulder measures. This is why a battery of tests becomes valuable—it provides confirmations. Here's the key point: the hip behaves the same way as the shoulder. Flexion, abduction, and external rotation measures are identical in the pelvis and shoulder, telling me whether the posterior aspect of the pelvis can expand. The cool thing is that, unless there's a structural constraint, the upper thorax and pelvis will behave the same way. So if I have limited external rotation in the hip, I'll have it in the shoulder. Now I have double confirmation—I can use pelvic and shoulder measures against each other to confirm if I'm measuring correctly and, if so, whether my limitations are valid. It takes time to be reliable with yourself, so you must take many measures to be consistent. It's not about matching someone else's measurements but being reliable with your own. Once I can do that, I can use these measures if needed. You don't always have to use table tests. In the gym, you may never need them once you understand what these tests represent. If I know certain tests are associated with expansion or compression in certain areas, and I know how you move during exercise, I can watch someone do a cable chop, lift, press, push, or pull. If I see something off, I know what movement area they're trying to access. For example, if someone pressing overhead has to lean sideways and can't maintain shoulder position, I can use my understanding of tests to identify the movement limitation causing the compensation. This is powerful because I don't want to do table tests. By watching people squat, do split squats, toe touches, presses, or pulls, and understanding how movement relates to compression and expansion, I can identify restrictions or compensatory strategies. Table tests teach you how to access positions and movements; once you understand, you may not need them. They can confirm when things get confusing. Once you know where expansion and compression should occur, you can watch someone do a split squat across the gym and spot limitations, then adjust their movement strategy. For example, if their knee deviates laterally during a split squat, they lack internal rotation. I'd make that their lead leg with a contralateral load to help them turn into the hip and access that internal rotation. Ultimately, I want you to understand these tests so you can coach people during exercises without relying on table tests.

Oh, the extension thing?

Does that make sense? Yes, that makes more sense. So I could use a case study in a way. Correct.

Yeah, it does. Now, the degree to which, based on what their orientation will be. So if I have somebody that shows me 60 plus degrees of hip internal rotation, you got a spine that's turning away from that hip. That's what it's allowing it to do. If I turn the other way and I get 90 degrees of hip external rotation, I got a pelvis and a spine that are turning that are allowing that to happen. So I hope this was helpful for you Cameron. If you have any other questions, please go to askbillhartman at gmail.com. Don't forget to get signed up for iFastU so you can follow along and improve your skills in all aspects of training and rehab. And then I will see you guys. Oh, hey. Real quick, podcast will be loaded up on Sunday morning. So this was a killer week of info and videos, so you'll be able to listen to that on Sunday as well. Otherwise, I will see you next week.

I suppose, yes.

Yeah, yeah, yeah, right?

I mean, it's just the whole concept of ISA and breathing. I think it's been really interesting and I'm exploring it more so that to see if I can expand my toolbox and also how I go about addressing things that I see in the weightlifting hall.

So if I'm measuring somebody on the table, or if I'm performing a squat, I'm actually looking at this more as a quadrupedal type of a gait situation. So I'm going to look at this hip here. So if I was a quadruped and I was walking, as I step forward, my early representation is going to be here and my late representation is going to be here. And so now if I look at this in the later stages of ER in a squat, what I'm actually doing is I'm representing this early propulsive strategy, which means I've got the sacrum moving backwards on the ilium to make that turn. So as I step forward and right as I start to weight that that extremity I'm going to turn like that and so that becomes my early representation just like when I was at the end of the of the heel rocker in the foot I'm going to have that delay right there that creates the delay strategy that allows me to start to slow down that leg side so the other side can then step forward Now the thing that I want you to recognize about this is that it looks like it's in this some imaginary straight plane that doesn't exist. It looks like it's an arc but it's not an arc. It's a series of shape changes in the pelvis that allows us to access spaces around us and to produce the turning that's associated with the shape change. If we start to think of the stuff in arcs like the imaginary sagittal plane and the imaginary frontal planes, it's going to limit our understanding about how the active strategies produce movement or interfere with movement and limit our movement options. So for instance, if I was an Olympic weightlifter and I had this posterior compressive strategy on the back of the pelvis, then I know I'm not going to be able to access this deeper range of external rotation that I would need from my squat. So what's going to happen is that instead of being able to squat here, I'm actually going to have to move the leg outward. And that's not even external rotation. That's actually an internal rotation strategy that's going to allow me to finish that deep squat. If I don't understand the fact that I'm producing shape changes that produce turns into ER and IR, I won't understand how I can apply load to a split squat to emphasize capturing more internal rotation or more external rotation. So to wrap all this up, what I want you to recognize is that when we're talking about about the the extra rotations that are moving through the pelvis via these shape changes in turns this this initial phase of hip movement in ER is actually this late propulsive strategy and then as I get into this this deeper range of ER this is actually going to be represented by my early propulsive strategies.

