REPLAY: The Missing Link- Live Training #1

In this special episode of Unreal Results Podcast, I share the replay of Live Training #1 from The Missing Link (Fall 2025). You’ll learn how one change to your assessment—adding a simple breath hold—reveals whether the viscera, CNS, or peripheral neurovascular system is driving a patient’s presentation, so you can stop chasing symptoms and start getting faster, stickier results.

What’s inside:

• Why most clinics plateau at 60–80% success—and how to break that ceiling without overhauling your entire approach.
• LTAP™ overview: 5 orthopedic-based assessments guided by osteopathic principles to pinpoint the true driver (viscera/CNS/peripheral NV vs. MSK).
• SI joint as the “traffic cop”: A reliable gateway into whole-organism status (and why this isn’t just a “low back thing”).
• Standing March Test walkthrough: Setup, light-touch palpation, what “normal” looks like, and the exact breath-hold cue that changes the result.
• Interpretation that actually guides treatment: When the breath hold changes the test vs. when it doesn’t—and what to do next.
• Adapting the test for scoliosis, spinal fusion, neuro conditions, and how to handle high-pain states.

Join the mini-course this week: https://movementrev.mykajabi.com/the-missing-link-fall-2025

Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com

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Transcript

Live Training # 1 TML Fall 2025

[00:00:00]

Hello, hello, and welcome back to another episode of the Unreal Results Podcast. This is a special episode for you. This is actually a replay of the first live training of the fall 2025, the missing link, the mini course, where I teach you how one change to your assessment can get you better results for your physical therapy and your athletic training.

Clients now. Um, I love to put the replay up on the podcast, um, both regular podcast and on my YouTube channel, just so it is easier to consume the content because the course is free for a week. So I want it to be doable for you. I wanna be able to get you all the information that you need. To be successful.

And part of that is consuming the live calls and learning and like being challenged in your beliefs and then go and practicing with your patients. So I know [00:01:00] that the 90 minutes of the live call can be a challenge for people. So getting it as a replay in a place like YouTube or a place like the podcast means that you can also speed it up if you need to slow it down, pause it, come back to it, replay as many times as you want, so.

This is all for you to make it easier to consume so you can get the results. Because it's not enough that you just sign up for the course. You actually have to do the work. And part of doing the work is the learning and then I cannot emphasize enough to do it practically. In your place of work with your friends and family, I want you to practice this test 'cause I want you to see it for yourself in action.

How a simple breath hold changes your. Mobility when there is influence from the viscera or the nervous system. So if you're enrolled in the course, make sure you log into the portal. You can download the presentation handouts, take notes. There's, um, [00:02:00] other handouts for you to help organize your practical application, uh, short video tutorials of the test itself and then treatment strategies.

So, um, definitely make sure you check it out. Come join us in the Facebook group. Connect, ask questions, share videos of the test, you doing it on your clients, and let me know how I can support you. So without further ado, enjoy the replay of live training. Number one, I.

If you wanna say hello and maybe, uh, where you're coming from and what kind of professional you are in the chat, that's always nice for me to see and everybody else to see.

We will take these calls will be about 90 minutes. Um, I will stay as long as I need to to answer any questions, but I will try to have the teaching all wrapped up and done by 90 minutes and I'll take all of the 90 minutes. I never am at a loss for what to say or things to share, [00:03:00] so, all right, so massage, therapists, osteopaths, PTs, yoga.

Love it. So many from all over. This is awesome. Uh, this is my eighth time teaching, uh, this online course. Um, this is way more than eighth time teaching in general, obviously. Um, but yeah, this is the eighth time I've taught this free course. I absolutely love it. It is so much fun bringing so many people together and exposing you all to a new paradigm, a new way of thinking about the human body.

And, uh, yeah, just sharing what I do. So I love it. Love to see some more Canadians here. I still have spots in the, uh, Toronto course coming up, so hopefully I'll see some of you there. All right, well, [00:04:00] yes. Keep saying hello in the chat, and then I'm gonna go ahead and share my screen and get started because like I said, we got a lot.

So basically I have it so that you're all mute, unmuted. Um, sorry you're all muted to keep the flow of the, uh, session going well, and then, um, once it's time for questions, I'll allow people to under unmute yourself too. If you wanna say your question instead of, um, type it. But in the meantime, as we're going, if you have questions, you can drop 'em in the chat and I'll try to keep an eye on it.

Sometimes it can be a little bit, uh,

sometimes it can be a little bit tough. Just one second. Zoom's giving me a funny message.[00:05:00]

Saying, I didn't have enough of a participants in the meeting, which is weird. Okay, we're good. We should be good. Always gotta account for tech stuff, but I'll share my screen now and we'll get going.

All right. Pull my chat back up.

All right. Somebody say they're not getting let in [00:06:00] the waiting room, but there should be room, so Okay.

So welcome. Thank you for being here. A lot of people enrolled. Um, I'm hoping that you'll all get to experience the whole course. We'll talk about the layer of the course a little bit more, but I want to just dive in. Obviously, hopefully you know who I am. My name is Anna Hartman. I'm an athletic trainer. I have over 20, uh, plus years of experience and I've worked with professional athletes my entire career, uh, from a clinical standpoint.

So I practiced most similarly to a physical therapist, and for the last 12 years, 13 years, I've been combining osteopathic. Uh, manual therapy and assessment and with traditional, uh, performance, physical therapy and athletic training. So, super excited to lead you through this course, and I can't wait for [00:07:00] you to experience the mind blowing paradigm shifts that we're gonna be going through.

So one of my favorite quotes is from this doctor, Dr. Rad. He is actually a psychologist. Uh, it was from the book. The, uh, body Keeps the score. He said, we have only one real textbook. Our patients we should trust only. What we can learn from them and our own experience, and this is really what we're going on a journey in over this week, is to understand that the smartest person in the room is going to be the body in front of us and then our body from our ability to pay attention to what somebody else's body is telling us.

So it's a. Journey into letting go of our ego, driving our practice and realizing that the body in front of us knows way more than we will ever know. So this schedule for the week, it is a, um, obviously the course is free. That's why you're here. That's, you know how I advertised it. It is [00:08:00] free the whole week.

The reason why I put a time limit on it is because if you've ever showed or signed up for free stuff before, it probably still is living in your inbox or on your, um, web browsers, never having actually done the work. And we don't get the results unless we do the work. And so putting a timeline on restricting our free access just helps me help you to get through the process of getting the actual res results from the course.

And so the course, we have two live calls today. Let's live call and Thursday's live call. And then today, Monday, Tuesday, Wednesday, Thursday, there are modules that open every day with a short tutorial that you'll be learning as well. So it's a cumulative, including the live calls for the whole week, about five hours of content, but very doable to get through the whole week.

And really the emphasis is going to be practical application. [00:09:00] So hopefully it doesn't, uh, give you too much work. But then we have the weekend, next weekend to catch up. The free access does not end until the end of day on the 28th, which is a week from today. So you have the content and practical things to dive into at work, and then the weekend to make up ask questions, get more coaching, and, um, help and insights, especially inside our Facebook group or in the comments of the course.

And then we, um. You know, hopefully you'll get through everything and see the results in real time in your work. So just as a reminder, also, this is also to get you to go through the course to encourage you to go through the course since it's a free course and we don't have any skin in the game. I wanna give you some skin in the game by offering prizes and bonuses.

So we have. Raffle prizes at the end for participation. And then we have show up bonuses. So the show up bonuses are when you [00:10:00] show up to this live call, you get the visceral focused regen session and clinical reasoning. It's a new regen bundle I put together, um, with clinical reasoning. I don't sell this outside of this course, so it is truly like a special bonus with only you will be able to get it.

It's valued at $127. So at the end of this call, I'll put up a pool, a poll, POLL, and you can check in and that's how I know that you are here and you will be eligible for the bonus. The second live call is a central nervous system focused re session and clinical reasoning. So a couple new regen sessions, and then all the clinical reasoning for that too.

So same thing on that call, put up a poll towards the end of it, and you'll check in, and then that's how you get the bonus. The prize is for participation. There's one grand prize. At the end of the course, um, you'll get free tuition to complete to the complete bundle and [00:11:00] your, um, complete bundle of the locator Test assessment protocol, which is the online course and in person course.

So really high value grand prize to be eligible for that. You show up for the live calls and check in, join the private Facebook group, share a case at the end of the week and complete the course in the Kajabi platform. And then there's five prizes available for people who complete the course. And those course that those prizes are a course bundle of the Never treat, the Shoulder first online course and the nerve workshop.

So two of my favorite self-paced courses. To be eligible to win those, you need to join the private Facebook group, share a case at the end of the week, and then finish the course on the course platform, but don't have to show up to the calls live. And then. There's also a prize for joining the Facebook group and that that is a, um, 50 minute lecture and short tutorials exploring the concepts of biomechanical rest, which is the concept from Philip [00:12:00] Beach.

