Yeah, it's just it's somebody that can't capture the middle propulsive representation right so they can't push into the ground straight down into the ground so they're trying to push through any yard foot so what do they do they're the people that come in yeah I I sprained my right ankle 17 times since seventh grade. Right. So, so where is your question along along that line of discussion.

Okay. Yeah. So I push forward. Right. I have a constraint of my first met head on the right side. Okay. You follow?

So my last question involves some confusion. I think I understand, but I'm not sure. Let's say we use a left forward, contralateral load with the goal of bringing someone's left side back to acquire relative motion and bring the center of gravity posteriorly. As we go down, I think using the contralateral load is a good idea because it creates more of a yielding action on the left. But where is this effect occurring?

There's more than one way to skin a cat, but that's a horrible representation. However, there are actually 82 ways to skin a cat, depending on whether you start from the ears or the tail, but that's the need to know. Does that make sense?

So why would a heel lift not help?

You're moving towards the early side, you're moving away from the late side. Does that make sense?

But the premise is the same because it follows the same rule. So if this is going that way, and I have to slow this part down.

There's a lot of weird metallic background noise.

Understanding the time constraint allows you to select the appropriate activities, right?

Yeah, to understand.

All right, so let's back up. Do the two sides of her body look the same? No. OK. So if you get the same measures in both hips, are you acquiring those measures in the same way?

Yeah.

But it's like, it's just not possible. So don't worry about it, but you got to select exercises that allow you to do what you need to do.

She's dampening right now.

Yes sir. Makes sense.

Can I redirect your attention? Go to the pelvis. If I had a rudder on a boat, which bone in the pelvis would be my rudder? Sacrum.

So all you're doing is getting the whole lower part of the leg, so that from the tibia to the foot, the whole thing turns, which means that, yes, I'm getting relative motion at the knee that I wanted, but the whole foot and the distal tibia are following. And so I don't get the differential that I wanted, because when you're doing a knee mobilization, when you're doing a tibial mobilization, to change the knee orientation, you have to create the stable position of the foot and the distal tibia. So you get the differential within the bone itself. And again, this is a real common mistake in knee mobilizations that it's not clear sometimes, or it's not explained well enough that I need a stable position of the hips. We've been talking about that with Alex's question and with Christian's follow up. It's like I need that stable position of the pelvis because I have information that's going back and forth through this extremity. I need a stable position of the foot and I need to make sure that the distal tibia is fixed. So I get the change where I want it. Otherwise, there's too much movement and then everything that I'm trying to accomplish is dampened. Doesn't mean you don't get any change. It just means that the effective change is probably going to be less than what you wanted. So when I'm doing a knee mobilization, like an early knee mobilization, like we were talking about before, early IR, I'm actually sitting on their foot, so I put their foot in a very specific position and then I sit on it in just the right way that the foot doesn't move, relatively speaking, it moves a little bit, but it doesn't move a lot. Then I actually capture the tibial position and I use my free hand to move the tibia approximately, and that gets me the greatest degree of relative motion that I can produce under the circumstance. And it tends to be consistently better in that regard.

No, absolutely. I'm open to everybody. Go ahead.

So there's an advantage there. That's the sort of regressed solution, if you will, for somebody that can't do some form of supported inverted activity. So literally the shape of their body gives us an advantage by just laying them down on their side. Now you have to concern yourself with head position and things like that. You don't want a head that's hanging off of a thorax or something like that. So you might have to support that to some degree, but you can just use your sideline. Like anytime that you need to get the superior aspect expanded. So, if you've got an upper diaphragm rib concern or you've got a manubrial concern as far as that expansion is concerned, sideline gives you that advantage, right? In every case, because I'm still reorienting gravity and that's what allows that space to expand. So I don't have to do anything funky with arms or neck or anything like that. I just literally need to tip you over and I've created a mechanical advantage for expansion. Yeah.

Oh, I got you.

Okay, so there's less gravity. That requires less muscle activity. So right away, we've acquired a position that creates pressure that reduces gravity. So the motor output for me to hold this position is immediately lessened. Therefore, I don't need as much muscle activity to begin with.

Right. OK. So the difference between the two in regards to the descent of the split-squat. So both are internal rotation representations. However, it is the direction in which the energy is moving. So you store and release energy as you would take a step forward. So you land on the ground, you absorb energy, you move over the foot, you push off the ground, you're pushing into the ground. So again, you take energy out of the ground, you push it into the ground. So early to late, correct? So that's what our split squat looks like, okay? So I can't speak intelligently about why they would not have it in the later representation because there may be something that they're doing that I would observe that would help me identify this. However, you do have a big clue in regards to where they're experiencing the knee pain and in which leg. So you have a situation where as they're moving into a more internally rotated position where they have to absorb more energy. So as you descend into the split squat, that is an early IR representation, which means that internal rotation orientation is coming up from the ground towards the pelvis to make the shape change. And so you have an interference at the knee that is not allowing this internal rotation to propagate proximally. It is stopping at the knee, so to speak. It is interfering at the knee. Most likely what you have is you do not have the internally rotated representation at the knee at the time of the discomfort. OK. And so this could be the foot position. This could be the fact that the tibia is not able to internally rotate sufficiently relative to the femur to access the internally rotated position, right? Or the top-down interference. So you have ER that comes down from the top, you have IR that goes up from the bottom, and you may have too much of an ER representation, approximately, that is not allowing that shape change to occur. And so once again, you have the interference below that level. And it's stopping at the knee. So again, what I would do is I would make sure that, number one, you've got access to the appropriate foot position. You've got to make sure that you've got the tibial IR available to you. And you've got to make sure that you've got the hip IR available to you.

So you could literally just try both and see which gives you the better visual.

OK. But once we get past that 90 degrees and get all the way to full knee flexion, does the tibia have to re-ER? I'm thinking about the ER, IR, ER, propulsive cycle. So does it have to re-external rotate?

There you go. Real simple. Nice. Yeah. Yeah, I like that. That's good.

Not the left foot in standing, left foot in turning. Did you do a standing rotation? Look at her standing rotation, feet together, feet together. Look at her standing rotation and watch her left foot. Does she have a history of a left ankle sprain?

Exactly.

Okay. All right. That's a good one. What else? What are they trying to do? So you put something between their elbows and you see that. What is that? Like why would they choose that as the next strategy?

Have you ever coached a hook line activity? I mean, I play with them myself. I use them a little bit, but... Okay. Anybody in the call ever coached a hook line activity? Okay. You ever put a ball between somebody's knees and then you set it up and they drop the ball? Seriously, like you put it between their knees and they hold onto this and you set up the rest of the exercise and they immediately drop the ball. Like they drop it, like it falls out from between their knees. Well, you just told them to hold onto the ball. But what happened was, as they're posteriorly orienting, they're actually increasing the amount of proximal ER, the ball drops because they're actually separating their knees instead of holding it together. Now, if you held onto the ball and you continued to posteriorly orient, you're increasing the proximal ER. And again, they're trying to squeeze the ball, but they're squeezing it from proximal to distal with ER. They're not creating the IR representation from the ball towards the pelvis. Do you understand?

Yeah.