So as the foot breaks the ground, and this would be our advancing leg if we were walking, we're going to create a bigger delayed strategy. So we're still going to be concerted at yielding on this standing leg. So we're going to be starting in ER. But as we break that 60 degrees or so of hip flexion, we're going to start moving towards IR on both sides. So this leg will be slowly advancing forward towards that really strong middle range of propulsion in the stance leg. And this leg is going to be approaching 90 degrees of deflection, which we also know is going to be IR. So what we should see is the pelvis moving from a slightly ER position to an IR position. So we're going to see some mutation of the sacrum under these circumstances. And we're going to be approaching that IR position. And so if you've ever worked with kids and you have to do A marches or A skips and you'll see all sorts of sort of mobility issues or substitutions and you'll see them turning into or away from their hips or you'll see some side bending, these are the kids that can't really create this IR position of the pelvis where where they have to have a constant or pelvic diaphragm and they can capture this internal rotation, which is the really strong propulsive positions. And so again, this is why this position becomes very, very useful. Because when you start to see these substitutions, you know you've got somebody that cannot capture this internally rotated position. As we take the hip past 90 degrees, we're gonna re-er under both circumstances. So now I'm gonna move this hip towards a later propulsive strategy. And I'm gonna have this hip moving towards an early propulsive strategy. So now I'm gonna create a delay on the lifting side leg. So as I break this 90 degrees and this goes into a deeper hip flexion, now I'm gonna see this moving into a much more erred position on this side. So that's what should happen. So I should see the ER, the IR, and the ER strategy of this normal propulsive phase. But what you're seeing, Mikhail, is you're seeing that very, very early representation of this external rotation on the standing or the support side leg. So you have something that's moving into the later propulsive strategy too soon. And so that's why you're seeing this really, really strong ER position when we know that we should be approaching IR under those circumstances.

Standing in the same spot and breathing involves counter-nutation and nutation of the sacrum simultaneous and synchronized with the movement of the sternum to maintain a fixed spatial relationship. The movements of the sacrum are not independent; they adapt to maintain this fixed relationship. In the perfect human being standing and breathing, we have an expansion during inhalation and compression during exhalation. As we breathe in, we get counter-nutation of the sacrum, and the axial skeleton expands. When discussing synchronization, it's better to consider analogous structures. For sacral movement into counter-nutation, we should discuss the dorsal rostral area expanding as they behave analogously. During exhalation, we get nutation of the sacrum and compression of the dorsal rostral area. The sternum still moves through its pump handle action, synchronized with the expansion and compression. Therefore, in the perfect human being, we would have synchronized movement of the sternum and sacrum. However, focusing on analogous structures is more effective for modeling movement and determining why certain presentations or strategies influence movement. Regarding pelvic diaphragm descent during inhalation, in a perfect human being, the descent of the thoracic diaphragm is simultaneous with the descent of the pelvic diaphragm to maintain a fixed spatial relationship given the fixed volume of incompressible fluid in the gut. Compensatory strategies could influence this, but we're discussing the perfect human being. If held upside down in an all-fours position with the pelvic outlet at the same level as when standing during inhalation, the body would adapt to changes in gut pressure. This is why different body positions and orientations are used to influence motor output strategies and reacquire range of motion. Altering body position can change the shape of the axial skeleton and reduce the demands on motor output and compensatory strategies that interfere with movement. For example, prone inversion uses a wide stance and supine inversion uses a narrow stance due to the shape of the descending thoracic diaphragm and resultant pelvic outlet shape. Lying on one's side increases anterior-posterior expansion capability, so in a gym setting, narrow individuals might use prone plank and wide individuals might use side plank to achieve better shape change and restore movement. Everyone eventually uses compensatory strategies, especially at high levels of performance where force or speed requires reducing relative motion between segments and using superficial musculature. The question is whether one wants to carry these strategies into lower-intensity contexts, which can lead to movement-related problems or pain.

