Okay and then if we are, I guess I have a couple of questions on the specific. So the first one, if you're pulling your knee into yourself. You're turning the sacrum towards the front leg. Yeah. You turn it towards the front leg. You're creating a yielding strategy on the back. But I also heard you talk about if you pull the knee in, you're biceping yourself towards internal rotation.

Okay, so you have 45 minutes?

Okay. All right.

Okay.

So you can see the hip. There's the delay that we're trying to create. The right hip going forward, we've got the left hip going back. This is a much tighter turn. Now we're talking about emphasizing this shortest distance between two points kind of thing where it's a much tighter turn versus something that would be out and loopy, right? Happy Thursday. I have neuro coffee in hand and it is perfect.

Well, it's traditional and range shoulder flexion. But it is an IR position under those circumstances, isn't it? That's what's supposed to happen. See, that's the shape change that I'm talking about. It's like, so you can't say, oh, it goes, it goes, E-R-I-R, E-R, because it doesn't. It depends on the context. It depends on the shape change. So if you watch, if you take a freeze frame of an Olympic weight lifter in the profile view, side view, as they complete the jerk, their head is in front of their shoulder girdle. Right? Yeah. The weight is over the shoulder girdle and their sternum is expanded forward. Because if you don't do that, where does the bar go, Manuel? You probably lose it in front. Yes, exactly. Because there's nothing under the bar, right? So how do I create stuff under the bar? I take both scaps. I compress them against the posterior thorax. I shove you forward. I internally rotate. That's my force producing position, right? I'm producing force up into the barbell. So I'm turning inward. I'm eye-erring. My head's going to go forward because I'm compressing dorsal rostral. I am pushing the lower cervical spine forward and I'm pulling my head back in response to that, but I have to have the expansion anteriorly one because I need IR and I need space. I need an expansive thorax underneath the bar to stack the weight on top of. Otherwise, I can't do it. So again, it's like, when you say, is it the same? It's like, okay, what are we doing? What's the shape that we're creating? How much load is there? If I'm in a, you know what a T pushup is? It's like a, it's like a side plank where your, you know, arms are out to the sides and you're doing the, you know, like, like you go from push-up position and you rotate into the, to the side plank. It's like, how much expansion do you have there on that loaded side? Not very much because there's a lot of pressure there, which means I have to IR that, but if I'm laying on the table and I can expand, then maybe I have a little bit of ER there too, that's going to allow me to move into horizontal abduction. So that's why we can't, that's why I am so adamant about killing this arc concept, right? Which is probably my fault because I drew it on a white board, which is two dimensional. And so everybody says, oh, it's a flat plane and it's an arc. No, it's a space that moves depending on what shape you are.

What was your philosophy when you first started and how has it changed these days?

I don't want to say main because I don't think that's fair. I think that would be a leap, but it does happen. So think about this. If you put extra weight down on the pelvis, the bones have to absorb that. And so the bones yield just like all the other connected tissues. And so it's really not that different. Now, let's put that load on there for three or four months and see what kind of adaptability that you end up with. So literally they're going to get a pelvic shape change that's associated with the load that is based on how they're yielding almost every waking moment of the day. And so one of the things they end up having trouble with is they will have essentially a shape of a pelvis that is shaped like an inhale that will bias the pelvic diaphragm. And so it's very, very difficult to create enough pressure upward. So they can't close the inlet of the pelvis like they would for an exhale. So if they can't do that, then it's a battle of downward force of the internal organs on top of something that can't push back up. And so then they have incontinence problems. They have just simple efforts of squatting or getting up out of a chair or climbing stairs and like all sorts of force related problems because they don't have that pressure mechanism back.

