The Complexity of Physical Therapy

Today’s podcast features Bill Hartman.  Bill is a physical therapist, and in-demand educator in his approach to restoring a pain-free lifestyle, and understanding the governing principles of movement.  He has been a mentor to, or has inspired the knowledge of many previous guests on this podcast, particularly in regards to movement biomechanics, infra-sternal archetypes, and the compression-expansion model.  Bill owns IFAST Physical Therapy in Indianapolis, Indiana and Co-owns Indianapolis Fitness and Sports Training with Mike Robertson, where he works with clients ranging from very young athletes to professionals. It is very interesting to look at how we approach the nature of “muscle weakness” and compensations in training.  For example, it is common to look at all compensatory action in the body as a “bad thing”, rather than looking at how the body actually uses compensatory action to produce force, or adapt to a particular sport skill, in addition to when that compensation might actually be a problem.  The human performance field has also looked at muscle weakness in isolation, rather than digging deeper into the underlying structural alignment of the body contributes heavily to what we are seeing out of muscle strength and function. In today’s podcast, Bill goes into the adaptive nature of the body and what it really means when we are seeing compensatory actions in movement.  Within this, Bill also gets into the nature of reciprocal, or more “locking” movement of joints, depending on the task an individual needs to accomplish.  Bill spends a lot of time talking about strength training, how it can be a positive, but also the dynamics of the interference effect that can lead to undesirable adaptations for athletes over time.  Bill also covers external rotation and pigeon-toed athletes, and the nature of power training for wide and narrow ISA archetypes, and much more. Today’s episode is brought to you by Lost Empire Herbs, Exogen wearable resistance gear, and the Just Fly Sports Online Courses. For 15% off your Lost Empire Herbs order, head to lostempireherbs.com/justfly. To try Pine Pollen for free (just pay for shipping), head to: justflypinepollen.com. To learn more about the Sprint Acceleration Essentials or Elastic Essentials courses, head to justflysports.thinkific.com View more podcast episodes at the podcast homepage. Timestamps and Main Points 5:00 – Bill’s journey from working purely in the traditional therapy and training model, into one that embraces more of the complexity of nature, and universal principles of movement 15:28 – The adaptive process of the body, and how this leads into different alignments and representations 18:14 – The compensatory strategies of the body as an adaptive process 29:02 – Examples of when strength gains may end up creating an interference effect on the body 33:32 – How children are so flexible, and the role of shape change in human motion 36:50 – The role of mobility and “stiffness” in terms of speed and running efficiency 43:37 – General thoughts on stiffness and compliance for a typical field sport athlete 49:10 – Connective tissue and stiffness adaptations to heavy strength training, and the point where heavy strength can be a negative for explosive sport activities 1:04:45 – Relative motion and force production biomechanics in squatting, and knee mechanics as it relates to joint pain and injury risk 1:12:42 – The externally rotated, “bowlegged” representation of the legs, on the level of athleticism 1:23:16 – Power training with the needs of a Wide ISA type in mind Bill Hartman Quotes “When you start to look at the human as a complex adaptive organism, your perspective starts to change” “If you are made of water (fluid dynamics) is going to be one of the foundational principles” “The goal is not to negate everything that came before… but the level of reasoning is what the biggest change has been” “The interaction (between the parts of systems) is the most fascinating” “If the muscle was truly the problem, then this exercise should have solved the problem, but it didn’t, because it was a relationship (between parts) problem” “In a circumstance, we join joints together and they move as one; that is a compensatory strategy, because it is trying to solve a problem that relative motion cannot solve, and where this really shows up is force production.  Relative motion has a dampening effect on force production; I cannot produce maximal force in a situation where full relative motion is available” “In athletics, where forces are exceptionally high, if you are not compensating, you aren’t performing well.  We can’t classify compensation as good or bad, we have to say that this is part of the solution to a problem” “If I use too much compensation, then I can’t dampen forces” “Compensations are absolutely normal, you use them every day, but the question is, “is this helping me, or is it creating interference”?” “Try to get up out of a chair with full relative motions… it doesn’t happen.  You have to “lock things together” (to produce force and get up out of the chair)” “Raise somebody’s trap bar deadlift by 100lbs and that could be reasonable and useful, raise someone else’s by 100lbs and you just created interference with something they needed from a health or performance perspective” “Children have more movement options in terms of changing their physical shape, they are much more fluid than we are” “If you pull the long skinny jump stretch band, or the fat band back, which one has more energy?” “That’s what those (bilateral symmetrical heavy oriented strength training) are for, to take away the ability to turn, to produce force at high levels” “By tradition, narrow ISA’s have a narrow window in which to apply the down force in; if I increase their force production and they start to expand their force production in a way that is outside of that window, what happens is they have to squeeze themselves tighter and tighter from the top down, so the pressure gradient goes from the top downwards, instead of bottom up; so I am sticking you to the ground, when it’s time for you to produce force within a narrow time window” “By bias, the narrow ISA is going to biased more towards an externally rotated representation which means they have a shorter duration of short application; so their impulse time by physical structure is going to be shorter than the widest wide ISA” “When I go into a single leg stance, the bias is going to go into a more externally rotated situation” “The bias in the descent of a pistol squat reduces the VMO contribution in a lot of people, because I have to bend against the external rotation mechanics; external rotation mechanics are actually a straightened knee” “(By holding a weight in front of the body) you are giving people a chance to get more internal rotation (in squatting)” “High force production without enough internal rotation tends to be detrimental” “Internal rotation is down-force” “I would not put someone into a single leg stance activity until they have (the ability to internally rotate)” “They used to train people to run pigeon-toed because they found people that have this slight ER bias are faster kids, and then they tried to train that into people which is the mistake” “The limbs are formed (as an embryo) in external rotation, and we turn them in as human beings” “All compensatory strategies will lead you towards external rotation; we are going home” “How do I get a similar representation in a wide ISA; if I need connective tissue behaviors to enhance a wide ISA’s behavior I need him to de-load onto the box (in a box squat) so he does get the yielding action in the connective tissues, and give them time to spring back” “There’s a very easy way (to feel what a Wide ISA feels): All you have got to do is load the bar with chains and you will understand how a Wide ISA applies force into the ground…. the chains sustain the duration of force application; a band is more of the elasticity, gut behavior we talk about, but the chain sustains the duration of force production; (chains are a) a great way to slow down a narrow” “I think (the different types of band and chain tension) are very specific in how they should be applied” “The things that can be improved are potentials that have not been developed, not true weaknesses” “What’s the best way I can give (a Wide ISA) adequate time to deform (using box squat/yielding type work), so I can actually train that element, then I can come back to the short impulse stuff… I have an improvement in the connective tissue behavior, now I am going to utilize it” About Bill Hartman Bill Hartman is known for finding solutions for people in pain that have failed with other forms of treatment.  He is an in-demand educator in his approach to restoring a pain-free lifestyle, and understanding the governing principles of movement as applied to human performance. He regularly mentors physical therapy students and interns many of whom have gone on to land positions in professional sport or become successful business owners themselves. Bill owns IFAST Physical Therapy in Indianapolis, Indiana and Co-owns Indianapolis Fitness and Sports Training with Mike Robertson, where he works with clients ranging from very young athletes to professionals. He is the author of the book, All Gain – No Pain: The over-40 Comeback Guide to Rebuilding a Fit and Pain-free Body After Pain, Injury, or Physical Therapy.