My question is regarding the classic banded internal and external rotation. I have a couple of questions. First off, is that a posterior compressive exercise? Right? Maybe. Okay.

Okay.

Right.

It's the load in front.

See, this is the benefit of the last call of the day. See, now I'm going to get, now I'm going to get a bunch of requests. Can I be the last call of the day? No. No. It's all luck of the draw. It's like when you came through, it's like, okay, then it's going to be the last call again. There you go. All right. Go ahead.

Is that?

You're very welcome. I'll see you later. Okay.

Okay. So there's a difference between doing a set of like your 12 rep maximum and your one rep maximum. Okay. So there's seven components of force that influence the way that connective tissues behave. All right, two of them, one is rate and one is magnitude of load. And so both have an influence. So the bigger the load, so again, like think max effort squat, that's a ton of weight. And so the way that that load would be distributed would be very, very quickly. So I would need my whole system to be, as they would say, stable to be able to manage that load, right? So there would be almost no yielding. So you got to think about degrees. One end of the spectrum is maximum yield and one end of the spectrum is maximum stiffness and overcoming, right? So all activities fall somewhere in between the two extremes. So you can think about this interaction, like this overlap. And you say, this activity would be more of a yielding action. This would be more of an overcoming action, right? But both are kind of happening at the same kind of places. So I think with Orion, did I talk about that? Was that a box jump in the max effort squat? Did I use that example?

And if you concentrically orientate piriformis, that will guide you to an understanding of the creation of the right oblique axis. Do you want me to show you real quick?

Okay, yeah, because I've been noticing a lot of different kinds of shape changes in the weight lifters that I'm looking at, and I'll post more on the forum, but you know, I just had a lot of questions about what I'm seeing, and I wanted to get a better understanding before I put it out there.

That kind of activity, exactly. So what you're going to feel is the resistance through your right foot. That's going to bring your right foot down to the ground and allow you to push back and to the left. You've been doing activities to create the yielding action on the left side, but you have to be able to push yourself back into that. It's a right leg lead. You're going to hang on to the internal rotation on the left side that you can probably acquire, but you have to push back into the left from the right side. So it's a right side forward type of an activity, whether that be upper extremity or lower extremity. It's going to be a right side forward to push you back into the left.

In the past, we have that information available to us. And so maybe they've gone through some other diagnosis. So they come in with a known constraint change. And so they say, oh, I have this, this showed up on an X-ray or this showed up in an MRI. Or they're presenting with something that is mechanically familiar. So we see a relationship as we go through our relationship. And so we can identify a little bit more of the cause and effect that may be interfering with normal behavior. So again, this would be a situation, somebody fell on the ice, they go through the acute recovery, it seems to have gotten better, but they still have issues. And so now maybe they have like an adaptive strategy or an adaptive behavior that is promoting this ongoing pain. And so that's something that we can identify with our evaluation. Now we can go to a third realm here where we're talking about a much more complex situation. So this is the land of the unknowns and this is somebody that shows up with an insidious onset of buttock pain. So everything under these circumstances is going to be emergent. And so this is where we have to identify what we can identify. So we measure what we can measure, we intervene, and then we monitor the behaviors. And so This is where we see the emergent behavior, the response to the intervention, and then we would take the next logical step. So again, maybe we have some exacted behaviors here that are creating interference or not. But again, this is where we rely on our structure, our orientation, our muscle and connective tissue behaviors. And our goal under these circumstances where we start in this complex domain is we want to get moving into a complicated or even better a clear situation where we can actually apply a best practice situation because when we're in the complex domain everything is emergent. We just don't know what's going to happen because there's too many unknowns. Okay? So Tim goes on and he asks, in the physical therapist world we tend to diagnose clients with particular syndromes or conditions to do so. We often use tests which have questionable accuracy. That's an understatement. or clusters of tests to reduce the likelihood of false positives using your model. Do you solely rely on a battery of table tests to establish whether someone is in a concentric or eccentric orientation and not focus on identifying specific signs or symptoms, which would be correlated with specific musculoskeletal presentations as commonly taught in PD school. And then he says, do you try to differentiate pathology? So Tim, I'm 30 years removed from physical therapy school. I would hazard to guess there's very little that I do that is left over from that other than working with humans. So technically speaking, I do not try to identify pathologies, but my model does it for me.

And he's your age? Yeah. That's awesome. No, hey, hey, your citizen night. We're not that old. No, that's, that's pretty impressive. I mean, seriously, it's like, granted, it's not, not when he was like, you know, 22 years old or anything like that. But, but no, you went, you went 14, 6, 10 years ago.

Yep.

Initially it would have to be the first met head and the inside heel, but then I suppose as you start going, the left heel should start getting heavier as the right side goes forward.

Well, it's a lot. What would that be a solution for? In my mind, I thought of utilizing it as a before like an athlete is going to, until they change the direction drills. I'm like, okay, let's do this lateral. Lunge into the ramp, out of the ramp as like a bottom cool primer. I guess I don't love using that word, but I guess they're warm up because I guess in my mind it's a little more dynamic versus doing just a four foot elevated toe elevated, RDL, split squat, et cetera. That's in my mind where I was going with that.

Does it make more sense to condense that into one or two days that are just a little heavier on the volume of that. But then I have more days where we're just not getting those exposures. So they're spending more time not touching those.

Not at all.

The head of the club stays back, doesn't it?

Okay. Do you understand that if I compress that space, it pushes you down? Well, just so, okay. Take a tube of toothpaste, okay? Squeeze the top of it instead of the bottom. Which way does the toothpaste go? Down. So if I keep squeezing and squeezing and squeezing, you're gonna go down, okay? So the harder I squeeze that space, the more down I gotta go, right? So that's basically what Terry was doing, was he was doing activities that were squeezing that space, right? Which means that the harder and harder and harder I squeeze, I gotta find a way to breathe in, okay? Cause those are all exhalation strategies, are they not?

Yes.

Okay. You're in a little bit of a pickle there because that concentric orientation is going to make sure that the calcaneus does not move in the appropriate direction to capture the middle propulsive foot. And like I said, you have to carefully position your compartment and then you have to account for the soleus. So you may need to do some work there.

Take your pick, but this is a classic. This is a classic because all you have to do is have one misstep and you can strain a hamstring. You're a little too fatigued or whatever. This is why you hear if you've followed Charlie Francis' stuff at all. I think DampFath talks about this as well, where they're listening for the ground contact. You can hear the pitch and duration of the ground contact. A high-pitch sound when somebody's running across the ground means they're literally bouncing across the ground exactly the way you want. As the sound gets louder and longer and the pitch goes down, you know that they're starting to fatigue and it's time to shut them down because they're spending too much time on the ground.

Okay.

Dale, how tall are you? I can't hear you boss. It's one.

Well, where is the internal rotation? Where is the early internal rotation?

I have some geriatric patients who have some lumbar stenosis. They are bent forward. I am wondering what your training strategy is for them.

Well, it doesn't block it, per se, right? That would be like saying that the ilium blocks the sacrum.

Oh, listen, did everybody hear that? The biggest thing is Texas bigger than Alaska?

I knew that. That's why you went for it.