# A Historical Perspective and Rationale Behind the Hruska Abduction Lift Test

https://www.youtube.com/watch?v=OcJ_xzSdJgo
Translation: ja

[00:04] good afternoon everyone uh thank you for

[00:06] joining us for the part two of the hesa

[00:11] functional test webinar series um this

[00:13] webinar is a historical perspective and

[00:17] rationale behind the hesa abduction lift

[00:20] test um and if you have not found the

[00:23] handouts yet they are available on the

[00:25] webinars page of our website I will

[00:26] include a link in the chat here as well

[00:29] for you um but if you want to follow

[00:31] along with the handouts they are

[00:33] available online um just as a reminder

[00:36] we will take some questions at the end

[00:37] for 101 15 minutes um so if you have

[00:40] questions um please hold those till the

[00:42] end um and we will take a few questions

[00:46] uh live on this webinar but thank you

[00:48] again for joining us and I will turn it

[00:50] over to

[00:52] Ron thank you Jen thank you everybody

[00:55] for being

[00:56] here uh and for allowing me to you know

[01:00] spend some time on a subject that I

[01:02] really uh have thought about for better

[01:06] than 40 maybe even 50 years now in my

[01:09] life and that is this world and role of

[01:14] abduction um hopefully today the

[01:16] perspective that I have on the word will

[01:19] broaden your world and give it more hope

[01:23] hopefully more meaning than I think the

[01:25] average textbook will give uh meaning to

[01:28] it so it is really a pleasure to be here

[01:31] I just want to remind all of you that

[01:33] the title says a perspective it's it's a

[01:36] perspective of my historical basis for

[01:41] uh in you know from for living and

[01:44] looking at and learning about this thing

[01:47] that we do when we move our body away

[01:50] from an extremity or extremity away from

[01:52] a body and more importantly our body

[01:54] away from our body uh these abductors as

[01:57] you're going to learn this afternoon

[02:00] have two roles they they really keep us

[02:03] moving towards or away from some Center

[02:06] in us and we're going to talk a lot

[02:08] about Center Mass and Center pressure

[02:11] and uh then go over the reasoning Behind

[02:13] these things that have been in this

[02:15] institute from day one as it relates to

[02:19] abduction I think it's important to

[02:21] remember that these muscles wherever

[02:23] they are in the body they don't have to

[02:25] be at the hip they can be in the

[02:27] shoulder region you can have them in

[02:28] your cranial region you can have them in

[02:30] your pelvis your foot U there's even

[02:33] muscles in their foot called

[02:35] abductors uh they don't they're not uh

[02:38] in a vacuum they don't just live around

[02:41] the hip uh this webinar will concentrate

[02:45] primarily on the hip abductors but I'm

[02:47] GNA slip some stuff in there if you can

[02:50] understand the hip uh which is the

[02:52] primary group of abductors we have in

[02:54] our body I think everything else will

[02:56] Mak uh Mak sense from a different

[02:59] perspective active and that's what I'm

[03:01] really trying to hope we cover this

[03:03] afternoon they they are responsible for

[03:05] pressure they pressurize us uh we are

[03:09] sensing ourselves and what's going on in

[03:11] ourselves and around ourselves that

[03:14] includes both uh physical pressure uh

[03:18] psychological pressure and definitely

[03:20] physiological pressure so they are a

[03:23] group of muscles in our body and they do

[03:27] work as a group that gives us the

[03:29] meaning of pressure they Center us uh

[03:33] they keep us uh in a position of control

[03:38] if that's possible um each and each and

[03:41] every one of us have has a different

[03:43] Center of mass I'm not talk we're GNA

[03:45] break this up I'm not talking about

[03:47] center of gravity I'm talking about you

[03:49] know who we are our ubiquitous nature of

[03:52] being us our uniqueness our our our

[03:56] thumb print of posture is really how we

[03:58] Center our Mass and we use the pressure

[04:01] to Center pressures to do that which

[04:03] I'll cover uh they are the most

[04:06] important muscle of the body uh these

[04:09] this group of muscles the most important

[04:10] muscle of the body to keep us grounded

[04:13] uh when I push over to One Direction I'm

[04:17] using a foot to do it I have to use the

[04:19] ground or surface of the floor that I'm

[04:21] standing on to get it done uh we can't

[04:26] realize how to lift an arm up without

[04:28] getting it done below um I'm going to

[04:31] talk a little bit maybe I should be

[04:34] talking more about it on how our upper

[04:36] extremities totally built off of the

[04:39] Developmental and guidance that was

[04:41] provided developmental guidance that was

[04:43] provided by our abductors or our hip and

[04:46] our

[04:47] ankles they also give us this assistance

[04:50] with u opposite arm function uh when you

[04:54] say right you have to think left when

[04:56] you say left with your arm Express with

[04:58] your arm you you have to be thinking

[05:00] right uh we'll talk about the

[05:02] trendelenberg of the arm uh we get all

[05:06] these wonderful pictures and textbooks

[05:08] about trendelenberg gate patterns uh you

[05:12] are working more with trendelenberg arm

[05:14] problems and patterns than you are in my

[05:17] opinion my perspective than you will

[05:19] ever work with a a pelvis or a hip and

[05:22] then they allow us to lower ourselves uh

[05:25] they allow us to actually let you uh

[05:28] relax your knees relax your quads uh

[05:31] relax your back extensors your neck they

[05:34] allow us to lower ourselves to the floor

[05:37] we're standing on without abductors you

[05:40] wouldn't trust your your body to do

[05:42] something like that you would have to

[05:44] find every way you could to replace that

[05:47] those abductors abductors are not

[05:50] replaceable uh there are a lot of

[05:52] muscles in your body that are

[05:53] replaceable but when you lose an

[05:55] abductor uh you're you're going to

[05:58] you're going to lose the abductor you

[05:59] may compensate but you can't replace

[06:02] that activity and in the way the

[06:05] abductor is working in the way it's

[06:07] pressurizing you centering you and

[06:09] moving you from side to side so I I just

[06:11] want to remind you those are just things

[06:13] I just wrote up right before we started

[06:14] today to keep you all mindful the fact

[06:17] that this is a very uh important concept

[06:21] and that concept is uh posture how do we

[06:24] pattern our posture depends on how we

[06:26] emerge as humans with function that's

[06:29] centered around uh AB uh abductor

[06:33] activity so that's just an

[06:37] introduction our human posture patterns

[06:40] emerge as a function of ground

[06:42] support so I don't know Jen I just don't

[06:46] want that to be in my

[06:48] way of mass and ground sense of pressure

[06:51] to maintain upright balance it's

[06:53] important to control the position of the

[06:55] trunk and the center of mass that's

[06:57] located in the trunk somewhere in your

[06:59] your body it's somewhere in the trunk

[07:01] trunkal region and it this this

[07:05] emergence of this pattern uh uh is

[07:08] located in the trunk as I said but it's

[07:09] also steered by the trunk so we steer

[07:12] ourselves uh with our trunk as a

[07:15] platform for our visual vestibular

[07:17] sensory organs uh our arms do not stair

[07:20] us our legs do not stair us uh we are

[07:22] body on body people our our vular system

[07:26] our visual system as uh banan will tell

[07:30] and horo will tell you one of my

[07:32] favorite uh people in my past horx work

[07:36] they'll talk to you about this need for

[07:38] us to emerge with this postural pattern

[07:40] as a function of vision and frequencies

[07:43] of how we translate from side to side

[07:46] and it requires obviously abductors to

[07:48] do

[07:49] that now I before I go any further I

[07:52] should just give you a little disclaimer

[07:53] this this webinar for some of you will

[07:57] be more of a simple dialogue for others

[08:01] and that are going to watch us in the

[08:02] future it could be a little complex uh I

[08:05] can't give a two-day course on the

[08:07] pelvis I can't give a two-day course on

[08:09] the shoulder uh but our Institute really

[08:12] has uh presented all the material that

[08:15] you're going to see in this webinar uh

[08:17] some place in some course uh it's

[08:20] heavily influenced by what we instruct

[08:21] in the pelvis course uh there's a lot of

[08:24] ey and ey activity that would be a

[08:27] course that talks about impingement

[08:28] instability

[08:30] so for those people who have not

[08:32] attended those courses it may be a

[08:34] little confusing I try to write it in a

[08:36] way that will give you the opportunity

[08:38] to Google it research it research it or

[08:41] even look into a course that talks more

[08:44] clearly about the specifics of subject

[08:47] matter that I can't get into this

[08:48] afternoon whenever I can I will if it

[08:51] relates to the world to the world of

[08:52] abduction so I just want to throw that

[08:54] out out to everybody who's listening our

[08:57] central nervous system coordinates our

[08:59] joint joints and our muscles and

[09:00] regulates our sensory information from

[09:02] our visual somat sensory and vestibular

[09:04] systems to maintain this thing called

[09:07] balance uh our posture orientation is is

[09:12] equivalent to how well we regulate

[09:15] balance upright balance standing walking

[09:18] or running

[09:20] balance so I just want to make sure that

[09:22] we're all in the same page with

[09:24] that uh translation of our trunk from

[09:27] side to side on the ground surface that

[09:29] we stand on or move on uh that move

[09:32] toward or away from our center of our

[09:34] body also moves the sensory systems

[09:37] within and outside of their optimal

[09:39] operating ranges we all have operating

[09:43] ranges some of us have large ranges some

[09:46] of us have narrow and smaller ones and

[09:48] some of us don't have any at all uh so

[09:52] we we we know that range intuitively

[09:56] introspectively uh it's a intros

[10:00] uh concept what is our range how far can

[10:03] we move from a center and how do we do

[10:07] it what are we going to do that with uh

[10:09] we do it through pressure we do it

[10:11] through a center of pressure somewhere

[10:12] in our body uh if I touch a wall when I

[10:15] lean to One Direction I'm reducing the

[10:17] center of pressure demands on maybe one

[10:19] of my lower extremities uh Vision will

[10:23] reduce Center of pressure uh your

[10:25] vestibular system is what puts the the

[10:28] gap G on or takes the gas off based on

[10:32] how well we pressurize ourselves to move

[10:35] our Center of mass our central nervous

[10:37] system controls our pos position of our

[10:39] Center of mass through recognizing this

[10:42] transitory unfamiliar platform of

[10:44] movement proprioceptively and

[10:46] mechanically and it reacts to

[10:49] gravitational forces by holding us

[10:51] slowing us or dampening the way we move

[10:55] and the way we descend this webinar

[10:58] could have been called

[10:59] the historical perspective and rationale

[11:02] behind the herca dissension test um so

[11:06] keep that in mind that is a major word

[11:08] in this webinar dissension

[11:11] lowering losing the ability to descend

[11:14] our body or our diaphragms of our thorax