And I call that Creating Resiliency through Rest. It's one of my favorite modules I teach actually, inside the mentorship program. And, um, I just really wanted to reward people who joined the Facebook group because I have found after teaching this for eight rounds, that the people who get the best results are the people who take the action and are constantly checking into the Facebook group, asking questions, sharing their wins, sharing their insights from work.

So I really wanna encourage that. So that brings me to like, who are you? Who are you here? So when I look at all the, you know, the way I get people into my courses really is that the, um. Through social media. So chances are that you know about this 'cause you're already on my list or you follow me on social media or you got an ad on social media.

And so looking at the ads, looking at the posts that brought people in [00:13:00] gives me some insight on who you are and just confirms who everyone that has gone through this education has been. So, I have taught thousands of people this course and I have taught, um, over 500 people the locator test assessment protocol.

Course. And so it's like I have a good idea of what clinicians, what their problems are and like what unwanted experiences they're having and the solutions that I'm hoping to help people with. So looking at what resonated with people this round, right? This bringing you into the course today, were these posts talking about how a breath hold can change our SI joint mobility tests.

What that reveals and really it, the captions spoke about how when we do this breath hold, we're getting improved information from our interceptive receptors that our considering the viscera and the nervous system. And so perhaps this messaging spoke to you because one, you're curious, you love learning, you've [00:14:00] noticed some income inconsistencies with the SI joint test itself and you.

Whether you knew about considering the viscera in the nervous system before or after you read the post, you're like, oh, that makes sense of why it should be included. And this is this journey or this transformation between understanding that in our industry, we tend to look at the whole body, but we live in this paradigm that is very biomechanical.

That doesn't include the viscera and the nervous system. And when we open it up to include that, we have a whole new paradigm that I refer to as a whole organism approach. Another one that seemed to resonate with people was just flat out talking about the results. Unfortunately, most of us here probably realize that the standard in the physical therapy practice and the athletic training practice in these practices is a good result is considered 60 to 80%.[00:15:00]

Success rates, and that in my mind is very mediocre. That means you're helping six outta 10 people, seven outta 10 people, eight outta 10 people. So what about those two to four out of 10 people that you can't help? Those are the people that keep us up at night that like leave us like banging our head against the wall, wondering what we're missing, wondering why it doesn't work for everybody, right?

The thing that worked great for other six to eight clients, like why isn't it working for them when they have virtually the same complaint, right? They all have knee pain or they all have back pain, or they all have foot pain, whatever it may be. Sometimes it's like a simple thing that you're like, I don't understand why your patella tendinitis is not acting like everybody else's patella tendinitis.

And so the other thing with the results and why it matters and how we don't want to settle for this mediocrity in the industry is when you also look at the average. Um, of how many results it takes somebody to get better in the current system and the current paradigm, [00:16:00] it's anywhere between two weeks and eight months.

And that is just crazy because then you look at the financial burden and the time burden on the patients and the clinician, and it's just like, wow. No wonder our systems feel set for failure. But really what I wanna share with you in all this is changing the organ, changing to a whole organism paradigm.

And considering the viscera in the nervous system helps to get our result success rates higher and our treatment duration timeline shorter. So. This really resonated with people and I love to hear that because that we'll talk about in a second, like, this was me before I started adding visceral and neural skills to my skillset and assessing the body in this way that considered those too.

I was that person who I got actually really good results. I was probably more closer to that 80 to 90% success rates, but I would had to see somebody every day for two weeks and not just, and [00:17:00] like I was working with professional athletes, which is actually like not a flex, it's a, like that should make it even easier.

They change fast. They're active participants in their care and I was still feeling like if they had a tight hip flexor, I had to like release their hip flexor over and over and over again. So we've all been there and what I think is great is we, what resonates with you, which is why you're here, is you're like.

This could be possible. Like what if this is possible? And I know that there's something that we're missing, and so I don't wanna settle for the mediocrity that the rest of the industry is settling for. Uh, these post two also resonate with people. And when I look at them, and it's basically talking about how I stopped using a mulligan hip strap to mobilize the hip to improve hip flexion and hip internal rotation years ago.

And that's when I started like implementing this whole organism assessment, looking at the viscera in the nervous system because I saw as I got rid of people's protection [00:18:00] patterns and started seeing the body and the whole organism, their hip. Flexion and internal rotation just came easily and it stuck.

I didn't have to release their hip flexor over and over and over again. And so what it tells me that why this post resonated with you again. Is that curious of that? Huh? I've, I've used that technique and I have to do it over and over again for it to stick. And it's like, why isn't it not sticking? And when we start talking about influence from the viscera and the nervous system and this idea of maybe there's anatomy that we just don't know very well, that could help us understand the why behind why things can change so fast and how we can leverage that to get people out of pain and improve their dis movement dysfunctions is huge.

So this post brings in a lot of curious learners. And then these posts too are the classic, like you already know. You already know a little bit about the viscera, a little bit about the nervous system. Maybe you've taken some Baral Institute classes, maybe [00:19:00] you've taken some up ledger classes. Maybe you've taken, like Dr.

Perry, stopped chasing pain, visceral mojo, or eldoa with Dr. Uh Voer. Like maybe you've been exposed to the outer edges or the more like holistic types of treatments, but you're not quite sure how to blend them all together. All these treatment tools you have, how do we blend 'em all together? And then also, how do we make it fit back in with ortho orthopedic biomechanics?

Because it's great to be able to do some very specialized manual therapy on the viscera of the nervous system. But at the end of the day, if you work in an orthopedic clinic or you work with athletes in the athletic training room. We always have to relate it back to their movement and back to their musculoskeletal pains and aches and injuries.

And so it's taking all of the stuff that you learn and giving you a framework to put it all together. [00:20:00] So the common themes that I learned from knowing that all of those posts have resonated with you over the last three weeks is that you love to learn. You likely have a lot of tools already. Treatment tools specifically, everybody loves treatment tools.

If I were to sell a treatment course, it would go crazy. Selling an assessment is hard. Assessment is not the sexy thing. The treatment's the sexy thing. Everybody wants new treatment tools, right? Everybody thinks that it's a treatment tool that they're missing. So I know you have a lot of tools. I also know you get good results for your clients.

At the end of the day, people who love to learn and come to courses like this, you're the people that are already doing pretty good. You're on that probably 80% success rate, not the 60% success rate, right? So I know you get good results for your clients. I know you're driven to be the best you can be and do the best for your clients.

That is very indicative 'cause you're giving your Sunday [00:21:00] afternoon up to learn with me. Maybe somebody you've never even met before. I know you're curious. You're curious because I'm speaking. About things that a lot of people in the industries don't speak about. And I'm calling people out on the mediocrity in the, in the industry.

And I'm speaking to this curiosity in the back of your head of like, what's missing, right? So you love to help people. You feel like there's more, you feel like something is missing. And deep down, you know that better outcomes for your clients are possible. That even if you can help eight outta 10 people, it's the two outta 10 people at night.

Or you know, at the end of the day that are like driving you crazy and leave you frustrated and then leave you feeling like, gosh, like questioning how good you are. I get it. I, I've been there. I totally understand it. So continue to reviewing this, you have all the tools in education, you can easily become overwhelmed with complex cases.

Perhaps this is a big one that I, people end up coming [00:22:00] in, they're like, I have this patient that's like post-stroke, EDS, like. I don't know, pots like all of these different comorbidities and it's like, where do I start? It's hard to not get distracted by the patient's story. You get good results, but you're hesitant to guarantee them.

This is a thing that comes up. A lot of times when I talk to colleagues about like, why are there hesitant on starting a cash pay practice? They're really worried about charging that much money when they can't guarantee results. And I'm like, why can't you guarantee can't guarantee results? 'cause they're like, oh, well there's that two outta 10 people that it can't seem to help and it drives me bonkers.

And that's the limiter, right? So it's like, yeah, you actually can be able to guarantee results and we'll end up talking about that a lot this week. Maybe you work in a higher volume clinic or an athletic or training room and you have a lot of clients to manage and you're short on. Short on time. And maybe feel like you're not set up for success.

The reason I love this [00:23:00] assessment that you're gonna learn this week and then the full assessment and the ltap, it takes less than five minutes. It doesn't take the whole session With our clients, we can get the information we need. We can dial in exactly where to start to make the biggest change in their, uh, pain, mobility, strengths, movement patterns, and like get to the bottom of things, the deeper driver of things, and get them results in those one to three sessions.

So it works perfect for those high volume settings. Maybe you're further along in your career, you already get their good results, but you feel a little stagnant. You're like, I'm bored. I want more, and I wanna be more inspired by every patient that walks into the door. And you're starting to explore a little bit more about the viscera and the nervous system, or like I said before, you've already started exploring and you're just not how sure how to like connect it back into the orthopedic biomechanics.

So all these things lead us to feeling like we [00:24:00] need to treat patients multiple times per week or multiple weeks at a time per month to get results. We also may feel like treatment techniques might work in a session, but they're not sticking from session to session. This is the hip flexor release, uh, example I give all the time.

