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5 Mistakes Beginner Lifters Make

A lot has been made of how easily one can make progress in the first year of strength training programs.  It’s possible for beginner lifters to drop body fat and gain muscle mass at rates faster than these individuals will ever experience again during their training careers.

However, very little attention is paid to how much can also go wrong during this initial period.

Beginner lifters can pick up on bad technique that leads them down bad “movement paths” that lead to injuries down the road.  As Gray Cook has noted, you never want to lay fitness on top of dysfunction.

Additionally, these beginner strength training participants can gain a false sense of what effective programming really is.  If the basic muscle magazine garbage plan worked, then why allow your training program to evolve from there? You got strong on sets of 8-15 reps and used the Smith machine a ton, so why would you ever want to lower the number of reps per set or head over to the free weight area?

The point is that we’ve measured progress too much in terms of how people look and too little in terms of how people feel and move.  The truth is that it’s possible for beginner lifters to improve in all three areas with quality programming from the get-go.  With that in mind, I thought I’d outline five mistakes beginners commonly make in their quest to make serious fitness gains.  The timing of the post is actually quite fitting, as Mike Robertson introduced his awesome new Bulletproof Athlete resource.  I think this program has instantly set the new standard for an ideal beginner template.

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Anyway, without further ado, here are those five mistakes:

1. Overlooking the Value of Quality Nutrition

Let’s face it: there are a lot of frat boys out there who start lifting in college, and make ridiculous progress in spite of the fact that they crush beer, nachos, and chicken wings for about 75% of their total caloric intake.  That doesn’t mean optimal nutrition can’t expedite process and – just as importantly – set the stage for a better internal environment for long-term progress.  Just remember that even if you just want to “bulk like crazy” to start up, those fat cells are with you for life once you’ve made them.

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2. Not Building Work Capacity

Most beginners will build work capacity just by continuing to show up for training sessions and “surviving” the workouts.  That doesn’t necessarily mean that they’re adapting optimally to set the stage for long-term progress.

That said, in light of the “interval training is awesome and steady-state cardio is useless” propaganda of the past few years, there are a lot of people who completely omit steady-state cardio form their training programs – opting either for no supplemental conditioning or for high-intensity interval training (HIIT) only.  While some HIIT is certainly appropriate and acceptable, it’s not a good idea to completely overlook the value of building an aerobic base.

This aerobic component early on helps to optimize during- and between-session recovery – which, in turn, enables a trainee to get in more quality work over the long-term.  In fact, some of my best gains came during my “intermediate” lifting career when I was doing low-intensity cardio twice a week for 20-30 minutes.  As I wrote all the way back in 2005 in Cardio Confusion, as long as the intensity is low enough, it won’t interfere with strength or muscle mass gains.

3. Not Appreciating Soft Tissue and Mobility Work

When you’re a gung-ho beginner, nothing can stop you.  You feel great for every training session and just want to keep working harder and harder when the mirror gives you great feedback.  The problem, however, is that it’s hard to see the forest through the trees.  In this case, your abs or biceps are the trees, and the forest is how you’ll feel in ten years if you don’t go down a path that includes foam rolling and mobility work.  Rolling around on the floor on a stupid cylinder isn’t sexy, and doing side-lying windmills really isn’t anyone’s idea of fun, but trust me when I say that it makes a difference over the long haul.  And, the people who have the most continuity in their training career are the ones who make the best long-term process. 

I attribute a lot of my success in the weight room to the fact that I rarely get sick, and haven’t had any significant injuries over the year. In fact, at one point, I went eight years without missing a planned training session.  It took a storm with 38” of snow to get me to push a lift back a day!  I’m not saying you have to be this neurotic, but at the very least, set aside 8-10 minutes before you train to take care of your body.

4. Training Through or Around Injuries Instead of Fixing Them

Everyone has rolled an ankle at some point of another.  And, most people have had a cranky shoulder after a few hours of painting or playing catch.  There are obviously a lot of other examples of old “wear and tear” we might discount as normal and non-problematic.

