I receive the following inquiry via email the other day, and thought it might make for a good Q&A post:
I've come to the unfortunate realization that 15 years of sitting at a desk - combined with the simple fact that I'm almost 40 - have left me severely lacking in mobility. And, it's something I now want (and need) to really address. However, I'm also a realist and know that with a busy work and family schedule, getting to the gym is hard enough - but adding a lot of mobility work on top of that could be really challenging. So, I'm wondering what the best way to efficiently tackle this problem is? Should I do a little bit each day? Is it better to go to a yoga class 1-2 times per week? Or something else? I'd like to make some positive changes, but ideally without completely overhauling my weekly schedule. Thanks for any direction you can provide.
The short answer to this question would be a blunt one:
[bctt tweet="If it's really important, make time instead of finding time."]
That wouldn't make for much of an educational blog, though, so let's explore this in more detail. Here are ten things I'd consider if you'd like to really dedicate yourself to improving your overall mobility as efficiently as possible.
1. Frequency is everything.
Remember that - simply stated - mobility is your ability to reach a certain position or posture. It's different than flexibility in that mobility necessitates stability within a range of motion, not just the range of motion of a joint (or series of joints). In other words, you need motor control to have motor control.
Think back to when you were learning to ride a bike. Did you go out and try for 5-6 hours every Saturday morning, or did you put in several runs every day for a few weeks? If you're like most people, it was definitely the latter option.
[bctt tweet="Frequent exposure is key for motor learning, and you can't improve mobility without motor control."]
What does that mean in the context of mobility work? You need to do something every day - and possibly even multiple times per day.
For most folks, a quality pre-training warm-up is an important first step. If you look at my High Performance Handbook as an example, each pre-training warm-up consists of about five minutes of foam rolling and ten mobility drills that should take about ten minutes total.
2. Find new planes and ranges of motion in your strength work.
Most training programs are very sagittal plane (front-to-back) dominant. In other words, a lot of exercisers do very little in the rotational (transverse) and side-to-side (frontal). While you do have to do work in these planes during single-leg work, that doesn't mean much for actually taking them close to their end-range of mobility. Simply adding in some lateral lunges to your warm-ups and strength work can go a long way.
3. Sign up for classes if you really need the accountability or the instructor is absolutely fantastic.
Yoga and Pilates can be absolutely fantastic tools for helping you to improve your mobility if:
a) They improve your accountability so that you're more likely to actually make this a priority.
b) You have an outstanding instructor that both motivates you and teaches you about how your body works.
These options can also be terrible approaches if you have unqualified instructors or attending them absolutely destroys your schedule - and therefore becomes a burden more than a blessing.
4. Mix in a little work at night before bed.
This piggybacks on the aforementioned "frequent exposures" theme. I know of a lot of people who'll do a bit of foam rolling and stretching at night while watching TV or getting ready for bed. Anecdotally, it does seem to help some people unwind - possibly by kicking the parasympathetic nervous system on (especially if combined with a good focus on breathing during this work). If getting in some stretching and rolling before bed doesn't exactly thrill you, just pick 1-2 high priority drills and do them. Or just stretch out your calves while you're brushing your teeth!
5. Break up prolonged periods of immobility.
Each spring, I drive from Florida to Massachusetts. Then, in the fall, I drive back to Florida. It's a lovely 23 hours in the car over two days.
The first time I did it, I tried to be a cowboy and just plow through it with as few stops as possible. My hips hated me for about three days after the trip was done.
Since then, I make sure to stop every 2-3 hours. In fact, on my ride back this spring, I even stopped twice to train along this journey. I felt dramatically better in the days that followed.
I think you can extend this logic to how we break up our days, too. If you have to be at a computer for the majority of the 9am-5pm work day, try to get up and move around every 20-30 minutes. Walk to get some water, or do a doorway pec stretch.
It's a lot easier to do a little to maintain your mobility than it is to lose it and try to get it back.
6. Incorporate a bit more unilateral work.
When you take a lifter who's never done much single-leg work and start incorporating these unilateral movements, good things always seem to happen. I suspect that it has to do with the fact that a lot of these individuals are actually extending their hips past neutral for the first time in years, but I doubt that's the only mechanism.
To be clear, this doesn't mean that the hardcore squat/deadlift enthusiasts need to drop (or even tone down) these movements. It just means that it'd be a good idea to work in some more single-leg drills to the warm-up period, and to do some as an assistance exercise. They don't need to be loaded like crazy, either, particularly early-on. It's not uncommon to see groin strains (or very pronounced soreness) when someone incorporates single-leg work to a previously 100% bilateral program, so incorporate them gradually in terms of loading and volume.
7. Be patient and don't skip steps.
Getting transient (quick) improvements to range of motion isn't particularly difficult. You can get that from manual therapy, increased body temperature, or "tricks" to the nervous system. After these initiatives, we need to incorporate some stability training to make these changes "stick."
