Name: 頤養天年：有問必答--第 11 集 - 20 年 5 月 7 日 (IMMACULATE DISSECTION: Ask Us Anything - Episode 11 - 7/5/20)
Uploaded: 2024-08-30T13:45:47.000Z
Duration: 55 min

Hello, and welcome to Ask Us Anything, our Sunday free webinar where we talk about all things anatomical and answer questions from our amazing fans of Immaculate Dissection.

大家好，歡迎收聽 "有問必答 "週日免費網絡研討會，在這裡我們將討論解剖學的所有問題，並回答《無暇解剖》的粉絲們提出的問題。

進階形容詞比較級句型

So excited to be here with two of the most amazing people on the planet, as well as some of our other live participants who we're getting to know, we're so thankful that you're here tonight.

很高興能和地球上最了不起的兩個人在一起，還有其他一些我們正在認識的現場參與者，我們非常感謝你們今晚能來到這裡。

My name is Dr. Kathy Dooley, I am a chiropractor, rehabilitation specialist, and an anatomy enthusiast of sorts, here with the amazing Dr. Anna Folkmer.

我叫凱西-杜利博士，是一名脊椎按摩師、康復專家，同時也是一名解剖學愛好者。

Hi everyone, I'm Dr. Anna Folkmer, one of your co-founders of Immaculate Dissection.

大家好，我是安娜-福克默博士，"無暇解剖 "的聯合創始人之一。

I'm an acupuncturist and herbalist, and also an anatomy enthusiast of sorts, and glad to be here.

我是一名鍼灸師和中醫，同時也是一名解剖學愛好者，很高興來到這裡。

And last but absolutely not least, Danny Quirk, our anatomic artist for Immaculate Dissection and co-founder.

最後一位是丹尼-柯克（Danny Quirk），他是我們《無暇解剖》的解剖藝術家，也是聯合創始人之一。

Yep, the artist for Immaculate Dissection and giant anatomy dork as well, so always excited to attend these and be a part of them, so looking forward to tonight.

是的，我是 "無暇解剖 "的藝術家，也是個大解剖學呆子，所以我總是很興奮能參加這些活動，併成為其中的一員，所以我很期待今晚的活動。

So if you're joining us for the first time in our anatomy dorkness, as Danny very eloquently put it, which I do agree with, we decided to get together on Sundays and chat, and we started at the beginning of the pandemic, so it was March 2020, and we've gotten addicted to it, we love it.

是以，如果你是第一次加入我們的 "解剖學呆板 "行列，正如丹尼所言，我們決定在週日聚在一起哈拉，我們從這一流行病的初期開始，也就是 2020 年 3 月，我們已經沉迷其中，愛不釋手。

It sparks ideas for us for our ID Collaborative, our online learning series, and it gives us, you know, ideas of just getting people excited about anatomy and talking about some various questions that you have.

它激發了我們對 ID 協作、在線學習系列的想法，也給了我們讓人們對解剖學產生興趣的想法，並讓我們討論你們提出的各種問題。

Sometimes people will come to our courses and ask questions that's not always appropriate for the subject matter, and so this is kind of an open forum, and it's free, and we'd love that you guys join us on Sundays for this, if not live after the fact.

有時，人們會來到我們的課程，提出一些並不總是適合課程主題的問題，是以，這是一個開放的論壇，而且是免費的，我們希望你們能在週日加入我們，如果不是事後直播的話。

So we have some pretty cool questions from the gallery, and we thought that we might cover them.

是以，我們從旁聽席上收到了一些很酷的問題，我們想可以把它們都寫下來。

So do you want to start with the first question that was asked?

那麼，你想從第一個問題開始嗎？

The first question regarding the kinesiotape, okay.

第一個問題是關於運動錄像帶的，好的。

So the question that we got on Facebook was, can bracing using external support like kinesiotape and diastasis recti cause changes in blood pressure?

是以，我們在 Facebook 上收到的問題是：使用外部支撐（如運動膠帶和直腸腹肌鬆弛症）進行支撐是否會導致血壓變化？

Okay, so the first thing that we want to cover as an ID family is that we don't use kinesiotaping for anything other than the demonstration of ligament location, and I'd like to demonstrate the ilial lumbar ligament and the importance of iliacus and quadratus lumborum attaching to it, and anterior thoracolumbar fascia attaching to it, but I have to go from experience.

好的，作為一個 "ID家族"，我們要做的第一件事就是，除了演示韌帶的位置外，我們不使用其他任何運動造影技術，我想演示髂腰韌帶，以及髂肌和腰四頭肌附著在髂腰韌帶上的重要性，還有胸腰椎前筋膜附著在髂腰韌帶上的重要性，但我必須根據經驗來演示。

I used a kinesiotape from 2006, 2007, very religiously, every single patient, every single visit.

我非常虔誠地使用 2006 年、2007 年的一盤運動錄像帶，每一位病人，每一次就診都是如此。

In the last year of my internship for chiropractic, I saw a lot of patients, and to me, it was very cumbersome, and I didn't find it to be as useful as it was expensive or time consuming.

在脊骨神經科實習的最後一年，我看了很多病人，對我來說，這非常麻煩，而且我覺得它並沒有那麼有用，因為它既昂貴又耗時。

So I found that giving proprioceptive cueing and other type of things worked a lot better for me.

是以，我發現給予本體感覺提示和其他類型的東西對我來說效果更好。

Anna, I know that you said that you use magnets a little bit more?

安娜，我知道你說過你會更多地使用磁鐵？

Something that has a little bit more weight to it, just so that you're able to simulate some of those proprioceptors, and I use magnets for, I use silver and gold ones, kind of depending on the circumstances, but I find them a little bit better for proprioceptive cueing than some of the kinesiotape, at least as far as my work's concerned.

我使用磁鐵，我使用銀色和金色的磁鐵，這取決於具體情況，但我發現磁鐵在本體感覺提示方面比一些運動錄音帶更好一些，至少就我的工作而言是這樣。

Yeah, the problem I have, I guess, with the question is that kinesiotape is brought up as being a support, and I guess I don't know what they mean by support, because if they're talking about structural support, that's not what kinesiotape is doing.

是的，我想，這個問題的問題在於，運動錄音帶被認為是一種支撐，我想我不知道他們所說的支撐是什麼意思，因為如果他們說的是結構性支撐，那運動錄音帶就不是在做這個。

Kinesiotape is in the literature and supported as being something that's for more proprioceptive reasons or to encourage circulation, but it's not used as a structural support, like athletic tape, and so that's part of the thing that's good about it, is that it doesn't limit movement, and that you tape in certain directions, and that pull that's on the skin creates a dermal traction, and the whole theory is that you're encouraging things to move in a certain direction that you want to move in, and I see the appeal, for sure.

運動膠帶在文獻中被認為是用於本體感覺或促進血液循環，但它並不像運動膠帶那樣被用作結構性支撐，是以它的部分優點在於它不會限制運動，你沿著特定的方向貼膠帶，皮膚上的拉力會產生真皮牽引力，整個理論就是你在鼓勵事物朝著你想要的特定方向運動，我看到了它的吸引力，這是肯定的。

I think that because when you change directors of force so frequently, I particularly don't really love taping in a certain direction, because I think it's willing to change very quickly, and your body adapts.