[11:17] and our pelvis restricts our ability to

[11:19] lift ourselves raise our arms and Ascend

[11:22] on the other side this alternation of

[11:25] dissension and Ascension or abduction

[11:27] and adduction allows us to move

[11:30] ourselves forward and freely as we go

[11:32] forward the abductors of the hip are the

[11:35] first muscle group or groups that become

[11:38] restricted passive and yes even dormant

[11:41] if this alternation is lost when you say

[11:45] alternation when I talk about

[11:46] alternation I'm talking about abduction

[11:49] you can't really get good clear

[11:52] alternation through just adduction you

[11:55] have to have a B Du u c duction

[12:00] ight function on two legs involves

[12:02] continuous compensatory adjustments of

[12:05] the musculature through feedback and

[12:07] feed forward control to stay balanced

[12:10] this is done through proprioceptor

[12:12] receptors and the vestibular canals our

[12:14] ankles and our hips and don't

[12:17] underestimate the ankles the ankles are

[12:19] as important to that vestibular system

[12:22] as are your

[12:23] hips the primary force that regulates

[12:26] and tunes us to the evolving ground o

[12:29] ation is provided by our trunk hip and

[12:31] our ankles abductors abductors should

[12:35] descend us on the ipsilateral side as

[12:37] they ascend our Contour lateral side as

[12:40] we shift from side to side this webinar

[12:43] is designed to help one identify and

[12:45] assess these sites of abductor control

[12:48] dissension activity of our body as our

[12:51] Center Mass is elevated on the other

[12:55] side designing programs to reduce

[12:58] undesirable

[12:59] upright disorientation and Inter

[13:01] segmental unstable coordination of the

[13:03] trunks Center of mass requires an

[13:06] understanding of how the hip abductors

[13:09] especially the hip abductors work when

[13:11] in single leg stance or double leg

[13:13] stance as arms hang by the side of the

[13:16] body or when they are above the

[13:21] shoulder um you know I asked Jen to put

[13:23] a few of these in this webinar for you

[13:25] to be

[13:27] reminded that back in the early uh early

[13:31] 90s late 80s I really uh had the

[13:34] opportunity to work with a number of

[13:36] people in my life from all walks of life

[13:38] pardon the pun but from all parts of uh

[13:42] movement um uh careers and I really try

[13:45] to keep you know them to be mindful of

[13:48] how important it was to flex the knee

[13:51] whenever possible so the first thing

[13:53] this is dated back in January 4th of the

[13:55] year 2000 and how important it was for

[13:57] me to introduce to these people that I

[13:59] was working with flex the knee because

[14:02] once you Flex the knee your abductors

[14:05] are on if you straighten your knee out

[14:07] extend the knee your abductors really

[14:09] are confused your vestibular system's

[14:12] confused you basically lock out the

[14:15] world from entering into your soul and

[14:18] so I would spend hours and back back

[14:20] then you know I didn't have the

[14:22] computerization or technology we have

[14:24] today so if you look at some of these I

[14:26] think Jan you include four four ages of

[14:29] this you just at your leisure it's I you

[14:32] know I wrote everything out I didn't

[14:33] have time to type didn't have time to

[14:36] Google things to help people get get it

[14:38] or even uh for that matter use a you

[14:40] know an iPad to send it but that was a

[14:43] big deal uh bending the knee and then we

[14:46] went into the sideways activities uh how

[14:49] to walk sideways how to do side to side

[14:52] if you look at number two on that this

[14:54] daily home program I set up with this

[14:56] individual daily side to side feet uh

[14:59] off the off the wall in other words they

[15:02] were doing things to figure out how to

[15:03] rotate themselves by always keeping in a

[15:06] 990 position keeping that knee flexed

[15:10] knee flexion in the 1990s allows

[15:13] abductors to immediately work that's why

[15:17] the 990 historically is so important the

[15:21] perspective that I have on that type of

[15:23] activity is Way Beyond just uh a

[15:25] hamstring pulling a pelvis back into

[15:27] neutrality it allows you into that to

[15:31] get into a position where your resonance

[15:33] now is automatic you you don't inhibit

[15:37] anything at that point you're

[15:38] facilitating everything that's is going

[15:40] to handle gravity so I'm just giving you

[15:43] one example of that another P another uh

[15:47] home program that I wrote up in 330 of

[15:49] the year 2000 you'll see that I did a

[15:51] lot with TV sideline leg lifts uh back

[15:55] then everybody watched TV they would do

[15:56] their exercise if they laid on the floor

[15:58] and they put a foot up on the couch and

[16:00] had one leg up and one leg down and they

[16:03] did on both sides and that was their

[16:05] number one exercise when their number

[16:07] one program was to do these leg lifts

[16:09] with tubing around their their their uh

[16:12] ankles ankles were big to me and they

[16:15] still are we have in this in this

[16:17] institute things where that help you

[16:20] engage ankles you put a knee you put a

[16:22] ball between your knees you're

[16:24] activating ankle abductors you're ankle

[16:26] you're activating planter flexors of a

[16:28] big toe that abduct so this is history

[16:32] this is where it all came from um you

[16:35] know ambulating sideways up a up a

[16:37] stairwell number four the next one's an

[16:40] example of what I finally got smart and

[16:42] I typed some stuff up stuff up for my

[16:45] patients with theat tube exercises and

[16:47] this says hi hip theat tube back in June

[16:50] of you know 2000 and then if you look at

[16:53] number three at the very bottom down on

[16:55] on that on that page it says sideline l

[16:58] Ling on your side and under your with

[17:00] your your your your head your hand under

[17:04] your your your ear all I'm trying to get

[17:07] across is these are things that I had

[17:08] people do sideline leg PS sideline was a

[17:12] big deal back then to me and it's still

[17:14] a big deal number four I even wrote down

[17:16] side steps uh you know on stairs

[17:19] sidewalls side steps going upstairs

[17:23] sideways uh back in November of that

[17:25] year I send another home program out

[17:27] this is called Seline leg lifts uh we

[17:30] have all these techniques that you see

[17:33] now in this Institute started out like

[17:35] that that's where they came from they

[17:37] were designed by patients patients who

[17:40] told me this works best this doesn't

[17:42] work well I will only do three or four

[17:44] things you don't see more than three or

[17:46] four things on these handouts so I'm

[17:48] look at the very last one the last one

[17:50] you must do you know lay by that couch

[17:53] put your leg on that couch and learn how

[17:55] to continue to push your hip down and

[17:57] raise up the other leg again I just

[17:59] wanted to make sure that if there's any

[18:01] question of where this material came

[18:02] from I want you to see it so this is an

[18:06] abduction uh system the perspective that

[18:09] I had underneath all these patterns of

[18:11] mechan reception came from that that

[18:14] concept you have to really get into the

[18:17] the mindset of your vestibular system by

[18:19] pulling out these abductors whenever

[18:21] possible abductors inhibit extension

[18:25] they inhibit sympathetics they are the

[18:28] most sensitive mechanical proprioceptive

[18:31] information you've

[18:33] got you use them for standing you use

[18:36] them for movement you Pro you use them

[18:38] from side to side activity and even

[18:40] thought so the most sensitive mechanical

[18:42] proceptive information for standing is

[18:45] probably that from the mechanical

[18:47] receptors in the ankle and the

[18:48] associated muscles and those in the

[18:50] soles of the

[18:52] feet abductors of the body are products

[18:55] they're products of mechano receptivity

[18:58] of length and weight of body parts they

[19:00] are responsive to leg and to excuse me

[19:04] to length and weight of your

[19:06] appendicular uh resources arms and legs

[19:10] our our mechan receptors are sensitive

[19:13] to the growth changes in legs and

[19:15] weights of our body our legs and our

[19:17] arms are probably the same on each side

[19:19] in terms of size and heaviness but to

[19:22] your brain one is going to feel heavier

[19:25] one's going to weigh more one's going to

[19:26] be less sense one's not away at all

[19:29] possibly one's going to feel longer

[19:31] one's going to feel shorter all because

[19:34] of the receptivity that was received in

[19:36] growth and development of your body to

[19:38] gravity using abductors they're the one

[19:42] that gives you the sense of strength the

[19:45] sense of power the group of muscles that

[19:48] are responsible for this anthropometric

[19:50] control of both the body and the

[19:51] extremities are the

[19:53] abductors there are postural pressure

[19:56] muscles they influence they're

[19:59] influencers uh just like we have

[20:01] technology influences and we have social

[20:04] influencers on online we have these

[20:06] things inside of us that are pressure

[20:08] influencers and those are your abductors

[20:11] they are closely associated with Pro

[20:13] receptors and mechano receptors in the

[20:16] especially in the foot and the ankle

[20:18] they are finally calibrated by means of

[20:21] continual practice in some controlled

[20:23] activity that us that utilizes them when

[20:26] you're in control

[20:28] when you're in control you have the use

[20:32] of your abductors when you're not in

[20:35] control when you're not in control you

[20:38] don't know where your abductors are you

[20:40] don't use those abductors you are locked

[20:43] in you are stationary minded you're

[20:47] you're closed

[20:49] minded uh it's a it's an extremely

[20:52] important perspective of mine that I've

[20:54] always had you can tell who can't take

[20:57] on a new technique or exercise because

[21:00] they can't let go of that that single

[21:04] mindset that they have and that is uh

[21:07] extension or moving themselves forward

[21:09] on a on a on a line not in a world

[21:12] that's got everything around them that

[21:14] they don't

[21:15] experience our vision and our visual

[21:18] propri reception feedback from immature

[21:21] pre-and activities and from mature novel

[21:24] function increases our dependency on

[21:27] abductors our growth and development is

[21:30] uh how we develop the sensory awareness

[21:34] that was provided by our

[21:36] abductors they are usually embedded in

[21:38] developmental patterns mechano receptiv

[21:41] receptively and as I said earlier

[21:44] usually more so from the ankles and the

[21:45] hips than anywhere else in your body our

[21:48] vestibular ocular reflex and our

[21:50] cervical ocular reflexes automatic

[21:53] postural responses are characterized by

[21:56] how we how well we respond to this

[21:59] off-balance sensitivity with our hip

[22:01] abductors our hip abductors are our

[22:04] balancers they are a

[22:07] neurological uh game going on all the

[22:11] time because we we're meant to stay off

[22:14] balance we were meant to be caught off

[22:17] guard we were meant to be able to

[22:19] explore things and and experience novel

[22:22] things with that off-balanced behavior

[22:25] if we're overbalanced with our abductor

[22:28] we can't transition into the unknown

[22:31] without fear anxiety and

