Yeah, so what do you play? What kind of music?

Right, so if there is a constant downward force, such as what occurs when we talk about people with narrow intercostal spaces and limited breathing excursion, they're going to have an eccentrically oriented anterior pelvic outlet, which pushes pressure down and forward. So it is a perpetual load, meaning the rate of loading is instantaneous. Under those circumstances, the connected tissues will behave in a stiffer manner. That's just the normal viscoelastic behaviors.

Correct. If they can access that.

Okay, so let's be really clear about what we're describing when we're talking about the early and late representations of propulsion. Because people get distracted by extremities. So people will say, well, you have a contralateral gait pattern. Well, if you look at the arms and the legs, you're correct. But if we look at the axial skeleton, everything turns in the same direction. And so if we're just going to look at the pelvis, we'll look at the position of the sacrum. If I am in a position of early propulsion, that's a counter-nutated, externally rotated position, but it's the sacrum moving backwards on the ilium. This is the yielding action that I always talk about. This is the expansive strategy that's associated with the expansion of connective tissues as you make contact with the ground. So you have to have contact with the ground to be really, really good at this yielding action. So let's just say left foot forward on a split squat. Imagine I was stepping into a lunge, if I was stepping into a lunge where my foot has not touched the ground yet, I can push this forward, the ilium will push forward and it turns the sacrum away from the front foot. That's a late propulsive representation because the sacrum's turning away from the leg that I'm stepping with. As the foot touches the ground and I come down and I put that foot into an early propulsive position where the first metatarsal head starts to hit the ground, now this turns the other way. And this is the yielding action that we're talking about. So in a squat, there doesn't have to be the rotation associated with it that a split stance would. That's why it appears to be different, but we're still talking about the position of the sacrum. So as I initiate a squat, and people will say, well, it's early hip flexion, it must be early propulsion. It's like, no, because the sacral position is what determines what phase of propulsion that we're in. So as I initiate the squat, I am externally rotated, but I got both iliums pushing forward into external rotation in that position at the initiation of the squat. So it's still counter-nutation relative to the position of the ilium. It's still externally rotated relative to the position of the ilium, but it's overcoming in that position as I initiate the squat. When I get below the sticking point and I start to re-nutate or nutate, that's the sacrum moving backwards on the ilium, and that's why that would be the early propulsive strategy. So at the bottom of the squat, I need the yield. As I initiate the squat, I'm in the overcoming action of the connective tissues. The relative position of the sacrum and the ilium are the same, but the connective tissue behaviors are different. So that's the difference between early and late propulsion.

So now I've just limited your scope, right? Because if you try to talk about more than five things in an hour, you've lost everyone. So each of those five things get nine minutes. Each of those five things is structured as follows. I'm going to make a point. I'm going to give you a series of examples. And then I'm going to make a point. And then you get one minute to transition between those five things.

So I'm very consistent with how I execute and have probably improved in the last 10 years, even more so because I paid a lot closer attention to how I do certain things. And we can talk about that at a later date, but there's like a shoulder flexion video on YouTube that might be of use to you in regards to how we have to control some of the things that we actually can control as we measure. But in general, let's just respect the fact that there's stuff going on underneath our measures. Now, when we see something that appears to be magnified, so when we talked about the hip extra rotation video, a lot of that stuff gets blamed on laxity. Like people say, oh, you have overstretched ligaments, et cetera, and this is why we see these crazy measures. Well, that's just the failure of the structural reductionist model, not respecting the fact that there is shape change in the axial skeleton. There's reorientation of the sockets and that promotes changes in the way that the measurements arise. So we have multiple influences. We've got a position, we've got connective tissue orientations, we've got muscle orientations that all influence these outcomes and this crazy internal rotation measure is one of those as well. And so what you'll end up seeing, so if we looked at the average measure, remember we don't talk about norms, we talk about averages, we look at an average measure of hip interrotation depending on what textbook you look at, it's going to be somewhere around 40 degrees. But then you've got that patient that walks in and you throw them on the table and you're measuring and they go, oh my gosh, they have 60 degrees of hip interrotation and you go, oh my goodness, that hip capsule is lax and it's usually not. So, let's talk about what the orientation is that we're typically seeing under these circumstances and then we can kind of, as you asked for, we will unpack this to a degree. If I'm looking at the orientation of the acetabulum and if I look at the ligament structure of the hip has this cool little spiral kind of an orientation to it. And so the orientation in itself is if I try to turn this thing into internal rotation, it creates a constraint because it's already twisted in that direction to a certain degree. So this is one of the dirty little secrets about lower extremities. is they're already twisted into internal rotation. That's why the dorsum of your foot is on top when it should be on the bottom. And so this is the twist. So if I try to twist this farther, I hit the constraint. But if I look at orientation of this enominant, I can actually put this in a position where I actually untwist the orientation of the hip. And all I have to do is move it up and over top of that femur. So this is going to be an anterior orientation. So I will have traditional extension of the lumbar spine on the side where you get the magnified measure. And so that's going to take this pelvis forward and over top of the femur. And if I take it far enough, I'm going to start to pick up internal rotation because essentially what I'm doing is I'm untwisting the capsule and then I take my measurement and then that picks up all that laxity. It's not laxity. It's just slack in the capsule created by position. I take that up and then I hit the constraint somewhere about 60 because I'm using a dead guy zero position. So a nice representation that I can use is sort of this ringing out the towel concept. So if I look at the twisted towel as if this was the ligamentous structure of the hip, when I'm moving my intro rotation, it's already twisted. And so there's my constraint to intro rotation. But if I reorient the pelvis where it's over top of the femur, and I actually start to untwist the towel first, then I have all of this slack that I can take up in the hip capsule which is going to give me my magnified internal rotation. So remember that I have other internal rotation measures to compare against to make sure that I am dealing with this orientation problem. So for instance, if I lack hip traditional hip extension or ADduction. So traditional hip extension and adduction are internal rotation measures. So if I have a deficit in either one of those, then I know that my magnified internal rotation measure is most likely associated with this orientation. I also have my iterations to compare against as well. 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 extra rotation associated with the anterior orientation. So your expectation is that the same side shoulder would have a loss of extra rotation, but that rarely shows up in this circumstance. Because of the extreme orientation, because of the traditional extension and intra-rotation of 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 extra rotation measures in traditional extra 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.