我認為，當你如此頻繁地改變力的方向時，我特別不喜歡朝著某個方向拍打，因為我認為這樣做會很快改變，你的身體也會適應。

I also know, I can give you a test right now, to the fact that once you tape something, you're going to accommodate to it, so make sure that you feel the back of your shirt right now, feel the back of your shirt, feel it hitting maybe your scapular region, feel that really intensely, great, awesome, so five seconds ago, you didn't feel that, and

我還知道，我現在就可以給你做個測試，一旦你用膠帶粘住了什麼東西，你就會適應它，所以確保你現在感覺到了你的襯衫後背，感覺到了你的襯衫後背，感覺到它撞到了你的肩胛骨區域，感覺非常強烈，很好，真棒，所以五秒鐘前，你沒有感覺到，而且

I brought your attention to it, so one of the benefits, I guess, of kinesio tape is that you can see it, maybe it brings attention to it, but it's only for a short period of time before you filter it out again, just like you just did, now I can bring it back to your scapular awareness, and you feel the shirt on your scapula, it only took you a few seconds of me talking to distract you away from feeling that tape, so I have not found it to be as useful as the education of my patient, so when it comes to diastasis recti, it's a huge education for us in immaculate dissection on breathing mechanisms, and a lot of people are taping diastasis recti, they're taping it in the middle, in immaculate dissection, that's our last focus, we're focusing on lateral expansion of muscles like transversus abdominis, internal abdominal oblique, external abdominal oblique, that are forming the rectus sheaths, the aponeuroses that form around this rectus abdominis, so the worst part about diastasis recti is its name, I know diastasis is the separating of two pieces, but rectus abdominis, its two muscles were always separated and combined at the linea alba, and it's not just the rectus that's separating from midline, it's the aponeuroses, the rectus sheaths that are separating from midline, and what we correct with diastasis recti in a lot of people is their dysfunction on the anterolateral abdominal wall, and not just rectus abdominis, so for us, what are you going to do, you're going to kinesiotape TVA, IAO, EAO, rectus, anterior lateral thracolumbar fascia, iliacus fascia, psoas fascia, it would be a lot of tape. The second part of that question is about blood pressure changes, and I'm assuming they're talking about diaphragm hiatus, and aortic pulse, it's a lot of assumption, I'm hoping that I'm answering their question, and the ID team maybe can help me too as well, if I find that the person has diastasis recti, and has diaphragm dysfunction at the basically thoracic jamming at T12, and a really visible aortic pulse, kind of like the Andy's video that he did for our Instagram, he was talking about the bounding aortic pulse, I think that certainly you can monitor blood pressure through breathing, that's very provable by you just taking your pulse right now, inhaling, and as you exhale, the pulse slows, so certainly if you're harmonizing diaphragm, and it's pressure on the inferior vena cava, and abdominal aorta, you can certainly change things, as far as taping and blood pressure, I'm not sure that we're the right crowd to really answer that specifically, I wouldn't use tape at all, because I don't use kinesio tape at all, I instead educate my patients on where I want things to come from, and let them start to tap themselves, and give themselves proprioception, educate them through where things are supposed to be coming from, and that's our bigger focus, we're not antagonists to using taping, if you want to do all that, and use taping, great, but for me, I've had enormous success with using IDQs, and not needing any tape at all, it's an extra expense for me, and the patient to buy it, but Anna, do you have more to say on that, I'm sure you probably do.

我讓你注意到了它，所以我想，Kinesio 膠帶的好處之一就是你能看到它，也許它能讓你注意到它，但這只是短暫的，然後你又會把它過濾掉，就像你剛才做的那樣，現在我可以把它帶回到你的肩胛骨意識中，你感覺到肩胛骨上的襯衫，我只用了幾秒鐘的時間來分散你對膠帶的注意力、所以我發現這對病人的教育並沒有那麼有用 所以說到腹膜膨出，在無暇解剖中對我們的呼吸機制是一個巨大的教育 很多人在綁腹膜膨出的時候，都是綁在中間，而在無暇解剖中，這是我們最後的重點，我們的重點是腹橫肌等肌肉的橫向擴張、腹內斜肌、腹外斜肌，這些肌肉形成了

I mean, there was a lot in that question, that certainly worth discussing, and you hit all those topics, but we talked about the application of bracing, and things like that, in an ID collaborative episode, really early on, and we don't apply any sort of bracing in diastasis recti, when we're addressing this, so I think it's really important, how many ways are you trying to connect dots here, with your patient, correlation and causation aren't the same thing, we know that, and really fun research articles, that have lined up two things simultaneously, and shows ways in which they look like they're correlating, but they're actually not, I certainly think that you could talk about this from the angle of, well, if there's a diaphragm dysfunction, and it could miscue the obliques, and then there could be a tendency to have something like diastasis recti, which may be accompanied by a blood pressure issue, if there is some sort of diaphragmatic compromise around that hiatus, but it's trying to thread a little too much together, I think with this question, and because if you try to match the problem and the strategy together, a lot of times, that sort of confirms whether you're on the right track or not, because if you made this an if-then statement, and said, well, does taping address blood pressure, or does taping not address blood pressure, I would say there's entirely too many factors that go into what a person's blood pressure is doing, and none of them are a tape deficiency, and none of them are ever fixed with tape, so to me, it just seems a little unrelated from that perspective, but if you're curious about the application of a brace and someone's blood pressure, I know with people who wear big, thick belts and stuff, I would say be careful about that, because it's certainly possible that the external support that you're trying to apply to the patient may be giving them a diaphragmatic dysfunction, which could be then throwing off their blood pressure, so there's lots of different ways that you can look at the relationship or non-relationship of these things.

我的意思是，這個問題有很多值得討論的地方，你提到了所有這些話題，但我們很早就在一個ID合作項目中討論過支撐的應用，以及類似的問題，我們在解決這個問題時，並沒有在直腸腹膜膨出中應用任何形式的支撐，所以我認為這真的很重要，你有多少種方法試圖在這裡與你的病人聯繫起來，相關性和因果關係並不是一回事，我們知道這一點，還有非常有趣的研究文章、我當然認為你可以從以下角度來討論這個問題：如果膈肌功能障礙，可能會導致斜方肌功能紊亂，然後可能會出現直腸腹膜膨出等症狀，如果在裂孔周圍存在某種膈肌損傷，可能會伴有血壓問題，但這試

I think it's an interesting question, so hopefully, I'm a little unclear which part to answer, but hopefully, there's enough said about each one of those things that the person feels like their question is answered there. Yeah, unfortunately, it's like a bomb going off with the question, because first of all, it postulates that the person needs to be taped on the anterior, which we're very against in that section. We're very much against trying to get them to open up the lateral sides, and then that will create a natural bind in the front through the actions, through the tendons. Second of all, we don't use kinesio tape, but you certainly can. I mean, if you're supporting that lateral wall and if you find the tape to be useful, if you find anything to be useful, you probably should be doing it, but we're not kin tapers as far as the

我覺得這是個有趣的問題，所以希望我不太清楚該回答哪個部分，但希望每個部分都有足夠的論述，讓人覺得他們的問題在這裡得到了回答。是的，不幸的是，這個問題就像一顆炸彈爆炸了，因為首先，它假設患者需要在前部綁上膠帶，而我們在這部分非常反對這樣做。我們非常反對試圖讓他們打開側邊，然後通過動作和肌腱在前部形成自然束縛。其次，我們不使用肌動膠帶，但你當然可以。我的意思是，如果你在支撐側壁，如果你覺得膠帶有用，如果你覺得任何東西有用，你或許都應該這麼做，但我們並不支持錐形，至於

ID teaching team, so we're probably going to support you in your kin taping with ID principles, which are get the lateral wall moving. I just wanted to show you, Danny had painted this on one of our amazing colleagues, Frank Desiderio, and I'm just going to share my desktop with you guys really quickly and just show you. You can go to YouTube, and if you type in my last name or just duly noted diastasis recti, this is Danny actually painting Frank, and we show the diastasis recti in this diastasis recti video. Let me just get to the point to where you can see that we're talking about the rectus sheaths and the fact that diastasis recti doesn't come from here. It's coming from the lateral side of the wall, and then we have Frank lay down, and we do breathing strategies in supine, which is very important to us in diastasis recti, and you can see that I'm going to start coaching him through the ability to laterally breathe, and Anna, I think you might be filming this, are you not? I'm trying to remember if you or

我是 ID 教學團隊的一員，所以我們可能會支持你根據 ID 原則進行親屬綁帶，也就是讓側壁移動。我只是想給你們看看，丹尼在我們的一位了不起的同事弗蘭克-德賽德里奧身上畫了這個，我只是想很快地和你們分享我的桌面，給你們看看。你們可以去 YouTube，輸入我的姓氏，或者直接輸入 "直腸腹膜膨出"，這就是丹尼給弗蘭克畫的畫，我們在這個直腸腹膜膨出視頻中展示了直腸腹膜膨出。讓我開門見山地告訴你，我們說的是直腸鞘，而事實上，直腸舒張並不是從這裡開始的。它來自側壁，然後我們讓弗蘭克躺下，我們做仰臥呼吸策略，這對我們

Danny were filming it. I think so, yeah. You can see me trying to point out to the lateral side that we're trying to get the person to expand laterally and that the person that has diastasis recti tends to expand too much here, so I think that's what they mean by trying to kin tape them down here, but rather than trying to tape them down here when rectus is really not what's causing the problem, it's the fact that there's tightness here, the diaphragm's dropping down and forward, as Anna describes in ID1, and in the way that Danny paints this, he shows that what you're looking for actually is for our IDQs to be set neck long, chin tucked, chest wide, and for the person to be expanding more laterally, and so if you want to kin tape to encourage better blood pressure through better diaphragm function, that's very indirect and I would say almost a little bit too indirect for me to feel comfortable saying that they're correlated, like Anna said, correlation versus causation. I think that the biggest thing for us in ID is trying to encourage the person to not breathe through their neck, to breathe through the sides of the ribs in diastasis, and 100% of diastasis recti patients, they breathe too anteriorly and not enough laterally, so hopefully you can help them control their blood pressure, you can use taping if you like, but please don't just tape them, you need to make sure that they get a lateral expansion, and if you want to learn how to do all this, we teach all of this, all the intricacies in ID1 core concepts.

