What we're trying to do is just create a bias or a relationship where it makes it easier for that upper portion of the thorax to fill up with air versus saying, oh, more is better because all you're going to do is magnify the current strategy that they're using if you're too steep. So take that into consideration. I hope that's useful. So again, you've got prone inversions. You've got supine inversions. And again, it's beyond the scope of this capability here of sitting behind my desk to actually demonstrate these things. But at least this gives you a little bit of a ballpark estimate of what you're up against when you're looking for inversion. Remember that we're all toothpaste tubes. If we're squeezing down from the top and pushing those forces down we just got to flip it upside down and squeeze from the bottom up and then we got a nice full thorax and then you get your shoulder range of motions back. So always Test, intervene, and retest to make sure you're on track. Hope that's useful for you, Vic. And then it's Friday. Enjoy your neuro coffee. Get your business done today, and we'll be rolling into a really solid weekend, and we'll try to come up with some really, really good stuff up on YouTube this weekend. So I'll talk to you guys later.

I think that makes sense because the axis of the spine the expansion really would shift kind of in line with the shape.

Come on, guys.

OK, why? Is it because of his dashing hairstyle? Exactly. So you see the neck and you immediately think, wow, that neck goes on a really big, strong guy, right? Literally, just by looking at someone, you made a judgment call, and you're probably right because the muscle mass kind of goes with the territory. But again, you have to respect the fact that everybody's going to be a little bit different. They're going to process information a little bit differently, more slowly in many cases. So if I have somebody that has what I perceive to be sort of one end of the movement spectrum capabilities, then I do everything slower. I might need to create a vocabulary for them because if they don't spend much time being aware of movement and I need to teach them how to do that, that's where we get this difference between internal and external queuing. Internal cues are designed to provide a sensation that most people may not be able to acquire themselves. Why do you do manual therapy? You do manual therapy to give them a sensation that they cannot acquire themselves. So again, we have lots of tools. We have physical contact, verbal cues, movement-based activities, awareness drills, and things like that that we use for everyone to varying degrees. Some people just need a much stronger influence in one of those than others. You take a high-level athlete and literally just say, go over and do that, and they immediately know what to do because their movement intelligence is so high. Then you take the guy who's been sitting behind a desk as an accountant for 25 years who can multiply three or four-digit numbers in his head in 10 seconds. We don't appreciate that, but we knock him for not being a great mover because that's what we do. We have to approach that just a little bit differently. We have to respect what people are bringing to the table. Sometimes I have to go slow. Sometimes I can go fast. Sometimes I have to develop movement vocabulary so we can communicate because they don't know what we're talking about. And don't ever belittle someone, even internally. When you're giving your best cues and think you knocked it out of the park, and they just go, what? Because they just don't have that understanding. We just have to find a way to do that.

So, because of all the concentric activity that you've got on the backside, it's like these are the people that they won't even approach 90 degrees. Very, very limited. You'll try to move them through like a traditional measurement of hip flexion and somewhere around 60, 70 degrees, the knee's going to deviate laterally because there's so much compression on the backside of the pelvis. And they'll be the same orientation in the thorax. Side-lying is very useful because somebody that's this compressed goes from that shape to that shape. And so you need some form of lateral compression and there's no muscles that do that. And so that's a nice easy way to initiate some of the anterior-posterior compression. You just use gravity to your advantage to help you spread out front to back.

I feel like I've been operating from like outside in rather than inside out. And so in some ways that's felt difficult and left me discouraged at times.

But if you can get the finger measurement, are you familiar? Where they take their fingers and they say how many fingers wide is your diastasis? And if you get to like three, they go ah, you may want to tighten that up. And so chances are that they pulled everything in and they pulled it down and in as they closed the diastasis, right? And so you took your wide person and then you pulled the sternum down at the same time. So they tried to close the ISA surgically, okay? And then they pulled it down. So you have to treat this person as such. You're going to have to slowly work them back out of it, and you're going to have to recap. So here's an interesting little twist of day. You're probably going to have to drive them into some form of old school traditional extension. OK. Getting flexion with an exhalation. So what's going on is she cannot fill the upper ribcage right now at all. So she's getting pulled down, right? So her flexion is gonna be limited. And so that's probably gonna be your primary KPI as far as how you're gonna follow this, okay? But that's the goal. You're gonna have to get air up. Because she's not actively closing the ISA, which is a requirement for reflection. They created an AP compression. So she's getting squished and pulled down. She'll have some form of inversion in her program. Eventually, you're going to want to get her to hang maybe one arm at a time or something like that to try to create the expansion upward, but again, monitoring her ability to close the ISA. But stuff like sideline becomes important for her, because you can expand one side. So you remember the slinky that I had in the purple room? So you're going to side bend her like a slinky from side to side.

