All right. She had diastasis recti, but over the winter, she decided to have surgery and, assuming yes. Sorry. Yes. Abdominal plastic. And she started to get where she was going to the physical therapist for is like radiating pain in her neck and down into her arms and back.

And what do you think about like these minimalist shoes then that have like pretty much nothing as just the what in a case I guess you could call it.

Yes, it was a new patient and she hasn't really had a lot of conditioning over the last few years. So she just doesn't have a lot of movement skills. So we're going through some interventions and she's just not picking up on it. I'm trying to give her a cue after a cue and everything is just crashing and burning. And you enjoyed every second.

Curious about your thoughts on it. Speed breeds efficiency.

Then I'm going to see an orientation, most likely that's going to steal my ER. So now we know what comes first. So we got anterior compression first, and then we got the posterior orientation that is driving the loss of ER. One other thing that I know is I also have some posterior lower compression that's associated early on with the narrow ISA presentation. So I also have that to be concerned with. But because I have an orientation problem, that's going to prevent me from recapturing relative motions. So whenever I have the orientation situation in play, that's going to be strategy number one. I got to go after that. So my first intervention is going to be to try to reorient that entire pelvis. So as a unit, so we're not talking relative motion here, we're just talking about an absolute position of going from an anterior orientation to posterior orientation. There's any number of ways to do that. It's going to be a hip extension based type of an activity. You get your choice in that regard. Now because my next strategy would be the anterior compression I want to go address that as well so that's going to be the next thing I'm going to do. One of the great ways to do this for narrows and get a big bang out of this because if I put you in a 90 degree angle I'm going to get the expansion anteriorly And so I got to think, okay, if I have this strategy in the pelvis, I'm going to have that strategy in the upper thorax as well. So quadruped works great under these circumstances for a lot of reasons. Not only does it going to get me the anterior expansion that I need here, but it's also going to help me reduce some of the compressive strategy in the posterior lower pelvis, posterior lower rib cage. So again, very, very useful to go quadruped under those circumstances. Last thing I'm going to do with my narrow ISA person is I'm going to try to restore the normal relative motion of that sacrum. So I'm going to try to bring the sacrum base back into counter-mutation. That's going to be more of your dorsal, rostral stuff in the upper thorax. And so it's going to mirror that. So again, from a sequencing standpoint, if we were to back up just a little bit, we're going to go orientation. and to your expansion, posterior expansion for your narrow ISA client that has lost ER and IR because that's gonna strip away those strategies in the sequence in which they occurred. So it's really, really simple. So I hope that's useful for you guys. Happy Wednesday. Have a great day. Don't forget to call tomorrow morning, 6 a.m. Join us for coffee and coaches. Chips and salsa day is tomorrow too. Have a great Wednesday and I'll see you tomorrow.

But I just wanted to throw that out there and let you see that rotation is probably not what you think it is. And again, both sides of the body are doing the same thing at the same time. We just have a little bit of delay between one side and the other, and that's why we see the rotation. So hopefully that's helpful for you. Have a great Wednesday, and I'll see you guys tomorrow.

There's nothing I think. I think the internet is killing it on your impersonations of you killing it with your coffee.

That was kind of cool.

Yeah.

Dr. Mike, it is perfect today. And it is so good today. Exercise protocols for reducing blood pressure.

