For a wide ISA, yes.

Hang on, let me help here. Let's just say you had enough flexibility in the basketball that you could grab it and elongate it a little bit, okay? All right, you can follow from me so far. You take the balloon and stretch the balloon, okay? And then you let go. Which one's going to be faster?

Yeah, so that gets confused a lot because it's just the orientation of the knee.

Yeah.

Yeah, they're just trying to get into position than chances are they're using some form of strategy to create an external rotation that allows them to access a position. So you'll see this in some people that have like a really extreme round appearance to their back when they're doing their toe touch, or you'll see somebody as they're descending into a deep squat. So some people can descend very comfortably into the very, very deep squat, but they do it with a lumbar compensatory strategy that allows them to access that position. And it'll almost look like a huge bulge in their lower back as they descend into the squat or to the toe touch. So chances are that's what you're looking.

So you can't just say that, oh, the disc is the delay. It's like, well, wait a minute. Why did I suddenly have to use the disc in the first place? Because everything else is getting shoved forward. And I had the progressive destruction of the disc material itself that made it weak enough to become the yield strategy.

Compression.

That's what we're talking about, right?

So for people who are really stuck in middle propulsion, that exercise could be as far as recapturing relative motion. You could potentially use that exercise to kind of take them out of that view.

Yes, sir. Okay.

Well, good luck with that. But yeah, you can do that. I just don't think you're going to be able to convince. You're not going to convince a kid that likes to play basketball three hours a day not to play basketball for seven days. You know what I mean?

Yep. Okay. Was it more external rotation in the shoulder? Not relative.

I would love that

By increasing the anterior posterior diameter, his ERs are way out here. So he's oriented to turn his sockets that way and is twisting the musculature in that direction. As you increase the anterior posterior diameter, the orientation will adjust itself. Like he'll be able to access these positions in front of him. And the twists exist in the first place because he needs them. If you take away the need, then as you start to move the extremities through space and he does have spaces in front of him, that should start to adapt itself just like it got him there in the first place. Give him some place to go. He will find a strategy that will sort of undo that.

So, as far as, let's say it's someone who's just slouched way forward. So like everything's like kind of in the lower extremities behaving more stiffly. Yeah. And then from an exercise standpoint, standing on a box, dropping med ball, having catch, drop and absorb that.

I'm pretty tall.

So, there's a very, very good chance that he is lacking internal rotation in his shoulders, is it both sides? Both sides, more so the right. Okay, yeah. So it's very likely that he is lacking the capacity to internally rotate approximately. Right. So, upper thorax, scapula, shoulder are probably lacking a great deal of internal rotation. And so what you end up with is you end up with a lot of compensatory pronation strategy. So internal rotation strategies, because he's got to get his hands into a pronated position to play. And so you'll get a whole bunch of muscle activity. So like pronator teres, pronator quadratus, you're going to get a bony twist in the radius. You're potentially going to get a twist in the distal humerus. He's going to get a pronated hand relative to the radius. And so all of those things reduce the amount of space. And if it's traditional median nerve symptoms that he's getting and not like a global thing, if it's median nerve symptoms, the way that the median nerve tracks through the arm, it's going to get compressed potentially in multiple places, not just here. Okay. This is a biggie. This is a biggie because the last compensatory strategy to get your hand into pronation is pronation of your hand. And so then, then that closes the carpal space there where the ligament goes across the hand. And that's why they do the surgery. They just go in and they go, 'Oh, we just go in there. We slice the hand open. We slice the carpal ligament. We sew it back up. Everything's all fine and wonderful.' But that's the basic issue that you run into typically with that type of a situation is you've got just internal rotation compensations all the way down, literally into the hand. And so you've got to kind of undo that.

Like silly putty. Yes, it's okay. So silly putty all the time is a representation because if you pull it slowly it stretches and if you pull it fast it breaks, and that's literally how every tissue in your body behaves. Every single tissue. Yes. Because you're mostly connective tissue. Outside of the water, you're mostly connective tissues. Okay. And then you get some other stuff, like you get specialized cells, which muscle cells are specialized cells, liver cells are specialized cells.