丹尼在拍我想是的你可以看到我試圖向側方指出，我們正試圖讓人橫向擴張，而有直腸腹膜膨出的人往往會在這裡擴張過多，所以我認為這就是他們試圖用膠帶把他們綁在這裡的意思，而不是試圖用膠帶把他們綁在這裡，因為直腸腹膜膨出並不是真正導致問題的原因，而是這裡太緊了，橫膈膜向下和向前下垂，正如安娜在ID1中描述的那樣、是以，如果你想通過改善橫膈膜功能來改善血壓，那是非常間接的，我想說的是，這幾乎有點太間接了，我不太願意說它們是相關的，就像安娜說的，相關與因果關係。我認為，對我們來說，ID 最大的作用就是鼓勵患者不要用頸部

As Anna described too, just to show you, if you go to our website, maculardissection.com, you go to the ID Collaborative, we cover a lot of these breathing mechanics and the way that we coach breathing through the ID Collaborative, hopefully my internet will sustain here, folks, and I think it was episode three, yeah, this one right here, so you can just click on this one and it'll take you to where you can actually purchase this particular ID video just on the biomechanical breath, so if you're wondering how to navigate the website for these little videos, sorry, website's a little slow right now, my web is a little slow, it describes what you learn and what to do, and it's, you know, a pretty good 20 bucks spent, or you can sign up for the ID

正如安娜所描述的那樣，如果你訪問我們的網站 maculardissection.com，進入 "ID 協作"，我們通過 "ID 協作 "涵蓋了很多呼吸力學和呼吸指導方法，希望我的網絡能在這裡維持下去，夥計們，我想是第三集，是的，這一集就在這裡，所以你只需點擊這一集，它就會帶你到你可以購買這個特殊的ID視頻的地方，只是關於生物力學呼吸、如果你想知道如何瀏覽這些小視頻的網站，抱歉，網站現在有點慢，我的網絡有點慢，它描述了你學到的東西和要做的事情，你知道，花20塊錢很划算，或者你可以註冊ID

Collaborative membership where we cover breathing, so that might prove to be really helpful, and we are on par this year to talk about diastasis recti as a separate unit, but you're welcome to, you know, enjoy the biomechanical breath and our discussions on what's actually happening in breathing, because that might benefit you more than just saying, let me throw some tape on the front of them, and hopefully that will help them bind up, I think that that bind up idea of trying to create tension in the front of the wall, those are tendons that are stretched out, they're tendons for muscles that are located out to the lateral side, so if you're wanting something to really bind in the front, you better get moving on the lateral side, dating also, oh sorry, I think we also covered diastasis recti in the third Ask Us Anything, maybe, and that should be up on YouTube, right, yeah, so there, it is, it's a topic we love to talk about, we talk about it so good, if you just join us for something, it'll probably come up, so yes, Danny, anything else to hit when it comes to diastasis recti, and you have an awesome video on our Instagram where you go over like sitting postures, and breathing, and the aortic pulse, and blood pressure, and how it's affected by the diaphragm, yeah, no, I mean, just basically, we're just going to add, and kind of just contribute to that though, again, like kind of, kind of, just kind of jump back off of what was kind of said before a little bit, but, but yeah, like really, really big important thing though, is to really kind of work on lateral sides of things, like even though the name, anterior located structures, it's really not the thing that's causing issues, and like,

今年，我們將把直腸腹膜膨出作為一個單獨的單元來討論，但歡迎你來，你知道，享受生物力學呼吸和我們關於呼吸中實際發生的事情的討論，因為這可能比只是說，讓我在他們的前面扔一些膠帶，希望這將有助於他們綁起來更有益於你、我認為，想要在腹壁前方創造張力的綁定想法，是那些被拉伸的肌腱，它們是位於外側的肌肉的肌腱，所以，如果你想要真正綁定前方的東西，你最好在外側活動，約會也是如此，哦，對不起，我想我們在第三次 "問我們任何事 "中也提到了腹膜直腸膨出，也許，YouTube上應該有、是的，就是這樣，這是一個我們喜歡談論的話

I don't know, kind of the visual, I don't, hopefully it'll, hope it'll work this time, but

我不知道，從視覺上來說，我不希望這次會成功，但

I had kind of done this beforehand, but you can kind of think of it like, let's see here now, so if you're doing too much, kind of pushing forward anteriorly, you're kind of split at the front, but you know, if you strengthen, strengthen from the sides, it's going to kind of take that, all that tension coming out from the front, and keep you more braced, and more supported, but I was kind of thinking about that though too, in terms of like, you know, in terms of braces, or in terms of things like that, like if it's, if it's giving support, but preventing any kind of movement from happening, you know, I feel, I feel like that could just cause like, any kind of like, you know, side-to-side movement from happening, that can definitely cause some issues as well down the road, and you know, it may not get you very far in that sense.

我事先已經做了一些準備，但你可以把它想象成，讓我們現在來看看，如果你做得太多，向前推，你就會在前面分裂，但你知道，如果你加強，從兩側加強，它會採取那種，所有的張力從前面出來，並保持你更支撐，更支持，但我也在思考這個問題、就像，你知道，在支架方面，或在類似的東西方面，就像如果它，如果它給予支持，但阻止任何一種運動發生，你知道，我覺得，我覺得這可能只是導致像，任何一種像，你知道，從發生側向運動，這肯定會導致一些問題，以及在路上，你知道，它可能不會讓你很遠在這個意義上。

It's completely true, like the way you describe it too, is almost like a corset, like people get, they wear these binders after, like some people are assigned them after, you know, getting diastasis recti, the, the fallacy is that these people need to be compressed, these people need to be held in, because they think it's like a hernia, like a ventral wall hernia, and I do understand why people think that, but it's really because there's nowhere for the air to go, there's nowhere for the diaphragm to go, so it goes out to a path of least resistance, and because the linea alba is a bloodless plane, it's exactly like Danny showed you, it's bound up, the air, the pressure has to go somewhere, so it goes out to the front, it's not that the person needs a bind in the front that's extra, it's that they need to be opening through a 300, you know, degree breath, and they're so bound up on the lateral sides, especially after pregnancy, because the baby's expanding them so anteriorly, because the uterus is a midline structure, that the person could benefit not just from binding in the front, you, it's really hard to bind the front and not bind what's attaching to it, which are the, the muscles on the lateral side, so I love that analogy that you gave, it's great, it's perfect.

這是完全正確的，就像你描述的那樣，幾乎就像緊身胸衣，就像人們在穿上這些捆綁帶後，就像有些人在得了直腸腹膜膨出後被分配給他們一樣，謬論是這些人需要被壓縮，這些人需要被固定，因為他們認為這就像疝氣一樣，就像腹壁疝氣一樣、就像腹壁疝氣 我也理解人們為什麼會這麼想 但其實是因為空氣無處可去 橫膈膜無處可去 所以它會選擇阻力最小的路徑它被束縛住了，空氣和壓力總得有個去處 所以它就跑到前面去了 並不是說一個人需要在前面有額外的束縛 而是他們需要通過300度的呼吸來打開胸腔因為胎兒在前方擴張，因為子宮是一箇中線結構，所

What I was going to say, too, is just kind of think about it as well, like from the days of doing landscaping, we would have, especially if you were like building walls or doing things like that, like it'd be like, you know, 100, 150 pound rocks that we're lifting at a time, and you know, our boss is really adamant about us using back braces for that time, and found that on days that actually wore the back braces would have more, would have more pain afterwards, because couldn't really take a really deep breath to really like, obviously, you know, learning, applying it to a physical moving environment like that, you know, just take really, really deep breaths, you know, really support that spine, really, really get that, that IAP going, and then, you know, being able to move like a lot more efficiently, and wouldn't have those restrictions, that those were the days that would feel sore the next day, as opposed to other days, so. Oh, I am not a proponent of bracing, and yeah, I think that that's such a good observation to make, that when I watch people wear braces, I know why they're doing it, they have mechanics anyway, and so they wear the brace to actually encourage poor mechanics, and you, if you would learn good mechanics, then you can use the brace only in a clutch, like I think that a good example is, similar to Danny's, is my business partner is a very heavy deadlifter, and he would only wear a brace in competition, because it gave him an edge, he would never wear it in training, he would wear it in competition, because it would compress everything, and he would be able to get out an extra rep, but he would only do it for three total reps of his entire year of training, and compared to like people that train with it, or work with it, and it weakens the tissue, because when you break, research is very supportive of this theory, when you brace something, you're shutting down the muscles relative to that, because if you're getting exogenous support, your body's going to shut down, it's going to down regulate its own need, it's like energy efficient, it's like, oh, something else is doing that, why would I turn on?