[22:35] conflict this response suppresses the

[22:38] adaptation of undesirable cervical

[22:40] stabilizers stabilization for upright

[22:43] postural control uh it's a guarantee

[22:46] that individuals who overuse their neck

[22:48] for upper extremity movement or for just

[22:50] daily upright life probably are doing

[22:54] things at a level in this Horus

[22:55] abduction lift test of a two or one one

[22:58] they can't move out of it they can't

[23:00] transcend they can't

[23:03] transition so that leads us to this

[23:05] thing called the

[23:12] pelvis and there's so much I could say

[23:15] but I try to put it in a few few par

[23:18] paragraphs that reflect this uh the the

[23:22] accomplishments uh that you have as an

[23:24] individual because of the abductor

[23:27] influences on it the

[23:29] pelvis if your femur can

[23:32] abduct your thorax diaphragm and your

[23:35] pelvic diaphragm on the same side can

[23:38] also descend and that's a major major

[23:42] issue our diaphragms in our body Ascend

[23:46] and descend every time you raise an arm

[23:49] every time you take a breath every time

[23:52] you every time you kick your leg

[23:56] forward there has to be the this

[23:58] transition of upward and downward

[24:01] movement inside of you otherwise you

[24:03] can't go side to side and in order to go

[24:06] to side to side hopefully when you lift

[24:09] one diaphragm on one side the other one

[24:13] on the other side is concomly

[24:16] lowering uh that's how pressure is

[24:19] created that's how your psyche is

[24:23] generated so it's really important that

[24:25] you remember the femur can abduct if

[24:27] your femur can abduct your thorax and

[24:29] your thorax and the diaphragm inside of

[24:31] it and your pelvis and the diaphragm

[24:33] inside of it on the same side can

[24:35] descent hopefully upon

[24:39] inhalation upon

[24:41] inhalation as a body with respect to the

[24:44] Dome of each Central diaphragm of the

[24:47] thorax and the pelvis

[24:49] Ascend so the body the body surrounds

[24:54] the diaphragms and when the diaphragm

[24:57] contracts and moves down the body has to

[25:00] stay up otherwise the body and the

[25:02] diaphragm are moving together and you

[25:05] are now in a static state of respiratory

[25:08] function that means you breathe with

[25:10] your back and your lats and your your

[25:12] extension of your body to get air in and

[25:14] you just pull yourself forward to get it

[25:16] out so when the diaphragms contract the

[25:21] musculature around it has to go the

[25:23] opposite direction the muscle

[25:26] responsible for the body going the

[25:28] opposite direction of those diaphragms

[25:30] are your

[25:32] abductors what does this all mean what

[25:35] do it really mean when you think about

[25:38] uh dissension and

[25:40] Ascension simply we were designed to

[25:43] keep ourselves in check that's what's

[25:45] nice about this abductor group it keeps

[25:49] you in

[25:50] check uh keeps you under control it

[25:53] allows you to do some really funky stuff

[25:57] without going going Beyond a

[25:59] range um as our Center Mass moves with

[26:01] our vacillation of our trunk our

[26:05] abductors of the body are on the outer

[26:07] areas of both the appendicular and axial

[26:09] regions of our body and they provide the

[26:12] outer structural control for lung

[26:14] physiologic pressure rise during

[26:17] inhalation which is thoracic and pelvic

[26:19] diaphragm

[26:20] dissension and pressure relief during

[26:22] exhalation which is thoracic and pelvis

[26:25] diaphragm Ascension

[26:28] so here's a uh looking at a thorax

[26:31] abdominal pelvic region from the front

[26:35] and you can see that in the middle Jen

[26:37] I'm gonna start here in the middle this

[26:39] is a mid zone region where you might be

[26:41] breathing here but you're not breathing

[26:43] with a lot of effort shallow breathing

[26:47] uh you're in a more neutral State here's

[26:49] this is your thoracic diaphragm and this

[26:52] is your pelvic diaphragm but if you

[26:55] shift over onto the right leg the pelvis

[26:58] on that right side that diaphragm would

[27:00] more likely be more prone to Ascension

[27:04] the thorax thoracic diaphragm would also

[27:07] be going into that direction of

[27:10] Ascension no guarantees doesn't have to

[27:13] be in synchron synchronicity with it but

[27:16] it's a lot easier to Exhale when you're

[27:18] on that right side and it's a lot easier

[27:20] for the conom for the uh controlateral

[27:23] side to descend at both

[27:26] diaphragms

[27:28] and then if you shift back over to the

[27:29] left side you'll see the reverse you'll

[27:32] see when you stand on the left leg the

[27:34] left leg again will be in a state of

[27:36] Ascension an Ascension at both the

[27:39] diaphragms of the thorax and the pelvis

[27:42] this back and forth shuttering this back

[27:46] and forth movement is what we all are

[27:50] all have to have so that we're never

[27:53] locked into a state of one phase of

[27:55] respiration our respir aration is

[27:58] controlled by the things that move us to

[28:01] that side and to the left and to the

[28:04] right something got to move us there our

[28:08] respiratory cavity will move you there

[28:11] provided that the abductors are working

[28:13] correctly with those thoracic and pelvic

[28:16] diaphragms otherwise you can't move the

[28:20] air flow the pressure inside your cavity

[28:23] will block that movement and now your

[28:26] only way you're to move from side to

[28:28] side is you have to lock out your knee

[28:31] you have to extend your back and the ank

[28:33] will will take over for all the

[28:36] abduction work you need in your life at

[28:38] that point it's all you got

[28:40] left um ankle sprains tell lots and lots

[28:45] of

[28:46] stories uh they occur very easily you

[28:49] can hit a small pebble and spraying an

[28:51] ankle if you cannot keep your knees

[28:54] unlocked if you cannot shift from side

[28:56] to side and most importantly gentlemen

[28:59] go back if you cannot do the Big D the

[29:03] Big D desent abductors are responsible

[29:08] for

[29:09] dissension

[29:12] lowering those that hold their breath or

[29:15] want more air in their lungs are more

[29:17] likely more than likely to

[29:19] hyperventilate to hold themselves up

[29:21] with this accessory stabilization

[29:24] provided by the desent of the thorax and

[29:26] the pelvis diaphragm when you see people

[29:29] that have

[29:30] desent lots of of overactivity from your

[29:35] abductors they're

[29:37] hyperventilatory they want to abduct

[29:40] more they can't Center themselves they

[29:44] don't even know where the center of

[29:46] their body should be they're searching

[29:48] for it they think it's somewhere up

[29:51] there it's got to be somewhere up there

[29:53] and it's got to be somewhere down there

[29:56] as the pelvis looks down and as the

[29:59] thorax looks up they're not centering

[30:02] themselves from side to side left to

[30:04] right in an upright horizontal manner

[30:08] with vertical shifting they're only

[30:10] verticalized themselves for

[30:13] everything so their ability to really

[30:15] lower themselves and descent themselves

[30:18] is a neurological cortical dysfunction

[30:21] it's a cortical

[30:23] disability it's a respiratory

[30:26] disability and there's no abduction

[30:28] program in the world that's going to get

[30:29] that person to abduct if they first

[30:32] can't learn how to correctly descent

[30:38] themselves the dissension will be

[30:40] corrected as soon as they get one half

[30:43] of their body to realize how to ascend

[30:46] and the other half their body should

[30:48] follow dissension so they can start

[30:50] rattling and rolling again it's called

[30:53] frequencies it's called rhythm when

[30:56] you're threatened you're Rhythm gets

[30:58] really really really hyper regulated you

[31:01] you're trying you're searching it's

[31:03] called anxiety of the cortex so when I

[31:06] see a picture like this I I remind all

[31:08] of

[31:09] you perspective on me is that's not a

[31:13] physical issue that's not a

[31:14] physiological issue that's a

[31:17] psychological

[31:19] issue we inhale we pull ourselves

[31:21] together Against Gravity with muscles

[31:23] that connect to the midline or the

[31:25] midline regions of our body

[31:27] the previous webinar and the series

[31:30] focused on the adductor muscles they're

[31:31] the most they're more horizontally

[31:33] positioned to stabilize our foundations

[31:36] for hips shoulders and ribs that expand

[31:39] and move away from the midline during

[31:43] inhalation these adductors of our body

[31:46] pull the two sides of our body together

[31:48] as we inhale they check our outward

[31:51] expansion as our diaphragms are

[31:53] descending or are descending upon

[31:56] contraction

[31:58] the primary muscle that use that we use

[32:00] to position our unique and ubiquitous

[32:02] Center of mass around our Center body

[32:04] and the hip are the hip adductors and

[32:08] abdominal muscles the primary muscle

[32:11] however that we use to develop pressure

[32:13] to work around the center of Mass to

[32:16] develop a center of mass awareness of a

[32:19] center of mass are our

[32:21] abductors the pressure under our feet

[32:24] above our above our pelvic floor under

[32:27] our thorax under the thoracic diaphragm

[32:30] and under the shoulder blades are all

[32:32] regulated by our ability to abduct

[32:34] without losing control of our Center of

[32:37] mass and pelvic floor

[32:40] dissension therefore someone who can

[32:42] lift their leg Against Gravity in a

[32:44] sideline position without overextending

[32:46] their back to do so more than likely can

[32:49] inhale as their thorax and pelvis

[32:52] diaphragms move down or descend into the

[32:55] their respective thoracic imp pelvic

[32:59] cavities additionally they should be

[33:00] able to Exhale as their thorax and

[33:02] pelvis diaphragms move up into the

[33:05] respective abdominal and pelvis cavities

[33:08] without the need to lower their

[33:11] legs um I show you this picture and I

[33:14] show you this next one to remind you

[33:18] that

[33:19] um when when you see someone do

[33:22] something like this on their side you

[33:25] know that same individual

[33:27] can move with her body in a upright

[33:31] State horizontally better than she can

[33:34] move her body in a forward or backward

[33:38] State this is a gift this is a gift this

[33:42] is what those four home programs I

[33:45] showed you earlier in this webinar I am

[33:49] after that's not only a gift but that

[33:53] makes someone very very balanced

[33:56] emotionally

[33:57] very gifted

[34:00] physiologically and very

[34:02] empowered uh structurally and

[34:06] physically uh we all have this ability

[34:09] every single one of us have this ability

[34:12] and if it's not developed early on in

[34:14] life your ability to develop it gets

[34:17] harder and harder and harder as you grow

[34:20] older and grow so I'm only showing this

[34:24] to you because I think we think that

[34:27] this is too hard this is too much to ask

[34:31] it's too much to get on the other side

[34:33] do the same

[34:35] thing uh see I see an individual who has

[34:38] complete control of both their

[34:41] diaphragms in both the regions that she

[34:43] has

[34:43] diaphragms one's ascending one's

[34:46] descending pressur is being regulated by

[34:48] how she's breathing but not because

[34:51] she's breathing for that Ascension

[34:52] dissension regardless of how she's

