Nice. So I have a couple. So narrow, I'd say. Yep. Eye arch in the foot. Relative tibial external rotation.

Yes, I know I was going to say okay, now we get okay. So this is important this is going to be really, really important okay. So she's running out of internal rotation she's running out of it very, very quickly because chances are chances are you've got a compressive strategy posterior that's going to be the limiting factor. So when she tries to move actively, right? Chances are she's not moving away from the motion. So when you check her passively with shoulder flexion, number one, if you're not controlling at the elbow, then she can create some rotation through the humerus and forearm that will substitute for some of the rotation that she's missing. Okay. So if she's got any posterior compression below the level of the scapula on the affected side, what's gonna happen is she's gonna run out of the early phase of shoulder flexion very, very quickly. She's gonna hit internal rotation, upward rotation of the scapula is actually already occurring. So that's why she'll top out at 90 degrees actively, most likely. So she's gonna present with what we would call clinically impingement, right? Okay. So we got to get expansion in the posterior lower aspect of that thorax first. Okay. Otherwise, like I said, she hits in rotation very, very quickly because extra rotation is in this early phase of arm elevation because of the compressive strategy is out here. that's where extra rotation really is. So she's, if you're testing her through this range, she's already internally rotated. Okay. So again, posterior lower expansion in the posterior rib cage is going to get you that early phase of flexion back. And that's immediately going to extend probably where you can get her through that middle range of overhead reach.

That makes sense.

Yeah.

Yeah, yeah. It's not that it's not disuseful. It's just like you gotta, like I said, understand your intentions, understand the secondary consequences, look beyond the foot, right? It's like, how does this affect the knee?

Yeah, that's just, will she have that same proximal twist in the femur?

So it's not going to be the same. It's like, and keep in mind that we're always talking about the extremes for the purposes of understanding, like take the narrowest of narrows that you got, the widest of wides that you got, and then just watch them. Good morning. Happy Tuesday. I have neuro coffee in hand and It is perfect. All right. So catching up from the Intensive 20. So we're gonna dig straight into this Q and A. This is with Alex. Alex has been on the call in a while and we were in a sort of a knee-heavy situation and Alex didn't let us down in that regard. He had two knee presentations. The commonality between the two is recognizing the fact that in both situations, We had knee results with other influences that are producing these outcomes. One, he had a patella tendinopathy with an associated patella ulta. So that's an upward movement of the patella. And Alex caught onto that one right away. He sort of had a great grasp as to why that presentation would be affecting the knee as it does. And then we went a little bit deeper on the second presentation because we had to look at archetype. We had to look at compensatory strategies. We had to look at the position of the center of gravity to determine why this other new result would have occurred. But we laid it out, I think, very effectively. And so I think it's going to help a lot of people as far as the understanding as to why you would see some of these issues arise. In many cases, it's not going to be a knee. It might be something else, but the premise is the same. We want to start looking at these relationships. The foundational archetypes are going to give you the point A or measuring point B, and then we just reverse engineer and close the gap. So thank you, Alex. Great questions. Great to see you again. And everybody have an outstanding Tuesday. I'll see you tomorrow.

What, basically what happens when you're stuck in that ER position of the rear foot, it just goes right past it. Because again, the amount of time that you spend in a position is where you determine where you can put the IR. And again, that's why your friend has a bunion is because he spends more time on the first met head than he does anywhere else in the foot.

Okay. Yes. That would be the smart thing to do. It usually doesn't stop people just FYI. So what that represents is that's where you're trying to get internal rotation. You've taken away all the relative motion available in the foot and you go, I'll just make a new joint. I'll just keep trying to bend this bone in the wrong direction until it starts to come apart. And then I will make a joint eventually, if I let go.

Okay. Right. Makes sense. As always. Thank you. All right. It's been a while.

So if I've got the contralateral load, that'll keep me earlier.

Yeah. Do you see that you're saving time by starting now with that? You ever wonder why some people respond so quickly? Certain archetypes tend to respond very, very quickly after an ACL when you start to do the ground based stuff through the feet and the bouncy bouncy stuff. So you start working on axial skeletal behavior while you're protecting the ACL. Everything will come back faster.

Awesome. So when they land on their left foot, are they going to be better at a middle representation or an early representation by structure?

Well, once again, from a coordinate standpoint, if you're trying to teach people to produce force with compensatory positioning, right? So if I have a compensatory ER, and I'm trying to get a downforce, and I can't capture the internal rotation, think about this, Matt. It's like, when we talk about the direction that you're applying this, it's like, this is going to be a top-down kind of a thing, right? I have to drive the IR from the pelvis downward. If I don't have the pelvic position to drive downward yet, I'm going to try to teach somebody to produce force in ER. Does that increase the risk during the activity itself? Maybe not. Does that increase the risk during some other activity where they then try to use that strategy to produce force? Yes. That becomes my concern. Right. I don't think you're going to destroy anybody during the exercise. I mean, you could still hurt somebody. But again, when you think about, it's like, they're going to learn a strategy through this activity that they may try to use elsewhere. Which is what I don't want. And again, this is why the access to the force-producing position through relative motion becomes so important. We're going back to Zach's question. It's such a perfect setup for this. It's like, I got to have the relative motions available to me because the position that I'm ending in is no relative motion. Like the body becomes a big piece, right? Jamming force into the ground. I better make sure that my structure is organized effectively to produce force. Make sense?