There’s a problem, though: adding external load often brings these issues to threshold. A bum shoulder might not bother you grabbing a glass on the top shelf, but it’ll start to bark when you’re military pressing a significant amount of weight.  Don’t ignore these issues!

You see, we’re all resilient when we’re in our teens and early 20s, but things get a lot tougher as we get older for two main reasons.  First, we acquire structural abnormalities – bone spurs, rotator cuff tears, disc hernations, even fractures – that we never perceive until it’s too late.  Second, as we get older, degenerative changes kick in much faster, as tissues just can’t handle the same loading they once did. 

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The more proactive you can be with addressing old aches and pains at the start of a training career, the more likely you are to avoid missing significant training time for one of those issues down the road.

5. Getting Away from Compound Exercises Too Quickly

There’s nothing wrong with direct arm work if you want big arms.  However, early on in a training program, chin-ups and bench presses are going to give you a more impressive gun show than you’d get from curls and pressdowns.  Down the road, these isolation exercises may serve a valuable role, but build a solid foundation before you cross that road.  And, make sure the compound exercises remain the central focus all along.

These five mistakes are just a small sample of some of the flawed approaches a lot of beginners take; I'd love to hear your thoughts on the many more you've witnessed - or made yourself!  In the meantime, I'd highly recommend checking out Robertson's Bulletproof Athlete program if you're a beginning lifter or you work with those just getting into the "iron game."  It's a professionally organized, well written presentation of the right way to start people up with a comprehensive fitness program, from strength training, to mobility work, to energy systems development, to recovery/regeneration and nutrition. You can check it out HERE.

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Energy Systems Development: A Presentation You Need to Watch

You know how everyone has that one friend who is just absurdly smart?  You know, the kind of person who could hear something once, instantly remember it, and then instantly apply it in a productive manner?

Unfortunately, not all these people are all that motivated, so they may take their impressive ability to learn and leverage it to the max by studying everything they can get their hands on.  However, when you do find one of them who is ultra motivated, you wind up with game changers.  In our industry, guys like Bill Hartman and Charlie Weingroff are two that come to mind: quick learners who love to learn and apply.

That said, you can imagine my surprise and excitement when I realized that I had one of these in the making as an intern at Cressey Performance in the summer of 2011.  You may have even heard of him by now: Eric Oetter.  And, as this somewhat recent photo demonstrates, he's only 13 years old.

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Okay, the age was a joke, but the brain power isn't. In addition to interning at CP, he's also spent a lot of quality time at Mike Robertson and Bill Hartman's facility in Indianapolis, and undertaken a bunch of continuing education coursework (PRI, DNS, and several other schools of thought).

That said, to make a very long story short, Eric's making a name for himself in the industry - and as a little example of it, I'd strongly encourage you to check out this free video on Energy Systems Development he did as part of the pre-launch for Robertson's Bulletproof Athlete resource.  You'll need to opt in to view it, but I guarantee you'll find it to be well worth it. 

In this presentation, Eric discusses a lot of the myths surrounding aerobic exercise and energy systems development.  Most importantly, though, he provides practical recommendations to help you put this knowledge into action to improve your training programs, regardless of whether your goal (or your athletes' goals).  I learned some good stuff, and I'm sure you will, too.  Here is the link to check it out.

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5 Ways to Counteract Wearing High Heels

Today's guest post comes from CP coach, Greg Robins.

This week, my girlfriend is off competing for the Miss International title. I am really proud of her, as she is doing so to raise awareness for her charity. She asked me how she could cancel out some of the negative repercussions that come along with wearing heels for seven days straight. It got me thinking, and I decided to take my advice to her and make it into a post for the readers out there who regularly wear high heels - or train females who do so.

