I did a great podcast with Drew Kiel on the QB Docs Podcast recently.
Here’s a short preview.
We talked about everything from throwing, learning, failures, teaching, pain, and how to assess.
The QB Docs Podcast – Drew Kiel interviews Bill Hartman
#billhartmanpt #QBdocs #quarterback
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This week’s Q & A questions:
• How does the orientation of the pelvis influence movement options available at the ankle? I am curious to your thoughts, specifically in the context of speed skating where top performs express a high degree of ankle flexion.
• When addressing elbow orientation via training, what is the deciding factor when choosing between an elbow flexion or extension driven activity? A specific case would be someone who has an ER’d humerus and pronated forearm You’ve touched on the fact that we don’t really know why people feel better after interventions. It makes sense to me that even if interventions are “specific” there are many things going on simultaneously. I was wondering if you could elaborate on this and possibly your own evolution regarding this. You recently shared a case on Dorsal-Rostral expansion helping improve a patient’s height and “corrected head forward posture” and although we aren’t necessarily after improving static positions posture, I’m wondering how expanding into the upper back would not result in more kyphosis / HFP?
• When you say the word “orientation” are you saying that relative to the spine? If so, why do you use the spine to establish orientation?
• When you say “inhaled” versus “exhaled” are you talking about ribs and spine or just spine? If both ribs and spine then why is a narrow ISA inhaled if their lower ribs are in an exhaled position?
• Have you ever seen cases where the pelvis appears to have changed “orientation,” but the ribs still appear to be wide or narrow? If so, can you explain the mechanism behind that and how you continued treatment from there?
• When treating someone, are there different criteria or things that you look for when deciding what to target first – ribs, pelvis, spine, etc?
• I have heard the concept of “tissue quality” being discussed with many typical musculoskeletal “diagnoses”. Do we as physical therapists and fitness professionals have a good definition of what good tissue quality is?
• What would you say are the biggest factors that impact somebody having an inhaled and exhaled skeleton (Wide Vs Narrow ISA)? How much does a person’s injury/training history come in to play? I can understand how strength athletes develop wide ISA’s but was wondering if there are any sports/events that can impact to position of the axial skeleton.
• I work with some volleyball players and I am trying to work on their squat using the box squat. Given that they do not get much lower than about a ¼ squat when they jump in their sport, what depth should I focus on getting them to? 90o? Just above 90o? Should the goal be to get 120o of hip flexion to give them full excursion of their respiratory cycle? Defensive/back row players sometimes end up in a deeper squat position when digging the ball, should it be lower for them?
• In the “How to Measure Infrasternal Angle” youtube video, I got the interpretation that a Wide ISA is indicated by an opening/increase in angle with inhalation without a legit closing with exhalation and that a Narrow ISA is indicated by a lack of opening with inhalation. Is this correct?
• Does the resting measurement of the ISA give us any useful information and if so what does it tell us and how does it guide intervention?
• Does the outcome of the ISA test (wide vs narrow) effect the prescribed exhalation or exhalation strategies (sigh vs pursed lip) used during prescribed interventions?
• What do you do when an ISA is dynamic one side or one side tests as Wide and the other narrow?
• If someone measures with a ISA of 60 degrees at rest and it widens but doesn’t completely close is this person considered a wide ISA? Would be considered to be an exhaled axial skeleton biased individual?
#infrasternalangle #wideISA #boxsquat
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Power training is often measured or expressed as a product of our extremity movement.
The reality is that if we are unable to move or control the forces produced internally, then our power production in any movement is compromised.
We can manipulate exercises to emphasize different aspects of internal force management, but we need to look at how muscles work in a different way.
Here, I introduce the concepts of seeing muscle position in a moment in time as concentric or eccentric orientation, and whether the muscles are overcoming or yielding. Post your questions in the comments.
#powertraining #overcoming #yielding
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Simple rules repeated.
Cervical spine mechanics tend to be misunderstood and overcomplicated.
Joint shape needs to be appreciated. When you compare the lower cervical spine to the rest of the spine, look for the commonalities rather than the differences. You can make it as complicated as you like, but in reality, we can simplify lower cervical mechanics a great deal and target interventions very specifically.
#cervicalspine #billhartmanpt #neckpain
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We can use shoulder flexion and hip flexion as self-tests to assess your ability to breathe effectively.
There are other simple tests like a toe touch or squat, but they may allow compensatory strategies to achieve the end result.
I’m more in favor of the asymmetrical tests as you can test both extremes of inhalation to exhalation simultaneously.