Is that what you're saying?

Yeah. And so in that case, would you also do some supplementary tricep work? Why? Some direct arm work or? Why? or bench press lockouts with the off a board or off.

They kick back first. Yeah, yeah.

With regards to the performance aspect, I know we've spoken about that multiple times. My question is we're trying to evaluate these KPIs to see if that person has pain or has some sort of movement-related issue. We're trying to evaluate the whole system to see, okay, well, what do they potentially need more of, or trying to figure out why that's happening. Now, as you're saying, everyone has their individual kind of sweet spot. I find that, obviously, I think the way that I see it so far is that, because I've been playing with that in the past few years and it takes a long time to really develop that, like a lot of exposure to that person, personally at least to find, okay, this seems to be their sweet spot. This is kind of what they need. Have you found a particular way of doing this, either of like saying, okay, well, how are we going to correlate your hip range of motion with your sprinting mechanics or with in order to have an easier time figuring this out, figuring like, what are their KPIs? What's that spectrum? You know, like that path would always talk about the spectrum of like, this is where they perform well, and like outside of that, no good. So, like, how do you go about figuring this out over time to say, okay, this is what this person needs. Those are the KPIs.

What are some long-term negative repercussions of squatting that deep with the lumbar moving posterior like that?

But to me for like the goal of like movement restoration that didn't seem to like make a lot of sense.

Overcoming, trying to approximate some of the tissues and then giving away.

Most of the time it's just me screwing up. Everything that we do is based on probability. I measure my chest board, I have my three-dimensional representation of this human, and I have to make the best judgment based on my understanding. Then I intervene and retest. So I have no judgment in the whole process—it's just: here's what I thought I had, here's what I did because of that, here's what happened, and then I just do next. It would be rare because I have checks and balances within my process that help me confirm what I think is going on. But I miss the target. There's a percentage where I miss the target because it's all based on probability. To quote Annie Duke, we're playing poker. So 76% of the time I'm correct, 24% maybe not. Under certain circumstances, maybe sometimes I hit it out of the park and I'm 92% correct. The point is you've got to be prolific with everything you do—that's how you get good. Because, as Jolly Park wrote 3000 songs, but not very many were great, but she wrote a lot of them, and that's how you get great. So the number of failures you need to get really good is very high, but you got to do it in a safe atmosphere. That's why I'm such a proponent of mentorship and apprenticeship models, especially for what we do—it is the only way. In fact, it's the only way to learn how to do this is to do it under the direction of someone else first because that's how you're going to get your reps in a safe manner. So if you're just out of school, you must find somebody you can follow and work under and do it for free if you have to, so you get your reps, so you get your exposure, so you learn to see things. There is no book that's going to teach you what we talk about on these calls—this is all experiential. That's why it's so important. That's why internships are important, that's why apprenticeships are important, that's why having a mentor is so important because you need guidance. Because you can learn anything, but the stuff that we do cannot be taught—it has to be experienced.

Okay. So this is actually useful to know. I don't know how valuable it is from a return on investment standpoint, but the difference is where the load on the back leg is going to go as far as the contribution of joints. Okay, so if you are in an ER position of the foot. So there'd be like plantar flexion/supination, which would be like the dorsum of the foot is supported on a bench or something like that. You're going to use more of the backside hip to push yourself up and out of the split squat. Okay, keep in mind that when you elevate the rear foot, you shift load anteriorly anyway. So if you look at the last research that I saw, they were using a bench, and I can't remember how high it was, but it's like a typical gym bench. And I think that the maximum load to the front leg that they could produce was 85% of the total load. So it was body weight load plus bar, right? But if you use one of those padded bars and you hook your foot over it and you dorsiflex, you use more of the backside knee to distribute the load onto the back leg. Once again, it's not terribly valuable, but I can see little tweaks here and there that it might be useful to distinguish between the two. But it's also going to direct you towards where somebody might be lacking some movement that will influence the position and the outcome of the split squat, right? So think about as I sit down, so if I have the dorsum of my foot supported, knowing I'm going to load, like I'm going to be pushing through what would be traditional hip extension coming out of that. It's like, okay, is that really what I want to do? Or do I want to shift more of that load to the hip extension on the lead leg? And so again, people would call this single leg training. It's like, well, okay, if I get two feet in contact with something I'm using both sides, it's just how am I using it. And again, it's a subtle, but if you do both of them, like just go to the gym today and do both of them, you'll feel the difference. You'll feel the difference in where you're distributing the load. But you can manipulate the height as well. And again, that's going to push some of that load more towards the back. The question is, what do you want the outcome to be? I have people that come in and they say, well, don't I have to do a split squat this way? And it's like, well, no. There are many ways to execute. It just depends on your intended outcome.