It almost goes without saying, but wearing footwear that includes an excessive heel lift (i.e. high heels), greatly alters the alignment of your entire body. When we are misaligned, certain areas of the body will be asked to do more than they should, while other areas, in turn, are unable to fulfill their duties. We recognize this problem and its ill effects with people who function day to day with poor posture and movement habits. When we choose to wear this type of footwear, we are forcing ourselves into a poor position, regardless of where we were prior. To make matters worse, most of us are not in a particularly great position barefoot. The addition of heel lifts, as high as 2 - 4 inches, certainly does not help. 

That being said, high heels are a fashion statement, and sometime ladies just want to look glamorous. I certainly am not one to advocate against wearing something that makes you feel like a million bucks. However, if you don't want to feel like the polar opposite of that the next day, try applying these five tips!

1. Do more self massage.

I recommend keeping a golf ball, lacrosse ball, and (if possible) a foam roller or piece of PVC pipe on hand. As we touched on above, wearing high heels will cause a few muscle groups to work overtime. The idea with all of our tips is to "undo" what you have "done." With that in mind, we need to start with a concerted effort to take down the tone down of these overactive muscles. 

Use a golf ball to massage the bottom of your feet. This can be done by placing the ball underneath your foot while standing. Apply a generous amount of pressure while rolling the ball in various patterns along the underside of the foot. 

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Like wise, you can do a similar thing on the muscles of your calves with either the golf or lacrosse ball. In a seated position, place the ball under your calf and apply pressure while rolling the ball around the back side of your lower leg. 

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Another great spot on which to use the ball is the front side of your upper leg. Attack the hip flexors by using the lacrosse ball and/or foam roller. In a prone (face down) position, use the implements to massage the quadriceps (thigh) as well as the high, anterior (front) of the hips. While I would make these two spots the priority, you would be well advised to work on the outer thigh, and inner thighs as well. Check out our foam rolling progression in the video below. Pay extra attention to the portion targeting the lower extremities.

2. Facilitate the inhibited muscle groups.

Once you have finished with the self massage techniques described above, you will want to "re-ignite" the areas that were inhibited by the mal-positioning of a high heel lift. I like people to start from the core, and work their way out. There are three easy to use activation exercises to get you going. First, you can use a low level breathing exercise. Breathing exercises will help facilitate the diaphragm, and the external / internal obliques. By doing so, we can help "turn on" the mid-section correctly, get you away from an extended bias, and further bring down the tone of your body. A great option is the the deep squat breathing with lat stretch. Check out the video below. 

Next, we can facilitate the mid section a little more aggressively by adding some movement of the limbs while controlling the core. Dead bugs are a viable option here. Check out this video:

Lastly, some easy glute activation is in order. The glutes function in all three planes of motion. Therefore, it is important that we facilitate their function correctly. For lesser trained individuals I would recommend hammering the sagittal plane first and foremost. Supine bridge variations are the best place to start. From there, we can work into a side lying clam variation. Lastly, for the more prepared individuals an exercise such as the bowler squat is a nice way to activate the glutes in all three planes. Check out the videos and pictures below.

3. Stress foot/toe and ankle function.

When wearing heels, the most obviously altered joints are the toes/foot and the ankles. It is important that we address them appropriately. The toes will be constricted by the narrow toe in most of these shoes. Because of this they will no longer function normally during gait. Additionally, the ankles will be placed into a position of plantarflexion permanently. With this in mind, there are a few easy exercises that should be done in order to restore proper function of the foot and ankle. The first would be some low level mobility drills for the ankle, stressing dorsiflexion. Knee break ankle mobs are terrific in this scenario.

Furthermore, some ankle "alphabets" are also a great way to restore function to both the ankle and the foot.

Lastly, I would recommend doing toe pulls as well to wake up the feet, and toes. Check out the video below from Hitting Performance Labs showing us the toe pull exercise made famous by the folks at Z Health.

4. Re-groove a posterior weight shift.

The heel lift causes us to shift our center of mass forward. This can be a big problem, namely for all the reasons we talked about in the opening of this article. In order to combat this, we need to re-groove a posterior weight shift. Basically, the idea is that we need to re-teach our body what right feels like. Eric did a great post on the effectiveness of the left-stance toe touch, you can read it here. For now, make sure that you implement this exercise as often as possible, especially when you find yourself wearing heels!

