You are. In many cases, you are.

Well, it's more a matter of figuring out how and where they fit—how macro one is and how micro another is. So throughout someone's movement, there's a little bit of fluid shift within muscle, within fascia, within capsule, and that sum will create the shape change we observe.

Up. ER is up. Right. So, it's up and out. Would you agree? Yes. Okay. What way do you think his right acetabulum face?

It was regarding how to gain ranges of shoulder flexion. But the question was whether you could do it in a quadruped position. And then you started talking that when you put someone in quadruped position, you could also get the expansion below the scapula.

So again, you might have two different representations here. You're going to have to clarify the hand position and then the humerus elbow position in both cases. And you may have to do the same thing. I don't know. But the thing I want you to recognize is where do you have the biggest differential might be where you spend more of your time. So this is a bony band. This is a bony band here. This is, this could just be like a relationship of hand pronation to the wrist orientation.

Right. If I don't use a compensation to get there, I am in a space of relative motion. It's not full relative motion, because I know they don't have full relative motion, because my assessment told me so. But it did tell me where they do have some.

Yeah.

Gotcha.

So like literally all the space just closed up around them and there's no place to go. They have no other strategies available to them so they have to stop. So that's how like if you're testing a shoulder joint and you go to the end of the range of motion, the reason the joint stops moving is because there is no more space to move into. Like literally you've just compressed all the space around that joint and the joint stops.

Okay. You're standing in place. You jump forward and you land with your left foot out in front of you.

Okay. So you did the T one through three kind of stuff and then the lower cervical, right?

They are yielding. A lot of the times already.

Okay, so now you've got what used to be some elasticity in that connective tissue, and now it just takes more effort to deform it. And again, when you talk about some of my patient population when you say that, oh yeah, they've had pain since they were 20 and they come in, they're 55 years old. Yeah, I see those people too. And it's a very difficult situation because you're battling 30 years of adaptation. And so it does reduce the potential for change in the acute phase. Now, it doesn't mean that we can't make progress. It just means that we might not be able to make as much progress. Now, in addition to that, let's take the water out of the connective tissues, because we all dehydrate as we age. So now I have an adaptation for 30 years. I have reduced potential for change. And now you're in a pickle. So we have a combination of factors here that are all in play. Now, if I'm dehydrating, if I have a compressive strategy over 30 years, what do you think the spacing between the joints is going to look like in the cervical spine or lumbar spine? It doesn't matter which one we're talking about. What do you think those are going to look like?

And I push this forward.

No. Oh. Nice try, though.

Why would I ever do that? I have a brother, and we'll be doing stuff, and he knows what I do and understands that my analytical mind doesn't turn off. So we'll be doing something and he'll point out when I'm analyzing somebody and asks, 'What's wrong with that guy?' It's always on, it's always on. No, but see, that's okay. That's not a bad sign. It's just part of your strength, right? It's the stuff that interests you, the stuff that drives you. And it doesn't drive me crazy. I recognize that, but I also know where I am at the time, so I can buffer it. It doesn't have to come out. I have a prefrontal cortex that can step in and say, 'Hey, just relax and have a good time.' It's always going to be on, but you just have to be aware of it. It's part of the process. Like I said, don't look at it as a bad thing, but you should always be able to control it. See it and then go, okay, but you're not making a judgment. You don't have to make a judgment on that person, but maybe it made you one step better today. I'm okay with that, but I also understand where you are. It's like, nobody else wants to talk about that.

Yeah, I think potentially. And then make sure you have like a test retest. So in this case, your simple test is, let's rack a bar. Let's see what it looks like. Let's go over, let's do the safety squat bar activity to promote the AP, and then let's go back to the rack position and see if we were successful.

Okay. But it's not in any of them to the maximum, is it? They're all ER measures, so they're all ER. I had to create an expansion to get into that position. Now take your right hand and put it in your left front pocket. You went across and put it in the opposite pocket. Just talking about the right arm. Right hand in your left hand pocket. What position is that arm in?

So when you have a 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. Okay. There's a sequence of events that those things represent, but it tells us where you are in space. That's the important thing.

Taking that to the next sort of variable that I can see. If I had a water balloon and a basketball that were both of the same size, they would both technically contain the same amount, you could hold the same amount of volume within them. But the external, how was your point, the skin, what it's held together with is different on one than the other. Now wondering whether we can is there any inference that can be drawn by the model as to how that works with say connective tissue or something of that nature. To be able to impose more pressure so you got a power lifter or a sprinter or someone who is tissue is connective tissue stiffens over time. their ability to then impart that pressure obviously improves than someone of us trying to.

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 plantaris compression on the medial side and then also like his big toes.

