That's what I'm saying. That's what I'm saying is that you just have to monitor that excursion. Because you don't want to, again, at some point in time, they should be able to do all of that stuff for you. But if you're really focused in on trying to maintain the concentric outlet, then train the concentric outlet and be consistent with that until they can demonstrate it at will.

In this case, I'm going to have to teach them to internally rotate through the spine. Okay, how do you do that? Exhale and try to extend the back as he's going to keep a good stack and exhale as you stand up.

That's great.

Well, consider how many movable segments of the spine you have to work with, but it will not be the same because if I had a narrow versus a wide ISA representation and you threw them down on the table, they would roll all over the table as you're measuring them. So the measurements appear to be the same; they're still turning, but it just might not be to the same degree nor in the same place. So if somebody decides that they're going to herniate L4-5 on the left side as their delay strategy, that might be somebody who doesn't have the ability to create the turn. They're so far forward that their turn comes from there, whereas you have somebody who might not be as far forward that still has that turning capability as you move them through space. Remember, you're displacing the load of the limbs that will cause some of these turns to take place. Remember we were talking about the difference between a straight leg raise and traditional hip flexion, ERI measures. Because of the position you're in, this is where you start to get the pelvic turning—the pelvis turning as you perform the measures. So it's not the same strategy per se.

You're welcome, sir. That was a good question. You might be the highlight of their day. Good morning. Happy Friday. I have no coffee in hand and it is perfect. All right. a very busy Friday. This is Intensive Day 2, the unlearning day, if you will, for those of you playing the home game. So we're going to dig into today's Q&A. And this is a really cool video. There's going to be about six people that are going to really, really enjoy this one probably, but I thought it was a really important topic. Jordan is a student. He's better going to work in an extended care facility. And so this is a difficult population, challenging population. to work with because the adaptability windows tend to be rather small. There's risk of falls. And so Jordan's question revolved around that. It's like, how do we work with these people that might be a fall risk that do have smaller windows of adaptability? And so we went through some approaches that I prefer having some experience working in the extended care facilities. that is a little bit more enjoyable for the client and as well as the therapist in question. So again, I think if you're a student, you're going into a clinical rotation that's going to be really, really helpful. If it's a population that you do work with and you're sort of reaching some barriers, this might give you some ideas as to how to make some progress with those folks that just seem like they don't really have, again, the window of opportunity to make some progress. So this is not like the typical video that we would do where we're talking about higher levels of performance, working with athletes, et cetera. But again, I think an underserved population, a very important topic to be discussed. If you would like to participate in a 15 minute consultation, please go to askbillhardman at gmail.com, askbillhardman at gmail.com, put 15 minute consultation in the subject line, so I don't delete it and we will arrange that at our mutual convenience. Everybody have an outstanding weekend because the intensive the podcast will probably be up in the afternoon on Sunday So be looking for that don't forget to go to the YouTube channel and subscribe so you can get all of these videos At will and then I will see you guys next week here So I was wondering my questions in regards it might have been answered actually

Right. So it's an ER representation. So remember, a late propulsive foot is external rotation. But because the center of gravity is not far enough forward, the heel is still on the ground. So it pulls the arch back up and then I bring the toes back underneath. So the muscles that would typically lift the heel in a normal late propulsive representation can't lift the heel because the center of gravity is not far enough forward yet. And so it reverses gears and then it's dead guy anatomy 101. What do these muscles do based on their name? It's like, well, they're toe bender muscles. And so I got short toe extensors on top. I got long toe flexors on the bottom and I get this clawed representation of the toes. That's why you see that is because that's somebody that's trying to get up and over the front of their foot and they can't do it because their center of gravity is too far back. So just grab the poles.

What would I do? I kind of like where you're talking with Jen about just like, okay, make the try to recapture post activity as best you can and allow them to be the superhuman that they are. And allow gradual change there.

Right?

Yeah, like a back bend. Yeah. So three weeks post-surgical and I was like, wait a minute, how is she able to do that? And then I was measuring her again and she had like pretty good external rotation. She's a narrow ISA, if I recall correctly, but her flexion stops a little or it wants to turn when I'm doing your test a little bit above 90 degrees and she has a very flat thoracic spine and this overly flexed cervical thoracic junction kind of thing going on. So I was thinking, she's probably creating the space to do that. And that's why I don't get her or she has no good shoulder flexion measurement because she is just turning away from that. But that makes her able to do that three weeks post surgical because she is creating the space. So I was wondering several questions. First question is, is this maybe possible that her Um, presentation of her spine and where she is creating space led her to this problem. And, um, what are the, um, steps, how she got there, you know, because I'm, I'm seeing quite a lot of people with this flat thoracic spine representation, but they are also some are, uh, wide and some are narrow. So I was wondering how. how much or what are the steps, how do people get there, you know?