Okay. So that right there put us a little behind the eight ball as far as how we got things started. So we were basically flying by the seat of our pants. We were trying to figure things out as we went. So the thing that you want to think about, Nikki, is like you say, okay, what am I best at? What am I really good at? And what do I want to do? And then you, you take all the other stuff that goes along with that and you have two choices. Either you sacrifice your ability to do that other stuff that you like to do. Um, and you try to be better at the other stuff, knowing full well that you never will be because it's not interesting. It's not exciting. And it's not what you, what you came here for, right? Or you find other people. So, so Mike and I have like the world's greatest accountant. And then we have a business coach, Pat Ricksby. If I can mention Pat's name, I don't think he's afraid to have us mention his name. Um, Pat's amazing. We've worked with Pat from the early stages of our fast, thankfully. He has been savior on many occasions to help us out. And we have evolved. There are certain things that we now understand and do better as business people. But if I had my way, I would be the technician. I'd be the teacher. I would be that guy all the time rather than having to worry about paying bills and managing the finances, because there are certain aspects of that that we still have to do ourselves. One of the strategies that is very, very helpful when you're trying to coach or observe or understand what someone is doing is to imitate them. Totally underrated. You know, students always ask, they go, well, I want to learn about gate. It's like, OK, what do you want to learn about gate? Well, I want to understand what they're doing. It's like, OK, do exactly what they're doing. Like, imitate them, and you will feel what they're doing. And it's like instantaneous, and then the light bulbs go off. And then they go, oh, now I get it. So if you're ever questioning something as to what's really going on, Just imitate. So break the whole propulsive cycle into three phases.

But there's no sagittal plane?

Okay, well, so since it's your first call, you have to start.

No, I put my rowing machine in the backseat. Do you know how those like pop up like dance things? I just pull my roller out somewhere and start rowing. Sweet. Bill, you saw Terry yesterday? I did. How did you do it?

All right.

Day three. It's coming back for Halloween now. Oh, yeah? I'm going full dodgeball. Just in terms of from a conceptual standpoint, in terms of building out my model as a coach, something that I struggle to do. In application, it's fine. Once I've got the context of an individual, it becomes so much easier to kind of explain and conceptualize and talk about my model when I've got an individual with whom to apply it to. What I really struggle to do is to do that when I don't have the context of an individual with which to apply it to. And I'm also finding that when I run up against something that I haven't come across before, obviously my model, I'm reaching the boundaries of my model and the limitations of it. What have you found most useful in terms of, because I'm super visual, so I really like graphical representations of things. I'd just be interested to know what your experience have been in terms of developing those models and if you've found anything useful in terms of graphical representations of them.

I got my own hair. I cut my own hair. Oh yeah. Oh yeah. The problem was all right, but the backside was pretty ugly. It was pretty rough. It was a mess. What is your form, my friend? Oh, yeah. A little bit of innovation, a little bit of creativity goes a long way.

It is perfect scenario.

The chances of you finding this direct association in the literature is probably slim to none. But again, if you start to pay attention to your measures and you start to look at where these areas of compression and expansion actually occur, it's not difficult to make these associations in the shoulder measures. So Jiang, I hope that's helpful for you. I truly appreciate your questions and I will move these skeleton off to the side.

So I'm bringing the medial heel into contact with the ground so I can pronate. That's where I'm going to start to reach my mid and max propulsive strategies. So as I hit the ground and I come over top of the foot, and as the body comes over the foot I have to create a stable pelvic orientation above the foot. So now let's grab the pelvis and now we can actually see. So as I land on here as I'm stepping over I bring the hip towards zero degrees of what we would call hip extension but this is where I'm going to get a concentric orientation of the pelvic diaphragm and so that's going to create the nutated position of the sacrum. So now I have pronation down below. I've got intro rotation of the hip. I've got a concentric pelvic diaphragm and I've got a mutated sacrum. So that's how we can relate the plantar flexion and dorsal flexion to the sacral position. So when I'm plantar flexed, which is actually supination ER inhalation, I'm going to be counter-mutated. As I'm pronated, I'm going to be IR'd, concentric pelvic diaphragm, mutation of the sacrum. So hopefully that will answer your question, Austin. And if it doesn't, please ask me another one.