[34:54] breathing her body's ability ility to

[34:57] sort out what would be appropriately

[34:59] needed for a pressure to do that inside

[35:01] of her is being done because of what you

[35:03] see in front what you see her

[35:06] doing her shoulder on the right side is

[35:09] totally reflective of her ability to

[35:11] abduct that hip on the

[35:13] left this person's shoulder on the left

[35:17] side Jan I'm gonna go back is totally

[35:19] reflective of what she did on the right

[35:21] if that shoulder was not engaged with

[35:24] that that leg correctly she wouldn't be

[35:27] able to pick up that leg and you would

[35:29] then say she has weak abductors and the

[35:32] reality is you didn't put the body in

[35:33] the position for those abductors to ever

[35:35] be

[35:37] realized that's my perspective it always

[35:39] has been my perspective and anything

[35:41] short of that is not the humans built

[35:45] system by design for this type of

[35:48] activity that keeps your brain

[35:51] emotionally relaxed your psychic

[35:53] emotionally relaxed and your physiology

[35:55] more than ever relaxed

[35:57] two pictures just to put in your brain

[36:00] and brand it that's what the heres

[36:02] abduction lift test is asking your

[36:04] patients to be able to do and then with

[36:07] that test where are you in the sequence

[36:09] where did you go wrong as you attempted

[36:12] to do this what step was missing what

[36:16] specific region should you go after how

[36:18] would you go after it by looking at the

[36:21] step before or the step after

[36:23] it if someone cannot lift their leg and

[36:26] similar manner as shown on that previous

[36:28] two slides there's a possibility that

[36:31] the abductors that are raising or

[36:32] abducting the leg are limited because of

[36:35] poor Center Mass regulation end of note

[36:38] you change the center of mass regulation

[36:40] and that individual go from a two to a

[36:42] five very quickly usually but you gotta

[36:46] help help that individual find their

[36:49] Center of mass and to do so you have to

[36:52] introduce centers of pressure

[36:55] references

[36:57] reference perceptual

[37:00] sites secondary to thoracic and pelvic

[37:02] diaphragm internal pressure regulation

[37:05] or

[37:06] both that limitation of that poor Center

[37:09] Mass regulation or poor breathing

[37:12] mechanics secondary to thoracic and

[37:14] pelvic diaphragm internal pressure

[37:16] regulation or both that's why they can't

[37:19] lift their leg they didn't they didn't

[37:22] show you and demonstrate an inability to

[37:24] lift their leg because all of a sudden

[37:27] it got weak it got if it did get weak

[37:30] it's because of this

[37:32] slide it's because of mass pressure and

[37:50] respiration our hip abductors of our

[37:53] body are pattered off of internal

[37:55] pressure that was developed in

[37:56] associated with respiratory function or

[38:00] dysfunction our hip abductors are

[38:02] inherently also used for external

[38:04] rotation force to move our trunk to the

[38:06] opposite

[38:08] direction our hip adductors of our body

[38:11] are pattered off of cortical sens of in

[38:13] lines associated with bipodal or single

[38:17] leg foot

[38:18] pressure our hip adductors are

[38:21] inherently used for internal rotation

[38:23] force to move our trunk to the same

[38:25] direction of the side they are located

[38:29] there's a distinguishable difference

[38:31] between the

[38:34] two and if you don't understand this

[38:37] it's going to be very difficult to

[38:39] understand either the hesa abduction

[38:42] lift test or theusa adduction lift

[38:46] test those tests were designed and

[38:48] developed over this

[38:51] concept

[38:52] neurological growth and development of a

[38:58] perspective where are you where is your

[39:01] center of

[39:04] mass it's a point on the body that moves

[39:08] as a represent representation of the

[39:10] body's reaction to external

[39:15] forces it's the center of what you can

[39:17] and cannot do in the ranges that you

[39:20] have you may have more range to move One

[39:23] Direction than the other direction

[39:25] Therefore your Center Mass is not going

[39:27] to be in the center of your

[39:29] body very few people have a center of

[39:33] mass in the center of their body the

[39:35] young lady you saw laying on her side

[39:39] doing those abduction doing that

[39:41] abduction work probably has a Center

[39:44] Mass that's fairly in front of T8 it's

[39:48] in center of her

[39:50] body we don't work with patients like

[39:54] that we we don't even check

[39:57] it so when you Google where the center

[40:01] mass is I encourage you to do

[40:05] so you'll find that the center of mass

[40:09] is responsive and excuse me is is is

[40:12] following the response that the brain

[40:15] has to where your center of pressure is

[40:20] when you look at the pressure points on

[40:22] the bottom of a foot or

[40:24] both you can predict where the center of

[40:27] mass is going to be because of the

[40:29] pressure the force plate that's

[40:30] registering that

[40:33] pressure this Center of mass is not

[40:36] designed around

[40:38] Mass this Center of mass is designed

[40:41] around

[40:42] pressure and it's constantly

[40:47] moving never ever will it stop even when

[40:51] you're

[40:53] horizontal it's an ongoing challenging

[40:57] State a beautiful state of

[41:00] unrest we were made to own posture of

[41:06] unbalance we weren't made to own posture

[41:09] of balance if we own posture of balance

[41:12] we'd be on one leg uh we are working

[41:15] with patients who like to stand on one

[41:18] leg and they don't have the ability to

[41:20] move

[41:21] freely they have ranges in One Direction

[41:24] and none the other

[41:27] because of that inability to get that

[41:29] Center of Mass to start to resonate to

[41:32] shift to coil to rotate to go up and

[41:36] down to dance the kinesics of our body

[41:39] are designed around that Force that's

[41:43] applied to the bottom of that

[41:45] foot and in you know a bipodal system

[41:48] one foot goes down as the other one's

[41:50] going up just like your

[41:52] diaphragms and to regulate A Center Mass

[41:54] you should be able to lay on one side

[41:56] and regulate that side as Wells you can

[41:58] lay on the other side and do and do the

[42:02] major distinction between the center of

[42:03] gravity and the center of mass is that

[42:06] the center of gravity is the position at

[42:08] which the entire body weight is balanced

[42:11] while the center of mass is the position

[42:12] at which the entire mass of the body is

[42:16] directed we have an Institute here in

[42:19] Lincoln Nebraska that initiated with

[42:22] that

[42:23] concept pattern Direction

[42:26] puts you in positions where your center

[42:28] of mass is having a difficult

[42:31] time to respond to cortical function

[42:34] that you want from your

[42:36] body without

[42:38] re-registering proceptivity mechano

[42:41] receptively the the sense that you feel

[42:43] the sense of what's going on underneath

[42:46] of your feet our hip abductors control

[42:50] that

[42:51] sense our hip abductor our hip abductors

[42:54] and contralateral our and control

[42:57] pulling hip adductors have the greatest

[43:00] influence in our Center Mass

[43:02] Direction patterns

[43:06] positions when one stands on both legs

[43:08] and shifts the hips to the right with

[43:10] the right hip abductors and left hip

[43:13] adductors the center mass will more than

[43:16] likely also shift to the

[43:18] right so you'll see photos like

[43:23] this where you see someone standing on

[43:25] one leg on one single leg as their body

[43:30] is being balanced or being put over to

[43:33] the right

[43:34] side but the center of mass the center

[43:37] of mass is over on the right as the

[43:39] center of of single leg activities on

[43:44] the left this is called pressure center

[43:47] of pressure this is a pressure point if

[43:50] that knee can unlock that Center of mass

[43:54] will not be

[43:58] static I work with patients who have

[44:01] static Center masses usually on one

[44:04] side and a gift to move freely on the

[44:07] other side but in a small amount of

[44:10] ranges they lock out on their right side

[44:12] and their Center Mass never changes they

[44:15] go to the left side they waver around

[44:17] they don't like it they don't have much

[44:18] range they go back to the side that they

[44:20] lock out

[44:22] on so do

[44:24] you there may have Center of mass

[44:26] between both legs both legs are locked

[44:30] out our Ascension descension of our

[44:33] Center of mass and centers of diaphragms

[44:35] depend on this Cooperative adduction and

[44:37] internal rotation on one side of the

[44:39] pelvis with this abduction and external

[44:42] rotation of the other side of the

[44:46] pelvis in summary the human thorax and

[44:48] pelvis alignment in the frontal plane is

[44:51] influenced by the requirement to reach

[44:54] equilibrium around the hip

[44:57] joint where the forces are created by

[44:59] that lateral stabilizer called the

[45:02] abductor the abductor muscles that

[45:05] balance the loads imposed by the body

[45:08] mass these forces create the abductor

[45:11] internal moment that is essential to

[45:13] support the weight of the body and

[45:15] maintain the upright posture during

[45:19] walking Center

[45:21] pressure center

[45:24] pressure nothing controls holds your

[45:26] Center pressure better than

[45:29] abductors our pressure is temporarily

[45:32] influenced measurement that is usually

[45:35] recorded by a force

[45:37] plate however during quiet standing the

[45:40] anterior and posterior movement of the

[45:42] center pressure is largely influenced by

[45:44] the ankle joint and when you say ankle

[45:46] joint say Center pressure it's a living

[45:51] living body within a body it's got a

[45:55] little body of its own down there it's

[45:57] called the

[45:58] tus and it's responsible for where you

[46:01] put your body's

[46:04] Mass the ankle joint movement is is

[46:07] influenced by not only gravitational

[46:09] forces but flow and

[46:12] momentum but it's all pressure it's all

[46:15] pressure under a foot under one foot

[46:18] that your brain is aware of more than

[46:21] whether or not you're in a state of

[46:22] inhalation or

[46:23] exhalation Therefore your ankle is

[46:26] responsible for your respiratory

[46:29] function and if your ankle is respir

[46:32] responsible for your respiratory

[46:33] function the brain passes through the

[46:36] ankle for that respiratory

[46:39] function beet awareness feet proprial

[46:42] receptive awareness and mechan receptor

[46:44] awareness are directly fed everything

[46:48] that the cortex wants from the bottom of

[46:50] your

[46:52] foot transition translation

[46:56] transduction movement side to side

[47:00] vacillator vacillating movement our

[47:03] ankles were built for that and the

[47:07] strongest influence on an ankle to keep

[47:09] it safe safely operating is what you do

[47:13] with the abductors in that ankle on that

[47:15] ankle and around the hip above

[47:18] it the medial lateral movement of the

[47:20] center pressure is influenced primarily

[47:22] by your hip joint

[47:24] motion

[47:26] during forward locom more movement the

[47:28] cop the center pressure reflects the

[47:30] body's movements that occur as forces

[47:32] attempt to rebalance the position of the

[47:34] center of

[47:37] mass repositioning this institutes big