It's like, yeah, I was gr my athletes felt great as long as I could release their hip flexor every single day and I couldn't release their hip flexor every single day. They started to like not feel great again, right? And then we've got those few outliers, those two to three people outta 10 that we are frustrated about and steal our confidence because why don't they respond the way other people respond?

And then you wanna know, or you wanna consider the whole organism, not just the musculoskeletal system and the biomechanics, but you're not sure where to start. So maybe drop. Uh, in the chat if you resonate with any of these, right? Like feeling like you're missing something, problem a, b, don't know how to connect [00:25:00] osteopathic techniques to orthopedics.

Don't trust your general listening or feeling skills. Have a bunch of tools, not sure how to assimilate them. This is a lot of us, especially if later in career, your career, you've taken a lot of con ed. My favorite question I get from people on the internet sometimes is like, what, where is, where are you pulling from?

What continuing education have you taken? And I'm like, um, sir, that is like 12 pages of my cv. I hate to break it to you. So, yeah, struggling to put it all together. And then d overwhelm with complex cases. Don't know where to start or just feel like you're constantly chasing their pain or that you wanna consider the whole organism.

Yeah. Yeah, I love this lot of d. Lot of, yeah, lot of DEC, everybody. These are the things, right? So when we feel like this, when these are our problems, these are what we, we try to fix 'em, right? We're fixers. We try to fix problems. So when we're feeling like we're having these problems with our patients, we're trying to fix 'em [00:26:00] too.

And what we do, we do, we learn more and more techniques for treatment. We go to more and more continuing education courses, and the majority of the continuing education courses out there are treatment courses. Yes, maybe they include a little assessment, but the emphasis of the course is always the treatment, not the assessment or the algorithm for the treatment, not the assessment.

And then also, they're in the same. Same paradigm they've always been in, which is the musculoskeletal biomechanic pain mark. So it's not that the techniques are not great, it's just they're not in the right framework. We also try chasing biomechanics and movement dysfunctions. Right? Which doesn't matter.

Absolutely. Of course movement matters, but the body sometimes changes. Its output, its movement for survival. And some, sometimes these movement compensations have deeper driver, a deeper driver than like a tight hip flexor or you know, a glute that won't turn on. The body is so deeply int inte, so [00:27:00] intelligent and it's patterns, and it's out like the way it organizes itself is deeply embedded in this drive to survive and protecting the things that create a good survival for us, the visceral organs.

And so oftentimes the reason why somebody is not moving into hip extension is because they're protecting their colon or they're protecting their femoral nerve, and they don't want to go through such a big range of motion. So neurologically they change the output. The body will always win. You can force things all you want, but then as soon as it can, it will re reboot itself back to that protection pattern if it feels that it is threatened.

Another mistake we often made make, and this is sometimes a big cop out in the industry, is thinking time. The patient or pain is the problem. I hear from people a lot. Well, healing takes time. Or patients can be noncompliant. My person doesn't do the home exercise program. My person is [00:28:00] overweight. They don't exercise, they don't take care of some, all these things.

Or they'll say pain is centralized, pain is complex, pain is an output, it's biocycle social, and there's more to it than just fixing someone's quad tightness. And it's like, I agree with all of those things, but we hold onto them as excuses or cop outs when we just are not realizing the bigger thing we're missing.

And this I talk about a lot and I share the story of my mom and her lung cancer because this was, this is what was happening. The therapist that she was working with, who she had shoulder pain forever on and off, shoulder pain, that was always diagnosed as rotator cuff tendonitis or arthritis or, um. Poor posture, all the things, never with any like true diagnostic tests to prove any of it too.

I per se, she would fail physical therapy, meaning she would never get better. [00:29:00] And when she went in and would tell the physical therapist that she wasn't getting better, they would be like, well, you're not doing your home exercise program. But she was, I would see her doing it on a regular basis, but they would come in and because she wasn't better, they would just assume that she was the problem.

And they assumed she was the problem because she was overweight and they just assumed that since she was overweight, she didn't take care of herself, so she must not be doing the exercises. And so that you get in this. Like cycle of, it's called actually in psychology world, it's called the fundamental attribution error, that we are more likely to blame somebody else, blame something else outside of us than take responsibility and ownership and be like, well, maybe I am the problem, right?

As a clinician, like maybe I am the problem. What am I missing? And the reason we don't sometimes do that is because we put on this false confidence, this false ego, because we're told by the industry, we're told by society that we are the experts on someone else's body and we are the experts on what creates shoulder pain.

But at [00:30:00] the end of the day, the biggest red flag was the fact that she had shoulder pain. You treated it the right way from a physical therapy standpoint, and it wasn't getting better. So instead of blaming the patient, we should have taken a step back and been like, what am I missing? And that should have been the, the red flag in the head, in their head of like, I should ask about other red flags.

I should consider other things. The viscera, the nervous system, right? Have you lost weight? Have you had a cough? Have you, you know, have you been abnormally tired? So many questions we can ask to find drivers that are not musculoskeletal, that present Skeletally. So very, this is like, I'm really big. I'm like, this cannot be your cop out.

Yes, healing takes time, but not as much time as you think. So I could talk all day about that. I will continue on, uh, chasing symptoms and pain session after session, even though we shouldn't, we all know we shouldn't be chasing [00:31:00] pain, but we also all are people pleasers and we care so much about our patients and we just want them to feel better.

And so sometimes, especially when we feel like they're starting to be those two to three outta 10 people that we can't help, we just want to make them feel better, at least with their hour with us or their 20 minutes with us. And so we're like, well, we'll go ahead and just touch the spot that hurts because it makes you feel better in the moment.

And I'm a caregiver and I care about you, and I want you to leave here feeling better and feeling heard. And so you start end up getting in this pattern chasing pain over and over again. Yeah. So these are the things that you may have tried when you're trying to fix all of those mistakes. Right. Taking more courses, more manual therapy, less manual therapy, more exercise, less exercise, try a different system or a model.

You start at the feet instead of starting at the core, start breathing instead of starting at the hips, then you just go back to core control. Then you're [00:32:00] like, oh, let's do opposing joint. Your right ankle hurts. Let's do some right stuff at your right wrist. Do some neurology things. Sometimes at work, sometimes it still doesn't.

You're starting to grasp for other things, right? You look at a stable mobile alternating pattern model. You look at a developmental kinesiology stuff. You look at it from a FA fitness standpoint. From a movement variability standpoint, right? What it feels like, hopefully what it sounds like is like you're kind of grasping.

You're spiraling a little bit and trying a bunch of different other things. 'cause you know what you're doing is not working. And also, like I say this with the most kindness, because this was me at one time too. Like we've all been there. So I've been alluding to it. But when these things, when, when our solutions that we try, when we apply them to fix the problems we're having, fix the unwanted experience we're having, when it doesn't work, what happens is we feel unable to confidently guarantee results due to those select few [00:33:00] patients.

Um, and so we get frustrated. We feel like we're missing something, but we're like trying all the things. So we're like, what the heck are we missing? So we're even more frustrated. Feel uninspired, right? Like, I think being uninspired and doing the same thing over and over again, expecting different results is like the foundation of why a lot of us feel burnt out.

Um, we end up blaming the patient, the fundamental attribution error, which also feels really icky and out of alignment. And sometimes when you do it, you probably even are like, Ugh, I hate putting the blame back on the patient. But also that's just our default mechanism. And then ultimately too, you start questioning your knowledge and your worth as the expert and it loops you back into learning more and trying new things.

And then you get stuck in this endless loop feeling frustrated, uninspired, overwhelmed, and exhausted.

So now what? If this is you? It's [00:34:00] okay if any of these problems and mistakes resonate, don't worry. They're super common, right? Like there's 3000 people signed up for this. The, it is super common to feel these ways. All of the people I have taught and interacted with over my whole career, not just since I've been teaching this, but over my whole career, like this is.

What it comes down to me included, right? And so we, we all have this in co in common, and we all go through this cycle and start repeating it over and over again. But what I know is this, I know because we've been in this cycle, you already have a ton, a ton of tools and techniques that you can already have that you could get, start getting immediate results for your clients for.

So it's like, what are you missing? It's not the tools and techniques you already have, all the treatment tools you need to get good results. The thing you're missing is a new paradigm, this new paradigm, this new model that considers the whole organism and the influence of the [00:35:00] viscera and the nervous system on musculoskeletal pain and biomechanical dysfunction, and an ability to trust the body in front of you.

Take off your ego hat and listen to the body in front of you to guide the treatment sequence with an objective assessment. An assessment that considers this whole organism and considers this idea that the body has, can direct us to the place that it is protecting. And when we can know where the body is protecting, if we do treatment there in that spot, we start to unravel this whole chain of dynamic alignment issues orienting themselves around the protection pattern, as well as shifting the nervous system from this protection mode, this fight or flight mode, into a more parasympathetic mode that is gonna facilitate a self-healing, right?

