Right. OK. Have you ever had a patient with a supraspinatus tear?

So, if I'm trying to get that yield on the left, I would want to do the rack carry on the left and then the waiter's carry on the right. And that could be a progression within getting pulled by the cable or pushing with the cable.

Okay. Is it just that the behind the neck doesn't require, it allows her more ER? Yes.

Yeah, yeah. Thank you. Do we wear glasses?

Okay.

Wait. Manuel, say it out loud.

Okay, so it's a question of whether you already have that position or whether you're trying to strengthen that position.

So how it's traditionally taught in PT school, for low back pain, the answer for all of it is just all these different core strengthening exercises. So I was just wondering if you've thought about that ever through the lens of your model. Because one of the things that I think has been interesting to hear you talk about sometimes is how maybe some of these things that are traditionally taught are useful, but for a specific type of person representation through your lens. So do you see any utility in those types of activities for a specific presentation or are people just getting better with this sometimes?

Quadruped.

Sorry. Yeah. Yeah. Late. Cause the, cause the sequel position is different. Yeah, I, yeah, I meant, I meant like, okay, all right. Or so I think I do. So let's say if they, let's say they have their left foot on the wall. Yep. And we're trying to get that kind of that initial, so early propulsive foot stands and we're trying to get pressure on the inside of the foot. Yes sir. So I think this has kind of been answered at this point, but I guess I just wanted to go for it in this situation. So as they go to bring that, that right leg forward and they're bringing it to the midline. Yes sir. So like, uh, when we go to reach with that, or, or I think we are still reaching with that left elbow to that right thigh. Yes. Because it's staying like below that, that like 60 degrees or so. You got it. And then I guess, I guess now I started from answering myself. I guess I just want to see if I was kind of right after all the questions that went by. And it's kind of helping because they're in supine. So now their sacrum is already kind of facing forward at that point. So, or maybe more like in a new in a new tated situation. Gosh dang it. I thought I understood it.

Right. And it may not ever be a perfect squat, but we're looking for better. Right. Yeah. Do you see how you manage that though? It's like if somebody is struggling with gravity at body weight, you have to make them lighter or change the direction of gravity so they can learn how to manage the forces before you superimpose load. So what they should have told you in school when you're measuring table tests and they said this is how you measure hip internal rotation at 90 degrees of hip flexion—what they should have said is the whole system is turning into internal rotation. We just want most of it to come from the hip joint.

Yeah. Like what would be a, you can't squat deep.

I've had surgery with a cadaver graft, and it's been pretty good, but I've always noticed that this left side lacks internal rotation. I've lately found it hard when I plan to flex my foot and then attempt to pronate it—I feel restricted, like I'm hitting a wall. Where do I feel the restriction? Probably around the talus bone, and the lateral muscles like the peroneal muscles feel really tight on my left side, that same ACL-injured leg.

Okay. Great. Less time. Okay. So less time would be a faster rate, correct?

You could ruin athletes almost soon if you do the wrong thing.

Yeah.

Epi, endopere, myseum, and then I'm talking about here.

You know, if you see that kind of representation, they've got a whole lot of stuff going on there, but that's what it would have to look like for you to gain an expansive strategy, right?

School. Logan University.

So we have to be really, really particular here. So she's got a strength training background, correct? Yes, and I'm assuming a rather aggressive one then? Yes, yeah, she was doing a more aggressive like bodybuilding program. Okay, all right. So I'm going to make a couple of assumptions here. But have you done any hip measures on her by any chance? I have. Um, because she has a history of knee surgery on the same side, so I checked range of motion. Hip seems to actually be in, have really good mobility. Internal rotation was a little bit limited.

Yeah, that's what all our rehab sessions are.

Oh, yeah. Oh, yeah. Yeah. On the right side.

Under certain circumstances, compensatory activity always happens. It is a natural phenomenon where things get tied together. What you don't want to do though, because you're creating a focal local effect, is, okay, if I get the focal local effect at the foot, what did I just do to the potential of the knee to move? Do I really want to blow out a knee to try to mobilize the foot? I would rather not. This is why you have to be really careful. You have to be really careful as to what angles you're playing with.

Yeah.

Yeah. The most difficult thing is to overcome some of the, how do you term this? The tradition, the rules about everybody should be able to, like if you hear a statement like that, it's like stick one finger in your ear, listen to it out of one ear, but don't listen to it with both because you got to take it with a grain of salt.

And the nice thing about an activity that shifts the center of gravity or slows the center of gravity from going forward is like that the load is more straight down into that rear foot. And so there's time for you to capture the position.

And I want you to run on it without internal rotation, okay? And I want you to keep running on it without internal rotation. And I want you to keep pushing down on that foot through that archway as hard as you can, because you're gonna run, you're training for a marathon—everybody has to run a marathon once in their life to prove that they don't die. But what would a stress fracture of the first metatarsal represent under this circumstance?

Yeah.

Am I going to need more internal rotation left foot forward, bottom position than what I would need to access the left foot back campo?

You see that you're preparing the axial skeleton for all the stuff when you start to add the extremities back in?