That's a golf swing.

Yeah. So you've got three ER measures that have to be normal for you to have normal dorsal, rostral behavior, right? Any of those in deficit would be indicative of the fact that you don't have normal expansion in that area?

It's just the appearance of zero.

Okay, wait a minute. She's got two feet on the ground. Where are you putting the left foot?

Good morning. Happy Thursday. I have neuro coffee in hand. And it is perfect.

Yeah. So does the fluid get stuck there or does the humeral head get stuck there?

Yeah, but I don't know if you had to get that wild and crazy on the other side, but what I would offer you is like, now think about if you're gonna use a press, which you can do. So, you know, if you look at like the videos that talk about the waiter, waiter carry.

That makes sense.

Okay. So let's work through the thought process. Talk me through it. What's going on?

Right.

Where's the next first metatarsal head going to be?

And so is it just that he's running out of space on that backside, getting into ER? And so the knee's just a representation of trying to find more room.

My advice to you.

Yes, but okay. So let's think this through for a second. So one of the problems that you're running into when you're actually breathing under load is that you're going to get more relative motion, and so you've got to be really careful as to the timing of things. And one of the things that you need to recognize is if somebody's doing a breath hold, that is an exhalation strategy. The reason the air is not coming out is because you're cutting it off at the glottis, and so then you're going to create that internal pressure and it'll be an exhalation strategy. So you don't have to physically exhale per se. And when you're trying to create a concentric overcoming, under those circumstances because it sort of complicates that, especially when you're playing with something where the force production is a little bit higher. Like when we're talking about the heels elevated goblet squat that we would use to try to recapture relative motion there, we want to make sure that we're breathing through the excursion. In your situation, and again I wasn't there so I can't speak with great intelligence here, but the thing that I would say is if you're trying to get concentric overcoming the breath hold is going to be okay because that's literally going to create the higher internal pressure and it'll help maintain the concentric orientation of the outlet. And then it's just a matter of superimposing the rate or load as you are on top of that. So again depending on what the goal is. And in this case you're trying to limit the relative movement would be my understanding, am I correct?

There definitely should.

So think about what she's capable of doing with this back bend. And now let's directly oppose it. So she's got a low pressure belly. Okay. And I need to post your lower expansion first. Where can you put her that you capture all that at once?

Yeah. Yeah. Yeah. I would use them rarely. I would say never. I just don't spend a lot of time with it. Because once you start to recapture the relative motions proximally, and then you start to get the normal scapular motions, then you tend to not have to worry about this too much. Right, so again if I compress here or I create a position that creates compression superficially, you just created the restriction in ranges of motion. So when you have to reteach those kids when they come back, it's probably because they've been doing a lot of pulling and pushing and stuff like that on their own, right? So they're doing a lot of this, a lot of that, right? Yeah, you're just trying to take that stuff out of them.

that she can absorb load and produce force.

Being vague about loaded activity then becomes the question mark. Right. So give me, for instance, that what you're talking about so I understand.

So sometimes, for those clients who wear really thick, heavy shoes—mushy and heavily padded—they can't feel the ground and are all over the place. Taking them out of their shoes is a necessity so they can gain that understanding. Once they do, you typically don't have too much trouble.

So if you have like a kettlebell kind of like clean and then drop underneath it.

Well, it is. And, you know, I did a little talk last week about stretch shortening cycle because they've always looked at the tendons doing all this work. It's like, let's not forget about all the other connective tissues here because they're all getting loaded at the same time and especially the skeleton. The skeleton becomes very, very important when we're talking about really, really high force or high velocity activities because it can store and release more energy than everything else because it's stiffer. It takes a little bit more to deform it, right? It takes a high force to deform a bone, but if you can deform it, and it won't, it doesn't break, right? Well, that's a representation where the bone gets way too stiff too quickly and it snaps just like silly putty. But the reality is, is that we really have to start to appreciate how we're thinking about these things. Because again, it helps us select better interventions. Because if I'm thinking that I'm changing muscle, when the muscle is literally there to create a position, and then I'm not appreciating how the connective tissues behave, it's kind of a big deal.

Okay.

Yeah. But this is huge. This is huge. And we talk about this a lot because it is kind of confusing because people associate yielding with eccentric orientation and they're not the same thing. Eccentric orientation is the moment in time where the muscle is represented at a length. Right?

I got it. Yeah.

I'm paying all this money for a doc.

Well, that's, but I would just like some advice on kind of how to get everything under control so I can really progress her through this protocol and get her back.

Okay. So, so we're talking straight down force into the ground, small space, hit it, right? Okay. Um, those activities by design should reinforce that. However, you have to be concerned with how it's being executed. So it's very easy to use a compensatory strategy to hold yourself in what is perceived as the right position. And you will feel muscle activity where everybody likes to feel it.

That's a really good question because we were talking about medial foot contacts because that's one that everybody loses, right? So, think about being on the extreme outside edge of a foot. Okay. That would be representative of sort of the extreme barrier of your base of support. Like you tip over outside of your fifth met head, your toes, right? You're going somewhere, right? Okay. So you think about extremes of inversion, like it's this one point in space where all this density comes in, it's your center of gravity, that's as much inversion as you could possibly demonstrate, so much to the degree that there's so much compression that you can't see any eversion. Okay. Take the fifth met head and reverse that engineering process. This is the greatest representation of space away from midline. It is the last representation of eversion with no inversion. It's like, again, if you fall outside of that base of support, you have no downforce. So you have to fall. Okay. So when we're capturing foot cues, we don't really talk about the fifth met head all that much because most of the time you don't have to practice capturing, you have to just practice hanging onto it. Because again, most people will have pressure on the lateral aspect of their foot in many cases. And so as you're capturing the medial contacts, the mistake that some people will make is that they will over-react to capture medial contacts, and then they lift up the lateral aspect of the heel, and they lift up the lateral aspect of the foot, which releases the fifth met head from the ground. Because what we want is a foot that can do that with the foot on the ground. So that's all the concept. So I want a foot that can do that. And that requires that I have my two heel contacts and my two met head contacts. Typically because of the way that the center of gravity is shifting, we tend to lose our medial contacts. Because again, we're going to move away from midline to find spaces to move. And then that's why we lose them.

Cause you're saying you're giving them this position of space, right? Versus just like on a flat ground.