So using our assessment to dictate where to start treatment based on the body's own innate [00:36:00] right own innate wisdom V versus using a biomechanical basis all the time, and then following the protection pattern. And start treatment there instantly helps us, like I said, change, dynamic alignment, shift the nervous system, and then when we can shift the nervous system, the other thing that happens is we instantly decrease our sensitivity to pain, which since pain is a driver of so many of our patients' complaints, that's huge.

Right? So the solution, I already told you and know, this is what I want you to deeply know. You already have the tools and techniques to help no matter, no matter if you've taken all of the Baral, Institute, visceral classes, or none of them, whether you have been a somebody with 20 years experience or three years of experience, you have enough of the tools and techniques to help.

We need an assessment that can identify where there's a protective pattern and where it's originating from. Visceral central nervous system, peripheral [00:37:00] neurovascular system, right? Letting us know which one of those things it is besides just the musculoskeletal pro musculoskeletal system. And this is where the locator test assessment protocol comes in.

So the locator test assessment protocol is a, basically a protocol of five orthopedic based assessment tests utilized within an osteopathic princip. Uh, osteo utilized osteopathic principles as their guiding, guiding force, or guiding idea to explore the influence of the viscera to the musculoskeletal system.

Explore the influence of the viscera in the nervous system to influence the musculoskeletal system. The locator test assessment protocol listens to the body to determine the sequence of treatment. So this is what it is. It's these five assessment tests, starts with the SI joint. And we're going to, that's what we're gonna talk about in the missing link week is all about this first [00:38:00] test, the SI joint Mobility Locator test.

And then it looks at the central nervous system tension patterns. It looks at the thoracic, um, area, visceral influences, and it looks at the pelvic and abdominal visceral influences. And then also looks at the, uh, peripheral neurovascular in, uh, influences from the limbs. Basically using the locator test assessment protocol, we're basically asking the body these three questions, can I treat somewhere I want, or are you protecting something important like the central nervous system or viscera or peripheral neurovascular entrapment.

This is the question we're asking the body when we do the first test of the ltap, which is exactly what the missing link course is going to teach you this week. The other question, what exactly is it? Is it central nervous system? Is it visceral? Is it neurovascular? Entrapment? Like the what? Like it's not enough that it is [00:39:00] one of those, like what is it exactly getting even narrower.

This is what the rest of the ltap teaches. So we are going to learn the first test and the first test, I like to call it sort of the traffic cop. It can give us the most information. This is why I also know that I can teach you this in this week and I know I'm gonna get you results for your patients.

It's that powerful. It's a very important first step.

Yeah. You get, somebody just asked if you get the slides. Yeah. There's a handout in the module. You have all the slides, so no need to take a screenshot. So the focus for this week is learn the first step of the ltap to demonstrate the potential of a visceral. Poten a, a neuro or visceral protective pattern on the musculoskeletal system.

Learn simple interventions interpreted from a visceral or whole organism lens of view, right? So I'm not totally mean, even though I'm going to tell [00:40:00] you over and over and over again. It's not about the treatment. It's about figuring out with the assessment, where to start, where to go and apply whatever treatment you want.

I'm still gonna give you some treatment so you can start to see how you've always been treating the viscera and the nervous system. You just haven't looked at it through that lens. So it's gonna be some more traditional type of exercises, but looked at from a viscera and nervous system standpoint. And then also this week you're gonna see it with your own eyes.

So I'm really big at don't trust me, trust the body. Trust. Trust what you see. And so it's like I'm going to tell you all my thoughts about this whole organism paradigm, and I'm gonna talk to you about this. SI joint locator test and how we use the breath to influence, whether we know it's the viscera or the nervous system, or the peripheral neurovascular entrapments.

But you can listen to me over and over as many times as you want, but you're not actually going to believe it until you see it for yourself, which is also [00:41:00] why I want to emphasize the reason that I want you practicing this on real life humans this week. This is why we actually start the course on a Sunday.

'cause I'm preparing you with the idea of Monday morning watching a short tutorial and then going and doing it on every single person that comes in, right? Because I want you to see it for yourself. Don't trust me. See it for yourself. Believe it for yourself. Okay? So this is what I start all of my courses talking about the core beliefs of the course and the core beliefs from like a scientific model.

This is like laying out the hypothesis, laying out the PO hypothesis that we're trying to disprove through our scientific exploration in our project and trying to disprove something. We end up proving it, right? Most of the time that's how science projects work. But also sometimes we disprove it and I'm always open for [00:42:00] that.

Anybody who puts out a theory or a model of something needs to be open to it being not true. At the end of the day, I would be surprised. 'cause at this point it works so well for me and it works so well for the 500 people that have gone through the Ltap so far. It's like I would be shocked if it doesn't work, but this is why it's like, yeah, it's gotta work for you too.

So the core beliefs. The core beliefs are that the SI joint connects everything and its mobility is influenced by those connections. So we're gonna look at the anatomy briefly today, and you're gonna see that, but then also you're going to see it in practice. And then the other thing, the other belief is where you start matters more than the tool or technique you use for treatment.

Where you start matters more than the tool or technique you use for treatment. And so you're going to see this as the week goes on and we start talking about [00:43:00] interpretation and how to put this test in a true treatment session. And what it comes down to is if somebody comes in with ankle pain and you are going to employ this SI joint mobility locator test to determine where to start treatment, you still have to assess their ankle before and after.

So you see the effect of whatever treatment tool you used in whatever area of the body. And its effect on the ankle. If we don't assess the thing that the patient came in for, we never know if we made a difference, right? So it's this emphasis on assessment and reassessment as well. So I already shared that I talk about the SI joint mobility locator test as a traffic cop.

So this is a visual of that. The traffic cop is gonna kind of tell us where to go and every time we come back to the traffic cop, it gives us a new direction. And so we start to kind of lay out this transit map of like this sequence of treatment we need [00:44:00] to do in order to make the biggest impact on the person's issue that they're coming in with.

So we're gonna talk about why the SI joint, how to perform the test. We're gonna talk a little bit about SI joint pain and how that factors into the test. And then we're gonna talk about why the breath hold creates a change. So why the SI joint. The SI joint is a great test because there's not a lot of room for interpretation on movement because there's so little movement.

We know that it, it we, it is basically like the SI joint's either gonna move or it doesn't move. There's not a whole lot of in between, unlike the shoulder, right? The shoulder has so much movement. So who, it's hard to all agree upon if this is a mobile shoulder or this is a mobile shoulder, is this a hypo mobile shoulder or a mobile, right?

So the SI joint is nice because it only moves a little [00:45:00] bit, two to three millimeters of sheer motion or two to three degrees of rotation at the SI joint. That means that it's like, well, it moves or doesn't move, and it's pretty easy to notice the difference, right? The other thing that makes it a good test for the whole body is that.

Um, movement and function of the SI joint is influenced by many visceral neural and musculoskeletal factors. So it's a perfect area to assess, to investigate issues that have whole body effects. And then that means there's no need for an upper extremity version. So often the question I get from people after we go through this whole test is like, okay, okay, this is great, but how about an upper extremity version?

And I'm like, no, the SI joint is not part of the lower extremity. The SI joint is a whole body joint. Si joint function is what makes us uniquely human. And we're gonna look at the anatomy of that [00:46:00] in a second, as well as it is influenced by everything, the viscera, the central nervous system, the peripheral neurovascular system, and the musculoskeletal system.

And so when it's influenced by all of those things, it means it has the ability to give us really good information. So most classically when you look at the SI joint, we think about the SI joint being a joint of stability and um, also a joint that transfers energy from the lower extremity through the trunk to the upper extremity.

Um, we most classically probably think about the biomechanics of the force closure from the muscles and the ligamentous tissues creating stability across the joint, right? So the musculo scalp, this is how the musculoskeletal system attaches, right? So we have really thick ligaments that go between the sacrum and the ano bones, and then we have muscles that sort of [00:47:00] re reinforce it, the fascial connections from these muscles and these tendons and these ligaments are all interdigitated with each other and it crosses the body in that.

Sense that creates a nice force closure, but then allows for really good movement and opposite movement across the joints. Right? That bipedal rotational movement patterns that we have from a central nervous system standpoint, the SI joint is related because the central nervous system actually end like attaches to ends in the sacrum and the cox, and so the central nervous system that is its container, the central nervous system is the brain and the spinal cord, and its associated containers.

So the cranium, the vertebral column, which includes the sacrum and the tailbone, which means the sacrum is part of the SI joint. So the [00:48:00] central nervous system is directly influencing the SI joint. Then the viscera, so the viscera. Number one, the viscera sit. A lot of the viscera sit right in front of the SI joints, the colon, the rectum, the bladder, the uterus, prostate, they're right there all in our pelvic bowl, sitting on our SI joint at all times.