So if you teach it well, you can actually use it to your advantage. It's a non-provocative position that allows you access to relative motions that actually restore your ability to move. It isn't about rotator cuff strengthening as much as it is allowing the body to recapture its relative motions. Because frankly, red theratubing is not going to really influence a tremendous amount of force production, but it is going to teach me to recapture relative motions. Do you see how if you do it right, it's very useful? But again, if you don't attend to the details, if you don't attend to the positions, it's not very helpful because I don't give a rat's patootie what the EMG activity says. What I care about is the positions. What I care about is the intention and then the result. So if I do this correctly with someone, I should see my key performance indicators improve. So I should see improvement in my ER capabilities under those circumstances. Do you see why? Do you see why if you don't attend to the details? If I allow that scapula to compress the DR, yeah, I'm pushing it out there. Right. It's going to point in that direction, but it has to point in that direction because I took away all the relative motion that I was trying to recapture in the first place.

Well, okay.

Cause we'll all suck. We're all terrible at this.

It's below here. It's right here. This is kind of like it's not an absolute. It's, if you look at the notch, it's gonna be the stuff that, if I could grab that, if I grab the ischium kind of like a pistol, if I grab the ischium like that, it's going to be that musculature there that maintains its orientation into external rotation.

Happy Thursday. I have neural coffee in hand and it is perfect. Does everybody have their coffee today? The battle for the first question has a winner today. So, Luke, how long is your list?

Yeah.

I did. In the forum earlier this week, you mentioned that the stretch shortening cycle is incomplete in regard to tissue behavior.

So typically everything's going to happen kind of at the same time. So you had two scenarios that demonstrated a lack of external rotation. So you had a dorsal rostral compression feels external rotation, and then you had a demonstration in the lower back that was a substitution for a lack of external rotation. So they were similar in that respect, right? So he's kind of telling you that he has this narrowed window of extra rotation available to him to acquire the positions that you asked him to acquire, okay? So under those circumstances, if the goal is to improve the movement capabilities, your intention should be driven towards that extra rotation first. because he's lost both. If you measure him directly and he doesn't have internal rotation, and he's showing you two substitutions for lack of external rotation. then you probably need to go there if you're trying to improve his movement capabilities. Deadlifting is not about good movement though, understand that, right? It's high force production, right? It's squeezing, it's compressive. It's, you know, like you're starting from a position where you're trying to squeeze the bejesus out of everything. Cause you're literally pulling weight off the floor with, and again, you're talking about- We talk about muscular effort versus using connective tissues. The deadlift relies less on connective tissue behavior than anything else does as far as the big three lifts because there's no yielding action prior to other than acquiring the position. So like I said, I would think that you're gonna wanna go ER emphasis first because you need to make space for him to IR.

And so when you would go to your testing under those circumstances, would you expect the hip flexion to be more limited than the external rotation 90 degrees?

So, if you're advancing the leg and the arm at the same time, that's late. There was early, both of them at the same time.

My thought onto that was you're sharing this for everyone else to call BS on what you're seeing.

All right. So you watch him bounce across the ground, and you watch everybody else in the race that's just speed walking. This guy can actually capture the IR representation on the ground, which is why he has the capacity to bounce across the ground. You look at all the other guys and you look at their pelvic structure, you look at their thoracic structure, and you say, oh, these guys are trying to still run in an ER position, which means that they can't apply the force into the ground. They're not going to get the connected tissue behavior because they're dampening, which is why they don't have a flight phase. So you have to work on some, you remember the pelvic mobilizations over the roller and things like that to promote the proximal IR shape of the pelvis.

Oh, it's my fault.

I mean, clearly the baseball player had no coordination whatsoever. I mean, he's only played at the professional level for a few years. It's just that you got to make it easier. You got to make it like that's how you make it easier for people to find these contacts and cues. It's like, where was the weight before? Well, the weight was way back on the right heel, so they don't know what the left heel feels like.

When I'm off the wall.

Okay. So why is this still a problem for you?

Yeah, okay.

Yes.

Yeah, I know. I know.

Yeah. I guess. I've had people come in who. Like the, I guess I'm trying to figure out if like the insertional is the progression in a sense off of like the mid portion presentation from like a space time standpoint. And it may not be an answer for this, but like how come like there are people who their first pain complaint is that they feel it at the insertion. Like they don't go through the progression of feeling like, like it started in the mid portion and now like it's made its way down to the heel where I can just kind of shows up. Um, so I'm trying to figure out like why it wouldn't have reached threshold for them to notice it before then.

In the rear foot? Yes. I'm going to move from outside, like get lighter on the outside heel and heavier on the inside heel.