I think you have to earn them. I just think that's not for everyone. And there's like a sect of people that they'll be perfectly fine with that.

I did. I did enjoy every second. But every student, you don't qualify as a student, but every student that comes through here experiences that. Because I let it happen because it has to happen. And you just have to recognize it for what it is. So that it is just part of a process. But it also gives you information as to how many options you have in mind, right? And so you sort of like, you use up all of your strategies and then it's like, then where do you go? And I think that one of the things that people need to recognize in these circumstances is that it doesn't make you a bad therapist and it doesn't make them a bad person because I think that people get frustrated with patients a lot because you think you're giving your best cues. You think you know what you're doing. And then they just, it's not that they're not receptive to it. It's just that they don't have, they don't have the background to even understand what you may want them to do. And I think she is one of those people where you could give her the best possible information and you gave her good cues and you gave her like from a strategy standpoint, I think you were on point. But again, it just didn't come out the way you wanted it to at all. And I think that ultimately we were successful before she walked out the door. That's another thing to recognize. It's like, okay, we just gave her everything that she could execute effectively. And I think that's the difference. We always have to remember that it's not about us, it's about the patient and it's about how successful they are. So we put her in the only position that she was successful in and then allowed her to execute. And so like I said, ultimately you can look at this in any perspective that you want. As I always say, I go home with a big red mark on my forehead quite a bit where I bang my head on my steering wheel all the way home thinking like, I could have done this, I could have done this. But the thing that I want you to see is that yeah you failed and you failed and you failed and you kind of failed your way to success till you finally got to the point where you you recognize the fact that this is the best that she's going to do today based on her experiences based on her capabilities and then she will move forward and she will progress you know it's like not everybody feels like hitting a home run And yesterday was like the big K, if you will. But you gotta go through that. You gotta feel that.

Sure.

Rock and roll.

I know I need a t-shirt hoodie, but I'm not going to ask for one. That would be the wrong thing to do. Rule number one, wrong thing to do. We did some training where I was really when you were emphasizing aerobic conditioning, both through circuit training and through a part of your work and how you're really using that to build aerobic bases in your athletes. And so I was just wondering how your thinking on that has evolved over time.

Have you seen some of those?

I have a question. It's kind of off-topic, but how young is too young to start looking at interventions for how kids set up? My son is too, but he has severe anterior tilt; his thorax is very forward compressed posteriorly. Every time he runs, he basically falls and catches himself. That's his style of running. Obviously, you're watching it as a coach and it hurts.

Yeah. So I used to watch more. That's how old I am. But, point being is like, literally it's like they may not. They might not like your hairstyle. They may not like your shirt. They, again, it could be anything and they don't even recognize it themselves. But for some reason today, Nikki's not their favorite person. I don't know how that would be possible, but it is probably possible. Okay. But that's not under your control ever. So don't worry about it.

This has just been something of interest lately. Exercise protocols for reducing blood pressure.

And so, that right there put us a little bit behind the eight ball as far as how we got things started. We were basically flying by the seat of our pants, trying to figure things out as we went. So the thing 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? Then 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 and try to be better at the other stuff, knowing full well that you never will be because it's not interesting, exciting, or what you came here for. Or you find other people. So Mike and I have like the world's greatest accountant, and we have a business coach, Pat Rigsby. If I can mention Pat's name, I don't think he's afraid to have us mention his name. Pat's amazing. We've worked with Pat from the early stages of our business, thankfully. He has been a 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, the teacher, that guy all the time rather than having to worry about paying bills and managing finances, because there are certain aspects of that that we still have to do ourselves. One strategy that is very helpful when you're trying to coach or observe or understand what someone is doing is to imitate them. Totally underrated. Students always ask, 'I want to learn about gait.' 'Okay, what do you want to learn about gait?' 'I want to understand what they're doing.' 'Okay, do exactly what they're doing. Imitate them, and you will feel what they're doing.' It's instantaneous, then the light bulbs go off, and they say, '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.

Yeah, go on.

All right, I'll start. Can we talk about overcoming and yielding as it relates in general to everything, but also specifically to cutting mechanics?

