No.

Right? Yeah. So similarly, I guess we also that we can kind of take for granted, probably you sled pull, not sled push.

Okay. If I'm starting from the side. If I initiate a step, if I was standing up instead of laying on your side, picture that. If I step forward with my, so let's say you're laying on your left side, you step forward with your right foot. That's the foot ahead of the body is the foot ahead of the bottom. Okay. So that would look like it's, you're initiating a step, which would be like an early representation, right? So, so you're, you're initiating the roll from the bottom up, you would have an early representation where, and again, same thing they were just talking about with Brian, right? It would be representative of, of the, the energy coming up from the foot, right? Yeah. Yeah.

Okay, now I get it. I just looked for the space where I could turn into. So I oriented, okay, the humerus. Thank you.

Yeah.

Okay, but he can sit.

Yeah.

Yeah. So you've got to get her rib cage to move because she doesn't have enough diaphragmatic excursion. So let me throw this out as a representation. So when you have asthma, the biggest challenge when you have asthma is getting air out. So you're always full and then you're trying to get air in on top of it. What position is she in almost all of the time based on her compensatory strategy, if she's wide?

Right side.

See where my fingers are? Post your outlet.

Yeah, but again, the idea is making it meaningful for them. It's not about you telling them how smart you are. We know you're smart. It's okay. What you need to do is make sure that they understand that you are there for them. And the only way to do that is to speak in their language and to meet them at their story. That's where you spend your time. Now, the cool thing about this, if you meet them at their story, you can then bring them towards yours. So over time, Monica's been at IFAS a long time, and she hears what the clients start talking about. And they start talking about the same things that we talk about. And they actually do exceptionally well. They actually gain a great deal of understanding. And then they start asking the right questions. It's just the atmosphere that sort of involves everyone's thinking, but everybody has the story that they have. Some people study Dr. Google and they come in and they say what about this and what about this and what about this. And then we just show them the relationships and then we bring them towards us. And that's how you establish that's how you create the community and then you have the clients that talk to each other. And they go, oh, you got to do that too. Oh, I hated when I had to do that. And they're saying that in the nicest possible way. But everybody has that little commonality and go, oh, I used to do that one a long time ago. And now I do this. And so again, but you're literally creating a culture. And that's ultimately what people want, right? Yes, they want some sort of result, but they also want to be part of the group. Everybody wants to be one of the cool kids.

So you put her in a left sideline propulsion, right?

Right.

Yeah.

Right. Like we're just talking about the elbow and shoulder.

Yeah. So in regards to the people who appear to be super anteriorly tilted with super knee valgus, just all dumped forward and in. Is that in like a order of occurrence, some type of posterior compression pushing their pelvis forward, a twist of the distal femur, and then nothing else has happened yet. You haven't moved forward enough with their pelvis to enter weight propulsion, they're still up.

Okay, but there are two ways that we move that.

Absolutely. Well, there you go. So now you get back to key performance indicator and you say, okay, what, what change am I trying to make? How will it be represented?

Of the hip. Yes. I would say like a cross-connect.

Yeah.

So what's your question? So yeah, so this is going to be a really good question. Go ahead and ask it.

Yeah.

