Okay. And then if, so like, if, so like to speak another language when I'm talking with like others in terms of like orientation at the elbow, if I'm doing like manual work and I'm thinking like, oh, I'm trying to capture for us like ER at that elbow.

The question is: if I'm trying to promote the turn to the left, I know with some other activities, like putting someone in a left-side position, you need a certain amount of internal rotation to even access that position. I'm thinking about getting that left foot back for the Campos deadlift. Do I need to be thinking about that in a certain way? On the one hand, I see how I'm going to need more range of motion just to get the sacrum to face that way. But then at the same time, that position might be easier just by virtue of position to hold onto the turn as opposed to with the left foot forward. I won't be able to create that yielding action in turns to the left as easily, but I need less range of motion.

Well, yeah. I had to get somebody that was at the intensive. Grace, you sat through the intensive, didn't you? Yeah. Why isn't she doing any plyometrics, dude?

Okay. Now drop the left heel. And for you to go that way, you had to push off a little bit more on your first met head. Because that's where you can't kind of came from when you shifted over to the left side. Did you feel that?

It's not rounded shoulders.

Well, OK, so what about this? Can I give you a test question? What about the position that you're trying to acquire? And what is the end position? So they're pushed into the ground, right? And then think about what you're trying to achieve here in regards to your ER and IR representations, okay? We can go back to Zach's question actually. It'll help us conceptually. Right, because we're moving into a position where motion's going to stop, but how are we getting there? See, that's going to be the question. If we're going into a position where movement's going to end, very specifically in this case, because we're sort of constraining the system rather aggressively with some bands and the position, where are we trying to end up?

All right. I had a pitching question. This might be coincidental that I've seen this with the last few players I've been working with. For a right-handed pitcher as they get into their lead leg and plant into stride foot contact and start to turn, they're leaving the right side open and not getting the pelvis to turn around. I don't know if it's that they can't.

That would be another representation of that. But you have to understand the differences between the external rotations. Because the external rotation is describing a relative position. There's a difference in the connective tissue behavior between an early ER and a late ER. In fact, that would be the significant difference between the two.

So with the narrow rib cages, those who are sway backs, so like they stand and they go really far into that position. In that situation, even though they're in the sway back position, their ribs are sort of erring posteriorly, or at least the spinous processes are erring posteriorly. That's the situation in which you would more just want to bend the ribs from a less straight position rather than try to focus on bending the ribs back. And I guess get them to okay.

Yeah. So what that is is actually the spine going forward beneath it. So it's not the head going back. They're trying to get the thorax to go forward, right? So think about it. It's harder to see anti-orientation in the thorax than it is in the pelvis, right? Because you've got some more movable parts. But that's basically what they're doing is they're trying to anteriorly orient the thorax. So they're pushing this forward so the head goes back. So they're not pushing the head back like this. They would fall backwards. If it was a head movement, they would fall backwards. So they're pushing the thorax forward and then holding the head fixed in space. So they're just following that principle that you expressed. It's like, OK, the nerves are going to go from the top down and the Y's are going to go from the bottom up. That's all they're doing is demonstrating that.

If it doesn't turn, they have a reduced ER and then it tends to magnify the IR if it's forward enough.

Okay. That makes sense. So given that the orientation is top down, would I want to do the offset so that the ER, I guess the ER would be from the bottom up in that case for the narrow to help offset the superficial.

Just that. Would that increase the distance between those two extremities?

Yes, so he doesn't have a big space for middle P. But if you can get the early representation that you're describing, so you've reduced a lot of the ER, or reduced a lot of the anti-orientation to get the ER, which is great. You start superimposing some IR there, and now you've got to get them a true middle representation. You've got to untwist the need for force production.

In terms of remeasuring afterwards, what would pop up as you're doing the activity? No, you're going to see something happen.

So you can see the difference right away. It's like all I have to do is change the heel of the axis and the weight bearing becomes totally different. Okay, so right now, instead of going forward onto the met heads you drop back to the right heel. Okay, now where's the available space was still in front of you. All right. And now when you start to move forward on the right side, you're going to end up in the same place that you did when you were narrow. You're just going to get there in a different sequence of events because everybody has to go forward. There's no other way to go. There's no other place to go. Okay. And because you're already weight bearing on the right, it's like you can't go more to the right. You have to go forward.