All of the, all of the women who menstruate, all the people who menstruate you are very aware of how connected your viscera is in is to your sacrum. Because we get to experience sacral pain on a regular monthly basis, most, most of us. And so it's like, yeah, no doubt that the viscera influences the sacrum and the SI joint, but yet it still seems like crazy to people to believe that the viscera can drive musculoskeletal pain, even [00:49:00] though we also all know that when you have a heart attack, you have.

Left shoulder and arm pain, upper back and neck pain. Those are like standard accepted things, but to the idea that the, the liver can cause shoulder pain sometimes is like wild to somebody, right? So it's so funny And same thing with this, the SI joint, like all these organs you can be constipated and it locks up your SI joint.

Does that a lot. Anybody who's had severe con constipation knows that back pain is part of it. This is also why I get so many pelvic PTs in my courses is because they deal with this a hundred daily basis. They know that the visceral causes musculoskeletal pain. They see have people come in for incontinence or urgency or whatever, and whether that was their main complaint or not at the end of it, as that improves, they're also like, oh, my hip doesn't hurt anymore.

So great. Right? So the viscera is very much connected to the SI joint. Here's a great view of [00:50:00] that, the colon and the rectum and the bladder just sitting in there in front of the SI joint. We're gonna see another picture in a little bit of the fascial containers, and you're gonna be able to see how that means too, even the viscera and the thorax can affect our SI too.

But here's a picture of the peripheral nervous system and its relationship to the SI joint. Obviously the SI joint is a joint, and so it's innervated by nerves, nerves, innervate joints, just like they innervate muscles. And so uniquely, maybe not uniquely, a lot of joints are innervated by more than one nerve, but the SI joint is innervated by five nerves.

And so it has, that's five times the, the influence, right? Meaning like there's five, all of those five nerves wherever they are going to innervate. In addition to the SI joint [00:51:00] has the ability to influence mobility at the SI joint. These are those nerves, the opterator nerve, which is one of the nerves from the lumbar plexus, the lumbosacral trunk, which is that that's the beginning of the sciatic nerve or what turns into the tibial and the common peroneal nerve, the superior gluteal nerve, the sacral spinal nerves, and then the nerve to the quadratus for morus.

The interesting thing about these, right, the opterator nerve actually has a visceral connection. The opterator nerve also innervates the parietal peritoneum, so when there is vis visceral discomfort, visceral inflammation, visceral issues, the operator nerve gets that message and then influences things.

The SI joint being one of them, the hip joint being one of them. The groin muscles, the inside of the skin on the leg, uh, and the knee joint are all influenced by the ator nerve, [00:52:00] right? So there's a big connection here. And then the rest of those nerves are nerves to lower extremity. And so we're going to see how the traffic cop of this test can direct us to where the problem is coming from.

From. And it's more than likely because of the influence of these nerves. So first, let's talk about how to perform the tests. So also. Just remember that in the module, the Kajabi module, where the course is, where you signed up, is individual tutorial videos of how to perform this test too. So we're gonna talk about it today on the live call, but also know that it's like this is not the only time you're gonna have have to like learn how to do it.

You have a whole video tutorial on how to do it in the ltap, right? The whole, the full locator test assessment protocol. We use actually two SI joint mobility locator tests. Not always at the same time. We [00:53:00] just know that we have more than one test to choose from. Why do we have one more than one test to choose from?

Number one, to accommodate practitioners that are not licensed to touch and assess joint movement from a joint mobilization standpoint, and then also to support the learning process. Chances are some of us who are clinicians feel really comfortable with one but not the other. So that gives us a check and balances ability to be able to teach and feel and observe if we're feeling the what we're supposed to be feeling.

Also, to have something for virtual assessments. Obviously since 2020, there's a lot of people that went online for healthcare and are still online for healthcare. It allows us to reach a lot bigger audience and help more people. And so it's important for me to be able to provide virtual assessment solutions for people too.

And like I said, in real time, once the tests are learned and the practitioner is proficient, there's [00:54:00] no need to do both. You can just stay with one. And on that standpoint too, if there is another SI joint mobility test that you love and are really proficient, you can do that too. This same. Addition, the same change, the one change to your assessment.

That's going to give us more information, which is the breath hold. So it says, can I use any SI joint mobility test for the breath hold? Yes. Once you understand these principles, you can make up assessments and techniques as you want. That's a whole, that's part of the learning process. So you can use a standing step test or a gait assessment, seated flexion test.

There's multiple si, joint mobility, low cutter tests that you could use with the same lens and get the same information. The only ones that do not work for this is going to be the prone tests. So no SI joints lying on your stomach. That is becomes not a great test for us. So here's a picture [00:55:00] of the SI joint ligaments so you know what you're testing.

This week we're only learning one of the two tests. We're learning the standing March test. The staining March test is. Still the gold standard in SI joint mobility tests, um, despite there being literature saying it's not reliable. But now that we understand the influence from the viscera and the nervous system and the peripheral neurovascular system, I would never expect this test to be reliable because it is in inherently a joint that presents hypomobile strategically, not structurally.

And so that means it's going to change all the time. That is why we use it as the test that's a traffic cop because it's constantly changing. It's going to change, uh, based on whatever flection, whatever influence is the highest protection pattern. And so it's going to change throughout a whole assessment.

What we're actually assessing with the March test, and I'm gonna [00:56:00] come out of the presentation mode so you can see my mouse, but what we're actually assessing with the March test is these top ligaments here, the ileal lumbar ligaments, so. The ligaments that go from the lumbar spine to the top of the ileum.

These ligaments will reflect tension or lack of mobility in all of the SI joint ligaments. So we don't have to test all of them. We can just test this one and get the information we need, and that's what the March test does for us and how we're going to be using it. And then there's this actual cadaver picture here that I stole off the internet that shows you it in a more true sense.

It is a very thick, continuous ligament that you don't see all the individualness of it, right? You get to see this hugeness of it. Okay.

So here's [00:57:00] another view from, uh, above, which is nice. On the left, this is looking into the pelvic bowl. So you can see the posterior ligaments, the, the difference between the sacrum and the innominate bones, right? Those ligaments there, and that's what we're touching. So you can appreciate the, where the joint is and what motion is happening.

So in the standing march test, oh, basically what we're doing is single leg hip flexion, observing dissociation of movement at the SI joint between the a innominate and the sacrum. With and without a breath hold. Normal would be the innominate bone moves into a posterior rotation and the sacrum remains in the upright position.

Hypomobile would be, the innominate does not move into a posterior rotation. Or both the sacrum and the dominant move together. Then for the [00:58:00] test, we're repeating it with a breath hold. We're taking a small sip of air in through our nose and holding it and then repeating it. And what we want to pay attention to is, does it change?

If we tested it with resting breathing and they had no mobility, it was hypomobile, it did not move, and then they do a small breath hold and now it moves, that will mean something to us. But first, that's just we we're focusing on assessment, not interpretation. We're just focused on doing the test. Does the SI joint move?

Does it not move? And if it doesn't move, does it change with the breath hold? Here's a video of it that you, this is one of the videos you'll have in your tutorial, so go ahead and play it. In a second, but we're going to basically from the top of the iliac crest, the top of the pelvis, and then follow that down to the point your PSIS on the [00:59:00] innominate bone there, usually it's kind of like right to the side of like the dimples on your back here.

So once you're there, you're going to then go to the spine, place one thumb on the spine, one thumb below the PSIS. Then what you're going to have her do is have her march her leg up and you're going to see what the bones do. And then back down. We're gonna do three of 'em. Yeah.

Okay. One more time. So for her, go back down. You see that my fingers say sort of together that her spine and her dominant bone are going together. Okay. Now we'll check the other side. So hold on, let me get on the parts first. So I find that PSIS then I'm on the spine and then Yep, she's gonna march on the left.

You can hold on the wall [01:00:00] if you balanced and not gray. Good. One more time. So now what we see on the left side on her is the A nominate drops down the spine stays still. That is what we want to see. That is a normal function of the SI joint, that after they get to a certain degree of hip flexion, the A nominate bone posteriorly tilts with the hip flexin abnormal is when the spine goes with it or it does not separate.

Okay. So on the abnormal side we're gonna do the same thing with a breath hold. So get back on your points and then go ahead and take a deep breath. Hold your breath and then march your right side. Good. Two more? Yeah. And then one more. And we see that normal motion come back on that right side. [01:01:00] So this test is telling me just what the last test did, which was the right side is the hypomobile side, and it changes with the breath hold, so it directs me to do.

We're gonna talk about interpretation in a second. So I cut it off on purpose. Um, I do see a couple questions that I wanna answer in the chat. Um, Stacy asked, am I on L four L five for this hand that's on the spine. You can be on L four L five, or the base of the sacrum. So as long as you're on any of those three is fine because again, we're testing the ileal lumbar ligaments.

Yes, you're welcome. Spencer asks, does the added stability of the wall not factor in? No, it does not factor in. And you just want their hands on the wall like touching the wall. They're not leaning against it. So if they're leaning against the wall, it does factor in, actually engages that force closure system.