Yeah. So this is a toughie because you've got scarring that's going to create a limitation in the ability to expand, and expansion is where you're going to capture a range of motion. Now, it doesn't change the rules as to how you're going to approach this. It's just going to change the constraints. And then it might impose some limit on the amount of change that you can make, but the rules are the same. So just like we were talking about the female with the shoulder, with the post-surgical, you're still going to try to drive expansion. Now, let me talk to you about this kyphosis thing. Under most circumstances, what you're actually looking at is a compressed upper thorax. And so it might look rounded, but what it is is she's bending herself forward because she's trying to create a space to get air in the upper thorax. So the upper thorax is actually kind of flattened. And then, especially when you see the Lordosis, that it looks like it goes from the sacrum all the way up into the middle thorax. You know what I'm talking about? So what she has is she has a bend in the thoracic spine that'll probably have the apex really close to the inferior angle of the scapula, because she's compressing the scaps against the upper thorax. And so she creates that little bit of space. So she pulls her sternum down in the front. And she creates a little bit of space in that posterior aspect of the thorax. And that's actually your inhalation strategy. So you're still gonna try to drive dorsal rostral expansion and you're gonna try to drive up pump handles. So the amount of manual work on the rib cage is now gonna come in really, really handy. Okay, so you can use upper extremity positions to help create some of the expansion, so you think about like an overhead reach and if you can think about a scapular position and how pec minor would attach to the rib cage. So you got ribs three, four, and five that pec minor should attach to. So if I can move the scapula into that, what would traditionally be considered like a posterior tilted kind of a position, it's gonna help hold those upper ribs up, which is gonna bring the pump handle with me. Okay, so that's gonna get me some of the anterior expansion that I need to bring her up out of this pulled down position. Then I drive traditional dorsal rostral stuff. Have you seen some of the dorsal rostral?

Yeah. So I've done work on the left side to try to help reduce the anterior orientation and that.

Yeah. How does it tend to get nutrition?

Well, I love your thought process because you're in a situation where you're accumulating and applying IR. So I think that's pretty straightforward. You understand that. And so what you're going to need to do is determine where that lack of internal rotation is. If the axis of rotation of the knee, tibia a little bit more specifically, is different, and it doesn't move medially. And we've kind of talked about this before, but it warrants repeating: when you have the substitute ACL and you don't get the axis of rotation of the tibia moving medially as the tibia translates forward, you don't have the normal IR representation that's going into the ground. And that's kind of a big deal. And that might be why you're experiencing, or you're seeing this consistently. Let's not say that tissues aren't sensitized and things like that in a post-surgical situation, but what if you have normal mechanics? And at what point do those IR mechanics change that the knee sensitivity or grace, there she is, or that knee sensitivity would disappear? So maybe you have something along the lines of the sensitivity that's an influence here, but I would also say that from a mechanical perspective, is there any other position where you have access to that ankle-foot representation that you want?

Right. And then you do the best you can. In some cases, you can't do it. In other cases, you can.

All right. Pretty fired up today. Day two of the Intensive 19. This is the Unlearning Day. This is where everybody gets a little uncomfortable. We're jamming a bunch of people into the tiny little purple room to embrace the struggle as it were and start to establish the foundations of the model. So this is where we actually construct it. This is the fun day for me. So very busy. And we're going to dig straight into today's Q&A. And this is with Alex. This is a great question. So Alex has discovered that you don't have to follow the sequence of events as we described yesterday. So we talked about foot contacts yesterday that make things helpful, especially when we're talking about influencing movement based on physical structure. So structure, in this case we would refer to the two archetypes, so the narrow ISA archetype and the wide ISA archetype. It's like, do we have to follow the principles that we talked about yesterday? Absolutely not. But there may come a time where you don't follow those sequences, you won't be successful, and you're not going to know why. And so we established these heuristics and rules of thumb to guide us in our process so we can be more successful, so we can shift probabilities in our favor, so we can have an understanding of when we're not successful as to why we may be unsuccessful. And then that can guide us to the next step in our process. So this was a big, big moment in the call, in the coffee call on Thursday. So thank you, Alex. I'm glad you brought this up. It's gonna help a lot of people. Everybody have an outstanding Friday. It's Intensive Weekend. The podcast might be a little delayed this weekend, but we will get it up there. Everybody have a great Friday and I'll see you next week.

Yes, because the ground contact times are longer in acceleration. And since you're working with Lee, you'll see Lee use that a lot in like the first few steps of like if he's doing anything change direction, regardless of which direction he's going, you will see him use it in that short window. Because again, it's like, if I'm trying to increase velocity, the last thing I want to do is increase the duration of the force application. Because again, that becomes interference.

There you go. That's what I wanted you to do there.