So we are going to have an internal rotation bias throughout this entire thing. This is just like a press. This is just like a bench press. It's just like a squat. We have a compressive strategy from start to finish, but we still need external rotation to allow us to access ranges of motion, and therefore that's what we superimpose our internal rotation upon. So when we're doing our pull, this is going to require that we maintain some measure of posterior expansion. If you lack the ability to expand the dorsal rostro area and therefore access some measure of external rotation, that means we have shrunk the ER field, and now we're going to need to figure out a way to superimpose this internal rotation. So what we end up doing is we'll typically throw a compensatory strategy on top of that, so what you'll see is scapular retraction, which turns the glenoid outward into ER, or you're going to see traditional spinal extension under these circumstances because that is the substitution for internal rotation at the shoulder when I don't have access to it at the shoulder.

Mike Robertson and I recently posted the first part of a tutorial on superimpressing, so it just seemed like bench press is very prominent in my mind right now, so we're going to go with it today and we're going to attack two questions specifically about this. So the first one comes from Norman. And Norman says, in my past coaching experience, I've accidentally come across a strategy for helping power lifters lock out better for those who stalled the lock out. The strategy was to cue a forceful exhalation. Is this because the exhalation aspires towards extension and internal rotation, according to your model? And does that cue in the bench press allow you to capture that extension and internal rotation? Can you please expand on this thought? So I think you're on point here, Norman. First things first, let me point you towards, there's a couple videos on YouTube that you'll find in regards to lockout strategies that may also be of interest to you. So please go there. One of the things we want to recognize about lifting heavy things in all situations is that we are looking at an exhalation bias. So when we look at capturing range of motion, we're going to use inhalation, expansion, eccentric orientation, all those concepts are geared towards us acquiring positions. But when it comes to force production, it is exhalation, compression, concentric orientation. And again, this is where all the force production lies. And we need both, obviously, to execute any exercise. So we have some form of excursion of the joints that we have to move through to execute a bench press, but we want to minimize the eccentric orientation because eccentrically oriented muscle doesn't have tension on it. It doesn't produce force. And so, again, when we're looking at these strategies across the board, when we're talking straight training, we want to maximize concentric orientation, exhalation, compression. So if we consider the setup of the bench press, everything is designed for maximizing compression. So we talked about the arch position. So that's a posterior compressive strategy that we're using to minimize any form of expansion. We've got a scapular position that is compressing two bones against the back of the thorax so it cannot expand. The bench in and of itself, the pressure under the bench, enhances all of those things. We want to think about neck position. So in this circumstance, you're going to see an orientation of the cranium on top of the neck, such that it pulls the hyoid bone up. So the hyoid bone goes up, it compresses the airway, and so we minimize our ability to expand, and it also helps us to perform the Valsalva maneuver, which is an exhalation strategy. So Valsalva is an exhalation against a closed glottis, so that is another attempt to raise pressure internally. And so again, we do all these things to minimize eccentric orientation so our force production goes up. So you are 100% correct, Norman, that everything that we're doing under this circumstance is an exhalation bias. And by cueing the strong exhalation, at lockout, you're going to enhance their ability to lock it out. Now, here's what I would caution you against. If you release too much pressure, if you release the pressure too soon through an exhalation, they're going to fail the lift. So there's an element of timing that's going to be associated with this. And so in most cases, what you're going to see is you're going to see people maintain their breath hold throughout, or you're going to hear like the smallest little grunt or groan as they are locking this out because we want to minimize, we want to minimize that release. We tend to let the air out under these circumstances so we can actually capture the position. So again, we need external rotation. We need some eccentric orientation to achieve positions, but we want to minimize that. So, Norman, thank you for that question. I hope that answers it for you. Now second question comes from Anthony. And Anthony says, I'm noticing a lot of stronger lifters are lifting their heads off the bench in a bench press. Why is this happening? So, Anthony, I got a video recommendation for you. Go to, I believe it's June of last year. We're answering a question for Vikram in regards to neck position during the bench press. And so what you're going to see is you're going to see a cervical flexion orientation in many cases. And again, part of this is this anterior compressive strategy in the neck to help reduce the airway size to create compression, force production, enhance the Valsalva and the exhalation bias. But we have situations now where we have people that are getting very, very strong and so they are really maxing out their ability to constantly orient to IR and exhale. Well, these are force production positions and they also stop ranges of motion from occurring. And so what we need now is the minimal amount of extra orientation, eccentric orientation to acquire position. So in many cases, so these are going to be your stronger individuals. They're going to be more hypertrophied. They might be using some assistive equipment, like a bench press shirt, to even maximize the compressive strategy even farther. But they still have to touch the bar to their chest. And so what you're going to see is actually is cervical flexion substitution that's going to allow enough movement for that bar to get to their chest so they can truly complete the bench press. So if we look at a cervical flexion range of motion substitution. So what I have here is an individual who is compressed into your posterior in the upper thorax. And so you can see as he bends his head forward, you can see the prominence of the lower cervical spine moving towards flexion. And so what this is is this is an external rotation substitution. So this allows just enough external rotation to occur through the shoulder girdle to allow them to make the contact with their chest with the bar so they can truly complete the bench press. You're also going to see this, just a little FYI, you're also going to see this occur most likely in the lumbar spine under the circumstances of somebody trying to gain depth in a squat. And so they go hand in hand. So whenever you see this cervical substitution, you're probably going to see the lumbar substitution as well. So guys, Appreciate your questions. I hope they lead you in a good direction. If you have other questions, go to askbillhartman at gmail.com, askbillhartman at gmail.com.

So we might need to do some proximal tibial internal rotation mobilization to try to recapture a better knee position. This makes one of your key performance indicators knee flexion. What we really want in knee flexion is heel to butt. We're not going to be satisfied with the traditional 135 degrees of what would be considered the norm. Heel to butt flexion is going to be your ideal situation. That'd be a supine measure, by the way. You'd measure that in supine. So again, you might need some help in regards to recapturing some of these initial positions because we have to have enough internal rotation in the system to even execute our exercises to create this posterior orientation. So consider that.