So, their feet become essentially too far apart. So, this is my lead foot. So my right foot wants to go this way. And then how do you get downforce into the lead foot?

Yeah. So same thing happens when you take a step forward, right? So swing and golf clubs just walking.

Yes.

Yeah, so he's barring the hell out of that left leg, yeah.

Like when you look at it, it's always a ride downward. Okay.

Okay.

So your knee is actually inferior to where your hip was and you're turning your pelvis to the left as you're stepping forward with your right. You're turning dorsal rostrum. Now move your right knee a little bit closer to the left. I'm sorry, your left knee closer to the left hand. Move your left knee closer to your left hand. Now, are you ever in that position when you're crawling? Yeah. OK, so it's Carl, right? Yeah. Yeah. So what we're doing, so there's a big point of confusion in regards to propulsive activities, because there's a point in time where everything is going in the same direction at the same time. And there's a point in time where it looks like they're going in opposite directions. And this is because of the passage of energy through your body as you move. So as you walk across the ground, we take energy from the ground and then we push it back down into the ground. So you understand that like the early energy that comes up from the ground, we take that and then we push it back down as we propel ourselves forward. What we want to do those is we're going to take three snapshots. As you step forward, you take a snapshot. And so that's at the extreme end of like an early, and then you take the extreme of the late. And that's where everything is sort of, as you said, in phase. So everything is in the ER representation in the early. Everything is in the ER representation in the late. And then if you go like dead center middle, that's where you're going to see this superposition of ER and IR, where the IR would be most strongly represented. In between those two, you have a waveform that is moving through the system. And so there will be segments that appear to be moving in opposition. But what it is, it's just a relative timing issue. And this is the waveform as it were going through the system. And that's what creates so much confusion. And so what you were doing with your crawl is I was sticking you in a very obvious position where that that sequencing of energy passing through you was a non-issue. So I put you sort of like at the end of that late representation where everything looks the same. As you transition through that, so if you were crawling across the ground, there would be a timing of that energy, right? And then there would be that one point in time where I just stuck you in where it goes, oh, everything's the same. And that's the thing that needs to be appreciated because what happens is some people can't do that. They can't change from one to the other. Does that make sense?

Yeah. So you just got a little bit of manual work to do. Probably you got a little bit of orientation to work on before you try to get him to produce force through that single leg for sure.

Got it. Thank you.

How about we make that today's Instagram video? I think that was it. I think those are pretty good Instagram video topics. You win. Good morning. Happy Friday. I have coffee in hand, and it is perfect. All right. Well, a very busy Friday coming up. We're in Diggs Street in today's Q&A. This is with Andrew. This is actually a fairly short video, but very, very useful. We're talking about hinging activities, how we're going to apply this for a narrow ISA individual. Just as a quick review: Our narrow ISA individuals are biased towards this ER representation in the pelvis. So we've got a counter-neutated sacrum, and typically for your so-called hinging activities like some form of deadlift, RDLs, any number of forward bending type activities where we're going to try to move through the hip joint, we've got a bias towards counter-neutation that's going to interfere with our ability to capture the nutated representation because we're moving towards an IR representation as we perform these so-called hinging activities. We also have an issue with the narrow ISA individuals in that their center of gravity is actually up and forward. And so we're going to have to move the center of gravity down and back under these circumstances. And so again, they're just biased towards this representation that makes them a better squatter than a hinger. Andrew's doing actually a great job of sort of accommodating some of these issues with foot position and inducing some muscle activity, but there's also some issues that we have to protect against. For instance, if we have somebody that is compressed in the posterior lower aspect of the pelvis, so we've got a situation where we've got an ischium that's getting closer to the base of the sacrum. That's going to create some interference to the forward movement, the posterior weight shift that we're going to need to create this hinging representation. And so again, Andrew's got some strategies for that that we talk through, and we also talk about some of the problems with that. So Andrew, thank you for this question. It's going to help a lot of people. If you'd like to participate in a 15-minute consultation, please go to askbillhartman@gmail.com. Please put '15 minute consultation' in the subject line so we don't delete it and include your question in the email. We'll arrange that at our mutual convenience. Everybody have an outstanding Friday, a great weekend. Podcasts will be up on Sunday, and we will see you next week.

The sacrum relative to the ilium?

Yeah.

The opposite side.

What are we going to do?

How does the energy go up to the top of the golf club?

Pectoralis minor.