Okay. So let's think about this. You're talking about the posterior lower rib cage, is that what you said? Yes. So there's a couple of ways I can go about this. I know that I need to expand the backside of the rib cage below the level of the shoulder blade. That is emphasized in the early phase of raising the arm up from your side. So if we had to pick a number, we would say that first 60 degrees is going to be that influence.

Yes.

I understand what they're probably trying to get at.

Yes. Didn't have video. Sorry. That's why I joined right back.

Yeah.

That's awesome. Thank you.

How would you restructure the school system? I know this is a big topic, but if you had the choice, how would you design it?

Well, I think that this is a little bit beyond my scope. I'm not a hematologist or anything like that. Is that hematology? Yes. Not really my forte, but I do understand the concept of constraints. And so if we have a limiting factor, a physiological limiting factor, if she doesn't have a normal level of hemoglobin, then the amount of oxygen carrying capacity will be reduced, right? So it stands to reason, it stands to reason that the way that she produces energy is going to be biased towards a shorter-term energy system, which, as you already know, it already ramps up her behavior, one second, very important. So everything's gonna follow suit, right? So, and again, it's like, I don't think you're doing the wrong thing by seeking out those type of strategies, but I think we have to understand what the limitation may be here. Right. But I would also argue that maybe your intensity is not even low enough. So how low an intensity are you, are you training?

No, I think so. I think that's actually interesting. I've never thought of it that way. I think that is interesting. When I think about what's got me thinking about this lately is there was a new research paper from this study called the Mesa study, which is essentially just a modern day, large population health study. Like in America, the classic one was the Framingham heart study. This is like a newer version of that. What they showed was that, which is also an interesting commentary even from a fitness perspective, is that blood pressure levels have basically been set based on unhealthy people. So what we would consider healthy blood pressure is just where we took the population and said, here's where pathology begins. So let's be here, not necessarily that 120 over 80 is good. It's like from a BMI perspective right? It's not that BMI of 25 is good. It's just not overweight. Similarly, being not hypertensive is not necessarily good. It's just not hypertensive. There was an editorial that went along with this new paper and they were talking about that and really how we didn't start appreciating how early negative cardiovascular effects start taking effect until the Korean War, when unfortunately they had all these young people dying, but then they were able to look at their arteries. They found that all these young, healthy soldiers had all this atherosclerosis that had started. Long story short, the Mesa study, this new paper from the Mesa studies, is really suggesting that a hundred is more of the healthy level for systolic blood pressure. Beyond a hundred, you start getting stepwise increases in risk of cardiovascular disease.

So would you kind of define early propulsion as from initial contact to flat foot in I guess quote unquote classical terms or just the phase in which the entire foot is going through that wave of pronation from the rear foot through the midfoot to the forefoot.

I just want to hear about some of the effects of the gradients within the knee and how quick maybe that synovium repairs when it comes to some of those weight-bearing activities.

So I reach out with my right foot. It touches the ground and then everything moves in that direction. Unless I want to hit a big hard jolt, I got to be yielding. Initially I'm yielding, but I'm also decelerating. I'm also changing joint angles. So I have muscles that are changing links and then I have connective tissues that are absorbing force. The rate at which I absorb that force determines whether the tissues are really, really stiff overcoming or whether they're softer in yielding. So there's a combination of things, but we tend to just represent the description by the bias. So where you're gonna see the biggest overcoming element is at the turnaround. You move into it. I'm yielding, yielding, yielding. Less yield, more overcome. Less yield, more overcome. Boom, overcome going in the other direction. But this is happening all the time, just to varying degrees.

Yeah, he came in pretty clean. And then I tweaked, like I turned the statics into dynamics. And then you saw the after picture, like that was literally him moving through space rather than doing anything static.

Yes. So what I essentially do is I create a PowerPoint presentation. They have videos and I do a screen share. And so I'll literally have the video demonstration and I'll coach and queue through it. And then it literally still takes kids probably like a good four or five sessions before they finally understand like, oh, this is what he's like trying to have me do. So I'm not sure if it's just a miscommunication on my part or it's just like an inability for them to understand like the visual to the motor?