I'm set up in a left half-kneeling position and will create a propulsive strategy on the right side by pushing the right hip ahead of the left. Doing so creates a posterior compressive strategy on the right, which allows my left posterior to expand. This expansion in the dorsal-rostrothoracic area enables me to maintain or recapture overhead reach on the left side. As I press upward, I will maintain my posterior expansion by reaching forward without allowing my thorax to drift forward. If I were to reach forward and turn into the press, I would create a posterior compressive strategy on the left side, defeating the purpose of creating expansion for overhead reach. Since my goal is to emphasize left shoulder flexion, pressing with the right arm creates a posterior compressive strategy on the right that helps maintain left side expansion. In my setup, I shift my left hip posteriorly, turning my pelvis to the left to emphasize posterior expansion as I press on the right side. Pressing on the right creates a propulsive strategy that helps maintain left side expansion. It is not one particular exercise that is so important; what matters is respecting the goal. If the goal is to maintain or improve shoulder flexion, any chosen activity must maintain posterior expansion in the dorsal-rostral thorax. Take load into consideration: if my goal is to increase force production, I will superimpose an exhalation strategy because higher force production requires it. Remember that this high force production requires an exhalation strategy that may compromise your ability to reach overhead.

It's just a matter of reducing that upper thorax compressive strategy that tends to accompany the sequence of exhalation-based strategies for those people that are restricted in their breathing excursion. So hopefully that gives you a little bit of strategy and a little bit of understanding of the Camperini angle. So our next question comes from Brian and Brian asks, why might we use rolling activities for a wide infrastructural angle and quadruped activities for a narrow infrastructural angle? So first, if we understand what the wide ISA represents, so that is a compensatory inhalation strategy against an exhaled axial skeleton. And so what we have to do to restore full breathing excursion is we have to reduce the compensatory inhalation strategy and restore that dynamic. So what we can do with rolling activities, so if we're doing forward shoulder rolls because of the diagonal nature of that we can actually teach someone to exhale more effectively in a forward shoulder roll and that may actually help us reduce that compensatory inhalation strategy because to effectively roll forward I have to be able to exhale under those circumstances and so then the rolling becomes useful. Another strategy that we use is actually a log rolling technique so that is rolling along the long axis of the body and because of the wide infrastructural angle actually represents a widening of the thorax and the pelvis so it's a reduction of the anterior posterior diameter and expansion of the medial lateral aspect of that and so by going through the log rolling activity we actually compress the thorax again helping us to reduce the compressive strategy into your posterior and allowing that expansion to occur. So those are two ways that we can use rolling activities for the wide ISA. When we talk about quadruped activities for the narrow ISAs what the narrow ISA represents is actually a straightening of the ribs. And so if I was to represent the infrastructure with my fingertips here so the thumbs represent the spine and I've got a relatively round thorax and let's just say I have some sort of normal dynamic ISA but if I have a straightening of the rib cage you can see that the infrastructural angle would become more narrow and so what we need to do under those circumstances is we need to be able to bend the ribs. One of the easiest ways to do that is to put people in quadruped. Now if we look at compensatory strategies for the narrow infrastructural angle as the infrastructural angle narrows they create a posterior compressive strategy below T8. And so under those circumstances for me to bend the ribs I need to create expansion posteriorly from T8 inferiorly.

What I have is an eccentric orientation, especially of the external oblique, which allows that ISA to open in the diaphragm to descend. And so if I have to overcome that compensatory stretch, teach people to exhale more effectively, then I need to recruit those muscles that would close that ISA, which is the external oblique, which are the most superficial. And therefore I need a bit more of an aggressive acceleration strategy. And so what I would do is say it's a little bit more per-slip. It's a little bit more higher force and a little bit more of a higher pressure strategy. So one of the things that I encourage people to do under those circumstances is make sure that I can hear them exhale as they're moving through their prescribed interventions if breathing is associated with that. On the other side of the coin where I have somebody that would be an inhaled axial skeleton with a compensatory exhalation strategy, which would be your narrows. They're already recruiting the superficial musculature to close that ISA. Now, I still need to teach this person how to exhale, but if I teach them the same strategy that I used with a wide, all I'm gonna do is keep that ISA closed. What I'm looking for is the ability to prevent the trapping of air in the lungs. So when we have a narrow ISA with limited breathing excursion, they exhale so aggressively, they actually trap a lot of air in the lung because the pressure ramps up so quickly during the exhalation, that they can't get the air out in time. So what we teach out of those circumstances is a little bit more relaxed, open mouth, sort of a sigh for an exhale. Typically what I would cue people to do is to exhale as if they were trying to fog up the world's biggest window with their breath. So when you were a kid, then you would fog up the window and make a little smiley face or whatever you do. We would use that as a frame of reference for that type of an exhalation strategy because again, I don't want to ramp up the pressure so quickly inside the thorax. And so it becomes more of a sigh type of an exhale for your narrows.

