SPEAKER_02 56:50–56:55
Okay, so let's just look at an extreme representation of that. So, right away, she's in a little bit of pickle based on the diaphragm shape that does not allow a lot of, we're talking about internally now. Okay. So the compensatory strategy of the diaphragm does not create a posterior lower expansion in the lung because of the diaphragm shape. So she's going to be anteriorly expanded. It's going to shove her forward. She shoves herself back. Okay. So she, she, she chest backwards and then she falls backwards and then she pushes herself forwards and then she pushes backwards and she pushes herself forwards, right? So she just goes boom, boom, boom, boom, boom. And every one of these strategies is an exhalation compressive strategy. But, but the advantage of that is that she creates this orientation so that she's turning her glenoid laterally. Right? So that creates an ER space. Okay. It's not going to allow a whole lot of relative motion to occur. So chances are she's going to get for every element of ER that she gains, she gives up some IR. Right? And so where she's probably doing this back band is she's got this orientation, like crazy orientation into ER, right? And then that gives her just enough so she creates IR through the extremity so she can balance on her hands. Right? But I think you're correct that her ability to do that may very well have led to the fact that she ended up with this so-called shoulder impingement because it requires a tremendous amount of posterior compression to achieve that position. So think about it. It's like, if she's in a back bend with her hands on the ground and her feet on the ground. So she's in this inverted U-shaped, right? Okay. If she was a tube, which she is, she was a tube and I bend the tube and the underside of the tube is fully compressed here and then there's expansion on the other side, right? You see it? And so all of her ER measures in a relative sense should be limited. Now she's creating an orientation, but there's Misha thinking again because she's creating an orientation to capture the ER position. She's literally pinning her scapulae together and pushing it forward. Well, if I push it forward, it makes this look like it's not really expanded. She's pushing it forward to create ACAs. So she created a shape in a very compressed state, but that's how much compression she has relative to the anterior. So chances are you got somebody that's gonna have like a low pressure abdominal strategy, because she's gotta let it go somewhere to make the U shape, right? She's probably not doing it through her sternum. She's squeezing in her sternum, so she's gonna push stuff towards her gut. So her abdomen is gonna probably be where she's gonna give way the most.
diaphragm mechanicscompensatory strategiesshoulder orientationexhalation compressive strategyrib cage compression