[47:40] kind of a big word but there's nothing

[47:43] that repositions us nothing that

[47:45] rebalances us better than Center of

[47:49] pressure responsible for your center of

[47:54] mass that's what that abduction lift

[47:56] test is all

[47:58] about put your foot on my shoulder put a

[48:01] foot on the wall lift the other foot

[48:05] show me what you can do with that ankle

[48:08] the one ankle that's controlling the

[48:10] other

[48:11] ankle one ankle that's controlling the

[48:14] other ankle one hip that's controlling

[48:16] the other hip so you can shift your feet

[48:21] away from your hip or your hip away from

[48:24] your feet that

[48:27] easy the medial lateral movement of the

[48:29] center pressure is influenced by that

[48:31] hip joint motion during forward local

[48:33] motor movement the cop reflects the body

[48:35] movement that occurs that that occur as

[48:38] Force attempts forces attempt to

[48:40] rebalance again the position that

[48:43] consider a mass I could read it again

[48:45] and again and again a very important

[48:47] slide in this

[48:48] webinar the humans humans neurological

[48:52] systems and muscular skeletal systems

[48:54] may lead to severe verely inefficient

[48:57] movement as the body is constantly

[48:59] battling to maintain postural stability

[49:02] which may or may not lead to a balanced

[49:05] Center Mass that's

[49:07] possibly that is possibly is positioned

[49:09] in a state of balanced

[49:12] asymmetry humans are balanced in a state

[49:16] of balanced

[49:19] asymmetry we have an asymmetrical body

[49:22] you're going to have a center Mass

[49:23] that's moving around at all times

[49:26] and that's good we're constantly looking

[49:30] how can I balance my

[49:33] asymmetry with a fluctuating moving

[49:36] constantly battling to maintain position

[49:39] upright position with the center of mass

[49:42] by that slide I strongly encourage you

[49:45] if you have a pen and you're not in a

[49:46] car listening to this webinar write down

[49:49] the word

[49:51] abduction because that is a slide that

[49:54] summarizes

[49:56] the the abduction in your

[49:59] life pronation of the lower extremity

[50:02] internal rotation the femur under the

[50:04] acetabulum and planter flexion using

[50:07] abductor hysis and flexor halis brevis

[50:10] at push off all provide the center

[50:13] pressure needed to maintain appropriate

[50:15] Center mass of the body during forward

[50:18] locomotive movement you can't move

[50:20] forward if you don't control the center

[50:23] of mass what's moving forward is the

[50:27] center of mass that's what's moving

[50:30] forward your head should not be felt

[50:33] like it's moving forward your head

[50:35] should know that the center Mass

[50:37] responsible for the inactivity of your

[50:39] head and neck is moving

[50:47] forward since the hip controls minimum

[50:50] is minimally during since hip control is

[50:53] minimally during push off there is a

[50:55] there's a greater act there's great

[50:57] activity in the right forefoot for

[50:59] pronation postural stabilization and

[51:01] transverse plane

[51:03] control the foot

[51:05] complex is under active contraction with

[51:08] supination that are highly active in a

[51:10] pronated state when push off occurs too

[51:14] laterally normal weight bearing and

[51:16] function at the first MP joint or first

[51:18] Ray is

[51:22] impaired impairment of the ankle has

[51:25] probably the greatest influence on the

[51:27] respiratory system because of its impact

[51:30] on where is your center of mass than

[51:32] anything else in the

[51:36] body therefore our supination our over

[51:39] supination our ere external rotation of

[51:41] a femur under an acetab reduces the

[51:44] ability to laterally move the body to

[51:46] the controlateral

[51:48] side our vertical Center of mass becomes

[51:51] localized over the homolateral center of

[51:53] pressure point or the right forefoot

[51:56] contributing to limited side to side

[51:59] lateralization and I said earlier for

[52:01] some of you listening to this webinar I

[52:04] know I'm going a little fast I know

[52:06] there's a lot of words coming out of my

[52:08] mouth but you have a you have a handout

[52:10] that accompanies this webinar I

[52:13] encourage you to look at it and study it

[52:15] and think about it because this is all

[52:17] evidence-based researched activity it's

[52:20] all been demonstrated it's all been

[52:22] explained and expressed it's just it's

[52:24] not something that we normally would put

[52:26] in these put in these this type of uh

[52:30] language when you talk about

[52:33] abductors by demonstrating the ability

[52:35] to internally rotate the right fem under

[52:37] the acetabulum without rotating the

[52:40] pelvis or torso in the same direction

[52:42] prior to abducting the right femur on

[52:44] the acetum or the right acetum on the

[52:47] femur indicates that the center mass of

[52:49] the Torso can shift to the left without

[52:52] losing the lateralized location of the

[52:54] ideal Center of pressure reference

[52:57] provided by the right gry toe and its

[52:59] internal rotation plan reflection

[53:01] support for the proximal external

[53:02] rotation force on the leftward moving

[53:05] acetum that's one sentence intentionally

[53:08] written to help you understand the

[53:10] integrativeness between the hip the

[53:14] ankle and your center of

[53:17] mass this is the reason that last

[53:21] paragraph is the reason behind level

[53:23] three of the Rusk abduction lift t

[53:27] she's laying on her side Janie's laying

[53:29] on her side she's got a foot on the this

[53:30] is called the center of reference a

[53:34] pressure point a force plate and as that

[53:38] leg is internally

[53:39] rotated and as that hip is going down to

[53:42] on the floor that's laying on she's

[53:45] capable of taking her upper hip and

[53:48] turning it in for and if you're confused

[53:51] on why go back and look at the last

[53:54] slide

[53:57] rationally level three requires the

[53:59] ability to rotate the top extremity

[54:01] inward without the moving the top pelvis

[54:06] forward inability to do this reflects

[54:09] poor strength or k kinesthetic awareness

[54:12] of the ipsilateral glal glut gluoy the

[54:16] medius and the Minimus or impingement of

[54:18] the medial femal head on the anterior

[54:20] medial CID rim of the the laboral rim of

[54:23] the hip second Carri a forward

[54:25] anteriorly rotated contralateral pelvis

[54:29] position acceptance and acknowledgement

[54:32] of left Center mass movement or

[54:34] placement requires homolateral or in

[54:37] this case left iscal femal adduction

[54:40] concominant homolateral thoracic ilum

[54:43] abduction and controlateral or in this

[54:46] case right ILO femal abduction during

[54:50] Center of pressure Assurance from the

[54:52] right planner

[54:54] surface

[54:55] in other words the thorax abdominal

[54:57] abduction or lateral flexion on the left

[55:01] is occurring because the center of mass

[55:03] is over to the left as a result of a

[55:06] fixated left isim that's located between

[55:09] the leftward center of mass and the

[55:12] rightward center of

[55:13] pressure

[55:17] so leftward Center of mass I'm gonna go

[55:21] back is as a result of a fixed stated

[55:24] left isum that is located between the

[55:27] leftward center of mass and the

[55:29] rightward center of pressure so if you

[55:32] look at this lady laying on her side

[55:35] this

[55:36] isum is between a leftward center of

[55:39] mass it's between this this Center of

[55:43] mass and that right center of pressure

[55:47] that isim is responding to

[55:51] this pressure

[55:54] Force position Place sense and this

[55:59] Center of mass is produced by that

[56:02] therefore this isio seat stability is

[56:06] solid as it sandwich in between those

[56:09] two

[56:10] sides we have now isolated a site a site

[56:16] for hip abduction to occur here and for

[56:20] active hip abduction to occur here one's

[56:23] more Ecentric that would be the this and

[56:25] one's more concentric that would be this

[56:28] on the right side which we'll cover in a

[56:30] few more

[56:32] minutes let's talk about inverted

[56:35] pendulums all of the Rus conf functional

[56:37] test outcomes reflect the orientation of

[56:40] the individual sense of location with

[56:43] respect to the spine its sacral base and

[56:46] sphenoid base Jen I'm going to go back

[56:48] to the last

[56:51] picture this person's inverted pendulum

[56:55] is being shifted to the left it's going

[56:59] to the left the leg is going to the

[57:02] right the leg is going to the right the

[57:05] body is going to the

[57:07] left so when you look at humans move

[57:11] movement on three inverted you have

[57:12] three inverted pendulums one's called

[57:15] the sacral base the sacrum go to in it

[57:19] go to one side as the head and the

[57:21] body's Bob goes to the other side or it

[57:24] can go to the other side as the head is

[57:26] moved to the other side I hate to even

[57:28] put left and right on it because it

[57:30] doesn't

[57:32] matter the sacral

[57:36] base the space between your

[57:39] hips gives your brain a sense of need to

[57:45] abduct I'll say it again the sacral

[57:49] base the space between your two hips

[57:53] gives your cortical

[57:55] cortical mind cortical being a need to

[58:04] abduct when you're

[58:07] upright without that sacral based flow

[58:10] from side to side your need to abduct

[58:14] doesn't exist you're too

[58:18] static the foot and ankle on the

[58:21] right is the second place for your

[58:24] invert pendulum to work when the sacral

[58:26] base is excuse me when the Foot and

[58:29] Ankle I'm sorry has been replaced by the

[58:31] sacral

[58:32] base or when the foot and ankle on the

[58:36] left when the left when the leg is going

[58:39] to left Left Foot and Ankle provides

[58:42] your third inverted

[58:45] pendulum abduction is built off of those

[58:48] three inverted pendulums went

[58:53] upright the these inverted pendulums are

[58:56] con constantly seeking resolution to

[58:58] guide the body and head and neck toward

[59:01] the unstable fixed point at the top of

[59:04] the

[59:05] pendulum our necks should not be

[59:08] overstable they should be free they

[59:11] should be able to move they should be

[59:13] able

[59:14] to resonate and

[59:17] flow they shouldn't be

[59:20] fixed the fix Point since the fix point

[59:23] is unstable the body or Bob the head

[59:26] must be balanced relentlessly to keep it

[59:30] upright put a smiley face by

[59:39] that the balance that's relentlessly

[59:42] keeping you

[59:44] upright is provided by your

[59:50] abductors our cortical function is built

[59:53] around the control of our pendulum or

[59:55] body that hopefully will not fall over

[59:57] when the

[59:58] cart Saum or the feet

[01:00:02] move that's

[01:00:05] cortex this self-regulation of balance

[01:00:08] is accomplished through experimentation

[01:00:10] of different appendicular lengths and

[01:00:12] weights amplitudes and and oscillatory

[01:00:16] uh worlds

[01:00:18] strengths that are are presented you

[01:00:21] know our strengths that we gain over

[01:00:22] time these are all patterns

[01:00:25] in order to discover what determines the

[01:00:27] necess the necessary frequencies of

[01:00:30] oscillation of their pendular movement

[01:00:33] for acceptable balanced

[01:00:37] Behavior we're build of hundreds of

[01:00:40] little

[01:00:41] slinkies we should be coiled up and

[01:00:43] moving and have no fear because balance