And we would expect for both sides to not move. And so you wanna make sure that they're upright, not leaning, but just have their [01:02:00] hands, like far enough distance from the wall that they can touch there for balance. Just kind of like you saw her do. And actually now I set it up standard like that. I don't like even give them an option because when they're not having their hands there and they do feel a little unbalanced, it just makes it harder on you as the clinician.

And the most important thing about having a good assessment test is setting yourself up for success. And part of setting yourself up for success is eliminating as many variabilities or variables as possible and to make sure you're comfortable in getting the information that you need. And when they're not having, when they don't have a narrow base or support on the wall, they shift their weight so much that you have to.

Move while you're observing the motion or feeling the motion and it makes it harder to pay attention to. Okay. And then Renee asked, this is AKA Ja delay's test. Yes. This is JA delay's test with a breath hold, which is not Ja July's [01:03:00] test. This is why we call it the San March test. But yes, originally the Sandy March test is, was first described by Jale, and Jaleh actually, um, tested more than just the ileal lumbar ligaments.

But that is for another day to talk about that. Yep, you're welcome. Oh, and then the other question I wanted to answer was, um, Gilbert said, is there a best age to work on as I work with infants, toddlers to teens? Infants? No, but um, toddlers I have done this with. It kind of just depends on the type of toddler and how.

Developed they are. And whether or not you think it is a good test or not. And we talk about this a lot in the main course of like what makes a good test or not. But for now I'm like, yeah, I've probably done it on as young as like six. Um, not younger than that.

All right, so some things to keep [01:04:00] in mind, distance from the wall. So this is what I answered the question from Spencer, is I set it up like this. She's not leaning on the wall, she just has her hands placed there. She's arms distance away from the wall. This is nice too because it makes sure that you have clearance for the thigh and leg.

Sometimes people won't lift their leg up high enough if they feel like they're gonna hit their knee on the wall. So making sure people are arms distance away from the wall just allows for being enough distance to clear their thigh and leg and that they're in the upright position. The other like tip for success is once you find the anatomy, lighten up your touch, like all the way our receptors, the way our receptors work is here, we're trying to pick up this subtle movement of the an nominate bone.

And in order to pick up that movement, we need to rely on our muscle spindles more than the rini endings that pick up pressure. And so if [01:05:00] we are pressing too hard on the anatomy, all we're going to feel is pressure and we're gonna actually miss the feeling of the ate moving in our hands. And so we want a really light touch.

Like touch is gonna allow us to pick up more information associated with movement. Adjust the base of the sport support if they need to. So if the person is like shifting their weight a lot when they go to single leg, it just means that they started out too wide, bring their legs closer together. And then also you wanna make sure they take a small breath in and hold.

Even in some of my videos I still catch myself saying, take a deep breath. Don't cue them to take a deep breath. Just say I, I try to say Now take a sip of air in through your nose and hold it because it doesn't have to be a big breath. In fact, when it's too big of a breath hold, we get distension of the abdominal contents and reflexive increased stiffness of the thoraco lumbar fascia, which reinforces that force closure across the SI joint and [01:06:00] gives us two hypomobile joints again.

And so it's a false test. So that's why the degree of breath hold is important to pay attention to. So next is a question I get a lot is SI joint pain matter. And the answer is no, not at all. In fact, it can be this test and the information it's going to provide you is actually gonna be wonderful for people with SI joint pain because it's finally gonna give them the solution of what's going on.

Um, so pain, what I mean by no pain, doesn't matter. 'cause of course their pain matters. Pain does not matter in the interpretation. Of the assessment of the test. Now pain can matter if the pain level is so high that it creates a lot of guarding around their SI joint, increased stiffness, more force closure, and a bad test because now we're locking ourselves into a hypomobility standpoint.

So that means you have to pay [01:07:00] attention to the patient and how they are. Their body language is sometimes responding to you because sometimes they don't even tell you when it's really hurting. Right? And then we change positions as needed. We support their body, we to accommodate them to make it a situation where it's less painful.

Worst case, case scenario, they're in such high pain that you can't do the SI joint pain, or sorry, the SI joint tests. That's fine. We have the other four assessment tests from the locator test that we can use to still arrive at the, is this visceral central nervous system or the peripheral neurovascular system, or is it just musculoskeletal?

But obviously for what we're learning this week, we will be a little bit stuck with that specific patient.

So here's the interpretation. If the breath hold changes, the hypomobility, meaning that there was a SI joint that didn't move, [01:08:00] they held their breath and then it moved. This is the body directing us to start treatment at this viscera or the central nervous system. For the record, the brain is a visceral organ technically, but we tend to separate them.

So that's why I always say viscera or central nervous system, but it's still viscera. If the breath hold does not change the hypomobility, this is the body telling us that is a peripheral neurovascular issue on the same side of the hypomobile SI joint itself or. The SI joint itself. But in my experience, and then turns out as I've learned more of the classes through the Baral Institute and Jean Pierre Beal's experience and Jean Pierre Baral, if you don't know who that is, he's the, he's a osteopathic doctor who founded the Baral Institute, which is, um, the education that I've learned the visceral manipulation from.

He's an [01:09:00] osteopath from Europe, so if you're wondering who the hell that guy is, that's who he is. I'm not affiliated with them. I just have learned a lot from them and love their work. But he's kind of like the goat of the practice, and he came to the same conclusion I did that I was seeing with my patients is about 75% of the time when someone presents with a hypomobile SI joint, it is actually strategically hypomobile, meaning it's just being influenced by a protection pattern in the viscera.

25% of the time it is. The lower extremity of the same side. And of that 25% of the time, only five to 10% of the of the time is it actually a structural SI joint issue itself. And so it's like, that's like the last thing I'm gonna do is actually mobilize the SI joint itself. Uh, which is kind of crazy because it's often the first thing people do when they see an SI [01:10:00] joint that doesn't move.

So here is the traffic cop. So this is what it's telling us. We have three options. The traffic cop is telling us that we need to either start treatment above the pelvis in the trunk, or the head right in the viscera or the central nervous system or in the spine itself, or the lower extremity on the side of the hypomobility.

Or we have the star. The star is. There is no protection pattern. The body is granting you permission to start wherever you want treatment. That is going to be the solution. The, the interpretation. When both si joints move, when both si joints move, that means the body is not protecting something and when the body's not protecting something, we're automatically going to get better treatments.

So the people, when we look at the treatment success rates, right? When we go back to that 60 per to 80% success rates, those [01:11:00] 60 to 80% of those people probably had no major protection pattern in their body. And so their nervous system was more accepting to wherever you decided to start treatment. Whether you decided to start at their foot, their core, their hip, their breathing, whatever the joint, like the area of that hurts itself.

Wherever you started treatment, you probably got good results because there. Not in a protection pattern for the people who are not getting the results. We need to honor where the body is directing us. That's why we're coming to this course, right? To learn how the body is directing us. And this is what this si joint mobility locator test.

Does the traffic cop telling us are they protecting something? And if they're protecting something, is it visceral nervous system or is the same side lower extremity, peripheral neurovascular entrapments. So the big question then is the breath hold. Well, here's the thing, the breath hold, this [01:12:00] is the missing link.

The breath hold is the missing link to this. You know I said for this course, learn how one change to your assessment can get you better results. This is the one change to your assessment. The one change to your assessment is using a breath hold to see how. Other parts of the organism influence the musculoskeletal system, which we only then appreciate in this new whole organism paradigm.

We appreciate. We're curious and we're like, holy shit. When they hold their breath, a gentle breath hold, it really does change their mobility. What the hell does that mean? And then it's like, okay, we need to know a little bit more about what's happening when somebody holds their breath. What's happening when somebody's hold their breath is they're changing the fluid dynamics of the containers.

This is that picture of the fascial containers I talked to you about and I said, Hey, you're gonna see even more how like the viscera in the chest can influence the SI joint because all of these fascial cavities, [01:13:00] fascial containers, are attached to each other and they're all influenced by the diaphragm, by the respiratory diaphragm.

And the tensions are changed. We know this. We know that if we change our pressure volume or change our pressure in our thax, but changing the volume of our thax, we also get a pressure change in the abdomen and the pelvis, the neck, and the cranium. All of the pressure changes. When pressure changes. That changes the interoceptive information from the contents that are in those cavities.

And when we have more sensory information, more interoceptive or cept information coming in the brain, the brain changes its output. Output may be pain, mobility, strength, movement patterns, all of the above, right? So what's happening is when your body is protecting [01:14:00] something, especially when it's a visceral organ, the visceral organs, they don't have a whole lot of like mapping in our brain.

And so the messages are a little murky at times of where things are coming from, and they overlap with a lot of the same nerves and sensory information coming from our musculoskeletal system. So the body sometimes doesn't realize the message is coming from a liver that's just not moving very well. But when you hold your breath and give better sensory information coming from that area around the liver, then the body's like, oh, oh, I don't need to limit your hip mobility, your trunk mobility, and your shoulder mobility.