And so that would be representative of internal rotation superimposed on a little bit of hip flexion at 90 degrees in the hip. And so there's our commonality. But what we've got as far as findings are concerned is this is going to be a situation where we've got posterior lower compression. So we're going to lose early hip flexion because hip external rotation under these circumstances would be in this early stage of hip flexion. The problem is we got to think about this in 4D. Remember, it's not an arc. So if I'm coming up this way, that would normally be external rotation. The problem is under these circumstances with the posterior lower compression, external rotation is way up there. And so external rotation goes this way, not straight up in front. If I go straight up in front, I'm moving into internal rotation, which means I'm going to max out my internal rotation too soon. And then under those circumstances, I keep driving harder and harder into that orientation, and I bang into it right at 90 degrees. And so there's my compressive strategy. So what we have here is an outlet, a pelvic outlet that wants to remain narrow, wants to remain eccentrically oriented. As far as interference goes, we want to eliminate all this bilateral hip extension kind of stuff because again ER is way out there; we want to restore it here in the middle. So this means that those of you who are just fond of your hip thrust because you want glute development, let's get off of that train right now. No low cable pull-throughs and then your reverse hypers are also going to be off the table under those circumstances. So from an exercise standpoint we want to reorient the pelvis. And we're gonna stick with unilateral activities. And so you know how I love my cross-connects. And so we're gonna use a cross-connect, but I want you to pay attention to something very, very important here. And this is gonna be your foot contacts. And so if we're doing a supine cross-connect, we wanna make sure that we're capturing the foot position on the wall. This is first met head on the ground. So to speak, the ground is now the wall. And we got that medial heel contact. We wanna maintain that throughout, because this is where we're starting to initiate internal rotation from an externally rotated position. And this is what we have to recapture when we're talking about reorienting the pelvis. And then we want to move to something that's a little bit more hip flexion. So we can move into a hook lying situation. We still want to induce some internal rotation. So we're going to put something between your knees to hang on to that internal rotation, but from a position of external rotation first.

And so under those circumstances, what you're going to have is a bias towards an eccentric pelvic outlet, which is going to bias you towards external rotation and an inhaled position. And so oftentimes when people are lowering themselves into a split squat or any squat for that matter, they have to be able to capture enough internal rotation or enough exhalation bias and concentric orientation of that pelvic outlet to create enough internal pressure to distribute load evenly throughout the body. So what this looks like on the pelvis is that if we're biasing you towards an inhaled position, so there's your narrow IPA there, we have an eccentrically oriented pelvic outlet, so we have a lot of expansion in this downward direction. That's why you're such a good squatter and a toe toucher. But as you're passing through this middle range in the split squat, what we have to have is we have to have this exhaled position of the pelvis which widens that IPA, nutates the sacrum, and that's what allows that concentric pelvic diaphragm to push upward. So if we get that push upward internally, it makes life a whole lot simpler, because now we don't have to rely on extremity force to try to produce all the force to lower us down and then press us back up. So what happens is, if you have to rely on that extremity force, that's where you're getting that extra load on your knees that you don't like. And the nice thing is it shows up only in your split squat, so chances are, structurally the knee is intact. So we're making the assumption that that's the situation, but if your symptoms persist, go ahead and get it checked just to rule out any structural issues. Okay, so what we want to do then is we want to reconstruct your ability to produce the exhalation strategy and capture the internal rotation position as you're passing through the bottom of the split squat. So here's what we're going to do. First, number one, we want to try to eliminate any interference that you might have. So again, we don't have a lot of information to go on, so we're going to kind of make this kind of a broad scope recommendation. Number one, you want to try to reduce any compressive strategies that you may have. And so this is anterior-posterior in the pelvis, anterior-posterior in the thorax. What we want to try to do here, Vicki, is we want to capture the yielding capabilities on the posterior aspect of the thorax and the pelvis as you move from external rotation to the internal rotation position, and then also maintain enough anterior expansion so we can actually capture that true internal rotated position at the bottom of the split squat. So what we're going to do is we're probably going to look at some gravity-reduced situations here.

Most of the instabilities that we see from an ankle perspective, we're just going to use that as our example, tends to be subjective where they say, hey, it feels like it's going to give way in this position. Very rarely are we capable even separating out proprioceptive or somatosensory elements from the motor output. It is the same system. We're not going to really separate those. But clinically speaking, we're not going to be able to follow some of the guidelines that you'll see in some of the research where they actually use apparatus to determine whether we have an input problem or an output problem. It's going to be both under all circumstances. If you need a test of any kind, if you work in those clinical situations where you need a test, the Star Excursion Balance Test has some research behind it and has a little bit of crossover between some of the appropriate sub-development and the motor output element. If they are actually capable of separating those, there's some hop tests that might be useful as tests and retests again if you have to use those kind of things. Again, those are your comparisons. Now, let's talk about what we're dealing with, though, under these unstable ankle situations. Under most circumstances, we're actually dealing with an early propulsive representation of a foot. The way we know this is if you look at some of the research and they talk about the anticipatory position so that if somebody jumped off of a box and they demonstrate this anticipatory representation where the foot is actually landing or positioned towards an inverted position. So this would be our ER representation of the foot. And again, because we're going to be toes down, it's going to be our early representation. So we're actually looking at here is a foot that kind of looks like that. So I have the ER tibia. I have a foot that's biased towards ER or supination. Also in these same research studies, you're going to see a reduction in the amount of knee flexion on landing, and you'll see a loss of hip ER under many of these circumstances. And so what we're actually looking at is we have a foot that cannot internally rotate. So we're sort of stuck at the end of heel rocker. We want to have an ankle rocker under normal circumstances, but we have a foot that can't really do that. We still have to get force into the ground. So if the tibia is biased towards ER, that's going to keep me extended, but I need my internal rotation. So where am I going to get my internal rotation from? So then we have to grab our pelvis and we have to say, okay, well, I can't do it through the ankle. I can't do it through the knee. So what am I going to do?