我還想說的是，想想看，在做園林綠化的日子裡，我們會有，特別是如果你喜歡砌牆或做類似的事情，就像它會像，你知道，100，150磅重的石頭，我們一次抬起，你知道，我們的老闆是真的堅持我們使用背支架的時間，並發現，實際上穿背支架的日子會有更多，會有更多的痛苦之後、因為無法真正深呼吸，無法真正像那樣，很明顯，你知道，學習，把它應用到那樣的物理移動環境中，你知道，只是真正地深呼吸，你知道，真正地支撐脊柱，真正地，真正地得到那個，那個 IAP 去，然後，你知道，能夠像更有效率地移動，不會有那些限制，那些是第二天會感覺

Absolutely, and also if those braces have to come off eventually, then we seem very vulnerable,

當然，如果這些支架最終必須取下，那麼我們就會顯得非常脆弱、

I know I have a patient right now that has a ventral wall incisional hernia, and he's not been able to do a lot of his rehab that he's used to being able to do, I think it sounds like in the, since the pandemic and everything closed down, there's been a lot of caution, and he's found, he wore a brace as advice to him by his surgeon, and his surgery was actually postponed, because the interesting thing about openings and things like that in the anterior abdominal wall is the bigger ones are usually less dangerous, it's the small keyhole ones that are problematic, because if stuff can pass freely back and forth, that's fine, but if it passes through and gets stuck on the other side, that's a problem, so for this patient, he had had, he had had an incisional one, and then a very small one, interestingly enough, the incisional hernia was created because of, there was an inguinal hernia, and then there was a surgery with mesh, the mesh came loose, created a bowel obstruction, and then there was a full incision to address the incisional hernia, so the whole thing actually started from hernial repairs in the first place, which is really interesting, I'm not against, you know, addressing something surgically when it needs to be done, but we have to at least, you know, look at the sort of cause and effect of all this, and so since being sort of locked in with coronavirus and the pandemic, he has been bracing much, much, much more than usual, and the last update that I got this week is that there are now four extra hernias, and now it is absolutely essential, because they're very small and sort of sporadic all over the anterior abdominal wall, so four additionals, there's six total now, and that's with somebody who's been in a brace, and my sort of hypothesis on what's happened there is that the brace is not on 24-7, and so once you get used to that kind of support, it's different than when it's like a one, you know, a PR, a one rep max, you can't be doing a one rep max for 24 hours a day, so if the minute you start to accommodate that, your tissue starts to accommodate to that sort of false sense of security, it'll come out, you still cough and sneeze and fart in the middle of the night, and you know, anytime something like that happens, you're going to have some sort of potential for pressure leak, and you know, things take the path of least resistance, so bracing is a really interesting thing that I think we are all on the same page about, and you know, everything is always case specific, so we try not to make general blanket statements about anything, but you know, look at this too, and really ask yourself, like, what are we actually doing here, and does this solution match the problem that we are sort of facing? Yeah, I can't agree with you more about, like, it's a tough observation to have with a patient that you know you don't agree with the bracing, and I think taping is a lot less, of course, than bracing, and I know we've probably gotten off topic by talking about the bracing, but the whole point of this is that that feeling that you have to brace this person up is not really super effective, and just remember Anna's story about the incisional hernias, and the more that you create a sense of bracing in the front, I know why they're taught that, because there's a hernia, and that's the best way to go through the wall is through coughing, sneezing, defecating, you know, but the real focus in the therapy should be opening the sides, and then aponeuroses are broad, flat tendons, and tendons have the tensile strength of steel, so if you're starting to breach away from midline, ask yourself, why are they pulling away from midlines? Because the sides of the muscles don't have extensibility, so improving the extensibility of the sides of the ribs, I'm sure that's something that Anna's working on with her patient, and once COVID's over, you can probably do a lot more of it in person, but also very, very good analogies put into place, and good examples of cases. So we had another question about hip compression, is that right? And they were asking, was it the mechanisms of hip compression, or? It was, review the signs and symptoms of a compressed femoral head in the acetabulum, just any information around that, signs, symptoms, things like that.

我知道我現在有一個腹壁切口疝的病人，他不能做很多他習慣能做的康復訓練，我想這聽起來像是在，自從大流行病和一切都關閉以來，有很多謹慎，他發現，他穿了一個支架，這是他的外科醫生給他的建議、他的手術實際上被延後了，因為關於前腹壁的開口之類的東西，有趣的是，大的開口通常危險性較低，而小的鑰匙孔才有問題，因為如果東西可以自由地來回通過，那還好，但如果它通過並卡在另一邊，那就有問題了、有趣的是，切口疝的形成是因為腹股溝疝，然後又做了網片手術，網片鬆脫，造成腸梗阻，然後又做了全切口來解決切口疝、我並不反對在需要的時候通

Yeah, this is in our DVD, Anna, you teach the iliacus portion, do you want to talk about iliacus, and I'll talk about pectineus? Yeah, sure, so iliacus is a really interesting muscle, obviously it's going to lie in that iliac fossa, and it's going to go down and have an attachment onto the lester trochanter, and what we see is people, iliacus is this really interesting option for people to try to compress their hip for a sense of stability that they may or may not have, and the reason why is because the obliques, the anterior abdominal oblique, internal abdominal oblique, excuse me, and transversus abdominis will actually start to blend in into the front of the hips with the psoas fascia, and so a lot of times when people,

是的，這是在我們的DVD裡，安娜，你教的是髂肌部分，你想談談髂肌，然後我來談談櫛肌嗎？是的，當然，髂骨肌是一塊非常有趣的肌肉，很明顯，它位於髂窩內，向下延伸並附著在萊斯特轉子上，我們看到的是，髂骨肌是一種非常有趣的選擇，人們可以嘗試壓縮髖關節，以獲得可能有或可能沒有的穩定感、原因是腹斜肌、腹前斜肌、腹內斜肌、腹橫肌實際上會開始與腰方肌筋膜融合到臀部前方，所以很多時候，當人們..、

