So in this situation, as you hold it, basically you hit that position, catch the weight, and you start to yield. Then over the time that you hold it, the water is seeping out of the tendon for that period of time, a little bit more as you go through like 10 seconds.

Yes.

I appreciate that. And yeah, that's kind of what the end of my, I guess the end of my email question said was, you know, like, I kind of had the feeling that this is the direction that I needed to go. And like you use the bear crawl example, we do bear crawl examples. And I'm like, 'Hey, don't like shoot your head towards the floor. Like, try to get something there.' But like, it's, I also look at it and think like, you know, very basic, like breathing posterior expansion for the ribs or like, doing like a respiratory squat. Like those are really hard things to teach with like 10 middle schoolers in one room.

Absolutely. You got it. So we got a squat. We got a step. We got a step up. We got a lunge. We got a chop. We got a roll. We're killing this program. Yeah.

Yeah.

Well, okay, so you're a big bag of water. Let's just make it really, really simple. You're a big bag of water. If you've ever, for instance, we have these as tools in the gym now where we have the big water bags and stuff. All you have to do is swing one of those big water bags around. That's happening inside of you all the time. The force that is produced has to be accounted for because number one, it allows you to do amazing things like walk on two legs, throw a baseball 95 miles an hour, jump really, really high. Those internal dynamics contribute to our ability to perform. They are also detrimental to performance. If we can understand a little more about how those internal forces interact with our ability to manage them in an environment based on gravity, space, and the external forces we have to manage, if we can understand that we have stuff going on the inside and stuff going on the outside, it provides a better representation of reality. We can't see it, but we can get close to it, and it allows us to make better decisions in regards to our interaction. It gets us away from things that appear to be entirely superficial. When you see somebody, like a volleyball player doing a box jump—they jump off a box and land—there's a certain way they land. Some people will say, 'Oh, she has weak this.' When we see something happen, like somebody's knees moving down and inward as they land from a jump, they say, 'Oh, she has a weak something.' Actually, when you hit the ground like that, your guts come second. Your body falls first, your guts follow, because they float. When you hit, there's another hit coming. If you don't manage that, you have to be able to capture that force as well. People use these strong versus weak representations. If we can understand that we have management of internal forces that are beneficial or detrimental depending on our perspective and what we're observing in context, if we can learn how to manage those more effectively, our decision-making process becomes much more accurate and much more useful.

Right. Yeah, this is just one of those things where there's 15 athletes all working out at once. And I can't sit and coach just this moment. So I'm thinking, all right, what would be best on the overall? But yeah, I'll work with them.

Is that useful to create that type of a physical structure?

I don't know how it would correlate to the pain, but it will go down if they don't have the ability to produce force, so I/R will be lost.

Yeah, kind of. When you get the asymmetrical ones, where you get like crazy deflection on one side and very limited on the other side, and you also see this with your ER measures, ER measures, it'll help you distinguish that representation as well because the magnification of external rotation is definitely going to be the spinal rotation toward you, like you get like a 25, 30 degree ER on one side and you get 60, 65 ER on the other side. You ever have one of those people? Yeah. So that's a spine that's turning. And when you think about weight distribution of the measurements themselves, so the straight leg raise displaces weight away from the center of gravity on the table. When you bend somebody's hip, you're shifting mass over top of the pelvis, which will allow it to turn, whereas in the straight leg raise it may not turn at all because the distribution of load is different. You see the dip? See what I'm getting at? Yeah. So again, the outlier, that's why I talk about coffee cups on the chessboard. It's like, sometimes you get that one measure that's like, And but thankfully you get that one measure, because that that gives you the key to the whole thing because you know you see people that would like measure crazy symmetrical but limited, except for one thing. Right. And there's there's there's two reasons for that you have a constraint that gave way. which would not be fun. And you would know pretty much that it would be really uncomfortable when you do the measurement. Or you have somebody that like I said, they're moving as units or they're orienting to create the magnification of the range of motion.

What did you take away? Like what can they no longer do? That would be a normal, natural representation of stepping forward. No, so you're going to drive them towards middle at a faster rate by putting a lateral wedge in the shoe. Where do you initially contact the ground when you step forward towards early propulsion?

