Yes.

Gotcha. That was cool.

Boom, there you go. Okay, so when a therapist is applying manual therapy, expanding and compressing. Right, so the principle is to apply pressure or alleviate it. And so we would use, say, compression or tension. And we're trying to create an input that the body will respond to. So if I apply pressure to a hydrophilic tissue, which would be like something that loves water—which is like everything in you loves water—if I apply pressure to that, I get a shape change. Okay. What you need to understand is where do I need the shape change? Okay. Then the question is, do I have any methods available to me without laying my hands on someone that may apply pressure or tension in the right place?

Did I hear a nasty rumor that you're going to be coming to iFAST in the summertime?

Yes.

Okay. There we go.

For someone that is a wide ISA bias, the best strategy is to try and use your diaphragm to breathe. I'm going to push my diaphragm down, which is inhalation, and that holds the ISA open wide. That's why I don't talk about numbers with an ISA. I talk about the behavior of an ISA. If my ISA is biased in a compensatory strategy to breathe in against the exhalation of my axial skeleton, it will hold the ISA open. So it doesn't close when I exhale. The archetype of the wide ISA is someone that has an axial skeleton that is a better exhaler than an inhaler, and then they cheat to inhale, so it holds the ISA open wide, which is an inhalation strategy, but their bias—their structural bias—is exhalation.

Posterior your lower compartment.

Isn't that money? I love that. It works. It's great. Don't forget that on your post-surgical patient too when the time comes. So again, I need to make a little bit of room. I need to be able to get her into a better position so she can execute the other activities. So again, let's think about bringing that pump handle up, try to reduce some of the rectus abdominis that she's using on the front side too. So again, some of your rib cage work, and then again, if you're superimposing the breathing like you said you were on the previous patient, you have to start to drive that too, because that's the only way that you're going to create the expansion from the inside out. So I think you just kind of have to reverse gears on the superficial strategies that she's using. So again, reduce the rectus abdominis that she's using. Again, it's an inhale strategy. So what you're going to look for is get her into a comfortable position and then teach her how to capture this non-compensatory inhalation. Right, so use the porter head as high as you need to off the table. You teach her how to reorient the pelvis. So again, we're going to use the pelvis to drive mechanics upward. So don't try to force things in the upper thorax to move. Let's encourage them to move and then use the extremities to drive areas of expansion through the rib cage, okay? So your PNF patterns come into play again because that's going to help us drive that superficial musculature and allow you to create the expansion where you need it.

It's not just going to be pelvis. You get it?

Yeah.

And that's where like a traditional, like a half kneeling, like need a wall. Something like that.

Again, it's like, I mean. What is the best choice of intervention? Like as a rule, what is always the best choice of intervention?

And then, Robbie, can I give you a simple rule? You always move in the direction of expansion. OK, so for you to make a turn to the right, the left aspect of your axial skeleton has to expand and the right posterior needs to expand at the same time, otherwise you don't turn. It's not a relative motion. It wouldn't be relative motions. There's no relative motion in the golf swing, which has to happen because you've got to load the connective tissue behaviors. But to initiate the turn, you have to create the expansions. Otherwise, like I said, it's pure orientation. So here's how you can tell that somebody's orienting versus creating the relative motion turn. If you see the knee track away from midline and they roll to the outside edge of their heel, that's an orientation. Okay. Do you ever see Bobby, Bobby Jones's swing back?

One way that I've been playing with is using a lat pulldown machine. If you can stand under it, I have a bar up there that they hold onto. And then I add weight—like 60, 80 pounds or something, less than body weight—depending on how heavy they are. Then I have them try to keep their weight more towards their heels as they go down, especially getting their hips to go behind their feet. I've seen some cool changes with that. Long term, it seems like they need to learn how to control that themselves, so they need to learn how to bring their whole body backwards. But that's the ER, though. I thought that was cool; I have no idea what you meant by that.

Do I have that?

Left forward.

Well, then they're going to have difficulty reacquiring it because they're going to be pushed over.

That's actually really smart for the squat too, because I feel like so many of the compensations that people will exhibit are an inability to make the legs sort of the onus of the activity. So you get an external rotation orientation because the legs aren't underneath you to get an internal rotation orientation. So that makes a lot of sense. So just sit down to the box and then come back up. What if somebody is doing this with their whole thorax and head?

It's just, it's not like a biomechanical question. So it's more like a personal one. Oh, well, so. Well, sort of. It's okay.

But maybe if she had the capacity to reverse lunge, the picture that I have in my head is that this lady's not going to do much lunging for a while.

But I understand that if I keep rolling in that direction, I'll get late because you have to change shape to move through space. You understand that? So, initiating a roll. If I'm laying on my back and I'm initiating a roll to my left, I'm going to create an early representation of my axial skeleton in cross section. I have to create a wave that goes across me to initiate the roll in that direction. Then I'm going to create an overcompensation on the right. Then I'm going to go to my side. And then if I step forward with my right foot instead of leading with my arm, it would be an early representation. You just have to be able to see the shape changes as they occur.

It doesn't help me.

Left hand down on the table. Extended. So he's propped like that.

Push the left side forward a little bit more like that. Yeah. Okay. So he's actually like this. So he's like, yeah, he's like that. Yeah.

Okay, okay, okay.

Okay.

I'm going to stop you for a second. Start over. You cut in and out on me. I'm having trouble capturing the whole set.

I wonder then, should I, with that same example of the left foot lead split squat with the offset load, think of adding a cue like 'Turn your zipper towards your left a little bit'? What would that accomplish?

That's the goal. The goal is not the perfect split squat. The goal is, is it better than it was last time? Is this rep better than the last rep? Is this set better than the last set?