5. Take a break whenever you can.

Finally, you can offset the problems associated with wearing heels by simply taking them off whenever possible. If you have 10-15 minutes where you can catch a break, do so! If you really want to make progress, use that time to do some of the drills above. 

If you regularly find yourself in heels, I hope this article helps you out. Additionally, if you know someone who wears heels on a regular basis (I know you do!), then please share this with them!

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Interval Training and the Rowing Ergometer

For the first decade of my career in the strength and conditioning field, I wasn't too charitable when it came to cardio machines. But recently I've learned the value of the rowing ergometer or "erg". I learned this by getting my butt handed to me!

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Strength and Conditioning Stuff You Should Read: 7/24/13

Here's this week's list of recommended strength and conditioning reading/viewing:

The Mobility Manifesto - This is a series of free videos Mike Robertson just released to kick off the launch of his new product.  It's top-notch stuff that could be a seminar in itself, so take advantage of this free opportunity to get some great information.

Fish Oil and Prostate Cancer - Dr. Hector Lopez has a great response to the recent (media sensationalized) assertion that fish oil may lead to an increase in prostate cancer risk.

Do You Need to Squat Deeply? - This might be the article of the year at T-Nation, in my eyes.  Dean Somerset did a really good job of answering this question - and the answer is different for everyone.

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The Question I Hate to Be Asked

There's one question that I get almost daily, and in spite of the fact that it drives me bonkers, I still do my best to answer it:

What supplements should I take?

The problem isn't that there aren't some supplements out there that can really help.  Anyone who's done even a cursory review of the research can speak to the value of supplements like Vitamin D and fish oil.  And, anyone who has ever reviewed the typical teenage athlete's diet can appreciate that a greens supplement would go a long way.

The bigger issue is that this question is an example of the carriage getting put in front of the horse.  In other words, the people asking the question are usually getting way ahead of themselves and need to focus on proper diet first. 

If you don't know what a healthy diet actually includes, how can you know what you need to supplement (dictionary.com: "to complete") with to get to where you want to be?

It goes beyond that, as the supplement question opens a big can of worms for several reasons:

1. The margins in the supplement industry are absolutely absurd - As a result, there are a lot of unethical people who flock to this industry in hopes of making some serious cash, playing on people's ignorance and insecurities. This is why you see bold advertising claims, doctored-up before/after photos, and - shamefully - products that don't actually make their ingredients list.  Some companies may use cheap fillers to keep their costs down, or include banned substances unbeknownst to the consumer in order to improve efficacy.  As a result of all this, you can't just recommend a supplement anymore; you also have to take the reputation of the brand into account.

2. It's a dynamic industry - With big money and potentially world-changing discoveries to be made, the game is constantly changing.  New research is published daily, and new products enter the market just as frequently to complement the daily influx of brands.  Plus, new uses for old supplements are always being introduced.  As an example, we once thought creatine was just a supplement for athletic performance, and now it's being looked at as a valuable supplement in treating many chronic disease states. Unless you're reading journal articles full-time and asking around in the industry, it's hard to stay on top of all the new information.

3. Dosing matters - Using the creatine example again, we were once all taught that we needed to load creatine for the initial period - and most of us who did it spent the first 7-10 days on the supplement with gurgly stomachs and diarrhea.  Now, we know that's not really necessary.  And, contrary to what we were told back in the 1990s, you don't need to crush a load of simple sugars to get the muscles to "suck it up." How much you take, when you take it, and what it's taken with all impact a supplement's efficacy.

4. Supplements mean different things to different people - If a person is financially comfortable, he or she can likely afford a new-age and potentially marginaly effective supplement in hopes of some return-on-investment.  For someone else, that $40 might be a huge deal.  What works for one athlete won't matter nearly as much for another, too; the baseball players with whom I've spoken haven't really benefited at all from beta-alanine supplement, but the competitive cyclists and soccer players have thrived on it; the metabolic demands of the sport are entirely different.