So if the ISA is almost like a proxy measure for the adaptability of the easiest, the most easily moved ribs, right? And the top rib, the first rib is the most difficult to affect. Is there a proxy measure to measure the change there? Like, does the collarbone and this?

I did not expect any difference.

Let's call it Maximus. Awesome. Right? 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 actually this is a really good question. The thing you want to try to recognize here though is that if I have this posterior lower compression, I already have a scenario where I've got the anterior compression already in play. And so now what happens? So think about pushing the femur straight into the acetabulum and getting this uniform distribution of synovial fluid around the joint. And what that means is it becomes very, very stable. So I'm driving it straight into the acetabulum. So it's not a matter of shifting synovial fluid into your posterior. It's all the way around the joint. And so under those circumstances, it doesn't move. I have ER or IR. Because if I had a gradient, I would have motion in one direction or the other, right? There is no gradient anymore. That's what happens under these circumstances. They get so compressed. And the acetabulum, because of the compressive strategy that's anterior and posterior, the acetabulum starts to face a little bit more sideways.

Your failure is just the outcome that told you that was not successful this time. But my process told me that's what I should be 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 this 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 helps us because we stop punishing ourselves as much. You're always gonna have that thought process on the way home: I said the wrong thing, I did the wrong exercise, I could have done this instead of that. But that's good to have those thoughts because the people that don't have those thoughts on the way home don't reflect on their work.

But don't put her prone because it's not going to work. She's somebody that regardless of what her ISA measurement would be, she has to be able to actively close it to get her arms overhead. Some good activities like an upper dog or was it is that is anybody a yoga person on here like it was it? It's like a sunrise asana or something something where they're looking up. Okay, but so the so the cool thing here is that is that your your arm position puts you in an ER inhaled position and you're also actively closing the ISA. And like I said, it's a little counterintuitive. And it's not about being extreme. It's literally just getting air up into the thorax while you're closing the ISA. So again, that's why you start there because she probably doesn't have shoulder flexion and then you start to work upward.

Okay, so there's a couple of ways that 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. So that is emphasized in the early phase of raising the arm up from your side. So in what we would say, if we had to pick a number, we would say that first 60 degrees is going to be that influence. Correct? OK. So anything where I position my arm in that relative angle is going to help promote that expansion. So I have to have a compressive strategy anteriorly to move the fluid volume posteriorly. So just take a high to low kind of a cable press concept as I'm pressing down and reaching. I would have to compress anteriorly to accomplish that task, which would promote the posterior expansion. Right. Yes. Okay. So that's one strategy. The other would be to create a compressive strategy where I don't want the air to go right would be through that middle range. So you think about like if I wanted to compress the dorsal rostral area around the scapula, I would position that arm through that roughly the 90 degree of shoulder flexion range, right, plus or minus about 30 degrees. And that will create, like I said, that upper posterior compression, but what it doesn't do, it doesn't compress the posterior lower. So now I'm using another strategy that will block the expansion in one area and try to promote it in another. So there's multiple ways to go about this.

Yes.

Well, I think let's reverse it. I think that would be a much more profound statement is that efficiency breeds speed. I don't think it goes the other way. I don't think that doing something faster necessarily produces the desired outcome. I think that if you, when you think about just the sequence of events that it has to occur to produce a major league of basketball, if there's not an element of efficiency in that, I don't know how it even remotely occurs in some form of control.

That's why I joined right back.

Do you usually use like a similar type of thought process in regards to return to sport, following injury and surgery?