He kicked some booty. Did he? Yeah. As always. So he walked in. If anybody doesn't know, go on Instagram and you'll see pictures of the Terry project. And it's a little background. So Terry's a guy that I've known for, well, since I passed open, which was almost 12 years ago. And Terry's got hip replacements and knee replacements. And but he's a golf instructor and a tango dancer. And so he, he purchased a program that everybody knows about that is designed to improve your posture. And under and other things like they promise many, many things in regards to the outcome of their program. So he purchased this program and Terry is the guy that works diligently. Like if you ever ask him to do something, he will do it tenfold. And so he committed himself to this program and was incredibly successful to such a degree that it did the exact opposite of what he wanted it to do. Right, so he comes in with this hunchback kind of posture and massive kind of forward head ish kind of a thing and just a whole bunch of muscle activity that he didn't want Campos was student at the time. And so he got he got the So he saw him from the get-go and saw the changes like this evolution, like literally it looks like evolution. If you put all the pictures together, which is pretty cool. But anyway, so Terry's been on his own for about a month. Apocalypse for the dog thing, he's very excited. And so we always measure him as we would a regular patient. And so he was missing maybe five, 10 degrees of internal rotation yesterday. And that's it. Like he came in almost clean as it was. Yeah, it was pretty good.

It is Thursday. It's chips and salsa day. I have neuro coffee in hand. Everybody, I hope you have your coffee. Mine is perfect.

Day three? Day three. Because you know he's back to work. You know how you can tell, right? The staff is going on. Yeah. 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. Yeah. Have you ever drawn it out? Have you ever drawn out your model? Yeah.

You cut your own hair.

Yeah, but like people coming off of ankle sprains, I guess I never really gave much consideration or thought towards retraining or balance or single leg stance.

And I want to be able to move between those two strategies, and that would represent my full capabilities of inhalation to exhalation, as well as my full capacity to move my neck through its full excursion. So again, I don't think that we want to look at this as one better or worse. We want to say what is and under certain strategies. So if I'm producing high levels of force, the hyoid will be up because I'm going to use an exhalation propulsive strategy. And so that would actually help me increase the internal pressures and help produce force. When I'm looking to access eccentric orientation, a little bit more broad spectrum movement capabilities, I want to make sure that I can open my airway at will. Again, hopefully that gives you an idea of what we're actually looking at when we're talking about respiration at the neck. And again, you will see these same associations with some of the iterations and the actual skeleton. So the descended hyoid position will typically be associated with your people that are biased towards an inhalation strategy in the axial skeleton, your elevated hyoids are probably going to be biased more towards your people with an exhalation strategy in the axial skeleton. So again, Marcos, I hope that that's helpful for you. If you have any other questions about that, please feel free to ask them. Everybody have a great Tuesday. Again, happy birthday to mom and I'll see you guys later.

However, some people walk around in that position due to their physical structures, idiosyncratic physics, and how they deal with gravity. They actually live in that position, and eventually give up the opposing rotation. We have tibiofemoral external rotation and tibiofemoral internal rotation. What we want to ensure is that our athletes have access to both, as that represents our ability to move through a full excursion of knee range of motion. For example, during a traditional knee extension activity, you get tibiofemoral external rotation, and during a traditional knee flexion, you get tibiofemoral internal rotation. To have full knee excursion, we must have both rotations available. So, Matt, I would say you want to make sure you can identify whether your athlete has given up one of those elements of tibiofemoral rotation, as that would be a risk factor. It compromises the full excursion of knee range of motion, which should be my first priority. Secondly, as they move through their maximum propulsive phase, are they capturing this knee position and then can they reverse it as they push out of it? Therefore, during early and late propulsive phases, I want to recapture the tibiofemoral position of external rotation, and as I move through that maximum propulsive phase, I want to make sure I have tibiofemoral internal rotation available.

It seems that if they change from here to here, they surely change when we get into the deeper element of the squat. The thing you must understand about the deeper part of the squat is that we are reliant on the movement of the ilia relative to the sacrum in that deep squat. We're looking at that type of motion at the deepest portion of the squat, which means that I need to create a yielding strategy with the glute max and piriformis in this deeper portion of the squat. We have to understand that at their distal attachment on the femur, because of the orientation of the pelvis relative to the femur, they're still going to be maintaining some internal rotation moment. What you'll see, especially in Olympic weightlifters in the deepest part of, say, a snatch, is that you'll actually be able to see this femoral internal rotation in the deepest part of the squat. The reason they have to maintain some internal rotation in the deepest portion of the squat is because they have to maintain an element of a concentric orientation pelvic diaphragm; otherwise, they bottom out and then they can't reverse gears and come up out of the deep squat. But to get to the deep squat and to get the amount of hip motion, I have to have this relative motion here. So yes, the musculature above the trochanter is maintaining its internal rotation capabilities, but it will yield posteriorly.