[01:00:47] is not maintained over a range of angles

[01:00:51] and not just at one angle they all got

[01:00:54] to be wobbling and wiggling and moving

[01:00:57] what keeps us from falling apart are our

[01:01:02] abductors any resting equilibrium

[01:01:04] position of the pendulum is unstable and

[01:01:07] in practice

[01:01:09] temporary not going to last long

[01:01:11] movement to a different resting

[01:01:13] equilibrium position can only be

[01:01:15] accomplished by basic throw it catchet

[01:01:19] patterning of torque and not necessarily

[01:01:21] by an elastic

[01:01:23] mechanism throw yourself out there catch

[01:01:26] yourself throw yourself out there catch

[01:01:29] yourself Move Yourself away from your

[01:01:31] body catch yourself stop

[01:01:34] yourself maintaining quasi static or

[01:01:37] control when on one leg for balance

[01:01:39] requires 50 to 100% of the maximum hip

[01:01:42] abduction strength in both young and

[01:01:44] older adults effectiveness of a hip

[01:01:47] strategy and recovering one leg balance

[01:01:50] heavily depends on the maximum hip

[01:01:52] abduction strength and for healthy older

[01:01:54] women hip abduction is as important as

[01:01:57] ankle strength according to this one

[01:02:06] study much of this one leg control

[01:02:09] balance Janan go back much of what we've

[01:02:12] done in this institute is with control

[01:02:16] balance uh we try really hard in this

[01:02:20] institute to get people to control

[01:02:22] balance by feeling their Center of mass

[01:02:27] by not feeling their Center of mass

[01:02:28] acknowledging they have a center of mass

[01:02:31] that's over to the

[01:02:34] right provided by The Single Leg Center

[01:02:37] of pressure offered on the

[01:02:40] left we work with patients who have

[01:02:42] Center Mass over to the right on top of

[01:02:46] Center pressures that are also over on

[01:02:49] the

[01:02:52] right so when you see jie standing on

[01:02:55] the side of his sides of

[01:02:57] stairs this picture and the last picture

[01:03:00] are the very same thing much of this one

[01:03:03] leg control of balance is provided by

[01:03:06] the standing hip abductors those

[01:03:09] Ecentric abductors on the left she's

[01:03:12] pointing to

[01:03:14] them and the concentric abductors that

[01:03:18] are on the right of the nonstatic hip

[01:03:23] she's B balancing that Center of mass

[01:03:26] even though it's over to the right more

[01:03:29] towards the center of her midline by

[01:03:31] shifting her hip to the

[01:03:34] left and if she can't shift that hip to

[01:03:36] the left with this activity when she

[01:03:39] finishes this activity it did nothing

[01:03:42] for

[01:03:44] her if she did not lower that leg

[01:03:49] descend

[01:03:50] it if she didn't lower that leg and did

[01:03:53] notc sin it did nothing for her because

[01:03:57] she changed nothing inside of her

[01:04:01] body when we see patients like this all

[01:04:04] the time they go through the technique

[01:04:06] they go through the activity but there's

[01:04:08] nothing going on side with

[01:04:11] repressurizing the inside of the

[01:04:18] body this is why my name is in front of

[01:04:21] that

[01:04:23] test

[01:04:25] run she's going into

[01:04:28] concentric abduction on the right side

[01:04:30] wouldn't she be descending more on the

[01:04:32] right side than the left side since

[01:04:34] she's in more adducted State on the left

[01:04:37] side she's in an adducted State on the

[01:04:39] left side these abductors are an

[01:04:41] Ecentric State

[01:04:43] yes but because she's in an AB duction

[01:04:46] on the right side wouldn't her actual

[01:04:49] pelvis and thorax be descending more on

[01:04:51] the right side than the left side it

[01:04:53] would be okay it would be for sure okay

[01:04:58] 100% And the minute she stands up on the

[01:05:01] left side and takes another step it

[01:05:03] would just go back she's playing

[01:05:05] pingpong she's playing pingpong Jan

[01:05:08] inside it's not what's going on the

[01:05:10] outside gen it's going what's going on

[01:05:13] in the

[01:05:16] inside there's Bobby standing wall shift

[01:05:19] number

[01:05:20] six she's pushing her hip into the wall

[01:05:24] she's standing on the left leg and then

[01:05:26] she's rotating that bolster down or she

[01:05:29] rotates that bolster up and she's

[01:05:31] shifting on what's going on in the

[01:05:34] inside not what's going on on the

[01:05:37] outside her Center of mass is going to

[01:05:40] the left and then it goes to the right

[01:05:43] it's going to the left and then it's

[01:05:45] going to the right because she's

[01:05:46] standing on her left

[01:05:48] leg she's lowering and raising

[01:05:52] squatting on her her left leg coming

[01:05:55] ight what's that yeah that's how she's

[01:05:59] rotating the bolster that's correct

[01:06:01] bending her knees straightening bending

[01:06:03] your knees straightening this is a

[01:06:06] shoulder

[01:06:07] program this is an ankle program for the

[01:06:11] other ankle the right one that she

[01:06:13] sprained if she would have sprained it

[01:06:15] this is a shoulder program she's

[01:06:17] teaching her her she's allowing her

[01:06:20] brain to experience Force pressure and

[01:06:24] plate pressure to keep this shoulder in

[01:06:26] a position so it can abduct correctly

[01:06:31] when she raises that

[01:06:33] arm that's a cervical

[01:06:39] program that's an anti-anxiety

[01:06:45] program I just want to make sure we're

[01:06:47] all thinking about what's going on

[01:06:50] inside for pressure

[01:06:53] management

[01:06:54] this individual is in an upright

[01:06:55] thoracic abductus state with

[01:06:57] contralateral fa abduction arms are

[01:07:00] above the

[01:07:02] head that Center of mass is is now

[01:07:06] somewhere a little higher because this

[01:07:08] these arms are up I don't know where

[01:07:11] it's exactly but I can tell you it's not

[01:07:13] over just to the left it's still over to

[01:07:15] the

[01:07:17] right and he's pulling it up with his

[01:07:20] arms above his

[01:07:22] head

[01:07:24] without him extending his

[01:07:30] back to develop hip abductor concentric

[01:07:33] strengths as seen in level three level

[01:07:35] four and level five of the Rus abduction

[01:07:38] lift test one would have to therefore

[01:07:40] acquire the ability to move the hips to

[01:07:43] the side or Ecentric hip adductors D

[01:07:47] ductors become stabilizers for the

[01:07:49] center Mass so the control that the

[01:07:52] control concent hip abductors can

[01:07:56] improve the ground support kinesthetic

[01:07:58] awareness and the center of pressure

[01:08:00] sense provided by level two which I'll

[01:08:03] show you in a minute but level three

[01:08:05] level four level five as you see

[01:08:09] here you see

[01:08:13] here the intent of this is not to go

[01:08:16] over each single level the attent is to

[01:08:21] understand that you can't even think

[01:08:22] about any of

[01:08:24] if you don't have

[01:08:28] that that

[01:08:33] level I uh pause here a little bit

[01:08:36] because for those people who are

[01:08:38] listening this and can't are not looking

[01:08:40] at this slideshow there's a lady laying

[01:08:43] on her left side she has a left foot on

[01:08:45] the wall her knee is

[01:08:47] bent her right foot is on the wall out

[01:08:51] to the side and all we're doing right

[01:08:54] here is laying in that position and

[01:08:56] putting a hand in front of her with the

[01:08:58] other hand above her

[01:09:00] head as she's laying on that left side

[01:09:03] she's trying to pick up her left knee

[01:09:05] using the wall that the left foot is

[01:09:07] on to steer the trunk to the

[01:09:15] left to steer the trunk to the

[01:09:22] left so she can push herself to the

[01:09:26] left with her right hip

[01:09:32] abductors so she can then stand

[01:09:35] up and repeat that without the

[01:09:38] gravitational influence on her in this

[01:09:40] horizontal State and mimic that

[01:09:46] sense so she can correctly move herself

[01:09:48] forward in life without overextending

[01:09:51] her back and her knees

[01:09:55] I'll go back Jen to this next picture to

[01:09:57] this picture here so she can continue to

[01:10:01] demonstrate how to move in

[01:10:03] life with control level three level four

[01:10:09] and level

[01:10:13] five the horizontal activity techniques

[01:10:17] like it have a direct influence on the

[01:10:19] verticality that requires it so we threw

[01:10:24] some slide threw some techniques in this

[01:10:27] webinar to reflect those activities to

[01:10:31] reflect what we need from that level to

[01:10:38] position and I'm not going to read all

[01:10:40] these you have them in your handout for

[01:10:42] those people listening and can't see

[01:10:44] what's on the slideshow they're

[01:10:46] basically left sideline TS types of

[01:10:49] activities they get harder nature in a

[01:10:52] left sideline state where the right

[01:10:56] abduction is provided by left

[01:11:00] abduction left abduction has to be

[01:11:02] somewhat Ecentric minded for concentric

[01:11:06] minded abduction on the

[01:11:09] right and there's no there's no uh bu

[01:11:13] saying you should be doing this on the

[01:11:15] other

[01:11:16] side uh you can do do each of these

[01:11:19] techniques on either

[01:11:22] side

[01:11:24] so our upright abduction relationships

[01:11:26] to stance activity of the shoulders and

[01:11:28] hips I would like just to briefly

[01:11:30] comment on before we

[01:11:32] conclude at midstance our glutes our

[01:11:35] gluteal abduction activity requires

[01:11:37] concominant control posterior and middle

[01:11:40] deltoid abduction activity to move the

[01:11:43] arm away from the body so it can clear

[01:11:45] the body Palm out and late rise that

[01:11:48] clear the body at Palm in and late rise

[01:11:51] and this is where if you don't have

[01:11:53] access

[01:11:54] uh to the handout you'll have to look at

[01:11:58] it to understand that we talk about

[01:12:00] these activities in our forward look of

[01:12:02] motor movement

[01:12:03] course uh

[01:12:06] abduction uh our hip abductors like arms

[01:12:10] that Palm out and that late rise the

[01:12:13] late part of Swing Jen the late part of

[01:12:16] Swing late reach late

[01:12:22] rise glal abduction femur Abdu abduction

[01:12:26] on the ilium or ilum abduction on the

[01:12:28] femur requires concominant ipsilateral

[01:12:30] abdominal abduction lateral rib cat

[01:12:33] which is lateral rib cage abduction on

[01:12:37] ilium or ilium abduction on lateral rib

[01:12:40] cuge to maintain the center pressure on

[01:12:42] the stance side and the center mass in

[01:12:45] front of the sacrum as a contol out

[01:12:47] shoulder is abducting on the

[01:12:51] trunk shoulder abduction requires

[01:12:54] contralateral hip and lateral trunk

[01:12:56] abduction when we lift up an arm we have

[01:12:59] to have the contralateral hip

[01:13:03] abductors assist

[01:13:05] us now if you're laying on your back

[01:13:08] your side you wouldn't need that but if

[01:13:10] you're standing you do when the center

[01:13:13] mass of the pelvis remains neutral and

[01:13:15] centered between the hips and the

[01:13:17] shoulders we would call that a nontrad

[01:13:20] delburg

[01:13:22] position uh here Kenzie is demonstrating

[01:13:25] that she's standing on her left leg and

[01:13:28] she's getting her getting her right arm

[01:13:30] to go into extension but she still had

[01:13:32] to abduct