And then maybe you extend a career. Absolutely. But again, the process, I always look at this as this process that doesn't change because we're still gonna do the same thing. We're still gonna accumulate data. We're still gonna look for the KPIs, right? And he's gonna eventually show us what his needs are. But you're right, you do have developmental time here. So your experiment is a lot, you have a much broader time for safe to fail experiments here. Where you can just say, okay, let's put him in this situation, let's give him this, and then let's just see how he performs. Because what you might do is unlock something that's really, really important. So I work with a lot of guys out in Arizona, and they work with a lot of baseball guys too. And then you give these guys a little bit of something, and then they tap into two, three miles per hour, which gets them a better look. And or you buy them more pitches per appearance? Holy cow. It's like little things like that. When you're in those developmental stages, really powerful. Because like I said, you do have the time.

The multiple muscles, that's what I was like. But I've studied, and like you said, within the context of this, because of the emotional attachment and the desire to learn, I've studied or I've kind of retained a lot more of the anatomy than I ever did, kind of in PT school, because it was just that regurgitation here, memorize this and then apply it.

Yeah. What came before it? I measured his external rotation, which was about 20-30 degrees—pretty poor. So I had him lying supine, applied traction to his right arm to induce some scapular depression, turned his head toward me, and had him take some deep breaths. His external rotation then improved by about 90 degrees. Then we worked on more respiration. His ribcage appeared somewhat flattened in the lower posterior region, and his external rotation worsened again. That's when I thought, okay, I may as well start here. I recall you've mentioned before that this is the first step—reorient first, then work on expansion.

So the band creates an ER demand to be maintained throughout. So it allows the sacrum to counter-nutate at the bottom of the deep spot.

So I guess a really common presentation I think of a couple of people out in the clinic right now, where they all have like that bilateral posterior compression, and then they have a little bit of like that right oblique curve right there. So at least my interpretation of the moment is to go bottom up to make sure they can get enough hip flexion.

Yes, there you go, exactly. And so the difference between a weight releaser and the banded squat would be the weight releaser is stiff all the way to the bottom, then it releases it very quickly, so I get an impulse. Whereas with the band resistance, it's a decreasing stiffness on the way down. So I'm creating more elongation on the way down, still getting the energy absorption at the bottom, but the impulse might be a little bit slower coming off the box. So that's how you decide it's like, what response am I trying to create here? Am I trying to create this quick impulse or am I just teaching these tissues to first and foremost absorb and create the yielding action throughout the system? So if we looked at this from a procedural element, if I got something that can't yield at all, I'm going to put them on bands first, teach them the yielding action, get those tissues to actually yield, then I'm going to run them through the cycle of weight releases where it's stiff, stiff, stiff. And then go, bam. And then create this impulse that pops them right up out of the squat.

So whenever we use the elastic resistance under these circumstances, I tend to make it more of a rate-related intention. So if you had a front foot on a ramp, is that what you're talking about? Like for a split squat? Like a lunge? Yes. Okay. So under those circumstances, what I would prefer from a utilization standpoint is to take advantage of the high resistance at the top but try to get down into the split squat very, very quickly because again, what I don't want to do is slow this down per se. What I want to teach them to do is to dampen that force. So if I was going to use any resistance that would be elastic, again, I want the differential of rate. It's not about the resistance in and of itself because all I have to do is put a bar in the crook of your elbows and I've got resistance. What I want is the reasoning behind it is the differential. There's more force at the top than there is at the bottom. If I do it very, very slowly, under some circumstances, maybe that's useful. You've got somebody that can't hold the lowered position towards that IR. They don't produce a lot of force, but they do at the top. I suppose it's useful. But again, I tend to use it more for a rate dependent versus just pure resistance. A rubber band is not a substitution for a cable. They behave differently. Because of the elastic resistance, the force at the bottom is so much harder. It doesn't mean that I can't use it to my advantage. You know how I like to use the staggered stance chops to create the D-load? So at the very bottom of an elastically resisted chop, I am the lightest that I will be under those circumstances. So in that situation, I do like to use the resistance because it does unweight me to a significant degree. And it will allow me to capture a position because if I reduce the influence of gravity, I am less likely to superimpose a superficial strategy that will limit the relative motions that are available to me in the axial skeleton.

What's that?

Okay. Can I provide you with a more real example? Absolutely. So, in that, for example, of what you're talking about, would an example be, because I'm pretty sure I've seen this before, where someone is in a wide-angle position and they lose internal rotation yet they have external rotation, and you look at a lot of their other measures and you're like, this doesn't really make sense. And then that would be kind of like, of tipping in the thorax.

That's right.

And then at the hip, hip flexion, left was a little bit more than right. So about a hundred on the left and 95 on the right. IR.

In the case of a pitcher, I'd say maybe their arm strength is low or... Again, how are you measuring?