So rather than repeating myself, here's what I want to do. I want to go ahead and cut to that video here. Let me preface this by making sure that you have a little bit of an understanding. Watch the videos that are associated with concentric and eccentric orientation, overcoming and yielding actions first. So watch those videos first because what you need to have, you need to have an understanding of those concepts. Then you go to this video and then it sort of all clicks and kind of makes sense. So please watch those videos first. So we're going to cut to a breakdown of lead task plio step from the inside. We're going to talk about the internal mechanics that everybody has questions about. So we'll go to that. After that, you're on your own for the rest of the day, so have a great day. I will see you guys tomorrow. So I have a question from Justin. And Justin asks, I've been thinking about the mechanics of base-stealing in baseball and trying to use your rethinking agility video as a reference for understanding. But I was wondering if you could clarify the pelvic floor mechanics if you're starting from a lateral stance without a cut or change of direction preceding the acceleration. So this is a really good question because I think there's probably a little bit of a misunderstanding as to how this movement is initiated, especially in regard to base stealing. It's also going to reinforce an element of strategy that my buddy Lee Taft promotes called the plyo step. So if we think about the element of base stealing from what we would consider a more lateralized stance, if I'm going to be running this way towards second base, I have to initiate a strategy on the left leg to allow me to push to the right. I'm starting with my foot on the ground so right away I am in a propulsive strategy but what I'm actually going to do is I have to create an internal force so I literally have to get my guts to move in this direction first and then push them as quickly as possible to the right. So what I actually do is I unweight this left foot and what that does is it causes the left anterior outlet to essentially orient and create a yielding strategy which makes my guts fall down and to the left. As I then pick up my propulsive strategy on this side, I again re-elevate the anterior pelvic outlet which pushes the guts to the right. So I get this swoosh to the left and a swoosh to the right that accelerates me towards second base. This is literally the foundation for Lee Taft's Pliostat. It's the internal mechanics that are created by the external strategy. If I didn't take advantage of these internal mechanics, I would never be able to move quickly.

In the case of like say a large human being who is an offensive lineman in football, it may behoove me to superimpose a tremendous amount of muscle mass on him, increase compressive strategy, and actually take away certain things—make it more difficult for him to rotate because as an offensive lineman I don't want to get turned. So this might be a favorable shape change that's going to maintain tension through the system, and while the sacrifices are in certain ranges of motion, they don't negatively affect my performance. And so what we want to again take a look at is how we actually produce this compression and expansion and what the resultants are. So if I say create an anterior compression and I have posterior expansion on the opposing side, I have just improved my capabilities towards external rotation. If I look at the opposing representation where I have posterior compression and anterior expansion, I have now improved my abilities to capture internal rotations. Now, where we run into difficulty is with this antagonistic representation which is actually quite incorrect because if I have compression on one side and my assumption is that all I have to do is train the opposing side and then I'll recapture range of motion, I actually have to strategize, alter training to alleviate the initial compressive strategy. So if I create anterior compression and I have posterior expansion where I have ER capabilities, and I think, well, I have to recapture my IR, I'm just going to train the backside. What I'm going to end up doing is I'm going to have a compression on the front side and a compression on the backside unless I do something that alleviates that anterior compression. And so then my resultant is, again, I'm getting squeezed front to back and I'm giving up something potentially—potentially, again, I just don't know what the answer is going to be. So the antagonistic representation of the superficial musculature is incorrect because I don't have pushers on one side and pullers on the other. What I have is compressors on one side, compressors on the other side, and I have to manipulate their ability to expand and compress if I want to influence performance in a favorable way if I need to recapture some element of movement. So the way you do this, everybody's there in an experiment. It's an N equals one situation. I have to determine what my key performance indicators are. Sometimes I don't even know what those are until I start training someone and I see what the results are. So for instance, it may behoove me to strength train one of my baseball pitchers to increase their force production, and I will get a favorable response in velocity. However, if I sacrifice their ability to turn because of the shape changes involved or the reduction in movement, say through a baseball pitcher shoulder where I reduce this range of motion and I take away velocity, bad strategy. So I just don't know what those answers are going to be. And so again, we can't just automatically say, oh, muscle mass is good, oh, increased force production is good. I have to look at what the results are and then how does that influence that individual's performance.

Right. So do something that brings the pump handle up and see if it gets better. And then do something that expands posteriorly and see if it gets better. Right? So that's an allowable experiment. If you're not sure, intervene, do something, and then see what happens. And that will confirm your suspicion. So next time you see this, you can go, oh, this is going to be either an internal rotation problem or an external rotation problem. You're going to make that association. That's how we do this. That's actually how we do this.

I think it's going to help a lot of people. Truly appreciate you. If you've got any other questions, go to askapilharmonatgmail.com, and I'll see you guys tomorrow. This segment seems like it's all about the bench press lockout, but it's so much more. Good morning, happy Tuesday. I have neural coffee in hand and it is perfect. Okay, a little something different for today. I wanted to post up another segment from last week's Coffee and Coaches call. It was such a good call. We went 90 minutes and you've only seen like a small segment of this. The foundation of this question is about bench press lockouts and methods to address issues with that. But there's so much more in this question, as far as reasoning and decision making, along with the technical aspects of how you might work through this situation where you're trying to improve someone's bench press lockout. So thanks to Manuel for this question to lead us into it. And so let's just go right into the segment from the call.

We're going to go ER to IR under every circumstance. But again, we can create a little bit of a bias. And so what I can do is I can position the ilium in the sacrum in a little bit more of a bias. So what I'm gonna do is I'm gonna create this yielding strategy at the base of the sacrum here and I'm gonna be ERing this ilium. And so what this would look like would be to project the knee forward in this split squat. So before I even lower myself into the split squat, I'm going to create a stronger bias towards ER and then as I descend, I'm going to get less IR as I go down through that middle range excursion towards what we would consider 90 degrees of hip flexion. So right away, I get to bias it. If I wanted to do the opposite, what I would do is I would shift backwards and I would create a little bit more of a bias towards internal rotation. And then as I go down into the excursion, I get more internal rotation as I approach 90 degrees of hip flexion. So this is just your typical hip shifting kind of bias that you would be using. But the cool thing about this is the load position now that you mentioned is also an influence. So what I can do is I can take the contralateral loading and I can bias it towards internal rotation. So I create those same hip mechanics that I just showed you to bias towards internal rotation to lower myself into the split squat. If I use the ipsilateral load, I create the hip bias towards external rotation. Now here's the question mark. It's like, what are you trying to achieve? Are you trying to improve my ability to maintain external rotation? So under those circumstances, I create the hip mechanics that are biased towards external rotation, and I use the ipsilateral load. It makes it easier to acquire those range of motion mechanics. However, at some point in time what I may want to do is challenge that and actually produce force into external rotation under those circumstances. I'll bias it towards the internal rotation mechanics so I have to push myself up and out of those internal rotation mechanics to create more external rotation. So Brian this is a great question, very very useful. Just keep in mind that all we're doing is creating biases. Internal, external rotation are superimposed. And so, again, it's like how we start is going to influence how we move through that middle excursion and then how we end.