Okay, so that's huge, first and foremost, because rather than having something that ruminates and spins around in your head all day long, getting it down on paper is gigantic step one. Then it becomes real, and you start to see your piece of paper grow, realizing you have all this stuff to account for. There's nothing wrong with that. Step two is: you say you do it fine when you have a person in context. Why does it have to be a real person? You've had enough experience with people that you could come up with eight to ten examples and run them through your visual model. That helps you fill the gaps. You'll think: 'This person represented this. Under these circumstances, here's my expectation. Here's what I know from an intervention standpoint, what happened.' Then you start to see the probabilities. The why question is always the most important one, because it leads you toward more information and more questions. The why question is what gets started. People ask me how to learn to question this, and the answer is: ask why, then don't be satisfied with the current answer. Questions are infinitely more valuable than answers. Answers are true.

Well, I'm doing both. How do you do it without touching people? So I don't get people all that much anyway. So when we look at a hierarchy of treatment, like hands-on stuff is rarely the first intervention. I won't say it never happens, but it's rarely. My goal is to have everything that I perceive as the effect be a learning-based effect. Anything that the patient can produce themselves is ideal because then they are learning. They are promoting their own sensory input, they process it, and then they spit out the output. And that's what I measure. Did we get the effect and change that we intended based on that intervention? So most of what I do is I coach. If somebody would need another sensory input, position can do it. So a lot of times it's just a little bit of creativity with the position. But again, that just goes right back to where we started, which is just coaching people into positions. I coach people on an activity just like anything else. So I don't say that probably I do some manual stuff every day, but certainly not every patient.

I think understanding a basic understanding like physiology and stuff can help put bumpers up for you in terms of decision making. For example, I would never turn around and say 'What's the ideal biological profile for a basketball player?' because I don't know. Instead, you focus on the things you can see in front of you—like a 10-yard broad jump, vertical jump, agility t-test, or whatever you may choose. The biological adaptations will happen organically underneath what you're trying to help fuel. But for example, knowing that a heavy glycolytic workout takes a toll on the system might help me integrate that sooner than just trial and error. Like watching and realizing 'oh shit, I see that every time we do heavy 400 meter repeats, the next day they're fried for two days.'

So I had some antique furniture that I got. And it just happened to be enough height to put a barbell on and do squats off of. It was also heavy enough to do RDLs on. And then we tossed in some overhead, laundry basket, squats, heels elevated. Like you said, man, you get creative.

One of the things we have to recognize about the Box Squat is that as we sit down to the box, there's a slight delay in the way that the guts fall towards the pelvic diaphragm. So the body moves downward, the guts actually move up, and then come downward. So there's a downward acceleration of the guts. If I'm already too eccentrically oriented and I can't capture that concentric orientation of the pelvic diaphragm, one of the ways that I can reduce that downward force is to use the reverse band box squat. So by reducing the systemic load with the reverse band tension, I can actually reduce the internal forces associated with the downward acceleration of the guts. This makes it easier for me to capture concentric orientation and the overcoming action of the pelvic diaphragm. This would be like making the material of the trampoline stiffer. If you've ever had an athlete that's been described as having heavy feet or they're having trouble increasing their vertical jump with traditional means and methods, this reverse band tension allows them to learn to manage the internal forces more effectively. So rather than getting pushed into the ground with higher forces, they're actually able to reverse the internal forces and improve their upward, propulsive capabilities. So much like adding weight to the bar under normal circumstances, what you're gonna do over time is actually just reduce the amount of band tension. Another unique variation that's useful for those people that are having trouble getting off the ground is the rebound box squat. By hanging the weights from the band resistance as you propel yourself up off the box, the weights create a delay much like the guts pressing down on the pelvic diaphragm. This is like loading the springs of the trampoline and allows them to propel themselves up off the box rather quickly. A word to the wise as you set this up, make sure that you dissipate all the swing on the weights before you try to get up off the box. This activity makes a great transition to our final representation, which is the banded box squat. Now instead of deloading the internal forces, what we're going to do is we're going to magnify those forces with the downward pull of the band resistance. So we're accelerating the entire system towards the box, which is going to increase the amount of force directly into the pelvic diaphragm. Under these circumstances, I'm increasing the stiffness of the trampoline and the springs. So I'm trying to maximize the force production as I propel myself off the box.

