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This is Brent and in this video we're
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taking our overhead squat assessment up
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a notch. Now in our previous videos we went through sign by
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sign. We discussed what each sign implicates as far as long and short
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muscles. Which muscles are overactive an underactive. What you've already
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started to notice is that you never get an overhead squat assessment where you
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look down at your template, and you have one box checked, that's a nice thought. I
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hope to meet that individual eventually where I get a very simple corrective
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exercise program. But most of the time we start to see several boxes checked off.
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If you've really been paying attention and you've really done a lot of overhead
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squat assessments, what you've probably started to recognize that is that
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there's a pattern to which boxes get checked off. Now these patterns develop
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into clusters, these clusters start to implicate compensation patterns. Now in
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this video we're going to go over the lower leg dysfunction compensation
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pattern. So we're going to see certain signs packaged together, and you're going
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to see this over and over and over again. So now we're taking our ability as
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assessors, to go from seeing one sign to seeing the entire compensation
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pattern package together. I'm going to have my friend Melissa come out, and
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she's going to demonstrate what this looks like, which I know you guys have
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seen a million times before. If I get her all set up, second toe pointing forward,
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arms up over her head, her feet are hip-width or in line with her ASIS, and I
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go okay, and she's going to exaggerate this for me. I go go ahead and squat, we watched
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her feet turn out, her feet are flat and her knees kissed, how many times have you
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guys seen that? You guys would have seen that a ton right, and then if you looked at
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her from the lateral view, go ahead and turn, face that way for me. She does the
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same thing right, knees kissed, feet turn out, feet flattened, but then you guys also
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notice she has excessive forward lean, a little anterior pelvic tilt. And then
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when we turned her around, she may or may not even have an asymmetrical weight
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shift. How many of you guys have seen all of this package together. Well
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mechanically we can describe this lower leg dysfunction.
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I was going to say there was a route to lower leg dysfunction, lower leg
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dysfunction starts with the inability to dorsiflex far enough. Alright remember
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dorsiflexion is just not foot up this way, but the ability to translate the
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knee forward. That ability to translate the knees forward, so go down into your
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squat a little bit, it also keeps her center of mass, right we can think like
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kind of in this core area, that's what keeps it over her base of support. So we
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can already explain the excessive forward lean, if she can't dorsiflex far
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enough, she has to, her butt ends up way out behind her, and she has to throw
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her upper body mass over, creating that excessive forward lean, just to keep her
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center of mass over her base of support. Let's get a little bit more technical
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though, some you guys have heard of this concept of relative flexibility. So if I
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have hypomobility a restriction at one joint, I start compensating with
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hypermobility at other joints, she can't dorsiflex enough. So just for her body to
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try to get some more motion, her feet flattened out, which is going to cause
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problems, and then she steals even a little mobility from her knees by doing
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this. Go ahead and go down in your squat, this little turnout thing all right. So
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she can't dorsiflex here, she's stealing from here and here. Well hypomobility hyper
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are sorry, hypermobility hypomobility, and then of course that leads to hip
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dysfunction, because tibial external rotations, femoral internal rotation
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which drives tightness in her tfl which is also a hip flexor; and that's going to
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cause an anterior pelvic tilt. So I know I just said a lot these signs aren't
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separate though, they're actually all mechanically linked as Melissa's body
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here tries to figure out how to work around this one restriction that started
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with an inability to dorsiflex. If you guys go back and look at all of your
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solutions tables, you'll even notice that the muscles involved in like let's say
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feet flattened, and feet turn out, both the lateral gastroc
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will flatten the feet and turn out the feet, and you guys saw that. Feet turn
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out knees bow in -lateral gastroc, biceps femoris, tfl. Knees bow in -lateral
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gastroc, biceps femoris tfl and gluteus minimus. You see all of this
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overlap, it's almost disingenuous for us to start the way we did, which is with
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individual signs. It's actually these entire patterns that the body tries to
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create. So going back to our overhead squat assessment now, you guys just took
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yourselves up a notch by realizing that it's not individual signs, but clusters
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of signs that we're looking for. The one thing we have to make sure we do now
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though, is make sure that it is the ankle that is driving this dysfunction and not
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the lumbo-pelvic hip complex. Some of you guys have already seen that squat with
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modifications for further assessment, so stay with me here for a second. Sure
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knees bow in can be driven by the fact that her feet turn out alright, so that's
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tibial external rotation which causes relative femoral internal rotation, and
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causes her knees to collapse as she goes down into a squat. But she can put her
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feet back here, if she just had like an anterior pelvic tilt which was driving
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over activity of her tfl, gluteus minimus and anterior adductors, that could also
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drive her knees in. Go ahead and squat for me, but that would be coming from the
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lumbo-pelvic hip complex. So before I start fixing here, I need to make sure
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that the dysfunction is being driven here in her lower leg, versus being
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driven by the lumbo-pelvic hip complex, and that's actually fairly easy to do.