We actually created a little bit of a compressive strategy on the anterior aspect of the abdomen and pelvis so you can actually see the expansion posteriorly. And so what we're getting, we're getting a little bit of sacral counterneutation, which is our yielding strategy on that posterior side. So we might be able to acquire this in the reverse hyperextension exercise because of this initial starting position that provides us with an anterior compression that may promote the posterior expansion. And so our mechanics here would be similar to what we might see in the initiation of a toe touch, where we want to see that sacral counter-neutation and posterior expansion. So again, we're moving somebody from this strong, compressive strategy that's going to be in that middle-delete, propulsive element of propulsion, and we want to move them backwards to early. And this might be a way for us to do this. Now we've got some issues with this. So the position is favorable. Yes. But we also have to deal with load based issues. So too much load is going to promote a compressive strategy because I need that to lift heavy things. And so I may not be able to access the yielding strategy under those circumstances. So we're going to start with a lighter load for sure to make sure that we can capture the strategy that we're actually shooting for. The second thing is, is a technical issue. And so when we do these things bilaterally, so anything that's bilateral symmetrical, one's going to create a little bit more of a compressive strategy, it's going to limit our ability to turn. And so one of the things you'll see with the execution of reverse hyper is the fact that people will sort of exceed the motion capabilities of the hip and they will start to drive this anterior orientation of the pelvis even in prone. And so you can actually overcome the benefit of the yield length strategy by taking this way too far. And so one of the things you're going to want to try to do is limit the motion to the hip excursion because by driving the motion through the hip, primarily, you're going to promote a little bit of that push to your lower compression, but you might actually capture your sacral mutation of those circumstances. If you drive it farther, you're going to create that anterior orientation. We get the compression of the sacral base, and that's exactly what we don't want to do because that's what got us here in the first place. The other issue might be velocity. And so you'll see reverse hypers performed in any number of ways. If we use high velocity, remember that as we apply velocity to viscoelastic tissues, we have a rate dependent change that might make them stiffer. And again, we won't be able to utilize our yielding strategy, which is the goal under these circumstances.

If we get the next layer of compensatory strategy where we get an anterior compression that follows, and this is a center of gravity issue, so we're trying to maintain center of gravity, so we push back against the sternum, we compress that downward, now we bring the lateral aspect of that scapula forward to compress against the thorax, and now we can pick up this angulation that we're talking about between the scapula and the humerus that would cause this internal impingement. There's a little bit of a difference here because when we talk about the archetypes this will typically show up in somebody that still has the posterior lower expansion, the rib cage, so this is not typically going to show up in an end game presentation. And so where we are talking about the narrow where we have this kind of angulation with the wide, they pull this part of the scapula back forward to the thorax, and then there's a little tilt this way. So this is the posterior lower expansion that tilts this on a little bit of an anterior orientation. And then we get the compressive strategy a little more superiorly than posteriorly as we would see in the narrow. Now, in an asymmetrical presentation, we can still get this situation as well. It's going to be very similar to what the narrow kind of looks like because the term that's associated with the asymmetrical ISA presentation, we get the posterior expansion on the side, we get the same kind of an angulation as we would see in the narrow.

I received a question from Johnny that we answered recently, and he posed another excellent question that prompted me to move him to the front of the queue. We will address Johnny's new question today. Johnny says, 'Thanks for answering my questions recently.' You're welcome. He continues, 'I'm curious, why is inhalation needed when lifting something heavy? For instance, prior to a 1RM squat. Since you've expressed that internal rotation (IR) is force production, but inhalation would be external rotation (ER), is the reason along the lines of needing ER expansion so that we can compress IR?' Johnny, I love your thinking process, and you are on the right track. Let's break this down further for a clearer understanding of the mechanics and our use of breath, especially during high-force production and in specific exercises like the squat. This concept applies to numerous activities, particularly those involving high-force production. First, we must discuss our evolutionary origins. We evolved from swimmers, who were biased toward external rotation. Upon moving to land, we had to work intensely against gravity, developing our internal rotation capabilities. It's crucial to understand that internal rotation is superimposed on an external rotation foundation. This is where we generate force. The heavier the load, the greater the force required. During an exercise's movement, we need to access range of motion. Consider the squat: I descend and then ascend, superimposing internal rotation and force production upon my expansion bias, which provides external rotation. The degree of inflation is determined by the required force production and the needed range of motion. Olympic weightlifters exemplify this well. Observe them during lifts like the clean and jerk. As they stand with the clean, you'll see them managing their breath, inhaling and exhaling to optimize internal pressure, accessing specific ranges, creating optimal body shapes, and maintaining sufficient force production under the bar. This is fundamentally what we all do during lifts. You may have experienced this yourself during squats: you need a precise volume of air in your rib cage and a certain level of muscle tension to perform the squat. Without sufficient expansion, you cannot access the range of motion required. This is why, as weight is added, squat form changes. You might see shallower squats, increased lordosis, more forward lean, or altered knee positioning. The lifter is trying to achieve positions but must alter their body's shape based on the load, their expansion capabilities, and their compressive strategy. If you inhale too much, you create excessive expansion, leading to too much ER and an inability to generate sufficient compression, resulting in a missed lift. Conversely, if you don't inhale enough, you'll face a force production deficit. Without sufficient inhalation, your ER excursion narrows, limiting the available internal rotation range. For example, your sticking point might be around 90 degrees of hip flexion. If your internal rotation excursion is insufficient due to inadequate expansion, you lack the necessary range to apply force, causing a missed lift. Johnny, we can analyze this through multiple factors: expansion capabilities to access external rotation, creating internal pressure with a compressive strategy, and maintaining body shape for force production directly under the bar. Think about the front squat; many lifters fail by dumping the weight forward because they cannot maintain the anterior expansion required. This is another critical shape change to consider. Johnny, I hope this answers your question. It's a fascinating topic. If not, please ask another question at askbillhartman@gmail.com. I'll see you all tomorrow.

