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The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_05 56:12–56:12
It is.
muscle orientationeccentric contractionconcentric contraction
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
SPEAKER_07 56:46–57:15
I have a question that is kind of quick. I was looking at one of your simple solutions about back pain in the lockout of a deadlift. The solution was to do a single leg RDL with two kettlebells, and I was trying to understand how that works. So I was wondering if you could walk through the mechanics of how that's working.
deadlock mechanicssingle leg RDLkettlebell traininglow back pain
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_04 1:31:35–1:32:47
You still have to experience the failures. So you learn something. You start with a better model, you got a much better shot at narrowing the probabilities quicker, but you still got to go through the process. This is the mistake that a lot of people are making is that they're relying on information to guide their process. It's like information informs. It doesn't represent the process. There is no cookbook, especially when you're dealing with complex human beings. You still have to do stuff. You still have to pay attention. You still have to identify. It's like, okay, what was this outcome? What are the possible influences that I have any measure of control over? So you remain process oriented, whether you're successful or whether you consider it a failure, you still got to go through the same process and ask the same question. It's like, okay, what did we do? What was the result? What could I have done better? Where did I make a mistake? Is there any influences that the client brings to the table that I'm not addressing? So again, the stuff that you have control over, you try to influence. The stuff you don't have control over, we call that luck. Right. Yeah, because there's a lot. There's a lot of luck in this. Nobody likes to admit that because they want to think they have control over things.
clinical processinformation vs. experienceprobabilistic reasoningclinical humilityluck in healthcare
The Bill Hartman Podcast for The 16% - Season 13 - Number 7 Podcast
Bill:
SPEAKER_05 59:30–59:30
Awesome.
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_02 56:13–57:12
Then how could it possibly be eccentrically oriented because eccentrically oriented muscle doesn't have any tension on it? We're talking about static stretching, you understand? You're taking a muscle that is concentric oriented, you're putting tension on it, you're moving it to the end of the excursion of the connective tissues. That's why you feel that, right? Because you're feeling the load on the connective tissue at that point. But the muscle is active. You're pulling on it. You're pulling on it. But it's trying to stay in a shortened representation. Some of the muscle may be eccentrically oriented on that circumstance to access a joint position, but under most cases you're just pulling on connective tissues. Otherwise you would demonstrate a full excursion of the joint range of motion. And in most cases under load, you will not do that.
eccentric muscle orientationstatic stretchingconnective tissue tensionmuscle activationjoint range of motion
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
Bill Hartman 57:16–58:28
Okay, so think about the way people tend to finish a deadlift. At the end of a deadlift, where would your bias be in regards to the propulsive strategy? You would be standing, but now you've got to load in your hands. If you were in the middle, the force would be straight down through your middle of your base support. However, now you have a low displacement and you're going to have to push yourself forward into that. Understand how it would change your center of gravity just a little bit? It's going to push you a little bit forward, off of middle.
deadlift mechanicscenter of gravitypropulsive strategy
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_06 1:32:47–1:33:13
We don't have control, man. It's so funny you say that. I had a patient come back in after a week. I worked with her. She said, 'Oh, yeah, I was feeling better.' And then my initial instinct was like, 'Oh, yeah, I must have really worked whatever I actually gave her.' Then I was like, 'Well, I have no clue. There was a week of events.' So maybe she got better sleep. All these things. That one experience was pretty pivotal for me.
clinical reasoningpatient outcomestreatment efficacy
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_09 57:13–57:14
Okay. Yeah.
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
SPEAKER_07 58:29–58:32
Okay. But you're trying to stay back.
deadlock techniquesacral compressionforce production
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_04 1:33:14–1:33:15
That's humbling, isn't it?
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_02 57:14–57:17
Because the muscle is active. Okay.
muscle activityeccentric orientationconcentric orientation
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
Bill Hartman 58:32–58:37
Okay, trying to stay back would be what?
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_06 1:33:16–1:33:34
It is. Yeah, because I don't have so much influence over one person's. I don't even see you for it will maybe for you an hour or so, but that kind of fact opposites 30 15 minutes somewhere around there They have 23 other hours of that day and then a couple other days.
patient interactionclinical influencetime constraints
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_09 57:19–57:19
Okay.
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
SPEAKER_07 58:38–58:39
Trying to get, I guess, to a...
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_04 1:33:34–1:34:28
So they see you again. What's the limiting system when somebody comes to see you for any complaint? What's the limiting system? Like if we consider subsystems within the human body, right? What's the limiting system? You don't know. You don't know which one you're affecting. So your treatment might be the best treatment under the circumstance, but it doesn't address the limitation. And so it doesn't, so they don't get better. And then they go off and they do something, right? That has nothing to do with you. You give them homework to do; they're doing their homework and it doesn't help. They don't know it, but they accidentally do something that does help and then they make the association. They go, 'Johnny's brilliant. Johnny's brilliant. He gave me this exercise and it took like five or six days, but now I'm good.' It's like we just have to respect that. Just respect the process. It's like sometimes we have nothing to do with the outcome. We just have to be there, right?