I mean, this is a really actually cool thing to talk about right after we talked about diastasis, because again, if this person doesn't have that lateral rib expansion that we are looking for in our assessments, and they start to, you know, sort of brace, and aren't able to get some of that tissue extensibility, they will start to compress their hips via this iliopsoas fascia that starts to blend in at the front of the hips, and they'll start to jam the femur into the acetabulum for a sense of stability that's, you know, not really an authentic place of stability, it's just sort of a strategy, and so we see this happen a lot in people who start to get these C-shaped signs and symptoms, they'll get these pinchy-pinchy kind of popping, clicking stuff rolling around, you put them in like a tabletop or a supine 90-90, or any sort of hip flex position, and they start to get a lot of referral down into the anterior thigh. You're really just sort of looking at a redirection of force, and so, you know, your body's efficient, it's going to get something done, but it may not always get it done with the most optimal structures to do that with, and so we want to make sure that we get appropriate force transfer from the abdomen, and we get that pelvic stability there to then transfer into the lower extremity, and, you know, a possible pathway for that, if someone doesn't have it, is iliacus, and so we talk about, you know, the appropriate ways to decompress the hip, and versus what the typical ways that people try to decompress their hip are, which gets really dramatic in a lot of people, and they, you know, they start to look for love in all the wrong places, and try to, you know, stretch their hip flexors out, and it's not really a hip flexor problem as much as it's a hip flexor that's sort of trying to kick in and give you a sense of stability, so we do show ways to maintain your IDQs and decompress the hip in a way that it is safe, and not something that is, you know, going to put you at a risk of, like, a labral tear, or something like that, where someone all of a sudden breaches some tissue capacity, and goes into a tissue sensibility that they don't necessarily have, and just point out what you're talking about, Anna. Anna covers iliacus in a lot of detail in IDQ, and then the three of us discuss pectineus. Danny does some really great art on that, but when it comes to hip compression, it's intra-abdominal pressure loss from conjoint tendon, the connection to iliopsoas fascia, so you always want to check with someone who has the signs and symptoms of just feeling like a hip is jamming in its socket, pelvic inclination on that side, hip hike on that side is usually present, and then you can see, I think in the DVD I'm talking about this, typically you'll get Anna talking about this, but she's talking about iliacus, and does such a beautiful job of demonstrating that, but in this free video that we have on the OTP website, you can listen to a little excerpt of our DVD, where we give you a little sneak peek into IDQ, into when Anna describes this in a lot more detail, but you can see me on Dr. Jake Altman here showing that the person's in kneeling position, we're putting tension into the iliopsoas fascia here, to centrate the femur, and the person's breathing into the sides of the ribs, you see me cueing the sides of his rib cage, this is because muscles like transverse abdominis, internal abdominal oblique, they're attaching to that iliopsoas fascia that Anna's describing, and helping with force distribution, and what's actually flexing the hip, the irony of the matter, is not the hip flexors like Anna's describing, it's actually you get gut pressure, and then you cue this tissue to come up, and it's a reflexive cue, which is pretty fantastic to think about, because people blame the hip flexors for so much, and they end up weakening their hip flexors, and then they don't train them in flexion, and in ID we would never do that, we train things in all of their phases, so if we know that psoas and iliacus are contributors to this hip compressive thing, through their attachment to fascia, and their attachment to the chondroit tendon, then just nearby is pectineus, and pectineus is an adductor that's innervated by the same thing as iliacus, femoral nerve, so pectineus is innervated by part femoral nerve, that's the part that flexes the femoral nerve, and then there is the adductor portion, which is obturator, because the bowels go together, right, if you want to adduct, you use obturator nerve, and so the obturator nerve part of this jams the femur and the socket even more through adduction and internal rotation, so now your flexed adducted internally rotated position is what we call hip compression, and hip compression is healthy, it's present during the loading phase of ambulation, where see how Jake's leg is forward here, that's a hip compressed state, and that's a healthy state, he has a hip decompressed state on this side, meaning you have extension, abduction, and external rotation, so the de-approximation of the femoral head from the acetabulum, so in this phase, you'll see him EQing his breathing, having him annealing, and we're trying to decompress his hip, so for people in ID, what we try to get them to do is meet them where they're at, take them where they're not, try to analyze if it's the iliacus, it's the pectineus, if it's a breathing problem, or all three, and then we help them centrate the femur relative to their breathing and pelvic position, we do these things called pendulums, where we move them back and forth, and I was trying to find the YouTube of looking for love in all the wrong places, because Anna inspired us to do an Instagram of it, I'm trying to remember if I put it on the YouTube, let me see if I did put it on the YouTube, it looks like I didn't, so you'll have to go to our Instagram to find it, but if you go to our Instagram and look up iliacus pendulum, or hip flexor pendulum, actually I think it's called hip flexor pendulum, hold on, and then you'll see me showing the demonstration of looking for love in all the places, but watching Anna Falkner do it can never beat, I mean it's so good, it's so good, but let me look up hip flexor pendulum really quickly for you, see if I can find it, are you guys seeing my screen now, yes, yeah, basically if you see somebody trying to stretch their hip flexors, and it sounds like they should have like chariots of fire playing in the background, and you want to give them a streamer, they're probably doing it wrong, I know right, I was fairly certain that I had put it on YouTube, but I must not have, so which is a real shame, because it's really, really good, and I'll stop the share just so I can find it, but the way that we cue hip compression, the signs and symptoms of course are hip jamming at socket, you want someone to yank it out, pelvic inclination on that side, internal rotation with flexion bias, when they do a toe touch, usually their knee will bend, when you have various activities, you'll, the person always says they get relief when someone tractions their hip, so they've probably been assigned hip flexor stretches out the wazoo, and it's not going to get it done, just as Anna described, because first of all, the person feels an enormous amount of load in that position, so they may not actually like it, and so if they don't like it, they may not do it, oh I almost found it folks, if you go to our Instagram and our IGTV and you find it, it's called the hip flexor, I just scrolled past it on accident, my sincerest apologies, now I can't find it, so unfortunately you're going to have to do some hunting until I can upload it onto our YouTube, so I thought that

我的意思是，這是在我們談完腹膜膨出之後要談的一件很酷的事情，因為同樣，如果這個人沒有我們在評估中尋找的肋骨外側擴張，並且他們開始，你知道，有點像支撐，並且無法獲得一些組織的伸展性，他們就會開始通過髂腰筋膜壓迫他們的髖部，而髂腰筋膜開始在髖部前方融合、他們會開始將股骨塞入髖臼，以獲得一種穩定感，你知道，這並不是真正的穩定感，這只是一種策略，所以我們經常看到這種情況發生在那些開始出現 C 型體徵和症狀的人身上、你把他們放在桌面上，或者仰臥 90-90 度，或者任何一種屈髖姿勢，他們就會開始向大腿前側發出大量信

I had, but I evidently did not, but if you go under our YouTube IGTV, you'll find it, it's hip flexor pendulum, so you can see me doing the dramatic version and the non-dramatic version, and that's a way to teach centration of the femur, because really what hip compression is, is de-centration with a bias towards flexion, adduction, and internal rotation, and so you're trying to get them to do that during healthy phases, and not doing that during phases where you want them to leave that position, it is healthy to compress the hip, particularly during the loading phase of ambulation, it is not healthy during the terminal stance phase, during the mid-stance phase, and so if they're carrying that hip compression into multiple phases of gait, it tends to become uncomfortable pretty fast, they show signs of iliopsoas bursitis, they show signs of just a jam sensation in the hip, an overstretched sensation in the posterior hip is usually present, none of which are comfortable for the patient, so those are your signs and symptoms, and what you can do about it is probably take ID2 and be a good idea to learn all the intricacies, because it's not as simple as saying, hey let's put them in kneeling and hope for the best, you have to know what to look for in that kneeling position, you have to know how to center them up, okay, I mean it's like taking 15 hours of instruction and putting it into like a 10 minute question, it's pretty tough, so hopefully we've been succinct enough to inspire you to study, and then we do have this article on OTP, you just type in OTP hip compression, and not only are it's basically a write-up about what we discuss, and also a free video, so you get a little sneak peek into that, so OTP hip compression, On Target Publications is the one who filmed our video for us, when we were fledgling at that point, we just had three IDs, now we have six, so we appreciate the question, okay, so we are still looking for questions from our live participants, if you guys have anything, I didn't miss anything, right? Nothing that was on Facebook, but one of our attendees that's in the chat right now has raised her hand, so person with hand raised, if you want to, if you're asking a question or you want to comment, maybe you can put that in the chat box, good, while they're thinking and typing, the chat box is to the left of the share screen at the bottom of your screen, we tend to not turn on your audio, just because we have to mute ourselves, even when we're talking, after we're talking for the feedback, for the recording, we want the recording to be a higher quality for you guys, so if you don't mind typing in the chat box, we can answer your question there, in the meantime, we've got some pretty exciting things coming up on the ID Collaborative this week, if you guys haven't heard of it, it is our learning series that we do, and every week we have two topics, and on Tuesday, we're talking about debunking psoas myths, and Anna and Danny made an absolutely awesome video on this, and it's like a one minute little snippet that we're going to tease you with during the talk on Tuesday, but we want to debunk a lot of myths about the psoas, one, the most important of which is that it's a hip flexor, which it's not that it doesn't act when in hip flexion, it's definitely active in hip flexion, but both of your psoas are active during one hip flexing, which means it's more complicated than most people think, and we also want to stop giving it for credit for things it doesn't deserve, and give it credit for things that it does deserve, like lumbar stability, but we want to take away the fact that everything that's wrong with your hip ever, especially in the front of it, is psoas. Notice how Anna was talking about hip compression, and we barely mentioned psoas. We mentioned psoas fascia, and we mentioned iliacus and pectineus, nearby brothers of psoas, but not psoas itself. Psoas gets blamed for so many things it doesn't deserve, and it's actually got a highway systems of nerves running through it, so that if psoas were really the problem all the time, then your genitalia, your front of your hip, your side of your hip, and your butt would constantly be numb, and luckily for all of us, we're not experiencing that on a regular basis, yet we're all still blaming psoas for all of our problems, and how it got named as the muscle of the soul, I still don't know. Now, Anna, you're vegan.