Okay, so think about the strategy that when you take your initial measurements, they're going to give you a representation of the strategy that you're using to manage yourself. Right? So based on that, after you put somebody in a position, you should have an intention of what you're trying to change or influence. What am I trying to influence? After you do that activity, did it change? If it didn't, do something else along the same lines of thinking, if you still think that you're correct. But the point is, before you choose an intervention, you need to have an intention. Don't just randomly throw stuff at the wall and hope that it sticks. We want to have an idea. So if I'm going to put you in sideline, I think about: If I took away the influence that made you create this movement strategy in the first place, I have to have a measure that tells me that you stopped using it. So maybe it's like, okay, I recaptured external rotation and was able to superimpose internal rotation on top of it. So let's just say that they were like, 50 degrees of external rotation, zero internal rotation. You land them on the right side, they mess around a little bit, and they go 60, 20. Way to go. That tells you that that left-sided strategy is no longer in play. So now it's like, okay, I probably need to get more of the internal rotation. So I might do another activity in a similar position, or I might move them into a slightly more challenging position and see if they can hang on to what they just gained and then pick up some more. So that might be going from right sideline to supine. Okay? Do you follow where we're going here?

Take a box squat. And if you do a full load on a box squat, you're going to yield more than if you did a touch and go. So if I want somebody's connective tissues to behave more stiffly, I might say, okay, de-load to the box first, and then spend less time on the box, and then less time on the box, and then touch and go, and then, and you see where I'm getting at. You can also do this where you would do like, maybe I jump up to another box where you would start them on just a simple box squat, de-load, less time on the box, touch and go, and then jump. So I'm sort of ramping up the stiffness, versus somebody that's going from like a full yielding action that might be what we would deem less than ideal. So somebody that might like a tall slender volleyball player that might have a lot of eccentric orientation, a lot of yielding capabilities, but not a lot of turnaround. So the vertical jump is a little bit lower than you would like it to be. And so again, you transition them into a faster and faster loading representation so the tissue becomes stiffer. And then you turn that into the more explosive activity.

L5S1, L4, 5.

So let me see. If I put all the weight right here where my finger is, this angle will increase. I'm still moving sideways, so I get a bend in the tibia that goes like that. Okay, bending this way while the whole thing turns out this way. So I'm pushing down here. Again, it's like we have to move through time here. The pressure here is IR. Yes. The reduction in pressure here is ER. So this is slowing down relative to this. Like within the bone itself, this is moving faster in that direction. This side is slowing down. So it's going down into the ground. So the whole system is moving this way. This is slowing down the turn. So you can have this bowed representation with weight bearing on the inside, the medial aspect of the knee joint, and it will bend the tibial plateau. So the plateau is trying to stay level while the bone underneath it bends into this bowed representation, which is why you see ER at the bottom. The whole thing is turning, right? And they're trying to keep IR into the ground through the medial plateau of the tibia. So this is twist on twist on bend. So it's doing this.

So I'm comfortable with the reference. The example you were using was like someone stealing a base from first to second, where we cut off the left leg. I'm okay with the initial representation being that they're just standing there in a slight hip hinge, athletic position, where the anterior outlet is concentric bilaterally 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, the anterior outlet switches to eccentric overcoming. And then the left side becomes eccentric yielding. But to me, the conditions on the right side don't work like that because the extremity really changes when you don't pick that side up. So I'm just curious why that flips to eccentric in the right anterior outlet.

If I am training someone and the foundation of their program is working in middle propulsive activities, I might need an activity that meets that coherence of the program. And so I'm trying to teach them to hold the middle propulsive representation. So if you did an arm bar with a very heavy kettlebell, do you think you're getting full relative motions? Then why would you ever use a heavy kettlebell for an armbar? Because I want to teach you to hang on to a middle propulsive representation. So if I'm training force production and I want you to be able to lead into a middle propulsive representation and come out of a middle propulsive representation, but I also want to produce high forces, I still need that representation. So it's still as useful. The whole world is not dependent on you having relative motion. I still have situations where I need to train that middle propulsive representation. I need to capture the IR positions and I need to teach you how to maintain that.

Well, wait a minute. Okay. So, think under this circumstance, you're actually going to have a compensatory ER representation on that left side. So we're late on both sides. And you're trying to move them back on the right. So you're actually trying to create the expansion posteriorly on the right. And so what you're going to have is you're going to have an ER representation as they're bringing that left knee upward. So you get the right foot on the wall. So you push on the wall, bring the left knee up. You're actually using the compensatory strategy on that left side to help you create the delay on the right side to bring them straight back on the right.

Right.

For a wide ISA, yes.