Additionally, everyone has a different social perspective on what supplements mean.  I once had a mother ask me about creatine for her son, and she commented that she viewed creatine as a "gateway drug" like marijuana.  This backlash is only getting worse and worse because of the unethical actions of a few professional athletes (blaming supplements for positive tests) and supplement companies (not living up to label claims).

For all these reasons, I really outsource my supplement questions to people who stay much more up-to-date on the topics than I can.  At our facility, I'm fortunate to have a great nutrition folks who stay as up-to-date on the research as possible - and also has a great mindset from which to discuss things with athletes, coaches, and parents.

Fortunately for us, though, we also have the good folks at Examine.com and their expertise at our fingertips on this front, too. They're a 100% transparent, independent organization that scrutinizing supplement efficacy - and a whole lot more in the health and human performance industries. In other words, everything they publish comes from peer-reviewed journals and is without influence from supplement companies - so you don't have to worry about "bro science" infiltrating their findings.

Their offering has expanded dramatically since the site was founded over a decade ago, and with that in mind, I’m going to encourage you to check out Examine 2.0, the newly launched update to their flagship offering. Examine distills thousands of studies into actionable insights. They also include monthly updates of the latest research, helping you to stay on top of what’s new in the industry (and get CEUs in the process). Through 8/25, you can get a big discount as one of my readers at http://examine.news/cressey.

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It Needs to Be Said: Throwing Doesn’t Build Arm “Strength”

Today, I'm going to tackle one of my biggest pet peeves in the baseball world: people saying that throwing builds arm "strength."  Sorry, but it doesn't. 

What I'm going to write below might seem like wordplay, but truthfully, it's a very important differentiation to make.  If young athletes believe that throwing builds arm strength, they'll quickly convince themselves that year-round throwing is safe and acceptable, when it's actually one of the worst things they can do for long-term health and development. Here's what you need to know:

1. Throwing builds arm speed - which is power.  Power is heavily reliant on muscular strength.  If you can't apply much force, you can't apply much force quickly.

2. Throwing also builds muscular endurance in the arm.  Muscular endurance, too, is heavily reliant on muscular strength. If you don't have strength you can't have strength endurance.

If you enhance muscular strength, power and endurance will generally improve.  That's been shown time and time again in the research, both in throwers and other athletic situations.  However, if you train power and endurance, strength almost never goes up.  Otherwise, we'd see loads of athletes stronger at the end of seasons than they were at the beginning. In reality, if you check rotator cuff strength and scapular stabilizer proficiency at season's end, it's generally much lower.  As physical therapist Mike Reinold describes it, managing arm strength during the season is a "controlled fall."

This underscores the importance of using the off-season (including a period with no throwing whatsoever) to improve rotator cuff strength and optimize scapular control.  Simultaneously, athletes gain passive stability at the shoulder as the acquired anterior instability (secondary to increased external rotation from throwing) reduces.

Now, we need more research to see if it's the case, but I think that one of the hidden benefits of throwing weighted baseball is that doing so essentially helps us blur the line between arm strength and speed, as I outlined in this presentation a while back:

Of course, it depends heavily on the volume, frequency, load, and type of weighted ball drills utilized, as well as the time of year at which they're utilized.  However, as I mentioned, it is somewhat of a noteworthy exception to the rule of throwing a 5oz baseball.  Weighted balls surely still take a toll on arm strength over the course of time, but that might be a "slower fall."

Regardless, when you're talking about a throwing program, feel free to say that you're building "arm speed" or "arm endurance," but let's all appreciate that you definitely aren't building "arm strength." 

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Quick and Easy Ways to Feel and Move Better: Installment 48

Thanks to Cressey Performance Coach Greg Robins, here are five nutrition and strength and conditioning tips to kick off your weekend on the right foot.