That always has to be a consideration, especially for you folks that want to blame the quads for being inhibited in things after a knee surgery, I would be looking towards like some measure of a fusion in the knee that is keeping that quadriceps eccentrically oriented and therefore it would test weak or it would atrophy under those circumstances. So in the opposing strategy then when we talk about tibial IR, if we have an anterior medial or posterior lateral then we're going to be lacking deflection because I won't be able to internally rotate the tibia effectively. So think about this for a second. So those of you that are complaining about a posterior lateral knee pain in your deep squat and you're looking for a structure that might be the problem. I can't rule out that structure is not a problem, but if the knee checks out okay, and you still have that posterior lateral knee pain, what you might be doing is you might be trying to squat with a tibia that is oriented better towards being an extended knee. So as you squat, you're actually sitting down and you've got an area of fluid accumulation on the posterior lateral side of the knee that you're trying to sit down on and you're just compressing that and then that results in the discomfort. Now let's consider some potential influences as far as what might be promoting these orientations in the knee that seem to be sticking it in a position. And the thing that I'm most fond of about talking about knees is I don't think that it's a very intelligent joint to put it mildly, I think it's more responsive to what goes on around it. So now we have to start talking about pelvis orientation. We talk about foot orientation. So if the knee is a pretty dumb joint and we're going to pick on this tibia femoral ER. So again, I have a fixed beam where I'm going to move it relatively as such. So it's externally rotated. And you say, well, why does this orientation predominate? And so there should be a picture right here. So you can kind of see what I'm talking about in a real knee. And this can happen on either side. So I can have this show up on the right knee, or I can have it show up on the left knee because what this orientation is, the tibial femoral ER orientation, is the system looking for internal rotation. And so what we have is a femur that is internally rotated on top of the tibia because I have to apply a force to the ground. I have to apply a propulsive force into the ground so I can stay upright against gravity, so I can walk and do all the cool things that humans do. And so when we think about embryology, when we think about evolution, external rotation came first. So you were a swimmer before you were a walker, you came up on land, and you had to figure out a way to put pressure into the ground, and that is through internal rotation. So again, that is our propulsion. So, if I have lost internal rotation anywhere in the system, I will find a strategy that will allow me to do so. And oftentimes, what we'll see is this tibial femoral ER strategy. We're going to turn the femur inward into internal rotation to create our downward force. So when we see terms like knee valgus, or we see situations of hyperextension of the knee, what we're actually talking about is we're talking about somebody that's utilizing an internal rotation strategy because that's what the resultant is going to be. So we don't really have a hyperextension. What we have is a lot of internal rotation of the femur on top of the tibia. When we have the valgus, what we have is a change in the center of gravity to an anterior medial strategy and then that twists the femur inward, turns the tibia outward and we will put pressure down and forward into the ground and so we have to do that through the knee. So the elephant in the room then becomes this pelvic orientation situation and so an anterior orientation of the pelvis is me looking for an internal rotation strategy. That's why we lose extra rotation of the hip when the pelvis anteriorly orients because I'm looking for more internal rotation and I have to sacrifice my ability to externally rotate. This is why hip extension activities then become very, very important when we're talking about restoring normal knee excursion because I have to establish my external rotations first so I can delay propulsion and then recapture internal rotation.

This ER position to IR position so the arch comes down and then we've got a late propulsive strategy which is the toe rocker which brings us back to this ER position okay so we go ER IR ER as is commonly found in almost every motion that that we talk about. What you brought up was queuing lateral heel contact throughout the split squat. I understand where you're going with this, but there's a couple of things that we have to understand about these split mechanics as we come into this early propulsive strategy. We've got tibial ER, we've got traditionally a supinated foot, so we've got ER through the system. We've got first and fifth met heads down. We've got a calcaneus on the ground in this early position. One of the things we want to understand is that the deep posterior compartment of the calf, so the Tom, Dick and Harry. So we've got tibialis posterior. We've got flexor hallicus longest. And then we've got flexor digitorum longest posteriorly comes down around the medial ankle. So that muscle, that group of muscles is going to be concentrically oriented, but it's also going to be using an overcoming strategy at heel contact, but then this becomes a yielding strategy as the foot comes down to the ground. The reason we want a yielding strategy is because we want to distribute load through the tissue, so we have to create a yielding strategy so we have energy storage for the energy release. And so the yielding strategy is going to be through the bone, through the connective tissues, and through the musculature itself where the connective tissues lie. If we don't have that, then something's going to have to take up the slack. If I cue lateral heel throughout, what I'm going to do is I'm going to promote a strategy that maintains a concentric overcoming action throughout the excursion of the exercise. Maybe there's a circumstance that you might want that, but under most circumstances, we don't want that. So here's where that shows up in the real world. When you get your runner that comes in with a posterior tibial stress syndrome or shin splints or whatever you want to call it, they're typically using a concentric overcoming strategy as they run and so the bone then becomes the only source where we're getting any significant yielding strategy and so that's why you get tibial stress. This is what the end game is your your tibial stress fractures and so what we want to do is we want to teach people to distribute those loads for energy storage and release in a much more efficient manner. So Brian what I would do is I would take your little

And then there are going to be circumstances that we just can't control. All of these injuries tend to be multifactorial, especially in dynamic situations. But with that in mind, let's do a quick review of some foot stuff. And then I'll actually show you a little bit of a progressive strategy that you might be able to utilize. At least conceptually, you'll be able to use this that may actually help you improve the ability to produce these forces during the propulsive days, especially with cutting and such. So we grab our foot. Remember we've got a heel rocker, ankle rocker, toe rocker—that's kind of common vernacular. What we're going to say is when we're landing, we're going to be landing in this early propulsive foot strategy. So we're going to have a higher arch, we've got a tibia that's going to be externally rotated. Now, this is not a force-producing position under most circumstances. If you try to produce force under this circumstance, you're going to tend to want to roll laterally. Again, this is the mechanism for your typical lateral ankle spring. Just like Philip was saying, we want to get that medial calcaneus down to the ground. So during this ankle rocker phase, what we've got is the tibia that's internally rotating. We're moving towards the traditional pronation, which gets the medial calcaneus down to the ground, and it moves us through the middle propulsive phase towards max propulsion where we're going to apply the greatest force into the ground, which is at that point of maximum pronation. Okay, so we have to be able to capture this middle phase of propulsion and then max propulsion as a protective mechanism against this ankle sprain, but it's also our highest force-producing phase. Once again, we go back to: are we really preventing injuries, or are we just preparing people effectively? And again, I lean towards the preparation side of things.