systemic limitationtreatment efficacypatient outcomestherapeutic process
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_02 57:20–57:40
To change joint position, that is a muscle-based change. So for me to move my elbow from its bent position to a straightened position, the biceps would have to change its orientation from concentric to eccentric orientation.
joint positionmuscle-based movementconcentric contractioneccentric contraction
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
Bill Hartman 58:42–1:00:16
An earlier representation well it wouldn't be because here's what most people do here's what most people do here's what most people do is they're using a much later strategy to finish their deadlift so they're compressing the base of the sacrum really hard so it's not just straight down as if you were standing it's down and forward okay yeah all right so what does that what does that take us out of it takes us out of middle okay uh moves you more towards late yeah exactly exactly and so now they're now you're producing force in an ER representation right mm-hmm okay which can be problematic because people walk around like this all the time. It's like somebody comes in with they come in with like SI joint pain or they get centralized lower back pain. They tend to be biased towards a later representation and they're trying to produce force there. Well you got a lot of force in your hands. If this is like a heavy deadlift okay? A lot of compressive strategy okay? In a less than ideal representation okay? All right. Now if you're in middle if you're in middle how much like and I'm talking like right at the point where you're going to produce a lot of power okay. So right near max P how much space is there to move in?
deadlifting mechanicship representationsacral compressionforce productionbiomechanical strategy
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_06 1:34:29–1:34:29
Yeah
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_09 57:40–57:41
Okay.
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
SPEAKER_07 1:00:19–1:00:19
Not a lot.
biomechanicsforce productionjoint compression
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_04 1:34:30–1:36:15
that just makes it so messy, dude. You want messy? You're dealing with human beings here in a world that we don't understand control. It's easier to believe that at least. Well, it's very ego-satisfying, right? Yeah. But again, it's like that if you can grasp that concept now, it takes a lot of the emotion away from it. You're still going to have those days where you're incredibly frustrated. It's like you're going to take responsibility for the outcome, whether it is or whether it isn't. It might be your fault. It might not be your fault, but a lot of times you just don't know. And again, if you can look at it from a process standpoint, it takes the emotions out of it. And believe me, it's less wear and tear on you. It's early in my career. I make the joke about the scar that I have on my forehead from banging my head on my steering wheel. Every night I used to drive home after work and going, 'man, I'm an idiot. I just don't know what I'm doing.' It's like, 'why can't I help these people? Why isn't everybody getting better?' right? And it's just the reality. It's like, okay, from where I was in that process of my professional evolution, it's like, I did the best that I could under the circumstances. I wasn't intentionally letting people down. I just didn't know enough. I didn't know how to manage the probabilities. I didn't have enough tools in my toolbox. It's like, so you got to think of this as just a total evolution from the perspective of your own development, from your ability to apply, from your ability to make decisions. It's like they can hand you the cookbook, but it doesn't mean that it's gonna matter at all under many circumstances. There's people that you're not gonna be able to help. And there's a lot of people that you will.
clinical uncertaintyprofessional developmentpatient outcomesprocess-oriented thinkingemotional regulation
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_02 57:41–57:42
You understand that, right?
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
Bill Hartman 1:00:20–1:01:03
Not a lot. It's a very small space, right? So we're compressing. So ER and IR are always there, right? And then as we get closer and closer to Max-P, all the space between ER and IR start to disappear and then they become one, okay? And that's where motion stops, okay?
spatial compressionER/IR mechanicsforce production
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_06 1:36:17–1:36:20
Yeah, I've actually thought about that. Accept it now. Yeah, I thought about that too, like the discomfort, like as a student, you're trying to learn like, okay, I'm going to get everybody better. Like, how am I going to do that? And then not like you're saying just not accepting the fact that that's just not going to happen. Oh, like literally hinders the learning process, in my opinion, because then you don't branch out and all these other things and I don't know, accepting that has just made it a lot easier for me.
professional developmentlearning processacceptance of limitations
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_09 57:43–57:44
I think so.
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
SPEAKER_07 1:01:05–1:01:08
You're trying to internally rotate into that hip.
hip rotationinternal rotationmovement mechanics
The Bill Hartman Podcast for The 16% Season 7 Number 4 Podcast
Bill:
SPEAKER_04 1:36:21–1:36:22
Accept it now.
professional acceptancelearning processpatient outcomes
The Bill Hartman Podcast for The 16% - Season 11 - Number 8 Podcast
Bill:
SPEAKER_02 57:44–58:29
All right. But if I put a big weight on it—let's just say it's a weight that I can't lift, but I can hold it in that position—that's not a relaxed muscle. That's not an eccentrically oriented muscle. There's just a lot of tension on it. So if you're doing a fly with the intention of creating expansion anteriorly, I would say that that's probably an exercise in futility because you've got muscles that are trying to produce tension. So if I fix my hands, I fix my hands out here with a load on it and these muscles are active. This is the fixed point. And what do you think's going to happen at this end where the muscle attaches to my sternum?
muscle tensionrespiration mechanicsexercise physiology
The Bill Hartman Podcast for The 16% - Season 11 - Number 3 Podcast
Bill:
Bill Hartman 1:01:09–1:01:14
What if I had the kettlebell on my left hand and it was outside of my left foot.
kettlebell exerciseinternal rotationexternal rotationhip orientation