Yes.

So, okay, which is associated with the orientate. So the pelvis is moving as a single unit. It's not moving with relative motions. Anti-orientation is not nutation. Nutation is a sacral position relative to the ilia. Okay? Okay. So you gotta get, for a wide ISA, I need a normal, nutated, exhaled IR representation of the pelvis first. If the whole pelvis is anteriorly oriented as a single piece.

Yeah.

So something I did have her do was hold the bridge. I helped her hold the bridge with my hands on the pelvis. And had her do some long, full exhales.

Okay, cool, cool, cool. And you know, it's kind of dancing. There are many of them.

No, we already stepped forward with the right foot. What's my left foot doing?

What else? Well, you got one more ER measure that you could probably use as a guide.

Which part did you not get?

So where do you want to put her? Where do you want to put her in reference to her feet? Where do you want to put her so she has an ER representation and then can superimpose IR on it?

The band definitely can keep the knees out via a load, creating a leading resistance that helps promote the maintenance of an ER representation, but I still have to produce the IR somewhere. If you think about the possibilities, if you have somebody that cannot expand the angle of the IPA—so it's the ISA of the pelvis, right? The infrapubic angle—if you can expand that, you can create concentric orientation that would create an upward movement, which is your IR. So if I put the band around somebody's knees and they do that, I am successful, because what I did is change the orientation of the hip joint, which allowed the muscle orientation to change into a more favorable position. That actually can happen. But again, what I'm doing is I have to have an IR strategy available to me. In a lot of cases, I put the band around somebody's knees, they push out against it, and then they have to orient more. Because I have to create an IR force. But again, it's like: are you looking through this little hole at somebody's knee and thinking, 'Oh, fix the problem?' Did you just give them another alternative solution? That's the question mark.

Right? So if we're doing like extra rotation with the arm at the side, for example, we're trying to get like the posterior muscle activity on the shoulder to shove fluid to the front. Absolutely. To allow for that motion to happen.

All right, those videos are still great, but I need, like, I use one hour of my day just to go through them and try to understand what's happening, but it's great when you get it.

Yeah, it's more specific to what's happening.

Good morning. Happy Friday. I have neuro-coffee in hand and it is perfect. Okay. This is a busy weekend. It's work weekend on the two week sprint. So we'll be very busy. So let's dig straight into today's Q&A. This is with Zach. Zach was on the Coffee and Coaches Conference call yesterday, brought a great case to the call in regards to a weightlifter with right shoulder pain. The cool thing about this, it will be very relatable for those of you that do not do table tests, but still need to be able to understand how movement exists based on shape change, based on spaces where we do access ranges of motion. For instance, if I was working with somebody that had a great deal of anterior compressive strategy, we know that that takes our extra rotation space that we can normally access in front of us and it moves it away from midline. That's exactly what was happening with this weight lifter as she described some of the symptoms that she would get during some of her lifts. This is why we do the subjective examination with our patients—because a lot of the information that they give us tells us a great deal about how we need to look at these relationships. For instance, if somebody off the street comes in and says, 'Hey, I got right shoulder pain, hurts when I lay on that side,' what that means is they can't change shape enough to lay on that side. Because usually what you would get is you would get anterior-posterior expansion when you lay on your side. But if you don't, then you're laying right on a point. And so that's why people get uncomfortable in their hip or on their shoulder when they're laying on their side. So little pieces of information like that are valuable to us to help us guide our process. So again, you won't need table tests if you pay attention, if you understand spaces, and if you can get rid of the straight plane thinking that we were all brought up on. Zach, a very useful question. Thank you for bringing this case. It's going to help a lot of people. If you would like to participate in a 15-minute consultation, please go to askbillhartman 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 Friday, an outstanding weekend. Podcast will be up on Sunday. Don't forget to go to the YouTube channel and subscribe so you get all the videos. And I will see you next week.