I suggest you try to own this. You may want to go with the Kindle unless you're really, really strong, because this is like 1500 pages or something like that. But great, great embryology. The other embryology resource I like is Larson's. If you want to take a look at that. So understand where you came from. I'm a big fan of that. So when you understand the structure of the internal organs, it lends itself to how a lot of those organs are oriented and behave. And then it's just a matter of understanding how it moves when we move. So now we're back to physics. We're now we're back to fluid movement, ingredients and such. So you got to put the structure together. You got to put the physics together. And then you just basically start to pay attention to how we move and what these internal organs could be doing under certain circumstances. So much like a wave crashing into a rock, those organs are constantly moving inside of you. They produce forces that we have to manage. And a lot of times, especially when we see our young athletes performing agility activities and we see their lack of control in certain elements of cutting and deceleration, we can actually identify or picture what these internal forces are doing to produce the external strategies. And then that allows us to make some decisions in regards to training. And then it's just a matter of determining, do we get the outcome that we desired? Were we correct in our assumptions? And then we're working again based on probabilities, which is how we do everything when we're dealing with humans. So hopefully, Brian, that gives you a place to start. So to reiterate, embryology and physics and observation. So go with those three elements.

Yeah.

Yes. I was up at 3:45 in the morning. Yes. Out the door at 4:15 to 4:20 to get to that first client at 4:55. That's tough. Yes. So that's how desperate I wanted to get out of there. Right. So yeah, that was like three years though. Like, luckily I didn't train that early, but I trained 6 a.m. clients for three years straight.

And then the stubbornness or the psychological weakness that's associated with having the identity of having to be the biggest and strongest kind of room at any cost bought us a new pair of hips. So we sort of have to accept that. Now, having said all of that, there are probably strategies that we can implement to reduce the secondary consequences. But again, we're sort of playing with fire because you don't know what your genetic potential is and you don't know what adaptations are going to be required if you achieve a certain goal. And so that's why we need to be a little bit more strategic in our application where you and I might have like a specific hypertrophy goal or body composition goal or force output goal. And then you have to monitor that over time and you say, okay, am I giving something up in return for this force production? Am I giving something up in return for this gain in muscle mass? And then identify what that is. And now we say, okay, is there a strategy that I can implement that will help me maintain whatever this is and still accomplish my goal. And so I don't think we can, we can sort of categorize a little bit that gives us some guidance, but it ultimately becomes a personalized experiment of what happens. So we, and this is how I approach everything, whether I'm in a purple room, working on the rehab patient or whether I'm out in the gym, working with an athlete. We have to take these things in small bites. And so we have to say, okay, so we're going to implement this strategy in an attempt to create whatever adaptation it might be. So you work with athletes all the time. And so you see this all the time. So you're working for speed or force production or whatever you're trying to make a change with, right? That enhances performance. But then you also have to monitor the other stuff because you wanted to stay healthy and effective. But ultimately, while we think we might know what's going to happen, we still work on a probabilistic strategy where we just don't really know what's going to happen. We have an intention, and then we say, OK, did my prediction come true? OK, great. So I accomplished the initial goal, but what was the secondary consequence? Did I give something up in return? So for instance, I knock a 10th. off of somebody's 10 meter acceleration, right? But I lost 15 degrees of hip rotation. OK, is that an okay thing? So if this guy is a straight ahead athlete, not such a big deal because I expect something like that to make him faster in a straight line. But if it's a defensive back that has to lower center of gravity, change direction, guess what? I just took away his ability to lower center of gravity and change direction. OK. So, so was that a, was that a reasonable sacrifice? And so this is, this comes down to like, okay, am I training this guy for a combine, you know, like the, the dog and pony show of the combine. Or am I training this guy to be successful as a field athlete? And so again, you just got to make those decisions. But again, for guys like you and I, where we've already compromised an element of health, it's like, how much farther do we want to really go here? And then what are we using as our guide to determine, I probably need to alter my strategies, change my goal or my intent. And then, again, continue to monitor. So the strategy doesn't change. It's always going to be evaluate, intervene, and then reevaluate and make sure that I'm on the correct path. And so, you know, if you're doing seven sets of 10 with your kettlebell, okay, what's the byproduct of that? You know, what are you measuring to let you know that, okay, I can still do this because that feels good to me because I get to train, but did I just sacrifice something? And so what you need to do is you need to come up with those key performance indicators that are going to be your measures of this is what I cannot give up.