And so one of the great things about quadruped is if I put you such that your hands are below the shoulders in quadruped that puts the shoulder about 90 degrees of shoulder flexion which is mid-range through where the scapula would be upwardly rotating which creates a posterior compression in the posterior upper thorax and the dorsal rostral thorax is compressed and then that provides us a way to expand below the level of the scapula as we inhale. And so again, quadruped becomes this great strategy for people with narrow infrastructural angles, assuming that they're strong enough to support themselves through the upper extremity. Because we're bending the ribs, we're widening the ISA, and we're expanding the posterior rib cage below the level of the scapula, so from about T8 on down. And so that's why we would use this quadruped strategy for narrow ISAs.

So the two sides of the thorax in this case are behaving differently because chances are they're creating a turning strategy to help manage some of the internal forces or external forces that they're dealing with. So the simple answer is I treat the wide side like a wide and I treat the narrow side like a narrow. So in many cases we just perform an asymmetrical activity that flip-flops that strategy. So we will compress where they're expanded and expand where they're compressed to get them to turn in the opposite direction. In doing so, we restore dynamics to both sides at the same time. So that's a really good question because a lot of people don't understand that.

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 external 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 external rotation and internal rotation 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?

At the back end, at the latest element of the propulsive phase where my foot is still on the ground, because I am grounded, I have to have an orientation of the pelvis that's moving on the femur, but I'm moving towards that same position of external rotation, supination, and inhalation. So that would be the difference is that as I'm positioning myself early, it's going to be more femur moving on the pelvis, and then as I am late, it's going to be the pelvis that's going to be orienting relative to the femur. So that would be the biggest difference in the two. So I hope that answers your question.

So I can allow this expansion to occur here at the sternum, which provides me the positioning to allow this internal rotation to occur. So I have to look at the two ends of the muscle as behaving differently. And so again, that's why limiting our thought processes to a shortening contraction versus a lengthening contraction. I could be lengthening it at one end of the muscle and concentrically orienting at the other end of the muscle simultaneously to allow these movements to occur. That's why we have to look at this as shifting volumes and pressures and then shape, because the shape of the muscle doesn't necessarily mean that I am contracting at both ends when I say it's concentrically contracting. I can have an eccentric orientation at one end and a concentric orientation at the other that allows movement to occur at one end and limits or creates motion that occurs at the other end. This is a very, very important thing to understand because this is how we perform. Nick, I hope that answers your question. We're going to talk a little bit more about these kinds of things in regards to baseball and movement as we move forward because we're getting a lot more questions in regards to performance.

Completely. And then even working further down, shoulder internal rotation was commensurate with the flexion, where it was 30 degrees bilaterally. Then hip abduction bilaterally was 30 degrees. And the infersternal angle was 100, so not terrible, but it wasn't dynamic. She didn't get good rib motion when she would inhale and exhale.

Yes.

Apart from a squat, what are the other key expansive movement patterns? Well, that would be really nice if we could just make an exhaustive list. But the reality is, is that every activity that you choose will have elements of an expansive strategy or a compressive strategy depending on what your goal is. So we could take a split squat, and we could make it very very compressive depending on what we're trying to do or we're going to make it very very expansive. The nice thing about split stance orientation in regards to an exercise is that I can bias one side of the body and so if I'm restoring rotations this element becomes very very important because wherever the expansion occurs will allow rotation to occur. So when we talk about baseball, golf, tennis or other rotational sports these split stance orientations and establishing these eccentric or expansive inhalation biases become very, very important regards to strategy because the people with high compressive strategies cannot turn, which is why you start to see these deficits occur in these athletes that overuse strength training as an element of their performance enhancement, especially when they have to turn or rotate. So again, hopefully that addresses some of that for you. If you have a particular question about a specific exercise in regards to its capabilities, that might be a better question to ask next time, Drew.

Well, I mean, I've been thinking a lot about what you said regarding this concentric strategy I'm kind of locked into at all times and how that's probably affecting my sleep, my ability to relax, and stress as a whole. Now that I've got hips, I'm loving training. I'm deadlifting once a week. I know, I know, I'm ready to bail on bilateral squatting. It just doesn't feel good. I'm constantly shifting into my hip no matter what I do. I just don't feel good. Split squat variations feel good, and deadlifting actually feels good. Today it was seven sets of 10 with a 100-pound kettlebell. So, I'm not tied into loading heavy. I would like to have the capacity to do that every now and then, but I'm not married to that idea at all. So I just wanted to talk to you more about that and some things I can do from the training standpoint to unwind some of this, but also feel like I'm still getting after it. That's an important thing for me—to feel like I'm still pushing myself.

Yes.