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All I have to do is take my ankle out of the movement. If i take my ankle out of
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this and everything recklessly gets better, then i know that's where the
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dysfunction comes from, and that's what I'm going to correct. So I'll
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have her do her overhead squat and I'll do all of my signs alright, so let's go
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ahead and see the the overhead squat hands over your head,
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do your squat, we see feet turn out, we see knees bow in, that's our anterior
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view. Alright lateral view hands up over her head, she squats down, I see an
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excessive forward lean, an anterior pelvic tilt. Posterior view good and I
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see a little asymmetrical weight shift to the left, great now what I'm going to
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do is go okay where is this coming from. I'm going to have her get on high heels
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so I'm gonna put her in a whole bunch of plantar flexion, so now that dorsiflexion
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restriction is not an issue. I do get a lot of questions on how high this needs
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to be, you guys need to pick a platform whether it's a couple weight plates, foam
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a half foam roll, rolled up mats, the backs of someone's shoes, it does have to
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be high enough so that they don't show their ankle signs, basically feet
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flattened, and feet turn out. If they still feet turn out and feet flattened,
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your platform here for their high heels isn't high enough. For this I think she's
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going to be fine. So she's going to go ahead and throw her hands up over her
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head and squat, you noticed that all of this stuff gets cleaned up. So we know
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that her knee and her ankle signs of course were actually coming from lower
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leg dysfunction. If I turn her sideways
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she squats, notice how that excessive forward lean disappears, I know that was
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coming from here. We do see something interesting with Melissa she still has
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an anterior pelvic tilt all right, so that anterior pelvic tilt is probably
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coming from a lumbo-pelvic hip complex dysfunction. I can even double
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check if I have a put her hands on her hips, all right and go ahead and stand up.
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Do one more for me, you still see that anterior pelvic tilt. So most of our
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signs are coming from lower leg dysfunction, that's probably what I would
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aim for first. But chances are i'm going to have to come back and look at the
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lumbo-pelvic hip complex specifically, and write a program to fix this. If I go
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posterior view, we said in the posterior view before we saw an asymmetrical
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weight shift, she was faking it, but let's pretend that she thought we saw an
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asymmetrical weight shift, and then we put her in high heels and shift went away.
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A lot of you guys have been asking me for an asymmetrical weight
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shift video, and I'm going to do just one specifically dedicated be asymmetrical
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weight shift. But I do find a lot of people have an asymmetrical weight shift,
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not because of something that's going on here, but because they actually had one
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calf or one ankle, or one sided lower leg dysfunction, that when they squatted down
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was forcing them over. You're not going to correct this then, even though it's an
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asymmetrical weight shift I wouldn't go after this. I would go after the tighter
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side of their lower leg dysfunction. Thank You Melissa. So big step guys, you
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just took a huge huge huge step. We just went from looking at signs of
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dysfunction to what the body actually really tries to do, which is create a
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compensation pattern. Now before you freak out and go oh my goodness that is
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a lot of stuff I have to correct, it's actually not that bad, and you start
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looking at how overlapping the muscles and those signs were, how mechanically
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linked those joint signs were.
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You start realizing it's not a very long list at all. Despite all of the stuff we
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just saw, it only comes down to lateral gastroc, soleus, fibularis, biceps femoris,
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TFL VL, ITB complex and gluteus minimus. That's six release techniques. If you go
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back and look at some of the stretching videos, the lateral gastroc, soleus and
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fibularis muscles get stretched together in that modified slant board
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stretch I've shown. So we're already condensing down pretty quick. This gets
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its own stretch. The gluteus minimus, tfl gets stretched together. Tibialis
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posterior, medial gastroc get activated together. So that still only leaves us, let's see here, five
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activation techniques, and then we have our integration techniques. Even when we
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get really really complicated it doesn't amount to more than 20 techniques let's
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say, 25 techniques. Or even if you're really really sophisticated you can do all
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this different manual stuff 30 techniques. Try to keep in mind this
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isn't like resistance training, I'm not having them do multiple sets of this
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stuff over and over again. I'm going through each muscle doing what I need to
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do one set a piece, people do not get rest between sets. I guarantee at the
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minimum let's say this takes 16 or 17 techniques to correct, everything from
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ankle all the way up to here, I can get somebody to do that in 20 minutes. It
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might take two or three sessions before they can get through it in 20 minutes,
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but eventually that's one minute per technique, and they're just rocking
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through it; and you're fixing the entire compensation pattern which makes sure you
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leave a lot less behind, so that your outcomes are a lot better, your carryover
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from session to session is a lot better, and this is what gets really cool. So I
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want you guys to look up this article on brentbrookbush.com that I wrote, it's
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under postural dysfunction and movement impairment, called lower leg dysfunction.
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You'll be able to see where I start combining these signs, and it starts
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implicating all of this other cool stuff. Like we can start looking at subsystem
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activation. In this dysfunctional pattern we see that the deep longitudinal
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subsystem and anterior oblique subsystem become
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overactive, but the posterior oblique subsystem and lateral subsystem become
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under active. You can't really even look at that stuff though until you see the
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entire package. Everybody's talking about fascia, everybody's talking about it. But
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we know fascia isn't a single joint, a single sign thing, it spans several
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joints, it connects lots of muscles. Well once we're looking at several joints we
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do start to see a little bit of that fascial connection. We see the TFL VL ITB
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complex come in. Alright we see the tibial internal rotators which have this
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this tendinous fascial connection at the medial knee come in, lots of stuff going
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on here. If you guys look back at the deep longitudinal subsystem you'll see
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that that's actually a huge fascial system, including the sacrotuberous
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ligament, and the deep layers of the thoracolumbar fascia. So we're taking a
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big step guys. I know we're taking a huge step going from signs to patterns, to
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integrated functional anatomy, and some really sophisticated exercise techniques
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and routine design, but that gives us a whole lot more to work with. I think you
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guys are going to have a whole lot of fun with it. It's basically unending what
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you could possibly do with all of this information. I hope you guys have fun. I
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look forward to hearing about your outcomes.