1. Train upward rotation without true vertical pressing.

At Cressey Performance, the majority of our athletes are overhead throwers. Training overhead athletes means that you need to train upward rotation of the scapula. While pressing overhead could serve as one option, we find that it isn’t always the best option. Too often, people are unable to achieve an overhead position, while also keeping the rest of the body in correct alignment. Namely, most folks will have considerable amounts of rib flare and lumbar spine extension.

Instead, it would be advantageous to train upward rotation with exercises that allow for considerable shoulder flexion, but also promote better overall positioning. So how is that done? A few of our favorite exercises are as follows:

Yoga push ups: These offer a close chained pressing movement that allows a person to get shoulder flexion, and when cued correctly, a considerable amount of upward scapular rotation. Make sure when performing this variation that you press directly into the upwardly rotated position, while shrugging and protracting the shoulder blades. One nice cue is to “push the floor away completely.”

Landmine presses: These exercises are my favorite class of open chain pressing movement to stress upward rotation. Instead of completing the movement with the shoulder blade still packed back, shrug and protract the shoulder blade a bit. A perfect cue with this one is to “reach out” when pressing.

Obviously, if you're already someone who is shrugged up and protracted all day (desk jockey), it's not a good fit for you.  In a more athletic population, though, it's usually a very good fit.

2. Use the “stir the pot” exercise...safely.

Anterior core weakness is something we combat on a daily basis here at CP. With the plethora of overly extended athletes that come through our door, we are always looking for new ways to challenge their core stability. While the standard prone bridge is a staple, after some training, we need to progress individuals to something more challenging.

Stir the pot is a fantastic way to do just that. The added demands of both the stability ball, and the small amount of movement from the shoulders adds a difficult variation to the aforementioned prone bridge.

Please note that even with former Division 1, high caliber athletes, this exercise may be a little too advanced. We recommend that you wipe the sweat off your forearms before doing this drill, and be sure to dismount the ball safely - or just omit this exercise until you're prepared to do so. Watch the video below (all the way through) to see exactly what I mean:

3. Make your “fillers” more effective

The idea of “fillers” has become quite popular, and for good reason: everyone is busy, and utilizing them is a terrific way to maximize training efficiency. So, what’s a filler?

Most commonly, fillers are low-level activation, mobility, stability, and motor control drills. They should not be strenuous enough to take away from your program, but when used correctly, they can aid in improving movement quality, outputs, and results. In order to make them the most effective, fillers should be personalized to fit your body type.

Hypermobile (excessively “loose”) people should spend time getting stable, and hypomobile (“stiff”) people should spend time getting loose.

Loose people are already able to get to just about any range of motion they desire. In fact, they are generally able to get to some ranges that are not desirable. Therefore, they are better served doing low-level activation and stability based drills between sets. This will help them “own” positions better and promote better control within their ranges of motion.

Stiff people, on the other hand, need to fit in some extra mobility work as often whenever possible. Their time is best spent working on various mobility drills, as well as some low level activation drills. Doing so will help them to move better in general, and get into more advantageous positions when performing the exercises in their program.

The drills each population chooses can be individualized based on the needs of the person and / or the demands of the exercise with which they are paired.

Many hypermobile people need better core, hip, and shoulder stability. So, drills like dead bugs, bowler squats, wall slides, body weight Turkish get-ups, and rotator cuff activation drills work great.

Many stiff people could use more thoracic spine (upper back) mobility, hip mobility, and ankle mobility. Drills like ankle, hip, and thoracic spine mobilizations are solid options.

Regardless of your body type, choose variations that don’t compete too heavily with the exercises with which they are paired. Furthermore, choose variations that hit areas which need extra attention for YOU, or that will aid in YOUR ability to reach good positioning with the exercise in question.

4. Put your lacrosse ball in an old tube sock.

If you use lacrosse ball to roll out against the wall, chances are you have a heck of a time getting the thing not to slip, and fall to the ground. Next thing you know, it’s like the meatball from the old nursery rhyme, rolling across the floor and out the door - or however it goes.