[01:13:35] it in essence good shoulder abduction

[01:13:38] flexion and extension which I just

[01:13:40] showed you relies on stabilization of

[01:13:43] the spine and trunk from contralateral

[01:13:45] hip

[01:13:47] abductors and abdominals when

[01:13:51] standing here's Jason standing on one

[01:13:53] leg with an arm over his head to reflect

[01:13:58] that standing on one leg with one foot

[01:14:01] off the floor and reaching with the

[01:14:03] contralateral arm and hand above the

[01:14:05] head requires concentric abdominal work

[01:14:08] from the side one is standing on or

[01:14:11] standing with these abdominal concentric

[01:14:14] to concentric muscles will need to work

[01:14:16] with the Ecentric to concentric hip

[01:14:19] abductors from the side one is standing

[01:14:22] with

[01:14:24] all scapula trapezius muscles on the

[01:14:27] overhead arm should shoulder side and

[01:14:30] all Glu muscles on The Stance side will

[01:14:33] become co-activated whether you plan it

[01:14:36] or

[01:14:37] not arm abduction on one side along with

[01:14:41] leg abduction effort on the other side

[01:14:43] provide the upright stability for small

[01:14:45] medial lateral shifts of the body's

[01:14:48] Center of mass and if time correctly may

[01:14:51] be sufficient to maintain balanced

[01:14:54] maintain balance under extreme rotation

[01:14:57] inertia of the upright body axis when

[01:15:00] when things are really out of control

[01:15:02] you slip on

[01:15:04] Ice our arms are the human

[01:15:09] hips

[01:15:10] abductors best references and our ankles

[01:15:14] are our our best allies when we raise or

[01:15:18] abduct our arms or arms we create a wh

[01:15:21] arm or arms we create a horizontal human

[01:15:24] balance pole a balance pole like a

[01:15:28] gymnast would have for Effective hip

[01:15:30] abduction to manage our Center of mass

[01:15:33] inertia especially when limited Center

[01:15:36] of pressure Force exists in other words

[01:15:39] you don't trust the thing you're

[01:15:40] standing on it's too icy it's too slick

[01:15:44] it's wet and you're not sure our arms

[01:15:46] become our balance beams our

[01:15:50] poles someone walking on a tight wire

[01:15:53] always has their arms out to the side

[01:15:55] for sure or they hold a pole for sure

[01:15:57] horizontal to help for sure be their

[01:16:00] ankles best Alice for

[01:16:04] sure and if you reflect on what you just

[01:16:06] said Jan when you have the ground you

[01:16:09] don't need your arms because the new

[01:16:12] pole are the

[01:16:14] arms down here legs that go forward and

[01:16:18] back unfortunately you see only that but

[01:16:22] they don't

[01:16:23] they go from what side to side in small

[01:16:27] trajectory ranges your hips do not work

[01:16:31] correctly if those hips cannot abduct

[01:16:34] and adduct those are your balance poles

[01:16:38] your balance

[01:16:39] beams they are required otherwise you

[01:16:43] will put your arms out one or

[01:16:47] both the most universal identification

[01:16:50] indicator of weaknesses in the hip

[01:16:52] abductor muscles is a telberg sign when

[01:16:54] the pelvis drops on the contralateral

[01:16:56] side during a single leg stance on the

[01:16:59] affected side or when the lateral thorax

[01:17:01] abdominal region laterally flexes on the

[01:17:03] weak hip abductor side during forward

[01:17:06] locomot movement most would consider

[01:17:08] this dysfunction as a sign of Glu

[01:17:11] weakness I do not I'm in not one of

[01:17:14] those most categories because it may

[01:17:16] have nothing to do with the strength of

[01:17:19] the glutes it has everything to do with

[01:17:22] your strength to move your yourself from

[01:17:25] side to side your ability to transcend

[01:17:29] your ability to

[01:17:31] transition your transition yourself your

[01:17:34] ability to kick in an abductor for

[01:17:38] Center of pressure designed Center Mass

[01:17:42] placement because I've seen people

[01:17:45] get stronger in seconds with their

[01:17:48] glutes as abductors by just restoring

[01:17:51] that ability for them to shift with

[01:17:54] those abductors not lift with those

[01:17:59] abductors this dysfunction activity seen

[01:18:02] when standing or walking could be a sign

[01:18:04] of over centering of mass of the

[01:18:06] trendelenberg side with over reference

[01:18:08] of ground by the contralateral center

[01:18:10] pressure extremity just what I

[01:18:13] said or this dysfunctional State could

[01:18:15] represent over referencing of Center

[01:18:17] pressure too much recognition of Center

[01:18:20] pressure and overuse of Center Mass on

[01:18:22] the stable or over reference side with

[01:18:25] that Center pressure center of pressure

[01:18:28] and center of mass over

[01:18:30] regulated means you are locked up on one

[01:18:33] side or you're locked up on both

[01:18:39] feet so here's a picture of somebody in

[01:18:41] a trendelenberg

[01:18:43] position and I like the name

[01:18:45] trendelenberg but there's a possibility

[01:18:48] that that position is not because of

[01:18:51] weak muscles

[01:18:54] that iskim is sandwiched between a

[01:18:57] center of

[01:18:58] mass and a non-recognizable center of

[01:19:02] pressure on the other side the center of

[01:19:05] pressure that that person's experiencing

[01:19:07] is on the same side that the center of

[01:19:09] mass has experienced and they are

[01:19:12] literally literally being forced on that

[01:19:15] ground to stay

[01:19:20] there that's why this word all

[01:19:22] alternation is so

[01:19:25] important and it's so important to

[01:19:27] recognize that all our primary and

[01:19:28] secondary courses especially focus on

[01:19:33] it alternation and so what you see is

[01:19:36] what Jen did here she took this and just

[01:19:38] flipped

[01:19:39] it

[01:19:41] this combined with

[01:19:44] this is

[01:19:47] glorious

[01:19:48] this combined with this is pain

[01:19:54] everybody looks at this and thinks that

[01:19:57] this is a problem when the reality this

[01:20:00] is a problem because they never can do

[01:20:06] that do I need to repeat that think so I

[01:20:10] followed it with your

[01:20:13] laser human forward look and motor

[01:20:15] movement relies heavily on abduct

[01:20:17] related orientation for frontal planes

[01:20:19] and motor control on abduct orientation

[01:20:22] for transverse planes of motor control

[01:20:25] and on integrated adductor and abductor

[01:20:28] orientation for unbiased motor

[01:20:32] control during Sagal planes of

[01:20:35] movement if the thorax abdominal

[01:20:38] abductors do not contract as

[01:20:40] contralateral iscal femal abductors

[01:20:42] contract and vice versa during four

[01:20:45] local Mor movements Sagal plane of

[01:20:47] movement which is forward plane of

[01:20:49] movement becomes biased by overactive

[01:20:52] back extensors and hip flexors which is

[01:20:55] just what we went over with that TR

[01:20:57] delberg

[01:21:04] discussion how we doing different time

[01:21:06] should I take about I don't think have

[01:21:07] much more Jen am I okay going here fine

[01:21:12] okay lateral displacement of our Center

[01:21:14] Mass is one of the most difficult things

[01:21:17] we as humans have to deal with on a

[01:21:19] day-to-day basis usually this

[01:21:21] unconscious displac leads to uncon

[01:21:24] excuse me leads to conscious awareness

[01:21:27] of pressure points or discomfort

[01:21:29] associated with weight distribution and

[01:21:31] neurological balanced effort our Center

[01:21:34] Mass needs to remain within our bounds

[01:21:37] of Bas of support or we will Begin to

[01:21:41] Fall the location of our Center

[01:21:44] Mass can generally be thought of as the

[01:21:48] cause while the movement of the center

[01:21:50] mass is the effect

[01:21:53] if the center mass is located too far

[01:21:55] posteriorly the center pressure will

[01:21:57] move posterior to the center mass for

[01:22:00] the body to move in the anterior or

[01:22:02] forward Direction this is an example of

[01:22:05] that where the center mass is moved too

[01:22:08] to posteriorly the center mass and the S

[01:22:11] to posteriorly that I didn't say the

[01:22:13] media steum was full I said the shoulder

[01:22:16] blades and the arms and the upper torsos

[01:22:19] to posterior to the and then Center

[01:22:22] pressures trying to get underneath of it

[01:22:25] and we see this a lot with our patients

[01:22:26] who are

[01:22:28] overextended it's the center of mass

[01:22:30] issue if our Center Mass is located too

[01:22:32] far lateral to the right the center

[01:22:34] pressure will need to move further to

[01:22:36] the right of the center Mass which will

[01:22:38] cause the center of Mass to then move to

[01:22:40] the left that's what your brain will do

[01:22:43] to prevent it from falling to the

[01:22:45] right so you'll see patients that look

[01:22:48] like this their shoulders will be lower

[01:22:49] on the right side arms and legs will be

[01:22:52] out to the left

[01:22:54] left Center Mass is to the right center

[01:22:57] pressure is too far to the right they're

[01:22:59] trying to get over to the

[01:23:01] left as the center mass and Center

[01:23:04] pressure become sites for Associated

[01:23:06] functional cortical dominant Behavior

[01:23:08] the right iscal femoral adductors become

[01:23:11] primary stabilizers for upright postural

[01:23:17] perturbation again when every time we

[01:23:19] hear the word

[01:23:21] uh

[01:23:23] adduction or better two words heightened

[01:23:26] Abdu adduction the problem is not the

[01:23:30] overactive adductor the problem is the

[01:23:34] underserved under serving

[01:23:37] abductor this adductor biased Behavior

[01:23:40] contributes to ipsilateral shift or

[01:23:43] displacement of the center pressure to

[01:23:45] the adductor bias side when the visual

[01:23:48] vular system unsuccessfully attempts to

[01:23:51] regulate the the center Mass to the

[01:23:53] controlateral

[01:23:55] side as you'll see in that

[01:23:59] picture now the left AR left leg is

[01:24:02] further in line with the right leg and

[01:24:05] everything that person can do including

[01:24:08] including putting the tibia into

[01:24:11] Varys everything they can to stay on

[01:24:13] that right

[01:24:18] side so often

[01:24:20] seen the bias overused adductors Center

[01:24:24] of Mass on the right side of the body

[01:24:26] through hip and hip pelvis attachments

[01:24:28] reinforces the cortical postural need to

[01:24:31] co-activate the left hip abductors for

[01:24:34] Center of pressure references now your

[01:24:37] left hip abductors are really only being

[01:24:39] used for placement where do you place

[01:24:42] yourself versus structural physical

[01:24:46] holding you physiological uh lift or uh

[01:24:51] support thus heightening reflexive

[01:24:53] balanced control sense of limited

[01:24:56] support from the controlateral side or

[01:24:59] left

[01:25:00] side this imbalanced and limitation

[01:25:03] sense of Center Mass alternation and the

[01:25:05] overuse of adapted heterol lateralized

[01:25:08] Center of pressure directly contributes

[01:25:11] to the underlying chronic upright

[01:25:13] reactive and reflexive neurological and

[01:25:16] Orthopedic patterns of behavior that's

[01:25:19] associate with lateral

[01:25:21] displacement

[01:25:23] management of the right lateral

[01:25:24] displacement of the center mass or over

[01:25:26] referencing over reference Center

[01:25:28] pressure from the left foot

[01:25:30] requires one to minimize dependency that