我有，但顯然我沒有，但如果你去我們的YouTube IGTV下，你會發現它，這是髖屈肌擺動，所以你可以看到我做的戲劇性版本和非戲劇性版本，這是一種教授股骨集中的方法，因為真正的髖關節壓縮是什麼？所以你要努力讓他們在健康的階段做到這一點，而不是在你希望他們離開那個位置的階段做到這一點，壓縮髖關節是健康的、尤其是在行走的負荷階段，在末期站立階段和中期站立階段是不健康的，是以，如果他們在步態的多個階段都壓迫髖部，往往會很快變得不舒服，他們會表現出髂腰肌滑囊炎的症狀，他們會表現出髖部卡住的感覺，通常會出現髖部後部

I know it's not the muscle of your soul, and psoas means loin, and definitely not.

我知道它不是你靈魂的肌肉，腰肌的意思是腰部，絕對不是。

You teach a lot about psoas, and ID, and you talk about it, you know, being the filet mignon.

你教了很多關於腰肌和內臟的知識，你說它是菲力牛排。

Yeah, so I hear. I've never had one, but I've seen one in the lab a lot, and so, you know, it maintains that soft, supple, tender nature for a perfectly good anatomical reason, and it's to protect everything that runs through it. We talk about it, you know, like Kathy said, it has an inner state of neurovasculature that runs through there, and so psoas sort of packs around it and protects and acts as this really nice insulatory structure for a lot of the things that pass through it, and so, you know, there's a couple ways you can look at that. One, that tells you exactly why it needs to have that type of personality and quality, and the other reason is maybe the things that people are constantly doing to it aren't totally necessary, because when you look at it, it's very soft, and supple, and tender, so.

我聽說了我從來沒有過，但我在實驗室裡見過很多次，所以，你知道，它保持柔軟、柔韌、細嫩的特性是出於一個很好的解剖學原因，是為了保護貫穿它的一切。我們談到它時，你知道，就像凱西說的，它有一個內部狀態的神經血管穿過那裡，所以腰肌有點像包裝在它周圍，保護和充當這個非常好的絕緣結構，很多東西都通過它，所以，你知道，你可以從幾個方面來看這一點。其一，這告訴你為什麼它需要有這樣的個性和品質，另一個原因是，也許人們經常對它做的事情並不是完全必要的，因為當你看它的時候，它非常柔軟，有彈性，而且很嫩，所以。

They want to maul it to death, and tenderize it, and beat it, and do intra-abdominal intense work on it, and what's so fascinating to me is that there's so many organs that are nearby, like, you know, we have a psoas sign for kidney dysfunction. We, you know, you have an appendix and a cecum towards the right side. You have intestines galore, you know, covering the psoas, and in order for Anna and Danny and I to see it in the human dissection that we've done, and we've done some of it together, and, like, we just, like, pick up, like, the bouquet of small intestine, you know, and large intestine, you just pick it up like a bouquet, and still you can't see the psoas because the psoas is covered in that iliopsoas fascia that's actually transversalis fascia named for the muscles that cover it, and so this transversalis fascia is that same fascia that's covering pectineus, so it's really the reactivity of everything around you, not this one particular muscle, and so it's always strange when a muscle gets blamed for a lot of problems. I mean, it, you know, we need to debunk that myth hardcore for you guys on Tuesday, so if you guys are interested in learning more about psoas and maybe peeling apart things that you may have been taught that are just starting to question them or starting to think independently about what psoas is and how it contributes around things around it, I think that would be really fascinating to look at. Awesome, so we have another talk this week, and I'm trying to remember the topic now, it's not, it's failing me. Root canal. That's right, the root canal, and we'll be talking about the anatomy of the root canal, and if Anna is nice enough, maybe she can share her personal experience with it. Sure thing, super looking forward to it. I've unfortunately learned a lot about root canals lately, so opinions formed. She's got an absolute litany of literature, and she had to make a really tough decision for herself of to do or to not to do, and we're going to talk about the possible pitfalls and also the possible benefits and hopefully help you anatomically to understand what's happening in root canal, and I know that Anna's got tons of research collected probably already for us on this, and that she's really ready to share it. Okay, we got a question about the tips from exercise classes. Oh, a hip flexor is being taught.

他們想把它弄死，把它弄嫩，打它，對它進行腹腔內的高強度工作，讓我著迷的是，附近有這麼多器官，比如，你知道，我們有腎功能障礙的腰肌徵兆。右側有闌尾和盲腸。為了讓安娜、丹尼和我在人體解剖中看到它，我們一起做了一些，比如，我們只是拿起一束小腸和大腸，就像拿起一束花一樣、你仍然看不到腰大肌，因為腰大肌被髂腰筋膜覆蓋，而髂腰筋膜實際上是橫筋膜，因覆蓋腰大肌的肌肉而得名，所以橫筋膜也是覆蓋櫛膜的筋膜，所以這實際上是你周圍所有東西的反應性，而不是這一塊特定的肌肉，所以當一塊肌肉被歸咎於很多問題時，總是很奇怪。我的意思是

Got tight hip flexors in exercise class. What's so interesting to me is that people think that the hip flexors are tight all the time, and they don't do any kind of orthopedic assessment of it, they don't do any kind of analysis of it, they just say, oh it's tight. Well, first of all, you have fascia lata on the front of your thigh that's incredibly tight, and that fascia is usually mistaken for hip flexors. That same fascia is usually pretty tight on the posterior part as well, but the femoral nerve is sitting just deep to the fascia lata and intertwining and coming out superficially to get to the skin, and so people have a bigger perception of tightness. They have a more sensory awareness typically of that tightness than they do on the posterior chain. If you have these tight hip flexors all the time, you have these tight hamstrings all the time, those two things are antagonists, so the feeling for the need to stretch those things all the time, that to me is very erroneous.

運動課上髖屈肌緊張。讓我感到有趣的是，人們總是認為髖屈肌很緊，他們不對其進行任何矯形評估，也不對其進行任何分析，他們只是說，哦，它很緊。首先，你大腿前側的筋膜非常緊繃，而這種筋膜通常會被誤認為是臀屈肌。同樣的筋膜通常在後部也很緊，但股骨頭神經就在筋膜的深處，交織在一起，從表層到達皮膚，是以人們對緊繃的感知更大。與後鏈相比，人們對這種緊繃感的感知更為強烈。如果你的髖屈肌一直很緊，膕繩肌一直很緊，這兩樣東西就是拮抗劑，所以你覺得需要一直拉伸這兩樣東西，這對我來說是非常錯誤的。

Typically, if things are tight for us in immaculate dissection, it only means one thing, and that's worthy of your attention during assessment. It's not a need to stretch things all the time, and the grand irony of things is that if it's tight, it might also be locked long, it might be eccentrically loaded, and if you're yanking and pulling on nerves and fascia all the time, it tends to send sensory awareness up to the parietal lobe that things are tight, and it doesn't necessarily mean that they need to be stretched, and so if you watch our video with the very dramatic hip flexor stretching, you'll see that most people aren't even stretching their hip flexors anyway when they're doing demos, and we put people in immaculate dissection too.

通常情況下，如果我們在無懈可擊的解剖過程中發現東西很緊，這隻意味著一件事，那就是在評估過程中值得你注意。值得注意的是，這並不意味著需要一直拉伸。具有諷刺意味的是，如果肌肉緊繃，也可能是鎖定時間過長，也可能是偏心負荷過重，如果你一直在拉扯神經和筋膜，往往會向頂葉發送感覺意識，即肌肉緊繃，但這並不一定意味著需要拉伸、是以，如果你觀看我們的視頻，看到非常誇張的髖屈肌拉伸動作，你會發現大多數人在做演示時根本沒有拉伸髖屈肌，我們也會讓人們進行無暇解剖。

Anna puts them through the kneeling hip flexor pendulum for iliacus, and people are doing this very small movement. They're like, holy crap, I feel like so much happening, and these are people that usually feel nothing on a hip flexor stretch. I was one of those people. I know Anna was. We're like super flexible, but not flexibility, mobility, very different things. Mobility has the stability to control it. Flexibility is just loose connective tissues and just flopping all over the place, and so a lot of people, they're given these hip flexor stretches. Oh, I feel so tight, and then stretch it, and then they actually create more dysfunction in the tissue, and so we're not big hip flexor stretch people. We're more like assessment people.

