Back to the Stone Age.

Now, if you can move on to the next person if you want.

Okay, so what movement are you trained as a physical therapist to avoid in a circumstance of spinal stenosis? By tradition, you can even use the traditional extension. Yes, so they tell, okay, so what is that in reality that we know of, right? What is that? Is that your IR? It's IR, right? Awesome, because they're already trying to compress into IR. In fact, they're making a bony shape change into IR under those circumstances. So it behooves you to not use an IR strategy to try to resolve that. And so that's where they came up with all those forward bendy exercises to try to reduce the influence of the spinal stenosis. When the reality is it's like, hey, if we can get some of that AP expansion, we can actually reduce the strategy that was probably promoting the bony shape change in the first place. That's my perspective. Okay, so to answer your question, it's like, can you effective on a shape change? Well, a muscular strategy certainly seems to be able to do that because this is something that happens over time. People are rarely, not that it never happens, but rarely are these people born with, usually see it in somebody in their 40s and 50s, right? And so your manual therapies can certainly influence, Okay. But again, it's having some recognition of what the representation is. So you are applying these therapies appropriately to promote the appropriate shape change. So when you have somebody that's turned, okay. And if you can appreciate the fact that the bones are probably, like bones twist and compress, they expand, they elongate, right. And so if you can appreciate the fact that those bones are probably going to be following the physical shape of the term as well, then again, it's a matter of applying pressure in the appropriate manner to oppose that. So the rotation itself kind of helps you understand that, but again, where you put your hands is gonna matter. And this is one of those reasons why I think that in many cases, in many cases, many things will work or they won't work. All right because again, I'm not saying this is easy because it is somewhat difficult because you're looking at things on such a small scale relative to the big picture, but at least the big picture can help you identify where these things might be.

So let's say I'm in a situation where I have a client with, let's say, quote unquote rounded shoulders. My thinking is that I need to recapture orientation, meaning I want to create an opening of the thoracic interior. I understand I need to address pump handle with that, but I also find that I want to address the musculature higher on the thorax. I'm trying to recapture eccentric orientation of those muscles. So I think, okay, cool—let's put them in a situation where they're kind of yielding over time, with that, I have breathing. I'm wondering whether that would be efficient at altering their kind of risk.

Okay. And then when we talk about delay strategy, so my basic understanding, obviously this is all gray, but it's like, the connective tissue behavior sort of happens as a result of the seven components of force. So is a strategy simply like, is the way we're thinking about a delay strategy just like, I'm not trying to move that fast. So I'm creating a greater delay strategy. Like I'm just landing, allowing my foot to fall into the ground.

Well, and they can't move. They literally can't move. You just made her heavy. You just made her heavy in the feet, right?

Thank you for that tremendous insult, Zach. I appreciate that.

I appreciate you giving me permission to run my own show. Your responsibility is not to fix anybody. You can't do it. That's not your responsibility.

Yeah, so in the situation in which someone has turned right and maybe a bony adaptation keeping them there, you can grab hold of the transverse process or you can grab all the transverse process and an internal rotation to get it to turn, but you can't really grab underneath. It's difficult.

To expand the thorax?

Like, you know, is that... So a strategy is an overall representation of the system. So when I talk about the delay in the pelvis, it's just one part of the system behaving that way. So there's a delay down in the ankle and the foot. There's a delay in the pelvis. There's a delay in the thorax. There's a delay in the cranium. Okay? So this whole system creates a strategy that produces the delay.

Yeah. Thank you, Bill. Very helpful.

I'm just kidding.

You can't fix anybody.

But you can use ribs. So use ribs to think about this. Think about your sequence of events. When you're untwisting a knee and you're applying pressure to a tibia, you're influencing the position of the femur as well. So if I'm applying pressure to a rib, when other people say, they come in and they've been treated by somebody else and say, 'yeah, they said my rib was out,' and they push it back in and it feels good for a while. Those are just shape changes that are associated with the positions. So if somebody applies an IR force to an ER representation, that actually makes an influential turn—a favorable turn—they restore relative motion at least temporarily. That's kind of what you should be thinking. It's like this is an adjunct to the things that I'm going to do to help you learn how to control this position versus defaulting into it.