One tip I picked up while reviewing the book The Trigger Point Therapy Workbook by Claire Davies was to place your ball in a long tube sock. By doing so you can keep your hand on the sock and make sure the ball stays up the entire time. Give it a try!

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5. Try an Icee for a Refreshing Treat!

With a few days well over 90 degrees here in Massachusetts, I’ve been pulling out every trick I know to stay cool. It’s a well known fact that 80% of my shirts are black to conceal the mass amount of sweating I do on a regular basis. One of my favorite tricks also happens to be great way to curb hunger and keep my sweet tooth at bay. If you’re looking for an easy, low-calorie way to cool off and stay satiated try out this recipe:

Ingredients:

4-6 oz of water

5 or so large ice cubes

1 cup frozen strawberries

1 fresh squeezed lemon

(optional: add stevia for sweetness)

Directions: Place all these ingredients in a blender, blend, and enjoy.

This strawberry lemonade ice will hit the spot on a hot day, or any day, where you need to quiet the groan of your hungry belly!

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Strength and Conditioning Stuff You Should Read: 7/18/13

This week's list of recommended strength and conditioning reading (and listening) will have a heavy baseball focus.  Check out these websites:

Elite Baseball Mentorships - We've run two of these, and the feedback has been fantastic.  With that in mind, today is the early-bird registration deadline for the August 18-20 Phase 2 (no prerequisites required). We'd love to see you there!

Talking Shoulders and Elbows with Eric Cressey - This is the audio of a podcast I did for the Blue Jays Plus Podcast.  We discuss baseball injuries, player development, and a host of other topics. I come on the show at the 34-minute mark, in case you want to fast-forward to it.

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The Surgery that Changed Baseball Forever - With the upcoming induction of Dr. Frank Jobe (who thought up and did the first Tommy John surgery) to the Baseball Hall of Fame, Will Carroll wrote this outstanding four-part article for Bleacher Report.  Here are the links to check out each of the articles: Part 1, Part 2, Part 3, and Part 4.

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Assessments You Might Be Overlooking: Installment 1

I generally perform 8-10 new evaluations per week.  They may be individuals who plan to train with us at Cressey Performance for the long haul, or they may just be popping in for a one-time consultation regarding a particular issue or training technique concern.  Sometimes, they'll be rehabbing with one of the physical therapists with whom we work closely, and seeking us out to maintain a training effect in spite of their injury. 

Regardless of the scenario, I'm fortunate to see a lot of variety in a typical week of evaluations, and it has led to me thinking outside the box and appreciating a few things that are commonly overlooked by trainers and rehabilitation specialists.  With that in mind, today, I wanted to kick off a new series about these under-appreciated observations that can really make a difference in your takeaways from an evaluation.

1. Standing/Sitting Posture

There are a lot of trainers who'll observe this in passing, but in many cases, they'll only note something if it's something really dramatic.  My suggestion along these lines would be to note not just what's going on in the sagittal plane (kyphosis, lordosis, forward head posture), but also what's happening in the frontal and transverse plan.  Do they always cross one leg over the other?  Does one shoulder sit markedly lower than the other? Do they sink into one hip and carry more weight on that side?

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As an aside, Greg Robins recently wrote up a great posture blog about some of the most common aberrant patterns we see.

2. Handshake

Believe it or not, a handshake can tell you a ton.  If it goes like this, it's safe to say that you probably won't need to do any direct arm work with this individual, who'll quickly become either the coolest (or most awkward) client of all time. 

Joking aside, handshakes can tell you a lot, particularly with respect to joint hypermobility.  First off, what's the feeling of the fingers?  Are they more rigid or "pliable?" If they're more pliable, chances are that you're going to be dealing with someone who has considerable congenital laxity (loose joints).  Second, are the hands cold, even in the middle of the summer?  Chances are their circulation is poor - another common symptoms of those with considerable joint hypermobility.