Any kind of turning sport is going to be very, very similar in regards to the rules. So when the golfer takes the club into the top of a backswing, he is moving towards a position of external rotation. So he has to create a position of external rotation. So it's a space where he can access the shape of his body and external rotation. And then he turns into it. So the hip and the pelvis are oriented such that I have this whatever the maximum amount of external rotation that I have. And then the pelvis will turn towards that and that's the internal rotation. So both are always happening at the same time. That's why you hear me use the word bias because that tells me I have more of one than the other, okay? And so you have to have the extra rotation to be able to access the positions that you produce the most force in. If I narrow the extra rotation space, I've reduced my potential for internal rotation efficiency. Efficiency, doesn't mean I can't produce it. I'm just gonna find another way to do it. So what some people do when they don't have enough ER, which means that they narrow their IR, they dump their pelvis forward and that pushes into the ground. Perfect, there's my internal rotation. Because ultimately what internal rotation is, is a downward force. We just happened to create it by turning inward. Okay. So again, you just think about, think about the first amphibian that came out of the water and decided to walk on land. He's used to swimming like this, right? And then he gets up on land and there's gravity to deal with. And now he has to go, instead of going like this, he's got to go like that. He's got to turn in and push, right? Totally different. You know, if somebody's just a performance related, issue, right? It's not a pain related issue. It's not an injury kind of a thing. It's like, you just have to really well define what you want that outcome to be. Like what measure are you going to be chasing? And then you just, again, it's just a stepwise process. It's like every two weeks you're following a key performance indicator and you're going, okay, did this change? Yes. Okay. What was our, what was our test that we're using to tell us that we were on the right track in the first place? That's the process. It's not like you're gonna write this magical 12-week program and you're gonna go, everything's gonna be great by the end of 12 weeks. It's like, anybody ever written one of those? Never? Yeah, me either. No, I have, I mean. Well, you try, like you project. So there's nothing wrong with projecting outward, but if you're not following some sort of indicator that tells you that you're on track, it's like, you just wasted 12 weeks.

What's the difference? You're losing ER spaces. Do you understand the reorientation? Joe? Let me just talk about it. So if you buy a kinesiology book, and they look at the stuff back here, and they say that, oh, these are the external rotators, right? Until you start to do this. Or if I do this. So as the stuff that's attached to the femur from the pelvis, if I move towards any degree of traditional hip flexion, if you will, they change direction of pull. They become internal rotators. So if I do this and they become internal rotators, they're going to bring this along for the ride. And so the more anterior orientation I have, the more extra rotation I'm going to lose. That's why the anti-orientation, or that's why the ER measure is such a useful measure for the anti-orientations. And then you compare the two sides and right away, you start to get this beautiful picture of like, oh, the left side's more forward. That means he's pushing more from the backside, which means I'm going to have this kind of a flatter orientation in turn. Whereas if the right side's more forward, that's going to be tipping me up on an oblique. Now keep in mind that there's a lot of straight aheads and then there's a lot of obliques. I could literally go like that and I can create an infinite number of directions between those two orientations. That's why you'll get some varying degrees of ERs on IRs throughout.

Is this why if you watch a lot of powerlifters with their squat just repetitively over time, and once they hit certain areas, they either have like a hip hinge or something goes wonky?

It's complex.

Right. Because I'm trying to create a posterior yielding strategy on the opposite side to get expansion on the anterior side so I can capture the internal rotation. I believe I was turning the kettlebell inward, which was in rotation. So I have to have concentric orientation posteriorly. So I'm at 90 degrees of shoulder elevation, which would put the scapula in an upwardly rotated position. But I need concentric orientation there so I can create enough expansion anteriorly as I internally rotate. I need to coordinate internal rotation with pronation and the exhale strategy. The lockout tends to be like an elbow-ish kind of concept.

Yeah, it goes back and up.

The longer the change, obviously that represents the potential adaptability, right? And so just give you a for instance, so we got a guy that's a, you know, six foot, 3,300 pound football player. He hasn't changed much, right? Because when we don't want him to change all that much. And so because it's a performance related adaptation that we kind of know is going to be somewhat restrictive on certain elements of movement. When you're talking about, say, the rehab mode where adaptability is the primary concern. So we're trying to get as much adaptability into the system as possible because we never do know what's wrong. And so we're trying to get as much adaptability. And so we do want that to be maintained for a much longer period of time because again, that represents the adaptability until it's time for them to do whatever it is that they do that would reduce their adaptability. So if they go back into some training process where they're trying to recapture some element of performance, then we know that that kind of thing is going to change. And so under that circumstance, we would always want the ISA to be mobile, right? Because again, it is that foundation. It represents the first compensatory strategy. If we look at the two extreme archetypes, it represents the first compensatory strategy. So that's what stops the ISA from moving is when the diaphragm has a limited excursion. And if I can't move that, then I know that the rest of the stuff isn't going to move with full relative capabilities.

