It's actually less ER space so you don't have any ER space in front of you it's moved out to the side so it's moved away from midline. That's what you want to understand about that. It's the anterior compressive strategy that's going to limit the internal rotation. So what it's showing you is that you've got a tremendous amount of A to P. So when you get that posterior lower compressive strategy, the thing that happened just prior to that is the anterior compressive strategy. That's why we talk about these things in a little bit of a sequence because it allows us to see how these superficial strategies are layered upon the axial skeleton. So don't misrepresent what they're showing you. When you have posterior lower compressive strategy, you lose early traditional hip flexion. If we want to call it that, you're going to lose the straight leg raise is going to be limited. And then you're going to lose IR not because of the posterior compressive strategy, but because of what just happened prior to that, which would be the anterior compression. There's a sequence of events that those things represent, but it tells us where you are in space. That's the important thing.

My question is a bit more model-based, and I wanted to discuss some ideas I have regarding pressure and our water balloon or two-space representation. If I consider a vessel containing a certain amount of fluid—like a hydraulic ram—then a larger ram with more internal space can accommodate more fluid, creating greater pressure than a smaller one. Applying this to the body, is it feasible that one reason a muscle with greater volume can produce more force is due to having more volume to generate pressure from? Taking that further, if I had a water balloon and a basketball of the same size, they could technically hold the same volume, but their external containment—skin or connective tissue—would differ. I'm wondering if the model can provide insights into how this applies to connective tissue, such as how powerlifters or sprinters develop stiffer connective tissue over time, enabling them to impose more pressure effectively.

His knee is most certainly stuck in extension on that side. He's got a twist. He's got an eye-arring and then a knee-arring of the lower leg. The side that I think is probably more likely to become symptomatic over time because it's just based off the way that he moves and some of the other stuff that he has going on. He has changes to his Achilles, very mild plantarious compression on the medial side and then also like his big toes.

Well, you should be measuring something.

Yeah. But that's why everybody wonders why you see the Olympic lifters bouncing their butt before they pull. It's like they're optimizing stiffness. It's the same thing that when you've got the bar racked before the jerk and you try to get that perfect amount of air. So you're like sipping and blowing, sipping and blowing, sipping and blowing before you go into the jerk. That's tuning. That's tuning stiffness. Same thing from the bottom up.

L5 is one.

No, it's actually on the medial side. So when I bend a bow, the concavity is where the weight's going to be. So that's the compressive side. As I turn the whole leg into this bowed representation, the weight bearing is on the medial plateau, which slows that side down from the turn. That's why it looks like you have internal rotation of the tibia, but you don't. You have a bend in the tibia that's slowing it down so it doesn't turn as fast into ER. It's the weight bearing surface.

All right, I'll try to do a little refresher into the question. I think I remember it. So I'm cool with the reference. So the example you're using was like someone stealing a base from first to second. So be like, cut off the left leg. Yeah. I'm cool with the initial representation is they're just standing there in like a slight hip hinge, athletic position, where the anterior outlet bilaterally is concentric and posterior eccentric. I was wondering if you could talk specifically about the changes that occur as they lift the left leg up to reposition into the pliostat, because I'm not really seeing why on the right side anterior you have that switch to eccentric overcoming. And then left becomes eccentric yielding. But to me, the conditions on the right side, it doesn't work like that. Extremity really changes because you don't pick that side up. So I'm just curious why that flips to eccentric in the right anterior outlet.

Yeah. Probably so. So if I'm working, think about.

We all do. We all do, my friend.

Did I lose you? Sorry. No, yeah, I'm good. I'm good.

It's not extra. It's just part of the sequential layering of superficial strategies on top of the axial skeleton. There is a typical representation of the archetypes, and I think you understand that. What you have to understand is that the superficial strategies are going to appear in a relatively specific sequence of events based on where your center of gravity is over your feet. When you see posterior lower compression, your early flexion measures are very limited. So your hip flexion is limited, your straight leg raise is limited. So right away you go, 'uh-oh, we got a posterior lower compressive strategy.' If you have a posterior lower compressive strategy, you have all the other superficial strategies in play already because the last one to get layered on is posterior lower. Your assumption, so in your email, your assumption that this chessboard represents a right oblique representation is correct. So this is somebody that's tipping on a much more oblique axis as they are turning. That would be represented by your ER measures. When you see the deficit of ER on the right side, greater than the left side, you can make the assumption that you're on the right oblique. When you see the limitation of straight leg raise and early hip flexion, that means you're pushed forward. Tipped on the right oblique first, then got pushed farther forward. So the center of gravity is way over to the right and way forward.

So the post your lower compression end game, they look like they either got off their Harley Davidson motorcycle or they rode a horse into the clinic.

Okay. So when you're saying this wide staggered, would you still have that front foot elevated to push him back over? I don't know.

When you say maintain positions, what are you specifically referring to? Give me an example, so I understand.

Yes, I know.

Can muscles are just, they're not a slap really.

So looking at, he gets quite a significant anterior pelvic orientation. So that's probably his downward force and potentially where some of the low back discomfort may be coming from.

And again, that helps me. It helps everything in regards to modeling what is arguably something that we'll never fully understand.