Because again, if I try to go too far into a turn, all I'm going to do is create this massive orientation of the whole system, which is not really a turn. It's just changing what direction that I'm facing. And I want to create the ability to actually turn and rotate. So I got my water balloon. So another visual aid today. And so I have somebody that's that's compressed anterior to posterior. So this is looking down on somebody. And so they're compressed. So if I try to turn them too far, all I do is get this. And that's not really a turn. That's just a reorientation of the entire system. What I want to try to do is I want to try to create compression on one side expansion on the other side. And if I can do that, with my activities, that's going to actually start to restore my ability to create turns in these people and start to restore the rotations. And so if you go back to the red rectangle, those are going to be activities where I'm gonna start to deviate from center outward to the sides. So I'm gonna start with lateral stepping. So consider if I was doing conditioning with somebody like this, we'd be doing sideways sled drags, or I'd be doing suitcase carries, because what those activities do is they could create compression on one side, expansion on the other, compression on one side, expansion on the other. And this is how I'm going to start to improve the excursions and restore their ability to turn, because once again, if I try to force this, all I'm going to do is get compensatory strategies. So staggered stances, pressing and pulling below shoulder level, lateral movement. So this is where your side lunges, your side split squats, your low step ups come into play because that's what these people need because they only have a limited excursion in their peripheral joints and so we have to take advantage of what they do have and then slowly progress them out of that. So Jimmy, this is such a great question. If you're in the rehab side of things, these are the people that you're going to want to put into sideline because we take advantage of gravity. So if I put you on your side and you're compressed A to P, what happens is, and you can see in my balloon, so I get I get all the guts falling down towards the bottom and so that creates expansion on one side and compression on the other. So sideline becomes very important. I start to build people up from sideline. So now we're talking about immature oblique sits, mature oblique sits. This would be something that you would progress eventually into side planks and such if we're talking about moving into gym activities.

If I swing a tennis racket, a golf club, a baseball bat, if I'm throwing a ball, any kind of implement sport, any kind of rotational activity, all of these things are going to occur because I need to have an external rotation inhalation bias to access positions and movement and then I need to capture an exhalation, internal rotation, compressive bias to produce force. And so again, they're always superimposed. I'm just biasing myself in one direction or the other. So it's always two strategies, one plane. Always two strategies, one plane. It's all that you have. And all we have to do is understand is how they interact, how they're superimposed, and how we bias ourselves towards one or the other. And that answers so many questions about how we do things. So hopefully that gives you a little food for thought. For all of you golfers out there, hope it gives you a little something to think about because all you guys think that you're internally rotating when you're actually externally rotated bias in the top of that backswing. That's why you cheat all the time. That's why you see the foot roll to the outside edge. That's why you see the knees starting to point out towards right field at the top of those backswings. People don't have enough external rotation. It's not internal rotation. So, a little extra tip there for the golfers.

When we have an intact nervous system, we have to take a different perspective. The traditionalist view is that we have weak muscles, which would imply an intrinsic quality within a muscle that there's a problem with a muscle, and they would call it weak. However, I think this is just a bad interpretation based on a flawed model. Let's use an example: if we were to perform a hip flexion test in the sideline position, I would have you raise your leg in what is traditionally called hip abduction, which is actually external rotation. If I push down on it and it gives way, and I say, 'Oh, you have a weak gluteus medius,' here is the problem with that. We know that if I have an anterior orientation of the pelvis, the musculature above the trochanter changes its direction of pull. Traditionally, in 'dead guy' anatomy, we would call these muscles external rotators, but if I anteriorly rotate the pelvis, their angle of pull changes; they become internal rotators. This is why, even though this traditional hip abduction is an external rotation movement, if the muscles are oriented to pull in internal rotation, the test will show weakness, but it's not an intrinsic problem with the muscle itself. It's just the orientation of the pelvis. So, how can I use this test? Perhaps I can use it as a test-retest assessment. If I identify an inability to produce force in a certain direction, and then I recapture the ability to fully anteriorly and posteriorly orient the pelvis, the test might then become useful. Additionally, you must consider that all our movement is based on shape change. If I measure something in one context, such as on the table, and I say I've recaptured range of motion with full excursion of internal and external rotation and full inhalation to exhalation, and then I stand the person up, I've changed the context. Now, my isolated measurement becomes less useful because we're dealing with a much more complex situation involving the interaction of the entire body in space. Therefore, in complex movement, like a split squat, for me to access 90 degrees of hip flexion, I know I need to be able to access hip internal rotation under those circumstances; otherwise, I'll have to use a compensatory strategy. These situations are not dependent under most circumstances, as most people who come to see me are neurologically intact. So again, just wouldn't use manual muscle testing in those circumstances. I don't think it's totally useless out of respect to Florence Kendall and those who came before us; I appreciate their work. I just don't think it's a good representative model and isn't based on a good model, so its use becomes very limited.