So again, I get this compressive strategy right at 90 degrees. So here's the solution. Number one, we want to eliminate interference. So we're going to avoid bilateral symmetrical exercises. So most of this stuff with a barbell in your hands is probably a bad idea. Anything that's considered a lat development exercise is probably a bad idea with an exception that I'm going to talk about in a minute. So that takes chin ups and stuff like that off the table. Next step, restore the dynamic ISA. I have an ISA that can move, so I know that I can recapture breathing excursion. We're going to keep the activities in below, rather, 90 degrees of shoulder elevation. Because what we're going to try to do is we're going to try to capture that posterior lower expansion, but I don't want to provoke any symptoms in the process. And so again, everything's going to be below that shoulder level. The exception might be that we can use a variation of a deep squat pull down. This might not be the first exercise of choice, but it might be something that we can go to because there's a turn that's associated with this. So once we drive something with a reach below shoulder level, or a supported activity below shoulder level, we may be able to access a higher level of flexion without any symptoms whatsoever, and especially in this deep squat where we're gonna get some of that posterior lower expansion in that position, and then we can superimpose a turn. So we're actually gonna use the compensatory strategy that Mihail was talking about to our advantage when we create that turn and we create a reciprocal expansion as we move one arm through the pull down at a time and that's going to give us the expansion that we want so there you go so there's your solution this is for the Hawkins Kennedy positive test okay so let's go to the near impingement test so this is compression that occurs at about 120 degrees of elevation or higher okay so a positive nearest test so this is an upper dorsal rostral compressive problem so we're talking about the spine of the scapula upward now to get compression there that means we've also got a pump handle that's probably going to get compressed down So, let's move to our solutions. Number one, we want to eliminate interference. Heavy trapezius exercises will probably be off the table. We're probably going to have to lay off pressing, reaching and pulling at 120 degrees or above because that's where our provocation is going to be. So this also takes bilateral ITs and Ys and PNF D2 flexions off the table as well as horizontal pressing. Now, we need a dynamic ISA like always, but here's the kicker. I need to be able to capture an exhaled ISA.

You don't. But again, this is the iterative process of preparation. You don't know what the answer is going to be. You don't know what their capabilities are until you are exposing them over time and it helps. I think probably one of the advantages of [And Jen] can probably speak to this better than I can. But one of the advantages that we have when we have professionals come in is they have a profile of what their capabilities are. And we've got enough exposures that we kind of know where they need to be to play. And so then we can compare where they are to where they need to be based on their previous performances, right? They have enough data. Whereas we have somebody that comes in blind and says, 'Hey, I got eight weeks to train for an event.' And we go, 'Okay, well, what have you done before?' And they go, 'Well, I did this, this, and this,' and that's kind of very gray, right? And so we train them and we do the best that we can. We're making some estimates, we're making some educated guesses as to, 'Okay, I think you need to be at this level to perform to this capacity.' And then you train them and you see.

Would that provide you an element of solution for the shift that you're seeing? I guess that counter the representation that you're seeing.

Yes, and it also brings up another question, which potentially opens a little light on the difficulty in understanding it from the standpoint of movement, vis-a-vis lunges or whatever. Because I don't know why, but I wasn't looking at what you just said about that. If you're in a split stance position and the front knee is moving forward, the back knee is moving forward too, but sort of forward and down. It wouldn't be that way in gait. It wouldn't happen in gait.

Somebody has to have a show today.

So it's an absolute orientation and not a relative motion.

Okay, so is there a limit to the number of questions that one can ask through emails?

extending the elbow through that medial side. That's why the bone is more protruding. So I was wondering if it was just the opposite in the other case.

Does that help you, sir?

They can't lay like this, but they can lay like that.

Okay. So there's that moment of IR that you have to create during the split-squat to push back up, right?

Huge.

That's good. So you're affecting a change and I think one of the key elements here, not to cut you off, but the elements that you stated at the very beginning was that you've been managing it. And I think that's important to understand that that's what this is going to be.

No, sir.

Yep. And then if you're manipulating the foot position, so let's just say you want to emphasize early yielding, you have heel elevated. Yes, sir. In that position. And then you're doing it slowly and you're trying to affect the whole body, but you're trying to affect the hip. So would you have kind of like a force coming from the ground and from the ball and meeting in the middle.

Yeah.

Yeah. It's hard. I get to sit here in my little corner of the house and tell you how this is how it should be. And it's never going to be this straight line kind of thing. It's always going to be up and down. There's going to be emotions involved. And there's all sorts of interference, all sorts. And sometimes we're the cause of it. But from a principle-based approach, start to establish that process, make your patient or your client aware that this is a process, right? Change the rules, so they realize that the goal is ultimately the resolution of their problem and restoring their ability to do whatever they wanna do, but you gotta do this first. And then help them to be successful doing that. Yeah. Anything else I can do for you? We've got a couple of minutes if you got them.

Okay. We got four minutes. You got something else?

So this new client presents differently from anybody else I've seen so far. She's about 55 years old, athletic overall, and had been doing CrossFit until COVID. During COVID, she was really worried about it, especially since her husband has a condition that makes him more sensitive. Her stress level increased significantly during that time, which I think is related to what she went through. About three weeks ago, she reached out to me and said she had terrible pain up into her chest that wasn't deep—she wasn't worried it was a heart or gastrointestinal problem. It felt superficial but really intense. She was in physical therapy, and one of the therapists gave her a move that resembles CPR, which she said was excruciating—one of the worst pains she'd ever experienced. After that, she's been seen by a different physical therapist complaining of neck tightness and upper chest tightness. When I saw her, I could visually see how high her sternum is.