You got to be able to identify the difference between the posterior orientation with the lumbar spine inflection versus somebody that can deep squat into counter-neutation with the lumbar spine following as it normally would, right?

Yeah.

I will. I must say something though, Nate. I appreciate your facial expressions. Thank you. It lets me know that I'm not a total idiot when I try to make a joke. So do you understand what the difference is, what they are?

Either just like an anomaly or maybe that too.

Yeah, let's go over it.

That is exactly right. Okay. And so, now you've got a really good understanding. It's like, so they're kind of walking around in this orientation, like okay, they're deadlifting 24/7. So now think about, so now you kind of know where the expansion is going to be. Right? Where's the compression? On the opposites. Yeah. So now they walk in, they go, yeah, my back really hurts, Bill. This is why the archetypes matter. This is why the compensatory breathing strategies matter. And then you're just seeing this progressive reduction of adaptability, right? And then look for where they cannot alleviate that pressure.

Hold your cup up. Let me see. You got it? There he is, ladies and gentlemen. There's your neuro coffee guy. I would be nothing without this guy. By the way, Dr. Mike, my coffee is perfect.

And that is one of the levels of complexity of working with complex humans. We just have to figure out those ways to do that. So again, you just slow down and you just find a way. And one of the conversations that I have during the subjective is I always try to find out what people's background was when they were younger. So I say, what sports did you play in school? What was your favorite game? Or all that kind of stuff because that gives me an idea of a frame of reference. So if I get a guy that comes in and he goes, oh, I've done jiu jitsu for 25 years. And so now I have a frame of reference. So now when I'm teaching him a hip shift or something like that, or I'm trying to get him to feel something that's back, I go, now it's like, because when you lay them on their side, it feels like a hip escape and jiu jitsu to them. And so I say, now do your right hip escape. And they go, oh, so that's what, OK, now they know what it feels like. So you have to create a frame of reference. So again, you try to find that if you can. And then there's cases where everything just is like the uphill battle where, oh, yeah, I've never played a sport in my life. I've never really moved. I was a sickly kid. I had a lot of allergies. You're gonna have these scenarios that come up. You just, and again, I hate to default to this, but you just sort of find your way. But always respect what they're bringing to the table because they do have some, you know, probably specialized intelligence in some way, shape, or form. We just have to kind of figure out how we make that connection. So let's just talk about analogous structures for a second. So when you're looking at situations where you're looking for the analogous structure, you have to look at it from an embryological standpoint. So things that are derived from the same place, that's one possibility. The physical structures are the same. The movement behaviors are the same. So when we look at these things, that's how you identify analogous because they don't all look the same. And so that's what you're looking for. So the point of confusion, when I say that there's five muscles in the glute max, I don't care what you call it. I'm just looking at it behaviorally. And it's like, where else? It does so many things, right? They just said, they just looked at it from a distance 2300 years ago. And the Greek guy looks at the other Greek guy and he goes, what do you want to call that? He goes, I don't know. It's a big one. Let's call it Maximus. Awesome. What they weren't doing, they weren't looking at it from a behavioral standpoint. If they would have done that, they would have said, oh, this part does this, this part does this, this part does this, and this part does that. If they would have done that, we would have a totally different frame of reference for that musculature, and it would have a totally different name. Actually, it wouldn't have a name. There would be five different names.

So as you compress that backside and synovial fluid starts to fill the front portion of the joint capsule, would as that gradient gets harder and harder or bigger and bigger, does it get harder and harder to then pull back all the synovial fluid?