I think what we need to do is look at the relationships of how all of these parts interact to produce expansive and compressive strategies because that's ultimately how we move. Our last question for this week's Q&A comes from Misha. Misha, could you please go over in more detail how the anterior posterior compression of the pelvis restricts hip motion? Absolutely, I can. I'd be happy to. Misha, I would also, before I dive into this with the pelvis, I would say that the exact same process occurs in the thorax. It's really easy to see in the thorax because the distance that the gradients travel in the thorax for the compensatory strategies are just much easier to see. So we got a lot more time per se for these transitional strategies. In the pelvis, the gradients are very, very narrow. So let me show you what I mean. I'm going to grab my pelvis here. So if we look at the front of my pelvis and we look at the pubis here. So there's my pubic synthesis between my two fingers there. And then if I was to look at my sternum, my sternum is that wide. So again, I have more distance to cover with my inhalation, exhalation, gradients. And so what happens in the pelvis is that these transitions occur very, very quickly to the point where they almost seem to be simultaneous. They are occurring simultaneously just to different degrees but again I would encourage you to look at the compensatory strategies as they evolve in the thorax because it's just much easier to see and then just translate that to the pelvis. Since you asked about the pelvis we will go ahead and we will run through that. And so if I am utilizing a compensatory breathing strategy that promotes a compressive force on the front side of the pelvis, what's going to happen is I will lose internal rotation capabilities at the hip. Reason being is, if I compress the front, that means that the volume that comes down in the pelvis will be biased posteriorly, so I get expansion here. Now if you look straight down in the pelvis, and this is a plastic model that doesn't move, the pelvis actually changes shape. When I push more volume into the pelvis, it will change shape. So if I have a compressive strategy here, I get an elongation in this direction of the pelvis. That changes the orientation of the muscle fibers that attach posterior to the trochanter. So what happens is they pick up concentric orientation. So I get eccentric orientation of the front, concentric orientation of the back. And so what happens when I compress the front and expand the back, I pick up ER. and I lose the IR because if I have eccentric orientation here, I have a fluid volume in the front part of the hip joint that I cannot move into. I cannot compress that fluid because I have concentric orientation on the backside. Now, if I reverse gears and I say I have a posterior compressive strategy, which means that I'm going to push the volume into the anterior part of the pelvis, what's going to happen there is I'm going to pick up concentric orientation on the front side of the hip and I'm going to gain internal rotation because on the backside that because of the compressive strategy, Or yeah, because of the compressive strategy here, I changed the shape of the pelvis. So now I get a widening of the pelvis here that increases the length of the muscle fibers on the backside that happen. So now what happens is I have an eccentric orientation here. I have a volume expansion here. And I can't move into that, into extra rotation. And so what happens is I get pushed in this direction by the concentric strategy here, eccentric strategy here. And it turns inward. Typically what you're going to see under most circumstances again because these gradients are occurring very very quickly because they typically present visually and from a measurement standpoint they're going to present from the bottom up okay as I fill up the pelvis like a glass of water with the volume that comes down. You're going to see a lot of these strategies occur simultaneously. So that's why it becomes very, very important for us to distinguish between how much ER and IR capabilities we have. So we know where the compressive strategies are. We know where you're capable of expanding if you are. And then we know what kind of shape change that we have for the pelvis. that we have to intervene with to make the physical changes. So do I need to create more expansion? Do I have to restore the inhalation capabilities of the pelvis? Or do I need to increase the compressive strategy of the pelvis to overcome the limitations that are demonstrated in the hip joint? So hopefully Misha, that answers your question. If I was unclear, then please ask that question again and we will try to go through it again next time. That's all I have from Q&A standpoint for this week. So hopefully you have a great week. Check me out. I shouldn't say check us. I'm the only one here. So check me out on Instagram because I will be there all next week and we'll be throwing up videos on the YouTube channel as well. If you have any special requests as to what you would like to see on YouTube or on Instagram, please throw those up on those platforms as well. Or you get to email me directly at askbillhartman at gmail.com, askbillhartman at gmail.com and I will answer your questions on that platform as well.