安娜讓他們通過跪姿髖屈肌擺動來拉伸髂骨，人們正在做這個很小的動作。他們會說，我的天啊，我感覺發生了很多事情，而這些人通常在做髖屈肌拉伸時什麼感覺都沒有。我就是其中之一。我知道安娜也是我們就像超級靈活，但不是柔韌性，而是移動性，完全不同的東西。流動性有穩定的控制力。柔韌性就是鬆散的結締組織 到處亂跳 所以很多人都會做屈髖伸展運動哦，我感覺太緊了，然後就拉伸它，結果實際上造成了更多的組織功能障礙。我們更喜歡評估。

Why is something tight? Is this tight on both sides of the joint? Is it worthy of my attention?

為什麼會緊？接頭兩邊都緊嗎？值得我注意嗎？

Is it the tightest thing associated with the person's chief complaint, and so we have these rules and idea of tightest thing associated with chief complaint has certain clinical process associated with it and dysfunctional on our assessments, and if you don't follow those four rules, it doesn't matter if you're tight. You can be tight for lots of reasons. You can be tight because you're low on circulation. You can be tight because you're low on neurotransmitter function. You can be tight because for so many systemic reasons, dehydration, so it's not enough to say, hey, my hip flexors are tight because I work behind a desk all day, and I'm in hip flexion. Not really. You're passively in hip flexion. You're not doing active hip flexion, so I don't know that you need to be stretching things all the time, and so we are really passionate about that idea, and we know that it sometimes goes over like a fart in church because people are so used to hip flexor stretching, and it feels good or whatever, and I'm like, okay, fine. If it feels good and it also serves you a purpose that you find result in, then do it by all means, but for us, what we usually find in our assessments with hip compression is that if iliacus is locked short, you have to teach it how to be short and how to be long and how to share load back and forth, not just flex or stretch and see how long you can make yourself.

是以，我們有這些規則和想法，即與主訴相關的最緊要的事情與我們的評估相關聯，並有一定的臨床過程和功能障礙，如果你不遵循這四條規則，你是否緊要並不重要。緊繃的原因有很多。緊繃可能是因為血液循環不足。緊繃可能是因為神經遞質功能低下。你可能會因為很多系統性原因、脫水而感到緊繃，所以光說 "嘿，我的髖屈肌緊繃是因為我整天伏案工作，髖關節處於屈曲狀態 "是不夠的。其實不然。你是被動屈髖。你並沒有主動屈髖，所以我不認為你需要一直伸展髖關節，所以我們真的很熱衷於這個想法，我們也知道這有時就像在教堂放屁一樣，因為人們太習慣

It's not typically something that we're after in ID, so that was fun like lead-in to gut pressure with diastasis to hip compression, hip compression to debunking psoas myths.

這通常不是我們的目標，所以從腸道壓力、腹膜膨出到髖部壓縮、髖部壓縮，再到揭穿腰肌神話，這些都很有趣。

Root canal is a little far from that, but there are some people that think that certain teeth link to certain muscles, and I have no evidentiary support for that, so I don't think that psoas has a tooth, but psoas does have a pathway, meridian pathway possibly, that you might be able to far reach. We're not far reachers much in immaculate dissection. We mostly want you to study the anatomy and learn the big causative agents behind assessment, and the whole point of anatomy of the root canal is to most people don't even know what a root canal is, and they just kind of sign up for it without doing any research into why they may need it, and you may want to really do your research first. Anna does her research. She was not going to dive into anything lightly, and she's going to talk a lot about that on Friday from a personal perspective. I'll try to share as much as I can anatomically with it. I'm very honored to teach at a college of dentistry. We talk a lot about root canals, and I don't know what I would do in that situation. It's a really hard decision to make, but you want to have an informed one, and what we want to do is provide an informed one, and Anna will give you a personal perspective that I can't give you as well as a very professional perspective anatomically. Danny, have you had a root canal? Do you mind if I ask? Is it violating HIPAA if I ask? You don't have to answer. Yeah, I actually had one after I graduated from college. Whoa, you have two? I feel like I'm so left out. Oh, it was only one. It wasn't really necessarily painful or anything, but it was just like, I don't know, I guess maybe possibly too much information, but I just noticed that there was just really bad breath all of a sudden. Oh, that's not too much information. That's bacterial overfill. But there was never any pain associated with it or never any issues like that, so I remember just checking in the back of the mouth, and like half the tooth is gone. Oh, it's scary because it's like, yeah, there's so many things that are linked to bacterial overgrowth, and I'm sure we'll talk about that. It's not just fluoride deficiency. A lot of people think there's so much to it that's very systemic, and I think what's going to be such an interesting talk is that some people have pain, some people don't. Some people have deadening nerve, and they don't feel anything, which is way scarier, which is a big point of the root canal. There's Anna, and I don't want to spoil Friday because I know you guys will have, so I am so excited to hear you guys talk about it because I've never experienced it. I've experienced wisdom teeth removal and a couple cavity drills, but nothing all that significant, but I'm fascinated by root canal, and I hate that you guys had to go through that because I heard it sucks, but I'm so interested to teach people about it so they can make very informed decisions for themselves.

根管療法離這有點遠，但有些人認為某些牙齒與某些肌肉有聯繫，而我沒有證據支持這種說法，所以我不認為腰大肌有牙齒，但腰大肌確實有一條通路，可能是經絡通路，你也許能找到。在無懈可擊的解剖學中，我們並不擅長深入研究。我們主要是想讓你研究解剖學，瞭解評估背後的主要致病因素，而根管解剖學的整個要點是，大多數人甚至不知道根管是什麼，他們只是在沒有做任何研究的情況下就簽了字，為什麼他們可能需要它，你可能真的想先做你的研究。安娜做了她的研究。她不會輕易涉足任何領域，週五她會從個人角度談很多這方面的問題。我會盡可能多地從解剖

Yeah, no, it's definitely an interesting process for sure. I know just kind of speaking on my end there, though, I was hyped up for it to be this terrifying experience. It was actually pretty smooth, considerably speaking, but I can certainly see why it can be a little nerve-wracking for people, for sure. Someone in the panel had mentioned tooth regeneration and some of the research is going into that. That is a very slow process. There's a lot of discussion about different amalgams and stem cells. As much as it's exciting, it's kind of like piggybacking on Megan Colbert's talk on Friday with spinal cord research. We'd hear all these clickbait about stem cells and spinal cord injury patients, but the progress has been very slow. It is very promising, but very slow. Before you start getting stem cell injections to grow that, know that a lot of those research studies are done on very small N values. It's not super cleared yet for that, but it's very exciting. It's very exciting, the idea of being able to regenerate enamel and regenerate dentin and even regenerate the nerve if it's dead. Those are very exciting possibilities, not probabilities. If you get an abscess tomorrow, it is a probability that you may have to consider doing a root canal. We in ID want to be very open-minded, but we also want to be very consistent with things that we're reading and staying up on things for you.

是的，不，這肯定是一個有趣的過程。我知道，就我個人而言，我一直以為這會是一次可怕的經歷。實際上，從很大程度上來說，過程還是很順利的，但我也能理解為什麼會讓人有點緊張，這是肯定的。小組中有人提到了牙齒再生和一些研究。這是一個非常緩慢的過程。有很多關於不同汞合金和幹細胞的討論。雖然很令人興奮，但這有點像梅根-科爾伯特週五關於脊髓研究的演講。我們會聽到所有關於幹細胞和脊髓損傷患者的點擊廣告，但進展非常緩慢。雖然很有希望，但進展非常緩慢。在你開始注射幹細胞生長之前，要知道很多研究都是在很小的N值上進行的。它還沒有

Anna, I know you went through the gamut. I'm so excited to hear you talk about it because Anna's not only a really brilliant person, but she's very open-minded. It's hard to find that in a person. I find Danny to be that too. You guys are always just wide open and really want to read before you make a decision about something. Anna, you really struggled with that decision. I remember talking to you about it in February. Yeah, for sure. I think that you have to be open-minded about these things. If you practice holistic medicine or holistic rehabilitative therapies long enough, then you know that there is no one-size-fits-all answer for anything.

安娜，我知道你經歷了很多。我很高興能聽到你談起這件事，因為安娜不僅是一個非常出色的人，而且她的思想非常開放。在一個人身上很難找到這樣的人 It's hard to find that in a person.我覺得丹尼也是這樣的人你們總是敞開心扉，在做決定之前都會仔細閱讀。安娜，你在做決定時真的很糾結。我記得二月份的時候跟你談過這個問題是的，當然。我認為你必須對這些事情持開放態度。如果你從事整體醫學或整體康復治療的時間足夠長，那麼你就會知道，任何事情都沒有放之四海而皆準的答案。

I think that there's a lot of scary research that gets posted and sent around Facebook.

