Yeah, okay.

Yeah.

But what? You're going to lose that internal rotation again, which I'm okay with initially.

Why?

Yeah, yeah, yeah, exactly.

And then you mentioned that's what happened when the subtalar joint is fused. You use the word fuse. Is it inevitably that, or were you giving an extreme example?

Yeah. That's right. I know you're out there somewhere, man.

You're pushing yourself out of the cut. Yes. If you put your left foot forward and you do that right foot on the wall thing, you're out of, you're coming out of the cut.

It's your call, so you can take it away.

It didn't feel like I was pushing back.

We have to orient down, right?

Please do.

If you're married to the patient, I think that's acceptable, yes. It's very intrusive. It's literally you have your arms wrapped around somebody that you don't know. Yeah, it's a little weird. It's a little weird. It's like, if you're working with an athlete, they don't care. Like they don't care. Just do whatever you got to do. But, you know, if I have, you know, a young mother of two coming in that's going to sit on the end of the, it's like, no, no, no, I'm not doing that. All right.

So even though his hat is facing a certain direction, we can't rely on that as a representation of anything that's going on here because he's moving around on the bench. But what I want you to understand is that he is literally facing up and to the right, okay? So that's what that ER is. So the ER is not pulling him in that direction. He's actually pushing himself away from that direction. So his spine and his sacrum are oriented, so they are facing up and to the right.

Where would the movement be? Like it's not as simple as that, but let's say the weight is kind of going over to the right. And then kind of like down and then up, that was loud. Um, they kind of, yeah. So they go over their right and then forward and up and over their right. Does that make sense?

When you say slightly forward, what's forward?

Should be a middle P.

Oh, yeah. Well, I kind of have a quick follow up to Andrews because it's something that I play with all the time is breathing on exercise. And I'm going to be specific. Let's say a wall ball. What is a wall ball? So you have a 20 pound wall ball and you go down into a squat and you throw it to a 10 foot target.

They tuck under? Yes, tuck under, sorry. Well, of course they do. I actually had that happen yesterday. Somebody asked me that question. They asked, 'How far under do I tuck?' and I said, 'Don't.' That's one of the best ways to avoid it. So when you do an exercise in supine, it's very easy to find contact with the surface because their weight is on it. When you have somebody in a side-lying position and you're trying to teach the sequencing where they're trying to create a delay strategy and there's no physical contact with them, give them something to move into. So provide leading resistance. So, if you've got someone in right side-lying and you're trying to teach the turn from right to left, which requires that you have that delay on the left side, put your hand against the left sacral base and teach them to push into your hand. That way, you're giving them leading resistance, so they're going to use the muscle activity that they need to create that shape.

So the ways that you could tell, you said looking from behind you, would you be able to just tell?

Okay. There's not a lot of knee movement, right?

Yeah.

Okay. So I need to give her an assist. Do I not? So if I put the cane on the left side, she's doing a left suitcase carry, which will give me IR on the right side. Will it not?

That's what our insole has—an arch.

Is there an ER wave? I mean, I know that. Can you talk me through that?

Yeah. Where's pec major attached? To the humerus. Okay. Does it directly control the fluid shift in the shoulder joint?

All right, wonderful.

Or am I just doing the- How are you going to measure the neurologic aspect of it?

Of course not. His tibia is externally rotated. And also when he's starting on the left side, he's on the outside of his foot, and he's flexing his knee like crazy, which is flexing his knee, but he doesn't have access to that hip knee internal rotation.

Right, it shifts it downward, doesn't it? Yes, that's why you can't raise your arm overhead when you have a superior glenoid labrum tear. It's not that the muscles aren't lifting the arm. It's never going to happen—no matter how hard you try, it's such a tiny little thing. But what it does do is push the fluid content down underneath the humerus, which lifts the arm up. But if I don't have enough muscle to do that, I can no longer shift the fluid down. So the fluid stays at the top of the shoulder joint. And guess what? I can't compress the fluid compartment because it doesn't compress—it's water—and I can't raise my arm up. So I can't overcome that.