In a nutshell, what he's asking is about whether fascial planes influence how we drive internal fluid pressures, and if individual limbs move only in spiral trajectories or if there are straight-line and diagonal influences as well, suggested by collagen lay-down patterns. How do internal fluid pressures influence this? Would it be correct to consider a concept of spiral muscular-fascial loops that work like compression and tension type fluid-filled springs? I think you're actually on track with this last element of your question. I would offer that there aren't any straight lines at all. What appears to be straight lines is because the helical angles are very, very steep. And you have to look at every element of the system; you can't just look at fascia, muscle, or bone in isolation. You have to look at how everything is organized because it's all made of the same stuff. Everything you are is water and collagen. So you have to look at the entire orientation. But like I said, I think you're absolutely on track with the fact that we're looking at diagonal and rotational relationships, and what we want to see are reciprocal rotations through each segment. It's when the system tries to move simultaneously in the same direction that we run into problems. That's how you blow an ACL or the UCL ligament of the elbow. That's when you get compressive strategies and joints like hip and shoulder impingement. We lose the ability to create this reciprocal rotation between segments, whether it's side-to-side or through an extremity. So I think you're absolutely right. This is exactly what we're doing—moving these fluid pressures to demonstrate our capabilities of movement. So I think what you're studying now is on track, but respect that it is all rotational, spiral elements that we're actually looking at.

Are you going to promote the possibility that we now have a picture that has to pitch through lower back pain or elbow pain or shoulder problem, etc.? So there's any number of these things, and that's what makes this so complex because as right as we want to seem and as easy as this is for me to sit here and preach my opinions about arm care and physical structure. When we look at the individual, we have to make decisions about what we're trying to chase, what we're trying to achieve, and then what is the outcome that we desire. With the underlying understanding of the secondary consequences, and that's something that I can't predict, something that you can't predict. It's something that we have to look at as the individual's own experience, and now we're back to n equals one. We're back to the within-subjects design model, and this is how we have to move forward, but we have to move forward with great care and concern and not make these giant leaps of probability. We have to work within a framework that allows us to provide the ultimate level of protection while we chase this performance. And again, this is very difficult. There's not one right answer; there are many right answers that are possible here. But I love the fact that you asked that question, because it does bring up a lot of concerns in regards to how we prescribe exercises blindly in many cases, and we just can't do that. We have to start looking at people as individuals.

So this is a superficial strategy that we wish to talk about.

And Wolf Run? Yes. So that's the entire extreme. So for people that don't know, Pendleton is like the extreme northeast. It's even outside of Indianapolis.

You can also go straight to me and ask Bill Hartman at gmail.com. I'll be posting things throughout the week. We have a box squat video that we're actually shooting today that will be coming up later this week. So stay tuned as they say, and I'll see you guys next week.

Take a day and do a whole bunch of different carries and then give yourself some sort of self-assessment or reevaluation in regards to how you respond to those activities. You will find that you will be favorably responding to certain types, and there will be other types of activities that actually may steal some of your movement capabilities. So those will be the activities that you would want to stay away from if the goal is to restore maximum variability or to actually enhance your ability to do certain things. So if I can create a better compressive strategy under certain circumstances, my force production goes up. So maybe I actually help my bench press by doing a certain type of carry or maybe I improve my ability to deep squat or reach overhead by restoring some eccentric capabilities. So again, keep in mind that this goes in both directions, depending on whether I'm trying to reinforce something good in regards to performance or whether I'm trying to restore something for a more favorable movement-based outcome.