Yeah.

OK. Well, yeah. No, that's cool because I was seeing this and I was trying to derive some.

Okay.

I hope so. That's what I'm trying to figure out.

Would they both be oriented into external rotation?

Yes, because he has a very late representation in the left knee, which is a knee that is supposed to experience a reduction in force production. He's already in a late representation, and you're asking him to produce force at the bottom of the split squat where he has to move from late towards the middle representation where he's driving more force down into the ground. But he has the wrong knee orientation for force production. He's not able to turn the tibia into IR relative to the femur to produce force; it's staying twisted out into ER as he does it.

That's one. Give me another one. Say it again.

You see the difference between the two.

Yeah. Can you show me how to do the Apple test again.

Yeah.

Well, it would have to return to its, I don't know if you want to call it a neutral position, whatever it was.

But I wasn't really paying attention to the feet as much.

Okay.

I'm pushing down into the ground with my left side. So the left side of my body, the energy's going from me into the ground. Do you see the difference in the two sides?

Well, we already talked about flexion, right? Oh, yeah.

OK. A human inputs equal outputs entropy zero.

Where do you want to put her so she has an ER representation and then can superimpose IR on it? Say it, Ivan.

Yeah. Doesn't make it right. It doesn't make it wrong. It just, you have to determine what is. Okay.

I mean, so well, that would either be the inability for the fluid to get out of the front of the shoulder or the humeral head to get out of the front.

And then we have to teach you how to bring that side forward at the appropriate rate relative to the other side. And then eventually you've got to push that side forward with an element of control. And so that's what you want to think about from a sequencing standpoint as you bring somebody back through. So Ian, when you're working with these guys with all the knee stuff, think along those lines. It's like capture that earliest position first, and then you got to teach them how to move through this at the appropriate rate relative to the other side. And does that answer your question, Manuel?

More damage.

She just diagnosed it for you, boss. That's awesome.

Okay.

Yes, there you go. So everything has to anteriorly orient and the knee is just a representation of that. Okay. Cause I have to have, so think of this. If I'm on the lateral aspect of the foot and let's exaggerate it for effect. I'm on the lateral aspect. I don't have a first metatarsal head on the ground. Where's the next first metatarsal head going to be?

Yeah.

Yeah. It saves a lot of time instead of doing like straight leg raises in four planes and whatever it is that they teach you in school, right? Yeah. Yeah. This becomes kind of useful. But again, construct it in a safe position first. Laying down tends to be safe. A lot of people don't mind laying on their back. They can roll from shoulder to shoulder. That's part of the rolling. That's a weight shift. You put them on their side. They roll, they roll, they roll. They can reach on top of that. They can step over themselves as they're laying on their sides. So you're creating all of this generalized representation of turning. You get them up into a seated position. You can do like an offset stance for a sit to stand in both directions. So now I'm promoting turns and then like I said, you get them up on their feet and you do something that challenges them to have to step, shift their weight so they can create this sensation. And it's more fun for you because there's nothing worse than drag therapy. You know what that is, right? That like ball squeezes and like... No, drag therapy is where, okay Greta, we're gonna get you up and we're gonna walk with your walker down the hall and you drag them down the hall, right? Because that's exercise. It's more fun, it's more fun to make it a party in that atmosphere. Those people don't have any fun. Okay? Help them enjoy themselves. It's a miserable existence. You might be the highlight of their day. You might be the only person that actually talks to them. It's a tough situation to be in for everybody. Make it fun. If it's fun for you, it'll be fun for them. Okay.

Thank you, Bill. You too. All right, see you. Since starting to come on these calls, just being able to pick and choose like these traditional exercises that I was just throwing at someone randomly, and now she's having like a reason for them. Has been really helpful.

Right? But when you think about reaching overhead and things like that, you need to build them sequentially. So her posterior lower compressive strategy, because you've got a limitation in shoulder flexion, that tells you you've got a posterior lower compressive strategy, which means that as she is elevating her arm, she never had any external rotation there available to her. So her spine is already turning away from that arm, which means that she's raising her arm in internal rotation and then she hits that You know, that's why you get the Hawkins-Kennedy test. Is that the one? Yeah, Hawkins-Kenney. That's why you get a positive Hawkins-Kenney is the posterior lower compressive strategy, okay? And so chances are she was diagnosed with an impingement in some way, she had performed under those circumstances. So somewhere at 90 degrees, whether it was abduction, which would be dorsal rostral compression. And so if she's got posterior lower, if she's got dorsal rostral compression, you've got two of three impingements for sure. And so you're gonna have to clean that up first. Right? Get a truer measure of relative ER and then you should capture IR at the same time. Okay. Okay. Yeah. Does that make sense?

You've got some upward rotation. So you're not getting full dorsal rostral expansion, but you are getting part of it. Okay, so remember that if you looked at the structure, if you look at the structure there, you've got oblique angled muscle fiber, you've got horizontal angled muscle fiber, and so you're going to affect them differently because they pull in different directions, right? And so you're actually going to create the oblique orientation of the scapula under those circumstances. So the ER down by your side and the ER up here are affecting the SCAP orientation in two different ways. Do you see the difference?

Yes. What would we see then progressively like, so if we're looking at space time, what is that end changing look like? That she can absorb load and produce force.