我認為有很多可怕的研究結果在 Facebook 上發佈和傳播。

There's a lot of validity to some of it. I think ultimately, it just comes down to case-by-case. Unfortunately, I'm as a patient a huge pain in the butt, a really terrible patient.

其中有很多道理。我認為最終還是要視具體情況而定。不幸的是，作為一個病人，我是一個非常麻煩的病人，一個非常糟糕的病人。

I'm that person that will really drill my clinician. I need to know what your answer is based on. What do you think of this? What do you think of that? The way that I medical shop a little bit for my personal practitioners and my personal health team is the people that will have those conversations with me and not just do something because somebody told them it was a good idea or do something because, hey, that's just what we do as a medical community. It's the age of information. Those answers are no longer good enough. I don't want to talk about root canals yet because we got to talk about it on Friday. I will say shop around for people who will have informed discussions with you because there are doctors. I know we are certainly those clinicians for our patients. We shop for those people to trust our own health with. There's a lot of cool stuff to learn about yourself and a lot of cool things that you can help other people with. You just got to ask around. Ask people what they think. Ask people why they think what they think. That's a pretty telling question. If someone doesn't know the answer to that, I don't want your hands in any of my orifices if you don't know why you're doing what you're doing. It's a nice litmus test. I think that you're going to have so many fun things to say. I know we have another ID teaching team member who's been through a lot of dental stuff with root canal. One dentist told her root canal. Another one told her not root canal.

我是那種會認真鑽研臨床醫生的人。我需要知道你的答案是基於什麼。你怎麼看這個？你怎麼看這個？我對我的醫生和我的醫療團隊的要求是，他們能與我進行對話，而不是因為有人告訴他們這是個好主意就去做，或者因為 "嘿，這就是我們醫療界的工作 "就去做。現在是信息時代。這些答案已經不夠好了。我現在還不想談牙根管治療，因為我們週五就要討論這個問題。我想說的是，你可以四處尋找能與你進行知情討論的人，因為有很多醫生。我知道我們當然也是為病人服務的臨床醫生。我們要尋找那些能夠信任我們自己健康的人。有很多很酷的東西可以瞭解自己，也

There's a lot of debate whether to do it or not to do it. I think it's so important to have someone that you can communicate with. One of the panelists said make sure you have a good dentist. I'm like, oh, there are so many good dentists that also have conflicting ideas. I think that you have to have an informed decision that you then decide to do for yourself. When it comes to root canal, it's very controversial. You've got full books written about the perils of root canal. Then you've got a lot of research studies that support how it can really save you. There's a lot of debate. I'm sure there is a case-by-case basis of what you're going to decide. We'll go into some of the depths of the research and then personal experiences from Danny and Anna and hopefully one of our other ID teaching team members. Hopefully she can make it next Friday and come in and talk about her experience. She's been what you would probably describe as the pain in the butt patient, which I think is a patient person who's patient with trying to get answers. I find that if you don't do that for yourself, don't expect anybody else to do it for you. You have to be your own advocate. I love when my patients think that they're being a pain in the butt with me, but they're just asking me really good questions. As an informed doctor and wanting to be a good doctor,

到底要不要做，有很多爭論。我認為有一個可以與你溝通的人非常重要。其中一位小組成員說，確保你有一個好牙醫。我想，哦，有這麼多好牙醫，但他們的想法也有衝突。我認為，你必須有一個明智的決定，然後再決定自己做什麼。說到根管治療，爭議很大。有很多書都寫到了根管治療的危害。也有很多研究支持根管治療能真正救你的命。爭論很多。我相信你會根據具體情況做出決定。我們將深入研究一些深層次的問題，然後介紹丹尼和安娜的個人經歷，並希望能介紹我們 ID 教學團隊的其他成員。希望她能在下週五來談談她的經歷。我認為她是一個有耐心的人，有

I would love a patient like Dr. Anna Folkmer. It would be the best. I know she's going to read about it. She's going to do a lot of things to help herself and honestly take the pressure off me to make all the decisions for her. Well, we thank you guys so much for joining us tonight.

我很想有一位像安娜-福克默醫生這樣的病人。那將是最棒的我知道她會讀這本書的。她會做很多事情來幫助自己，說實話，也減輕了我為她做所有決定的壓力。非常感謝你們今晚的到來。

What a fun time. Awesome. We'll post this on our Immaculate Dissection Facebook page so that you guys can find it later if you found it to be useful and want to go back and hear anything again. Thank you so much for your time and attention. I'll make sure to include the links to the things that we discussed in the write-up under the YouTube. If you want to read the OTP article or if you want to watch the video of the hip compression, we have that for you, a diastasis recti video will also be there. Just look under the description and there'll be hyper links. You can click on those and go to those videos. Thank you so much for joining us tonight.

多麼快樂的時光太棒了我們會把這個發佈到我們的 "無暇解剖 "臉書頁面上，如果你們覺得有用，想回去再聽一遍，可以稍後再找。非常感謝你們的時間和關注。我一定會在 YouTube 下的文章中加入我們討論內容的鏈接。如果你想閱讀 OTP 的文章，或者想觀看髖關節壓縮的視頻，我們會為你準備好，直腸腹膜膨出的視頻也會在那裡。只需查看說明下方的超鏈接。你可以點擊這些鏈接，進入這些視頻。非常感謝您今晚的參與。

Dr. Folkmer, anything else to share with the crowd? Thank you so much. We really appreciate all of your questions and your interest and your support and your participation.

福克默博士，還有什麼要和大家分享的嗎？非常感謝。我們非常感謝大家的提問、關注、支持和參與。

Thank you. Danny, any last words for this amazing crowd?

謝謝丹尼，有什麼遺言要對大家說嗎？

Just a similar vein right there. Just thank you guys for joining and for partaking and coming along. Always nice when we have participants and everyone who goes by and checks it out.

就是類似的情況。感謝你們的加入，感謝你們的參與和到來。當我們有參與者和每個路過的人都來看看的時候，總是很開心。

Happy that you spent some time with us this Sunday and excited for next week's.

很高興這個星期天你能和我們在一起，並對下週的活動充滿期待。

Absolutely. We will see you folks hopefully in a week, if not sooner, on the ID Collaborative.

當然可以。我們希望一週後，甚至更早，就能在 "ID 協作 "上見到你們。

If you ever want to check out one of our courses, they are all online now,

如果您想了解我們的課程，現在所有課程都已在線提供、

ID123456. You find them at ImmaculateDissection.com. Just click on its very home page and make sure you cannot miss it. All of our stuff is basically online. You can find us.

ID123456。您可以在 ImmaculateDissection.com 上找到它們。只需點擊主頁，確保您不會錯過。我們所有的東西基本上都在網上。您可以找到我們。

We would love to educate you. If you ever do seminars again in person, you can use that as tuition towards an in-person course. It has to be the same level that you took. If you took ID1, you have to use it towards ID1. We would love to be able to get you in person one day. Until then, we would love to help you online. If you are doing telehealth visits with clients, we have study groups for telehealth. We show you how we use our ID with telehealth. I know

我們很樂意為您提供教育。如果您再次親自參加研討會，您可以將這些學費作為親自參加課程的學費。必須是您參加過的同一級別的課程。如果您參加了 ID1，您必須將其用作 ID1 的學費。我們很希望有一天您能親自來上課。在此之前，我們很樂意在網上為您提供幫助。如果您正在對客戶進行遠程醫療訪問，我們有遠程醫療學習小組。我們會向您展示如何在遠程醫療中使用我們的 ID。我知道

 Ann and I are doing a litany of telehealth appointments. It is helping our clients so much. In a time where it is really hard to get to your therapist, we don't maybe love doing telehealth as our primary source, but we can certainly make a lot of things happen and get a lot of things done with telehealth. We help you integrate your ID flow, our charts into an interactive experience with your client and telehealth. We would love to help you if you let us. Hopefully, you can join us for an online course in the future. If not, we will see you next Sunday at our free webinar or ask us anything. Have a good night, everybody.

安和我正在進行一連串的遠程保健預約。這對我們的客戶幫助很大。在一個很難找到治療師的時代，我們也許不喜歡把遠程醫療作為主要管道，但我們肯定能通過遠程醫療做成很多事，完成很多事。我們會幫助您將您的 ID 流程、我們的圖表與客戶和遠程保健進行互動。如果您允許，我們很樂意幫助您。希望您將來能參加我們的在線課程。如果沒有，我們將在下週日的免費網絡研討會上與您見面，或向我們提出任何問題。祝大家晚安