Pick the emotion part out of it and just look at the outcome. And then that defines the next step. So I always talk about taking the next logical step. What is the next logical step? Take your ego out of it. And that's really difficult to do because we do invest so much. You know, if you're really intent on being good at what you're doing, you're investing yourself in it. There's no question about that. But the thing that you can't do is invest so much emotion in it because there are dips and valleys within the process. And so again, we just have to look at it. It's like, okay, what is my decision-making process? And then it becomes this, I don't want to say robotic, but it just becomes execution. It's like, okay, I measure. I determine what those measures mean to me. And then I intervene and then I determine what the outcome was. Based on that outcome, I know what my next intervention should be and so on and so forth. That's how we have to look at this. Knowing full well we do not see the reality. We can't see what the patient sees or our client sees. We can't feel what they feel. And there is always the gray area and the unknown because everything that we do is based off of a probability. Let's just say that we're intervening: there's a 76% chance you're going to be successful and a 24% chance you're going to fail. And you fail. Does that mean you made a bad decision? No. It just means there was a probability of failure. So everything that you do has a probability of success or failure, assuming that you're within some reasonable accuracy, like I said, if we can ever get there. And we have to accept the fact that there are things that we cannot impact, things that we may be able to impact—or we may not be able to identify them. And so it makes people uncomfortable to live in a world where this probability is so obvious. Because in school, they said, 'it's this.' They gave you the black and white answer. And we don't work in black and white. There's a constant state of unknowns. You have no idea how someone would respond. Getting back to the whole language concept, that's why you have to be aware of how you speak to people. Because that's part of the influence, right? And so their state, based on how they respond to you, is another element that influences the outcome, whether you're going to be successful or not. So if they don't like Notre Dame, guess what? You have a problem. It's okay. Your failure is not a failure in the negative sense. Your failure is just the outcome that told you that that was not successful this time. But my process told me that that's what I should have been trying to do. So maybe I said something differently. Maybe they wore their lucky underwear that day. It could be any number of things that turn out to be an influence. Doesn't that make you happy to know that you just have so little control over things? Just the recognition of this sort of perspective, I think it helps us because we stop punishing ourselves as much. You're always going to, like I said, I always talk about the scar on my forehead from banging my head on the steering wheel on the way home—every day where you think, 'I said the wrong thing. I did the wrong exercise. I could have done this instead of that.' We always have those thought processes, but that's good to have those because the people that don't have those thoughts on the way home... good morning, happy Friday, I have neuro coffee in hand and it is perfect. All right, very solid week. We're wrapping it up. We're gonna go into a stellar weekend, which I'm looking forward to. Hope you are too. Hope everything's going well for you. So let's wrap this up with a really good Q&A for Friday. So this comes from Jason and Jason says, it's a common sentiment that we hear in the industry: a certain muscle is tight because it's weak, particularly in reference to hamstrings, hip flexors, and external rotators. How does this concept fit within the orientations and strategies of your model? Well, let's talk a little bit about the concept that you're asking about first and foremost and let's kind of figure out where that sort of comes from. And I think it's based on what would be the typical structural reductionist model where people are taking physical properties in the world around us and then trying to apply them to humans. For instance, if you pull on a rope or stretch a leather belt or a rubber band, you feel the tension. And if your model of the world is based on these physical properties and you apply them to humans, then my perceptions are going to follow. So it's like we compare muscles to tension in rubber bands, even though that's not remotely true. That might be where this kind of thing comes from. 'Nuts' and muscles is another one that stands out in my mind. Muscles don't actually have nuts in them. They might have contracted areas that become sensitive. But somebody called them nuts at some point in time. It caught on. It's a great metaphor. It's very useful for a descriptor to describe a sensation. It's just not much of a reality. Doesn't mean we don't feel tension in tissues.

Perfect. I have a GHR so she can lay to the side.

Yes.

And what you'll notice is like even though he's oriented into pronation at rest, he probably shows a limitation in pronation. And what you want to do is actually take a look at how much pronation he's got approximately relative to the wrist. So when you grab his wrist and you turn him over into pronation, you go, oh, he's limited. It's like, get a little bit more proximal and see how far you can bring the radius over into pronation and then compare it to the other side. Because chances are he's got a radius that's bent.

I do, but knowing what I know now, I'm having a hard time accepting that.

That's all right. So I want you to see, you know, all this.