Well, the number one mistake that a lot of therapists make is they make the situation and the interaction about pain. I can do absolutely nothing about it. Literally, I can do nothing about it. Now, my intent would be to help them alleviate it. But it's not my decision. And in fact, it's their decision. I don't talk about it too much. Campo is on the call and he was a patient at one point in time. And so he knows what I say to people when they walk in the door. And I always say things like, 'What's your status?' I never say, 'How is your pain?' Because the minute you give them that, that becomes the point of importance. And if I can't impact that, I just made it the most important thing. And now I'm already behind the eight ball. I put myself in a bad position because now, if we don't alleviate it, I'm the bad guy or I'm the guy that can't help them. So my goal when they come in is to focus on the things that I know that they have control over. So it's like, 'Hey, how did you do with your homework?' So I give them exercises to do at home. We call it homework. And they say, 'How'd you do with your homework?' So now the focus is on execution. So these are the things that you can do. These are the things that you can control. And so that becomes all of the focus. Because like I said, Nikki, you do not control your health. People like to think that they do because we do things that we do that make us feel good or we think that contribute to our health. And there are many things that we do know that do contribute to our health. But ultimately we never do, because there are so many factors involved in what we would consider health. Again, my goal with all of that with that concept is to take that off the table as a useful measure of the interaction. Of course, I want them to feel good. Of course, I don't want them to be in pain. But if I make that any measure of focus, you have immediately failed because now that is the one thing that they will be focused on. Then they start to blame themselves or they'll blame me or if it's a situation with you they'll blame you. We don't want to put ourselves in that situation because it's so difficult to be successful under those circumstances because if they don't walk out without pain then you fail.

I don't know. They had recess and I was in elementary school.

Are you monitoring?

And they were like all these young, healthy, soldiers had all this atherosclerosis that had started. And so long story short, The Mesa, this new paper from the Mesa studies really suggesting that a hundred is more of the healthy level for systolic blood pressure. And beyond a hundred, you start getting stepwise increases in risk of cardiovascular disease.

So when it starts to plantar flex and abduct is when you start to go into mid propulsion.

Manage the swelling, get the range of motion back very, very quickly. Well, these people are coming back better and faster, right? And so now we have this acceleration. And now it's now, the doctor says, OK, now how fast can we do this? But we have to consider the consequences of that. Right. And in some circumstances there may be no problems at all. Right. Like somebody might be able to get up after surgery, walk around, do everything that everybody wants them to do. They might be very, very quick and they might still have a great outcome. But we have to respect the people that don't do that. Right. And so, it's always going to be an n equals one situation, right? That's why we got to be careful with the cookbook.

Those of you that have ever done a Feldenkrais course where you look at the segmental rolling associated with Feldenkrais, also very useful in these situations. Because what you have to do is you have to teach this person to release the superficial compensatory strategies which are concentric orientation and exhalation all day long and so no aggressive breathing under these circumstances a lot of sideline stuff like I said a lot of rolling orientations are going to be money here but you're probably going to have to guide this person at first and so you're going to have to actually create the ability to turn, but start in the sideline, take gravity out of the equation, and I think your success rate is gonna actually skyrocket under these circumstances. Once you start to recapture the internal and external rotations, then you can probably go back to some of your more supine, prone, quadruped, supported activities, working towards building them up from the ground, so to speak. Once they get enough hip flexion, shoulder flexion, you can put them into half kneeling situations, but you're probably always going to want to maintain some sort of asymmetrical representation so you don't lose the ability to turn. Quick review put them inside lying start to build the ability to turn under those circumstances Using your PNF diagonals they become money in this situation Superimpose the breathing on top of that But it has to be this gentle progressive kind of a nature because if you do anything too aggressive all you're gonna do is Squish them back into position. So hopefully Catherine I appreciate your question. I hope that's that's helped for you Hope everybody has a great weekend. I will see you guys next week

Yeah, so I'm gonna let them go for a couple months and then we'll just follow up. But again, it's worth the look just to see the changes in the pictures. If you go through my Instagram account, there's a whole bunch of them spread out and you can kind of see the evolution. Like literally the changes. So when people talk about posture and things like that, I don't look at it from a static perspective, although in this representation, they are static photos, but it's been pretty cool to see. And it is, we did the exact opposite would be what you would perceive based on what Terry was doing and much more successful in outcome.

Here's the interesting thing about all this stuff is because of opportunities or the demands that have been placed upon everyone. I notice that there's more people outside, like a lot. We live in this condominium community, which is usually empty. You wouldn't know anyone else lived here, and I rarely see another human being. Now I have to be really careful when I take my dog out because he's a little rambunctious little guy and gets excited around people. I've seen more kids on bikes in my neighborhood in the last two months than ever. We've been here eight years, and I just hope this is one of those things that continues from a public health standpoint.

Isn't he awesome?