Okay.

Okay?

Great. Great question. Very useful. Very useful.

Yeah, me and Fred Flintstone hang out at the bar after work, right?

Good morning. Happy Friday. I have neural coffee in hand and it is perfect. All right, man, what a great week. Couple things. If you look down in the right-hand corner, I've had a couple of questions about the change in the logo where it says 'the intensive returns.' Yes, the intensive is coming back. We'll probably be doing something in early summer, so be on the lookout for that. I don't have any details posted, so again, just please wait patiently. If you're interested in participating in a 15-minute consultation, please go to askbillhartman.com. And speaking of which, we're gonna talk about the Q&A for today, which is with Johnny. So we've talked to Johnny before. Johnny's a really smart guy. He's a chiropractic student but asks really, really good questions. And so Johnny was watching the video that we did with Paul recently in regards to the origins of my model. And so Johnny wanted some clarification in regards to how the ER and the IR concepts evolved. And we got deeper and deeper into some of the treatment process too. So I think that anybody that works with complex humans is going to find this one interesting. So I appreciate you all for being here. Don't forget to go to YouTube and subscribe to the YouTube channel so you can get first dibs on the videos as they are posted up there as well. Have a great weekend and I will see you next week. Alright, camera is rolling, clock has started, Johnny. Go ahead.

In that situation, I might apply an IR force on the right side and grab maybe like the zero lower ribs from the front with my left arm and it helped facilitate the whole thing.

All right. So let's talk about, and this is with load in their hands, correct?

It's a coordination of the system behaving a certain way. That's why I use the word strategy because you can't just talk about one part of it because all of this stuff is happening at the same time.

All right, so I listened to the full conversation you had with Mr. Paul Corona. Ah, yes. So fascinating. I loved it. But I wanted to expand on the idea of external rotation being represented by expansion and compression being represented by internal rotation. So I guess when you were coming up with your model, how did you bridge that gap? Because to me, expansion and ER would make the most sense to start with respiration and looking at the mechanics of the rib cage. And then from there, obviously you see that the whole body ER expands and IRs and compresses after that. But I guess like, what was your first step in bridging that gap of expansion equaling ER, compression equaling IR? And just kind of want to hear thoughts on that.

We do that. So there are okay. Do you have an osteopathic manual therapy textbook?

Yeah, but it would be like a minimal load. That would be tolerable for a long time.

Okay, so in some sense, the strategy would be to allow certain muscles to take on eccentric orientation to allow the expansion to occur. And if I'm sprinting versus walking, I'm not really creating a strong delay because I'm trying to hit the ground and immediately go to the other side. I'm not doing much to delay.

Well, when you look at the helical orientation of anything, so if you look at a tube, right, you ever see the Chinese finger trap? or whatever, okay. So that's how that works. It works based on compression and expansion. So that's how you create the shape change, right? And so that's a great representation of just simply how a helically oriented tube behaves. And so you have to go backwards in time from an evolutionary standpoint, right? And we start talking about worms and we say, well, wait a minute, that's a perfect representation of compression expansion of how you create movement. It's like, do we have anything that would be representative of that? And you kind of do, right? You have a closed cylinder of fluid volume, don't you? And so it's like, hey, how would that behave? What happens to do exactly the same thing? And so how would I do that? Well, if only we had like a helical orientation and you start looking, you go, oh, wait a minute. I have these things on the outside that man called muscles, right? They're oriented in very specific directions and they're in opposing helices. If I squeeze it down, it compresses everything and it creates a downward force. Awesome. That's internal rotation. That's what we call internal rotation. If both sides are turning inward towards each other, it gets compressed. It gets smaller and more dense and it moves downward. Then if I move them in opposing directions to the opposite direction, everything expands and it goes upward.

No. Should I?

Understood, but okay. They are applying force against the resistance. Okay. So what is required to increase a synovial joint's ability to move? Is it muscle orientation or connective tissue behavior?