It's just that your liver's not moving very well. So I'm gonna grant you back all this mobility. So this is what we see at the SI joint is your body was in this protective pattern 'cause it wasn't really even clear of where what was happening and where it was coming from. And then you increase the clarity of the message by changing the interoceptive [01:15:00] information via a pressure change.

Because pressure is one of the only ways we get interceptive information from the organs. Pressure and chemo sensors. Those are, those are it. And so then the SI joint mobility is influenced because it's an output. Okay, now I have this bullet. I cannot deny it. It says, honestly, there's many theories and many possible reasons why, but none are proven.

This is just. Anna's interpretation of what she's learned over the years, what she sees in practice and what makes sense from a neurophysiology standpoint. Understanding about interoceptive, um, interoception, the nervous system, what nerves innervate, what visceral cavities, how the receptors respond, and how it's all integrated back in the brain, right?

It all is coming down to neurophysiology and anatomy and some evidence-based medicine. People don't love that. I rely [01:16:00] on anatomy and neurophysiology as the basis. Sorry. That's all we got. And then also, like I said, the beginning, you see it in action for yourself. And I also tease people in my classes. I'm like, Hey, sorry.

Once you see this, it's hard to unsee it. Once you see an SI joint that appears very hypomobile, like one you would've probably wanted to mobilize, change instantly with a small breath hold. You're like, holy fucking shit. It what I believed is not true. And then this starts the cognitive dissonance, and this is why I teach the course over a seven week period, is because it takes us time to work through our deeply held beliefs that are bias, steeped in bias, that the musculoskeletal system and the biomechanics is the end all.

Be all of everything. Okay, so breath hold. We talked about how it changes in interoceptive information. That interoceptive information is coming through [01:17:00] our brain, our pathways, our neural pathways, and with some of these main nerves, the trigeminal nerve, the glossopharyngeal nerve, the facial nerve, and the vagus nerve all influence the sensory information of the cranial container and the spinal containers.

The. Phrenic nerve innervates the containers of the thorax and the upper abdominal container. The cervical plexus also influences the cranial container and the neck container of the visceral organs. The vagus nerve innervates the abdominal also pelvic, hate to break it to y'all. Uh, also goes into the pelvis, pelvis, abdominal, thoracic neck, and cranial containers.

And then the opterator nerve influences the abdominal and pelvic container and the pelvic spine nerves influence and or gain sensory information from [01:18:00] the pelvic visceral container. Okay, so all of these nerves are sensory nerves. Some of them are also motor nerves and they. Bring information from the containers, from our body, from the really important things that are dictating our survival to the brain.

And the brain then get chooses. The output in relationship to the information it got, it has a clearer message. Okay, so hopefully that gives you some like new anatomy to think about some, some like basis for what I'm talking about and why this whole organism concept is important and how a breath hold can change.

A fundamentally orthopedic thing like mobility of the SI joint and how the SI joint is a whole body thing, not just a lower extremity thing. The goal for the course is to practice, practice the assessment, practice getting good of the assessment, and then doing the assessment with a breath hold and redoing it and seeing how it changed treatments.

The easy piece, [01:19:00] if I had one wish for you all, it would be to not do treatment. I mean, obviously you're gonna do treatment on your people, but not do treatment based on what this test tells you till the end of the week when you've gotten more reps of actually just doing the test. Because treatment is the easy piece.

You can have the most general treatment in the area where the body wants and you're gonna get a really great result, versus you can have the most specialized treatment in the area where the clinician wants and it's not gonna be that great. It's gonna fall flat. We're gonna talk about that more on live, on the next live call.

I want you to be curious, this week put on your scientific hat, right? These are, we are scientists. We are exploring, curious, these hypothesis, these core beliefs of the course. Um, this is gonna force you of letting go of the need to be right. I'm telling you that the only expert is the body in front of us, not us.

And so we need to get out of the habit of thinking that we are the expert on somebody else's [01:20:00] body so we can allow that body to speak through us through these assessment tests to tell us where to go. And then also reassess, assess, and reassess. We do not know the influence of our work if we never reassess.

Okay? So the goal for days one through three before I see you on the next live call, practice the assessment. Notice the change between the regular breathing and the breath hold. Don't worry about interpreting it just yet. There's a tracking sheet in your module that you can download and you can just circle to make note keeping and keep you on track to not get overwhelmed.

And then, oh, let me do the poll for us, see if I can do this. So we can track in polls and quizzes launch. There should be a poll that just popped up for you, and you can enter your name and email in the short answer and [01:21:00] go, all right, I see it working. So this is what allows me to know that you can get the bonus.

So, um, whoop.

In the next call, which is on Thursday, same time, same place, 3:00 PM Um, on our Zoom meeting, I think it's the exact same Zoom link. I linked the meetings together. Um, we're gonna talk a little bit more about SI joint pain. Si joint pain patterns. We're gonna talk about the treatment, we're gonna talk about case shares and like how an assessment would go.

And then I'm also going to invite you to the next round of the online ltap level one course, which is coming up, up, coming up October 6th. So we'll talk more about that and then I'm gonna leave you with this quote, and obviously I'll get to the questions and stuff too. But one of my favorite quotes from the founder of Osteopathic Medicine, Andrew Taylor still, he said a practitioner must [01:22:00] analyze and study their patients as if they were their best books.

So again. Our best teacher, the expert in the room, is always going to be the person in front of you that you are assessing and treatment. Lean more into what their body has to tell you than what your brain has to tell you, and you will rarely be steered wrong. So I'm gonna stop the share so I can see the chat better

and pin me and see what questions I missed. Let me look at the questions in the chat first, and then if people, once we get through those, if there's more and people wanna unmute themselves, I'll go ahead and switch that setting. But let me just scroll through.[01:23:00]

Um.

Lots of comments, which I appreciate. We answered the age thing. So Linda asked, some people are paradoxal breathers. I assume how they take in breath matters in the assessment. Is that true? This is, yeah. They can be. Yep, you're right. And so this is why I cue them, how to take in the breath. I say take a sip of air in through your nose and hold it.

And I also then tell them, breathe again whenever you need to. Especially if you're slow at paying attention to the reps, like you might need to like have them do that breath hold, you know, in between through reps. So don't be in a hurry. Olivia asks, what does LE stand for? Yes, lower extremity. Thank you Renee, for saying that 25% of the time when it's hypomobile, it [01:24:00] is.

The lower extremity per peripheral neurovascular entrapment, or the SI joint itself,

and we will talk about it on the second live call as well,

is the virtual assessment in the course. Lisa asked, this would be the virtual assessment. So the march test is the virtual assessment before you can do it virtually though and just observe it happening. You gotta get good with feeling it in your hands. Once you practice it and feel it good in your hands, you can start practicing just observing the motion because you're gonna be observing, trying to observe.

Can I observe that disassociated movement of the nominate on the sacrum? It's not the perfect test, right? Because it's not as good as using our hands. But in virtual settings it's like the best we got and that is like the nature of [01:25:00] virtual care. Anyways, the virtual care is never going to replace hands-on in, in-person care, but it is can be a still a powerful tool.

So same thing, a virtual standing march test for the SI joint mobility locator test is never gonna be as good as when I could put my hands on them, but it's better than nothing to get us information.

Gilbert asked, how effective is this with people who have had spinal fusion back surgery or implants for back pain? As long as, so when it comes to back fusions, as long as it's not a fusion of the SI joint itself. This should be fine because we're only assessing does a dominant bone move on the SI joint or move on the sacrum.

So even if their L four, L five is fused, that's fine. We're just using that to assess. That's a landmark, a relative [01:26:00] fixed landmark for us to assess the movement. In the other hand, on the nominate bone,

nelle asked any thoughts if people have scoliosis or para paralysis in the diaphragm. So, um, scoliosis it, this works for still great. Um, I like this supine SI joint mobility test better for scoliosis people. But, um, one of my. Certified providers. Megan teed, she does a lot of virtual assessments and she thinks, and she only works with people with scoliosis and she thinks the March test worked great.

So I trust her more than me 'cause she gets to see more people with scoliosis than I do as far as paralysis in the diaphragm goes. If it's um, just their diaphragm that's paralyzed, then I'm assuming it's half their diaphragm that's paralyzed, not the whole thing. Um, but also it doesn't matter fully [01:27:00] because changing pressure in your chest, even if it's via intercostal muscles, right?

Because if you can still breathe, you can still change pressure in your chest. So an inhale should work because if your chest pressure changes, then the pressure in the rest of the cavities change too. But it's something to consider, right? So always something to consider. And if it's a spinal cord injury person that has more.

Paralysis again, we're back to like, can they breathe on their own? If they can breathe on their own, they can change pressure in their cavities. So it should still work. And one of my other practitioners, she works mainly with si, um, like spinal cord injury patients and she uses this test to direct her quite a bit as well too with great, um, results.

