SPEAKER_02 0:00–2:56
Good morning. Happy Monday. I have no coffee in hand in. It is perfect. All right. We got a very busy Monday coming up in a dig straight into this Q&A. This is actually a question that I took from email. And it comes from Brian, who had a question about McGill's Big Three. If you're not familiar with McGill's Big Three, that would be the side bridge or side plank variation, the supported curl up, and the bird dog progressions that you'll see throughout Stuart McGill's books. I highly recommend these books. Low back disorders, ultimate back fitness reforms. I think he's got a couple other ones, but those would be the big ones that I would suggest that you purchase and read. Anyway, Brian's question is, I've been reading a lot about McGill's Big Three for lower back pain. I was wondering if you had a perspective on those exercises as they relate to your model. Yes, I do. First and foremost, I think that just like any other exercises, there are prerequisites that are required to effectively perform an exercise and McGill's Big Three is, no exception to that rule. McGill's Big Three would be categorized in my model as middle propulsive activities. That means that we've got to have a very strong internal rotation representation available to us. And so if we take our little pelvis here, What we're going to want to be able to see is we're going to be able to see the shape change that takes place in the pelvis to capture our internally rotated representation with the nutated sacrum. If we're in this ER representation, then the success of those exercises is going to be compromised rather significantly. So again, we have to have an early and a late representation of internal rotation. So the early representation of internal rotation is a distal to proximal acceptance of the internal rotation, and then a production of internal rotation from proximal to distal in the late representation. And so if we don't have both of those, then the execution of the exercises are virtually impossible without a compensatory strategy. So if we looked at the setups of these exercises, so if you start with the side bridge, As you're setting up into the exercise, you're going to have to establish this early representation of internal rotation. And then as you lift up into the side bridge, that's where we're going to produce the late representation of internal rotation. So again, we have to have both representations of internal rotation to even execute the exercise. If we look at the curl up, we have a similar situation here. We have the extended extremity, which is in our late representation. But because we have bent hip on the other side because we have a ground contact with the foot we've got to have that early representation of the foot on the ground which is a superimposition of internal rotation. So again we've got internal rotation on both sides that we have to be able to to successfully acquire. Bird dog no exception. We've got a bent hip on one side, which is the support knee. That's going to be our early representation of internal rotation. We've got the extended, or I hate saying that, the extended hip on the left side is also internally rotated. That's our late representation. So again, early and late, always represented in these activities. The advantage here is knowing that we need to acquire all of these internal rotations, we can now use these exercises as the assessment as to whether these people can actually acquire it. So what we're going to see is the most common compensations that we'll have for substitutions for internal rotation. Typically, we're going to see some anterior orientation. If we can't acquire the internal rotation, then we're also going to see the ER compensatory strategy. In the side bridge, you're going to see the anti-orientation. It's much easier to see this from the side view where you can see the anti-orientation. And then from the front, you're going to see the external rotation of the hips. So this is the inability to keep the knees together as you're moving up into this side bridge position. In the curl up, same kind of a thing. We're going to see an anti-orientation. With the McGill curl up, you're placing the hands in the small of the low back, and if we're using the anterior orientation as the substitution for internal rotation, what you're going to have is you're going to have an excess space there. So chances are you won't be able to make hand contact with the lower back under most situations without having to bear down, which is what you don't want to do as a substitution for this anterior orientation, not the good substitution for that. You'll also see the extra rotation of the hip. Primarily you're going to see this in the extended extremity mainly because you're going to actually turn the entire pelvis into ER on both sides, but you're going to be able to maintain the ground contact using a compensatory strategy. on that right foot. So it's going to seem like you've got the internal rotation on one side but you can't capture on the other. When the reality is you're erring most likely on both sides. And then if we go into the bird dog it's very easy to see the anti-orientation again much like the side bridge. You'll see that anti-orientation from the side view and then you'll see the extra rotation of the hip. If you stand posteriorly you'll see the rotation of the hip and again this is extra rotation on both sides even though it's going to be more pronounced on the unsupported hip, if you will. So, Brian, I hope that's helpful for you, so you can see that there are definitely prerequisites that are required to execute the McGill's Big 3. We've got a lot of information up on YouTube as to how you can reacquire this middle propulsive strategy, internal rotation, and then successfully transfer these to any number of exercises. Everybody have an outstanding Monday, and I'll see you tomorrow. Good morning. Happy Tuesday. I have neuro coffee in hand, and it is perfect. Man, as usual, a very busy Tuesday. We got a dig straight into today's Q&A. This is with Zach, and Zach is working with an athlete that transitioned from swimming to running. is experiencing a diagnosis of a posterior tibial stress syndrome, aka shin splints in its common name. Basically what you're looking at under these situations is a lack of distributed yielding capabilities within the connective tissues. And so there's two extremes. You're either going to see a situation where you're in an overcoming situation with the connective tissues and therefore not getting the distributed yield, therefore you're relying on a very specific tissue as the source of yielding action or you've exhausted all of the yielding capabilities of the tissues. And once again, you're relying on a very specific tissue to provide the yielding action. And so you're going to have to determine which situation you're dealing with, which is why you can't cookbook this thing. You can't just say, oh, here's the shin splints program and just follow this and you'll be fine. Because if you give somebody the wrong situation, then you have no resolution of symptoms and then an ongoing problem that doesn't resolve. Once you have resolved symptoms, so Zach did a great job with that, immediately reduce symptoms. What we need to do is restore the distributed yield and capabilities as the athlete is producing for us. So there's two parts of this. It's alleviating the symptoms and then restoring the normal movement behaviors that would be associated with performance. And so Zach is now in that phase of the situation. We kind of talk our way through this. This also relates to video I did recently where we're talking about capturing hip internal rotation, especially for narrow ISA. We've got a very small space within which we can capture this middle internally rotated high force producing representation. And so we need to do that in a very specific manner. So if you need to go to the YouTube channel, and take a look at there's a 13 exercise sequence I believe that I used to capture a hip intro rotation to transition somebody from say ground based activities towards the return to performance which would be more high speed high force like sprinting. So again check that out. If you would like to participate in a 15 minute consultation, please go to askbillhartman at gmail.com askbillhartman at gmail.com. Please put 15 minute consultation in the subject line so we don't delete it. Also include your question in the email. Everybody have an outstanding Tuesday and I will see you tomorrow.
McGill's Big Threeinternal rotationpelvic mechanicscompensatory strategiesposterior tibial stress syndrome