Okay. And so what are the consequences of pressure buildup in one spot?

Yeah, I think it's gotten us to really tighten up our progressions and really kind of have it dialed in where it's like, okay, we're moving through our steps. And if we can not be so fast to try to rush, as coming from a strength approach, to rush under the bar. And how much can we glean? How much can we get out of them before we need to add that extra stressor?

Okay. So basically there's multiple ways that an intervention might be successful and there's multiple interventions that would also be successful. I think it's another way to look at it.

No, I mean, we're a customer service business. So she was happy when she left. She's going to be happy that we're coordinating the care with her personal trainer. So I think it's a win-win. We got her what she needed. She feels like she has a team around her and she has some light at the end of the tunnel. When a cortisone shot didn't work, PT didn't work, acupuncture was kind of giving a little bit of relief. She was trying to have another kid but was hesitant to do so because of the disc herniation. So now, I think we've been impactful in her life on several different levels, which has been really good.

Yeah, it kind of was something that just happened to come up because one of the gentlemen that was training here at the time, John Bush, who is a very high quality goalkeeper for 20 plus years, came to us and said, 'hey, I'm getting ready to start working out of this facility. I think you should meet this guy.' So I met Chris McGrath who's the owner at Sojility and he said, 'look, we were kind of looking to maybe bring in a franchise or something like that, but you guys are so plugged into the soccer community already here. We would love to have you come in and do more of this.' So it was really fun because I think in a lot of what we do in verticals. So, you know, you got to be really good at one vertical. I feel like we're pretty proven in the soccer community between working with the Indy 11 and all the MLS people, whether it's Chad Marshall, Danny O'Rourke, Eric Zavalletta, we're a proven product there and we've got a system that works. So to go in there and then be able to take that system and apply it to kids as young as nine and 10 and give them a movement base, that's something that I just felt like we had to jump on.

And you also have a hit that doesn't feel anything right now. And so we don't get the normal signals. So we have to rely on this level of maturity and rationality to monitor those things that we can appreciate. So to wrap this concept up then, here's what I would suggest is you and I, and we can do this again if we need to come up with a strategy and say, let's use these three things as your KPIs to monitor over time. You implement whatever it is that you feel comfortable implementing from an exercise standpoint. If you need somebody to help you, you got Kevin to kind of help monitor things if you need that. He's very, very trustworthy and a great human. So whatever it is, but I think that the harder you want to push yourself, the more you need to be better at monitoring. You cannot let it slide because the minute you do that, it'll sneak up on you. And now we're going to have the conversation of, okay, what doc do I need to see this time? And that's the conversation I don't want to have with you.

Right. I remember the one idea that was very prevalent when you do the punch. He was talking a lot about releasing, releasing, like you have to be very, very soft in the face and the arm in order to make the burst in order to make the.

Yeah. I mean, the long-term consequences are not worth the pain, better pain, better, pain better. Especially at this point in the season. And then you're going to get, she's going to develop a sensitivity, which is what you don't want. Because you could resolve a mechanical problem. Let's just say you restore perfect mechanics, but you created a sensitivity. So now every time she accesses a certain space, she'll get pain even though there's no reason for her to have pain. And now she's going to be the kid with the bad back. She'll brand herself, 'oh, I have a bad back.' It's not bad, just a little misguided.

I wanted to ask when someone's trying to lift a weight, they're using some degree of like traditionally it'll be called like the Valsalva maneuver. I'm with you. Breath holding. Yep. Under those circumstances, they're essentially just, they're using the air like almost like another form of connective tissue behavior. It's just something that won't yield so that they can stay organized or... Well, okay, so it depends on what you want to stack weight on. Do you want to stack weight on a mushy bag of water or do you want to stack weight on a pillar of stiffness, right? That's essentially what you're doing. So here's what I would suggest you do. Sometime today you get on Google Scholar or PubMed or whatever your favorite research-based search engine would be, and you want to look at the difference between the respiratory and postural behavior of the diaphragm. And it will answer many of your questions that you have running through your head right now.

Yes.

Yeah.