So a lot of people saying thank you. You're welcome. Thank you for being here. Uh, Kevin, ask anyone, have much experience with MS patients? Um, yeah, so that same person, she works with a lot of neurological conditions and yeah, as long as [01:28:00] they, as long as you feel like the SI joint test is, or the SI joint is a valid joint test given their condition, then it should give you good information.

And the cool thing is about people with, um, MS or spinal cord issues or whatever it may be. Sometimes we assume those, um. We sometimes assume that those things are the reason that they feel stuff, and this is where we catch our ego driving the bus. The body is made to compensate and it often compensates really well for different disease states, even though they're a disease state.

And when we have an assessment, then it can actually direct us where to go. We realize that, oh, just because you have ms, it's not about your central nervous system. I'm actually finding that it's like. You have a tightness in your like sartorious area that is limiting blood [01:29:00] flow through your adductor hiatus.

And as soon as I cleared that up, like everything changed and you feel so much better. And so it's like oftentimes the way our ego shines through as a clinician is hearing someone's subjective story and picking the biggest elephant in the room, right? They have cancer or they have ms or they have whatever, like they just got in a car accident and like broke their ankle.

We think that's the problem. And the body's like, no, I'm dealing with that. Just fine. The problem's actually over here. And if you could get out of your own way and listen to me, I'm trying to direct you there because that's where I need the help. Right? So that is actually a really important message to share, learning, ask recommendations or contraindications for patients that have osteoporosis.

If they have osteoporosis, this standing March test should be okay for them. Um, it would be more of. Doing stuff in the thorax. Um, kind of depends on, I guess, where the [01:30:00] osteoporosis is and what they're coming in for. But the standing march test should be good unless you feel like they had an issue with the SI joint, making it hypomobile for a reason, like a structural reason that cannot change.

Amanda said, I treat SI joint hypomobility based on position tests, posterior anterior rotation and leg length discrepancy due to muscle balance at the hip. Curious if your course will tie this in? Yes, I think it will be great and it will show you maybe that you don't actually have to treat the SI joint itself to change the SI joint hypomobility, that it's gonna change on its own and influence by other things.

And so. It should allow you to narrow down those five to 10% of the people who are true hypomobility structural issues. And so the rest of the people, it's something else. [01:31:00] Shauna asked, could you do a forward flexion test instead of March test? Yes. The seated forward flexion test is fine to do as well, but again, you're gonna do it with and without a breath hold.

Kendra said I missed the first part of this video due to work as a recording. Yes. Um, my team will get the recording out as soon as it's processed, and then you'll get an email saying that it's ready, but it will go inside the course modules as well. It goes on YouTube and my podcast, so you can listen to it if you prefer, or watch it on YouTube if you prefer to, but we'll also live in the modules of the course.

Um, Susan said, how do you treat the operator nerve? There's many ways to treat the operator nerve. I can't remember if in the treatments I give you if it's in there, but that's more of a question for the second life call. Anyways. Again, remember what I said, let's focus on assessment. It's not about the treatment right now, [01:32:00] Lisa, have you worked with CRPS, chronic Regional Pain syndrome?

Um, no, not directly, but I'm sure people in my community have. So it, it's one of those things too, when we look at complex people like that, I mean, I guess a couple of my patients technically could be diagnosed with that. Uh, so it's a lie. It's not that I haven't worked with anybody, it's just not common.

But I tend to be kind of like the, what I said with the MS is like. It's an elephant in the room that people like to blame as the primary reason for what's going on. And I just disagree. I think the body always can direct me where it needs help and when I, when I can get out of my ego and listen and follow where the body directs me, like the body's never gonna direct me to the wrong place, that body will always direct me to a place that's going to help it.

And so I don't like if somebody has chronic regional pain syndrome, that sucks. But I know I can only do so much. But the best thing I can do for them is let the body guide me [01:33:00] where to go and see if it influences their chronic regional pain and, and their pain in general. So thank you. If Stacey said, if hips are anteriorly tilted and rotated, would this be influenced by the SI joint also?

Yes. So when we look at anterior rotation, that is a forward position of the an nominate bone on the sacrum. So, but that's not, it doesn't mean that somebody would have a hypomobile joint. You can be set up in a dynamic alignment that's anterior rotated and still move into posterior rotation. No problem.

So that's what we care about is are they able to go posteriorly rotate when their hip flexes? Yes. You all are welcome. Thank you. So happy that you guys are here. Make sure you have checked in on the poll and make sure that you have joined the Facebook group. Said hello, [01:34:00] dove into the modules. Let me know how I can support you.

I will be active in the Facebook group and on the comments throughout the rest of the week, and I can't wait for you to go through it. I can't wait to see how this works in your patient population and uh, just how it meets your deeply, how beliefs and like. You know, the cognitive dissonance part's tough, but it's like also really fun.

It's, it's fun to be challenged and it's fun to see new things and it's fun to see the body in this way and it makes each patient so unique. So thank you. Uh, thank you Olivia. I appreciate your compliment, Chad ass. Are we going to get to see a full demo of the assessment as well as the treatment? Yes.

There's a full tutorial video in the modules and all the treatments are also full video treatments. Uh, if you're asking if I'm gonna do it live on a patient, no, I don't do that on my calls typically, [01:35:00] but it's all video recordings, so it's like the same thing right. What I want you to do is go practice it with your own patients, and if you want feedback, video yourself and put it in the Facebook group and I'll give you feedback.

You'll be surprised at how much feedback I can give you and how great it will be by putting a video in the Facebook group. So I really encourage you all to do that.

Kimberly asks, I have done several biodynamic with stills education. Great. I don't know what that is, but I'm glad it fits into this. Well, often, and this is what I love about this, you get to keep whatever treatment strategies, whatever approach that you know works for you and your patients, and you just get to make it better.

This approach, the Locator Test assessment protocol, or using this SI Joint Mobility Locator test, it's gonna supercharge [01:36:00] your already great treatments and get you even better results. You don't like, you don't have to throw anything out. You don't have to throw anything that you already know and works out.

All of it works. It's just gonna work even better. And that's what I love about this is because yeah, you already help a lot of people. I don't want to like totally throw out what you were doing. I just wanna make you make it better by operating in a paradigm that appreciates the whole organism and appreciates that the body in front of us is the smartest thing in the room.

Yeah. Yeah. Chad said, Chad openly raised his hand and said he's a skeptic here. And he is excited to try it out. I love it. I love it. I love it when people are skeptic, but what you are also is open and that is the most important thing. So yes, please try it on your clients. Like, like I said, don't trust me.

Don't believe me. See it for yourself. That's where the power is at. And this, this whole concept too, of. The paradigm [01:37:00] that we're operating in is the problem. I didn't realize this at first. When I first started taking the Baral Institute classes, one of the quotes from Jean Pierre was that the teachers told, you know, I'm sure it was not exactly translated correctly, but he basically said that the musculoskeletal system or the muscles, not the skills, not the system, but the muscles were the garbage can of the body.

And I laughed at it and it stayed with me for some weeks after the course. And I found myself, the farther I, the more I thought about it, I found myself offended, like deeply offended because it, I was starting to see that maybe there was something to that because. My whole life, my whole career was about muscles.

I worked with athletes. I, I work in a performance training facility like, and then our whole paradigm is on the musculoskeletal system and the biomechanics. And so I started to like feel this dissonance [01:38:00] rise up. And what that dissonance was, was this challenge of the deeply held belief that the musculo-skeletal system and the biomechanics were everything and movement compensations were bad.

And it really challenged that. And it is actually not until we are challenged, it is not until we are offended that we actually feel the need to explore and perhaps change. And so it's actually my job as the teacher, I believe, is to offend you. If I didn't offend you, if I didn't challenge some deeply held beliefs you have about the body, then I didn't do my job very well.

So I. And, and again, I speak to this from experience of like, holy shit. Like that did not feel good. I, I, I, they challenged my deeply held beliefs about the muscles and I was forced to see it in real time with my patients that when I started treating from a visceral standpoint, like muscles that were like tight, that would've taken me days and days and days of releasing their [01:39:00] hip flexors to feel better, just melted before my eyes within one session and then never needed treated again for like three weeks.

And I was like, what? That doesn't make sense based on what I've believed for the last decade and a half of my career. And so, yep, that's when I was like, oh, shit's gotta change. 'cause I just totally proved to myself that this thing I believed is not true. And so now I gotta go find the truth. So thank you for being open, even though you're skeptic too.

Yeah. I love it. Kendra says, I say the muscles of the garbage cans all the time. I didn't realize somebody else had the same belief. Yes, yes. I call them bodyguards now. I feel like it's nicer than calling them the garbage can, but yes. All righty. Any more questions? I know we're 10 minutes over, but I did finish 10 minutes early, so I'm doing pretty good [01:40:00] on time.

Gotta pat myself on the back for that. Um, thank you so much for being here. I have loved doing, I love to I, if you can't tell, I love talking about this. I love teaching this. Let's connect in the Facebook group. So thank you for being here, and we'll see you on Thursday. All right. Have a good night.