To test these theories, here's a challenge for you.  Go shake the hands of ten of your friends/colleagues today. Note the feel of the hands, and then follow up the handshake with a Beighton Hypermobility Test. The screen consists of five tests (four of which are unilateral), and is scored out of 9:

1. Elbow hyperextension > 10° (left and right sides)
2. Knee hyperextension > 10° (left and right sides)
3. Flex the thumb to contact with the forearm (left and right sides)
4. Extend the pinky to >90° angle with the rest of the hand (left and right sides)
5. Place both palms flat on the floor without flexing the knees

I'm sure you'll find that the coldest hands with the most pliable fingers are the ones who have high scores on the Beighton test.  When you have folks like this, they need more stability work than mobility training.  And, if an individual has a noteworthy injury history, you need to ask if he/she has been stretched aggressively in previous training or rehabilitation scenarios - particularly if he/she had negative outcomes with those experiences.

Also, if a young athlete gives you a lame, limp-wristed handshake, it's a sign that he's going to need to step up his game if he doesn't want to live in his parents' basement for the rest of this life.  I recommend introducing him to the foundation of the Ron Swanson Pyramid of Greatness to get the ball rolling (definitely worth a zoom-in):

rspyramid_1500

3. Medications

It is absolutely shocking to me how many people in the fitness industry overlook medications on an initial evaluation.  Perhaps it is the new era of bootcamps and semi-private training leading to a less individualized approach (particularly with respect to assessment), but you can learn so much about what a client needs by reviewing medications.  And, it's one reason why we have an initial one-on-one assessment with every new client at Cressey Performance.

Of course, you're looking for the obvious stuff - beta-blockers, prescription inhalers, etc. - that have definite impacts on how someone will respond to exercise.  Taking it a step further, though, there are hundreds of other medications that can impact how you program for and coach a client.  The problem is that not everyone views the term "medication" the same - so people will generally underreport on their health histories. In other words, you need to "pry" and ask if there really aren't any pills they take.  Recently, there was even an instance when I was able to guess a medication a kid was on just by asking his mom after observing his habits during the evaluation.

200534351-001

As an obvious example, there are loads of people out there who pop non-steroidal anti-inflammatory (NSAID) pills like candy because they've got chronic low back, shoulder problems, or any of a number of other issues.  In their eyes, though, these "get-me-by" pills don't count as drugs because they can be bought over the counter.  They can mask pain during exercises, and obviously have significant side effects. It's a trainer's responsibility to be "in the loop" with a client, his doctor, and a rehabilitation specialist to determine what the right course of action is to get this individual off those NSAIDs over time.

In a youth athlete population, we've had three kids who have had extensive and prolonged negative reactions to the Isotretinoin (Accutane) that was prescribed to treat acne. In two of these cases, the kids were excellent D1-caliber athletes who gradually felt worse and worse over the course of months in spite of no change to training volume or lifestyle factors.  We were all stumped because they had never reported that they'd started taking the medication.

Once we found out the cause, their parents got them off the Accutate right away, and symptoms resolved over the course of a month. However, these experiences led me to look further into the side effects of this prescription medication. I was astounded.  There are reports of depression, muscle weakness, joint pain, vision problems, dry skin skin dryness, and several other side effects. The FDA even warns, "Accutane may stop long bone growth in teenagers who are still growing." I'm not a dermatologist, so it's not my place to say that it's right or wrong.  However, it absolutely, positively is something you need to inquire about on a health history if you see it listed - or even if you suspect that a kid might be a candidate for it.  That said, I've known a lot of kids whose acne has improved considerably once they've gotten all the crap out of their diet, but that's a conversation for another day!

If you see a sleep aid listed on a health history, you may need to think twice about programming high-volume training for an client, and spend some extra time discussing recovery methods.  If you see anti-depressants, anti-anxiety, or ADHD medications on a health history, it may change the way you approach coaching this individual.  These are really just the tip of the iceberg; you have to keep your eyes open and consider/discuss the implications when appropriate.

I'll be back soon with more assessments you might be overlooking.  In the meantime, if you'd like to learn more about some of our approaches to assessment, I'd encourage you to check out Assess and Correct: Breaking Barriers to Unlock Performance.

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