And that's what's underappreciated because, again, at school, they teach you like the shoulder moves this much. It's like, no, when you measure ER at this point in this way, it has this much. There are many contributors to that range of motion. It is not. Just because you're saying I'm measuring the shoulder doesn't mean you're measuring the shoulder. You're absolutely wrong, right? You're measuring the system.

And then this is a perfect leading way. So then what will follow that is, once they're pushed back, they'll do some sort of ping-pong to counter that. So that's when you'll start to see that dumping, that anterior orientation.

Yeah. So that's representative of a later propulsive strategy. Later propulsive strategy. Absolutely. Yeah. Because I got to push it out there. I got to get a way to turn. I have to create a term. And so when you think about late propulsion, so what late propulsion does is it turns the sacrum away. So if I need to turn the sacrum into the current, so to speak, I got to push it out there. So what's the best way to do that? Well, under certain circumstances, it's going to be use a late propulsive strategy, which is why you see a lot of people in that that late propulsive strategy. Okay. Now, there's another way that I can do that. Instead of grabbing in with the posterior lower down here, I grab right there where my middle finger is. If I do that, what happens is this side goes up. You see it? See how it goes up? Right. Okay. And so it goes up, but it still turns the sacrum. I still achieve my goal of turning the sacrum to the right. To the right. Yeah. And so that's the difference. But again, these are different representations of muscle activity in regards to how the pelvis is going to behave. So I still get my turn, right? But now you can see that I'm tilting the sacrum on much more oblique axis, which is why I just call it a right oblique orientation. So you see the difference in the two? Yeah. Yeah. And so if you look at some of the differences, when you see somebody in the flatter turns, because I'm using this posterior, this lower aspect of the musculature down so low, I'm going to see these people. So these are the people that lose early hip flexion. These are people with a lousy straight leg raise. These are people with that lack internal rotation. This guy is still going to lose internal rotation by traditional measures, but chances are he's going to have a better straight leg raise and he's going to have early hip flexion.

Yes. Would you say that there's a delay in the guts as you rise up and then they gain momentum as well and help you through that sticking point?

Because if I have a bar on my shoulders, it's connected to me. I'm holding it onto myself, right? So you're using your hands. I mean, and we'll have situations where we'll just, we'll just strap people to the bands, under their arms.

By definition, first principles are non-contextual. They are absolute. So real simple: when you talk about my model and I say compression and expansion are absolute, it's like that is across the board universal. Then it's just a matter of like, okay, how does that principle apply in this context? So when I'm talking about humans and movement, it's like based on our structure, how do I follow that rule? And then it's just a matter of identifying things. And so then it becomes kind of interesting and then we can go after little bits and pieces of research that say, oh, when you do this, this is what happens based on our best understanding of how segments interact or structure or fluid mechanics or whatever it might be. But the principle is absolute. And so again, by definition, there is no next. Now, here's where you can run into trouble: it's like you can misidentify a principle.

Okay. So, you understand that because again, internal rotation is down, external rotation is up. That kind of makes it really simple.

Sometimes what can happen is you get what's called a non-union, which is it's either an incomplete or not even a fusion of the sternum back into its previous state. And of course, it's not going to be in its previous state, so we need to understand that too. But if you get any sort of a hingey kind of relationship now, you don't get the coordinate expansion and compression kind of thing because you got an extra hinge in the middle. And so that makes it very difficult to create internal pressure. So if you were a singer and you had the sternotomy and you had a non-union, you wouldn't be able to sing. You cannot project your voice when you don't have this normal behavior of the sternum. So there's a sweet spot between this stiffness and this mobility that we need under these circumstances. So again, you think about like a higher force exhalation kind of a strategy, like if you were trying to project your voice and you had this spot that gave way, now you've got a weak spot in the system and therefore the pressure does not ramp up under normal circumstances. Secondly, if it's stiff and it doesn't turn, now we have the limitation in our ability to change shape that's associated with that, and you're going to have some form of restriction. So just think about normal breathing. If I have to breathe in, I should have this pump handle that can move. And if I don't have that, then I'm going to have to create a substitution to breathe in. So a lot of people that have anterior compressive strategies, they're committed to people say, oh, you're breathing with your neck. So you'll see all of this extra accessory muscle activity that's associated with trying to lift the rib cage upward to create the expansion versus the anterior-posterior expansion. So the question is, is this an influence for you or is it not? That would be the step one. Based on your age that the surgery was done, it's in your favor that it's not that much of a deal because when you're as young as you were when it happened, chances are you were still mostly cartilaginous as it were under those circumstances. And so because you weren't fully calcified, the chances of it being in limitation is probably slim. Now, your physical structure lends you towards certain strategies, right?

What's the affected side of the knee?

Absolutely. So you see what I'm saying? It's like, you know, some people need 400 pounds in their back to create the yielding action. And you'll see this and you'll see an improvement in someone's squat, you know, visually the representation of their technique will improve under the heavier loads because it is actually helping them to create the yielding action that they need.

And then if you pull the front knee, so let's just say the left knee, if you pull it into yourself, that's turning the sacrum. So they'll also create a yielding, early propulsion type activity. And then pushing forward would do the opposite.