[01:25:33] is placed on the right concentric minded

[01:25:35] lateral thoracic

[01:25:37] helium that's providing the abduction

[01:25:39] needs for the stabilization of the homo

[01:25:41] homol lateralized Center of mass and

[01:25:44] maximizing functional cortical

[01:25:45] integration of the ilio femal concentric

[01:25:48] position abduction from the glute

[01:25:50] muscles on the right side to enhance

[01:25:53] ease of lateral placement of the center

[01:25:55] Mass to the left when either in a

[01:25:57] vertical or horizontal state of

[01:26:01] orientation you can do that by level

[01:26:04] four achieving a level four of the rusc

[01:26:07] abduction lift test requires one to

[01:26:08] raise the top leg completely off the

[01:26:10] wall and hold it without using lateral

[01:26:13] trunk

[01:26:15] muscles that will Recon

[01:26:18] Centric concentric the right glutes

[01:26:22] it will re Ecentric eyes the left

[01:26:26] glutes the inability to raise the top

[01:26:29] leg completely off the wall and hold

[01:26:31] without using lateral trunk muscles

[01:26:33] reflects poor integration between the

[01:26:35] contralateral hip abductors and the

[01:26:37] ipsilateral hip

[01:26:40] abductors this level of activity

[01:26:42] reinforces the need to be able to

[01:26:44] minimize the right lateral thoracic

[01:26:45] abdominal muscle during lateral

[01:26:47] placement of the center of mass over to

[01:26:49] the left has the left foot lower

[01:26:51] extremity in hip are pushing into the

[01:26:53] wall through the level one

[01:26:58] application this is what you see with

[01:27:00] level five can you extend that top leg

[01:27:04] as you're pushing into that wall at that

[01:27:06] left

[01:27:08] leg this is a

[01:27:11] complete step in the in one of the in

[01:27:14] one of the stages of forward locom motor

[01:27:17] movement just because Janie's leg goes

[01:27:19] going out to the side and back on both

[01:27:22] pictures doesn't mean she's not using

[01:27:25] her abductors at a level that cannot be

[01:27:28] more demanding than

[01:27:30] that when one has the ability to move

[01:27:33] correctly abducted top lower extremity

[01:27:36] into extension without extending the low

[01:27:38] back or flexing the knee or rotating the

[01:27:40] leg externally they are de demonstrating

[01:27:43] that they can maintain their Center of

[01:27:45] mass orientation on the

[01:27:48] left through referencing that is offered

[01:27:51] from the right great toe level

[01:27:54] five that should be the dream the

[01:27:58] desire the dependency of our body for

[01:28:02] everything we do that

[01:28:06] level realization I call that the level

[01:28:09] of

[01:28:10] realization it's a big slide it's a big

[01:28:14] level and it takes some effort and it

[01:28:17] takes some design takes some

[01:28:20] self-processing four levels before for

[01:28:22] it so Ron just a quick question to

[01:28:24] clarify so your uh like level one your

[01:28:26] center of pressure is actually like your

[01:28:28] left toes but you're going to switch

[01:28:30] your center of pressure to your right

[01:28:33] toes in a level five yeah when you get

[01:28:35] to like level four and five if you can

[01:28:37] get there okay Jen I love you thank you

[01:28:41] this reference of pressure provides

[01:28:43] concominant Center pressure sense Center

[01:28:47] of pressure sense that's necessary to

[01:28:50] activate the right hip abductors without

[01:28:53] externally rotating the center of

[01:28:55] pressure leg and without overextending

[01:28:58] or abducting the low back and lateral

[01:29:04] abdominals this is a level five

[01:29:09] again it should not be

[01:29:14] difficult it's not like the adduction

[01:29:17] lift test gen where you'll never most

[01:29:20] people can't even get past a two or

[01:29:21] three

[01:29:22] if done if you follow the process as

[01:29:25] outlined in the the level 1 2 3 4 five

[01:29:30] instructions and you don't have any

[01:29:31] other major dysfunction major

[01:29:34] disabilities or major

[01:29:36] diseases because visual componentry here

[01:29:39] is not entering the

[01:29:42] picture this is a this is a uh this is

[01:29:46] something that most people can get but

[01:29:49] they have to learn how to process it by

[01:29:51] what are the they getting from doing it

[01:29:54] what did it do to them when they what

[01:29:55] Jen stood up what did they

[01:29:59] realize did you delay something did you

[01:30:01] give them something for a novel

[01:30:03] experience achievement of a level five

[01:30:06] should reflect the capability to perform

[01:30:09] the following three Center Mass

[01:30:10] functions when in left single leg

[01:30:13] support this is what we should get from

[01:30:15] a level five one a center mess to the

[01:30:19] right when standing on the left as that

[01:30:22] gentleman's doing right there even on a

[01:30:25] that's that's the goal if you do do that

[01:30:27] correctly you should have a level four

[01:30:30] five two Center Mass and centering can

[01:30:34] you Center your mass in the center can

[01:30:37] you get your right arm way up in the air

[01:30:39] and your left left leg down holding you

[01:30:41] there as your Center Mass it is towards

[01:30:43] the right but it's more centered and

[01:30:46] three Center Mass to the left left hand

[01:30:49] in the air when standing in the left

[01:30:51] single leg support

[01:30:52] you can have your hands touch or as you

[01:30:55] can see Hannah she has just her left

[01:30:57] hand only in the air left on

[01:31:03] left is as difficult for some patients

[01:31:06] as standing on the left raising a

[01:31:12] right as you can tell I'm pretty

[01:31:15] passionate about this Jen and for those

[01:31:17] who are listening I uh encourage you to

[01:31:19] maybe go a little slower I only have me

[01:31:22] minutes in this webinar stuff to get a

[01:31:24] lot of messages out there but I I work

[01:31:27] hard at these webinars and I'm VAR genu

[01:31:30] I'm very careful with every word uh

[01:31:32] those uh sentences have to be written

[01:31:34] the way they are for you to get the

[01:31:36] complete picture so you may have to read

[01:31:38] them a few times uh but I want to thank

[01:31:40] you for joining us and I really

[01:31:42] appreciate your genuine interest in this

[01:31:45] um adduction is a big deal adduction is

[01:31:47] a big deal uh but I really want to

[01:31:50] clarify why my name's in in front of

[01:31:52] those tests what was my perspective what

[01:31:54] was the history behind it where did they

[01:31:57] come from um how does it how do they

[01:32:00] resonate with me in my life and what

[01:32:01] I've done in my life so hopefully I've

[01:32:03] done that for you today and I'm looking

[01:32:06] forward to the next one coming up in

[01:32:07] January 26 okay Jen with any with that

[01:32:11] are there any questions that um before

[01:32:12] we take a couple questions um I want to

[01:32:15] clarify a slide that I'm wondering if

[01:32:17] there was a typo on just while we're on

[01:32:19] the webinar because it's easier to fix

[01:32:20] now if there was a typo but it was back

[01:32:23] on slide number 37 which I pulled up

[01:32:25] here for me if you want to just look at

[01:32:28] this um but it is it on page 37 show you

[01:32:32] if you want to read it in front of you

[01:32:35] is this if you just and I have it pulled

[01:32:37] up for them but that second paragraph it

[01:32:39] says when one stands on both legs and

[01:32:42] shifts the hips to the right with the

[01:32:44] right hip abductors and left hip a d

[01:32:47] doctors that's a misprint yeah it should

[01:32:49] be left hip that's a abductors and right

[01:32:54] hip adductors the center of mass will

[01:32:56] more than likely sh to that's that's a

[01:32:59] misprint I will re no doubt I will fix

[01:33:02] that and uh re-upload it online but that

[01:33:05] second paragraph should say when one

[01:33:06] stands on both legs and shifts the hips

[01:33:08] to the right yep with the right hip ad

[01:33:13] dog ductors I go through it so fast AB

[01:33:16] boy AB ductors the center of mass will

[01:33:20] more than likely also shift to the right

[01:33:22] thank you Jen all right just wanted to

[01:33:24] clarify that um let me go ahead and stop

[01:33:26] this share here now um there's been a

[01:33:28] couple questions not many but if anyone

[01:33:30] else had a

[01:33:31] questions um Joan

[01:33:35] asked is the lateral rectus of the eye

[01:33:38] on concominant anytime that a body

[01:33:41] abductor is on even if the eye doesn't

[01:33:43] move laterally boy Joan that's a that's

[01:33:46] a good question and I'm gonna talk more

[01:33:48] about it next year hard in this course

[01:33:51] to to talk about recti of eyes

[01:33:54] especially in a sideline State seated

[01:33:56] state in an upright state to answer your

[01:33:59] question upright state luses are

[01:34:02] abductors I mean they they do swing

[01:34:05] bodies to the side so whether or not so

[01:34:09] you're right they they are a form of

[01:34:11] abduction but it's depends on what your

[01:34:14] what your focus is on if you want to

[01:34:17] know the truth you don't want to use

[01:34:19] them as as a see Orbit on Globe you

[01:34:23] don't want a recti muscle to be in Orbit

[01:34:27] on Globe you want recti muscles to be

[01:34:29] Globes on orbits so when you're staring

[01:34:32] at something and you're literally

[01:34:34] staring at a Joan and you're moving your

[01:34:36] body because you're becoming a Orbit on

[01:34:39] a globe mover with your reti muscles

[01:34:43] That's not healthy it's called a you

[01:34:45] know eye AES um migraines head headaches

[01:34:50] so yeah it's not ideal does it occur

[01:34:52] sure it occurs but there's very little

[01:34:54] research will say you know that you got

[01:34:56] too much Orbit on Globe AC activity

[01:34:59] going on when you're attempting to shift

[01:35:01] a body uh and its mass over to one side

[01:35:05] you will recruit you'll recruit lots of

[01:35:08] muscles you just hit a major vestibular

[01:35:11] one no question however the the better

[01:35:15] question would be what is it doing to

[01:35:18] the neck what is your neck doing to

[01:35:21] assist to get from one side to the other

[01:35:23] that's where most the activi is going on

[01:35:26] but it's fair to say there's a degree of

[01:35:28] recti and it just depends on your it

[01:35:30] depends if you're you know if you got a

[01:35:32] dominant eye that you're using for that

[01:35:34] activity all the time it will become

[01:35:37] more of a orbit eye if it's a

[01:35:39] non-dominant eye it's a globe eye and so

[01:35:42] it's really hard it kind of depends on

[01:35:44] what kind of vision process you have how

[01:35:47] do you synthesize that process with how

[01:35:49] you move and patterns of dominance

[01:35:51] everywhere in the body when it comes to

[01:35:52] limitation of the movement itself but

[01:35:55] good good I like the way you

[01:35:57] think that is all we have that's

[01:36:01] question I just asked if anyone else had

[01:36:02] any questions I didn't get any responses

[01:36:04] so okay thank I hope you all enjoyed

[01:36:07] this um thank you again for joining us I

[01:36:09] hope you have a great weekend um and if

[01:36:12] you want to refer back to this webinar

[01:36:14] in the future it's on our website the

[01:36:16] handles are on the website and I will

[01:36:17] get that one typo corrected um but have

[01:36:19] a great uh rest of your Friday and

[01:36:22] weekend thank you again thank you

[01:36:29] everybody