Now obviously at very high speeds that distance in front of the center of gravity needs to be minimized because we want to minimize the breaking force to run really really fast but it still has to happen otherwise we don't get the compression and expansion that's associated with the the storage and release of energy. the pelvis is still going to move through its inhalation and exhalation bias but obviously the faster we run the faster that's going to occur and actually the excursion is going to be limited and much more biased so the faster we go the more we're going to be biased towards an exhalation strategy and so So now let's go deep into some differences. So walking has a longer period of time between ground contact and max propulsion compared to running. So what this means is that the forces are going to be dissipated over a much longer period of time because of the slower rate of locomotion. We need a longer delay in the propulsive strategy so we can swing the other leg out in front of us so we don't fall on our face. So running has a much shorter period of time, regardless of what running speed we're talking about. There's a shorter period of time between ground contact and max propulsion. At top speed, the elite sprinters, they'll hit ground contact as brief as 0.08 seconds. So it's nearly instantaneous as to how they're landing, which again, it's going to lend us to trying to understand, okay, what is this hip or pelvis actually doing at the point of ground contact and why we have such a strong bias. We still need a delay to swing the other leg through, but it's going to be very brief. One of the coolest things about walking versus running for me is just the behavior of viscoelastic tissue. We're talking about differences in force. There are seven components of force that influence the viscoelastic tissue. Tissue behavior. So we got magnitude, location, direction, duration, frequency, variability, and rate. So I can only say I'm in that order, but there's seven of them. But we're going to talk primarily about the rate-related issue because that's the easiest one that we can visualize with walking versus running because we're dealing with a time constraint. So the higher rate of loading, the higher the rate of loading, so the faster we load tissues, the stiffer that they're going to behave, the harder they become to deform But when we do deform them, they can store a heck of a lot more energy and therefore they can release a lot more energy, which is what we see at higher running speeds. But we also see a lot of cool stuff like stress fractures and tissue related issues that are associated with these high forces over longer periods of time. So if you want to start a great business,

Distal to proximal because I have to pronate my hand in many cases, such as when keyboarding. A lot of times we relate this to baseball, which is a really good representation because when I throw and release the ball, I actually have to pronate my hand and distal forearm. So I get a lot of pronation coming from distal to proximal. Approximately, I'm trying to externally rotate and supinate distally, but I'm trying to pronate. So I get this perfect storm of twist, which keeps tension on that pronator teres, which pulls the medial epicondyle. Again, we get that shape change at the medial elbow. What this ends up looking like is that people will get accused of having an increased valgus elbow. It's not a valgus; it's a twist. Go back to the valgus elbow video from a while back and you'll get that explanation. They'll get accused of having hyperextension of the elbow. It's not hyperextension; again, it's the twist at the elbow that's associated with the concentric orientation in that posterior-lateral aspect. So now we actually have a representation of what we're looking at.

And so right away, if you're a motion palpation person, you're going to say, oh, this person's in the anterior pelvic tilt, even though they have the counterneutation of the sacrum. It would be better though if we would look at the hip rotation representations of this. So under normal circumstances for our narrow ISI narrow ISA archetype, if they are biased towards inhalation under those circumstances, they'll have 100 degrees of total hip excursion give or take a little bit, but they'll be biased towards more extra rotation and less intro rotation. So if you look at the textbook and the textbook says you have 60 ER 40 IR, they're going to be biased towards a little bit more Extra rotation a little bit less in rotation. So let's just say that they are biased towards 80 degrees of extra rotation and 20 degrees of internal rotation. You would say, oh, this person is probably going to be this representation of a narrow ISA. The goal here under those circumstances is we have an inhaled pelvic representation. We want to teach them to capture an exhaled pelvic position, which will help reorient this ilium into internal rotation. We'll capture some mutation. You're gonna do this with a series of 90 degree angles. So the hips gonna be at 90, the knees gonna be at 90, and the ankles gonna be at about 90 degrees. So that's gonna be the easiest way because if you think about how our hip moves through space and we get the movement of the ilium that's associated with that hip range of motion, right at about that 90 degree angles where we're gonna start to recapture that exhale position of the pelvis. So that's where you're gonna wanna train these people. And this is where you're gonna do any sort of your rehab-ish exercises in this 90 degrees of hip flexion, 90 degrees of knee flexion, and then that neutral dorsiflexion where the ankle's at 90 degrees. Now, let's go to my wide archetype. And so we're going to see a pelvis that looks like that. So this is the exhale representation. So obviously we want to move them towards an inhale representation. The easiest place to do this is with early propulsive strategies. So this is your heels elevated type of activities with the hip closer to traditional extension. And this is going to help us to expand posteriorly; we create the yielding strategy posteriorly, and this is going to help us recapture that hip extension that we're probably missing. So remember that your wide ISA people, as a standard representation, they're going to be biased a little bit more towards internal rotation, a little less external rotation, but as long as they get a hip excursion of about 100 degrees, that they're only showing their structural bias.

So as we move through the squat and as we approach our internally rotated position here, we get the interrotation of the hip. We get an expansion on the right side. So we're going to get this expansion between the sacrum and the ischium here. We're going to follow that expansion. So now we've got a squat with a right shift. So that's how we get to the right shift. Now we've got to start thinking strategy here. So we've got a couple of issues. We've got a two-sided problem. We've got this late propulsive strategy on the left side that's pushing us forward. We've got to shift back into the right hip that we also need to address. So the first thing we have to do is we've got to get everything reoriented. And so I would have you go back and take a look at the Camperini deadlift variations from about two weeks ago. I think it was about two weeks ago that we talked about that. So what you're going to do is you're going to use a comfortable lateral load. You're going to elevate the left heel. We're going to try to get you back to that early propulsive strategy on the left side. So we've got to get the sacrum and the pelvis to reorient to the left number one. Once you recapture your hip internal rotation and your straight leg raise on that left side, then you're going to want to switch and you're going to use the ipsilateral load because now what you got to do is we're going to address this right side stuff. So we got to use the right side to push back into the left side to hold back that propulsive strategy. So this is right foot forward stuff. So your Camp Rainy dead left is going to be right foot forward with the load on the left. We can move into some split stance variations at this point as well. Again, right foot forward. So if we want to do, say a split squat with an Ipsilateral load. So when I say Ipsilateral will be a right hand load with the right foot forward. So this is somebody that is working their way out of a cut, if you will. So by loading on the right side, we're going to emphasize the right hip external rotation to push us back into the left, maintain that left internal rotation and delay that left propulsive strategy. We can also use a right foot forward split squat with a left cable load and what this is going to do if we maintain the expansion on the left posterior side with that left cable load we're going to be pushing again with that right foot to push us back into the left side, maintain our left hip internal rotation, delay that propulsive strategy.