They won't magically improve dramatically from one session to the next, though. In fact, you may only hold 5% of that change from one session to the next - and that's why you need to stay patient and persistent with these drills over an extended period of time to see pronounced results.
With that said, it's important not to skip steps in this process. Just because your squat pattern improved a little doesn't mean you're ready to sink a 500-pound front squat to the "butt-to-heels" position the right way. And, just because you experienced subtle improvements to your active straight leg raise doesn't mean that you're ready to run a sub-10-second 100m dash. Own the changes before you try to challenge them in more chaotic environments.
8. Manage your breathing.
We'll keep this one really simple and watered-down:
Inhale = tension = stress
Exhale = relaxation = destress
If you're holding your breath while doing your mobility drills, stop! You're just stretching your lats, not attempting a 700-pound deadlift. Control your breathing, and think about fully exhaling at the lengthened position to give your system a chance to perceive it as a "new normal." The yoga folks have been preaching this for thousands of years, but us meathead strength and conditioning coaches have only started to figure it out in the past decade or so.
One drill I love for teaching this is the TRX deep squat breathing with lat stretch. Just sink down into this bottom position and exhale fully on each breath. Give it a "two-one-thousand" count before inhaling again. I usually program five breaths per set.
9. Choose comprehensive mobility drills.
If you only have 10 minutes per day to devote to improving your mobility, you are best of focusing on drills that provide plenty of bang for your buck. In other words, you want drills that challenge multiple joints and planes of motion at the same time. Here are a few good options as examples:
10. Balanced programming and optimal technique help to improve mobility.
Sometimes, the best thing you can do is "audit" your programs and training technique to see if they're pushing you further into your mobility deficit. Maybe you're benching too much and rowing too little? Or, perhaps it's been a lot of squatting and not enough deadlifting? Could it possibly be that you've been board pressing a ton and omitting full range-of-motion benching that could actually be really helpful for your shoulder? There are countless programming pitfalls into which one can fall, but you'll never identify them until you take a step back to review what you've been doing.
Moreover, crappy technique under load reinforces bad patterns and loss of mobility. Additionally, it can turn soft tissue and neuromuscular control restrictions into joint restrictions (laying down bone that shouldn't be there). You can't just fix reactive changes to the joint with stretching, either. Train hard, but train smart and with solid technique.
These are only ten thoughts off the top of my head, and there are surely many more. At the end of the day, though, most of the mobility improving strategies come back to common sense. Your body desperately wants to move, and you need to make time for that movement - and approach it with a plan as you would any other priority in your life.
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I hope everyone had a great weekend. Here's a little recommended reading from the strength and conditioning world to get the week started off on the right foot:
EC on the Movement Fix Podcast - Dr. Ryan DeBell had me on his podcast a few weeks ago, and we talked about everything from business to evaluations and programming for overhead athletes.
Recap of the 2016 Perform Better Functional Training Summit - Harold Gibbons wrote up this great review of the Perform Better presentations he attended recently in Providence. I've been presenting on the PB tour for ten years now, and I can honestly say that these events are the best value in continuing education in the fitness industry today. I'd highly recommend checking them out, if you haven't already.
It's hard to believe that we're 20 installments deep on this series, but I'm glad they've been so well received and definitely plan to continue to write them. Before I get to the meat and potatoes, just a quick friendly reminder that the introductory $100 off Elite Athletic Development seminar DVDs ends tonight at midnight.
1. Tall athletes are usually longer term projects.
When you have a 15-year-old 6-6, 150-pound kid with size 17 shoes, you have your work cut out for you.
These athletes are challenging for a number of reasons:
a. Their bone growth has usually outpaced their flexibility (except in kids - usually those who haven't finished puberty - who have preserved their childhood joint laxity). This often means that they have to do a fair amount of "preliminary" work just to get into good positions to benefit from big bang exercises.
b. Their center of mass has rapidly shifted up away from their base of support, creating a constantly unstable state.
c. A longer spine is a lot harder to stabilize than a shorter one.
d. You can put 20 pounds on one of these athletes and barely notice. As a frame of reference, in the picture below, the 6-6 athlete on the left added 31 pounds between September and February (when this picture was taken) to get to approximately 200 pounds. Meanwhile, Greg Robins (the CSP coach in the middle) actually weighs more than him even though his about eight inches shorter.
e. Even if you put that 20 pounds on them, it might not be enough to have a "grounding" effect on the athlete. Unless an athlete is very gifted in terms of reactive ability (as you might see with lighter weight NBA players), you might need to add a lot more weight for them to learn how to properly load the lower extremity to create athletic movement using the stretch-shortening cycle.
f. At younger ages, they're often put in positions that don't require as much movement (first base, DH, or pitcher in baseball; center in basketball; goalie in soccer; etc.). This may rob them of crucial exposure to movement "education."
The take home points?
[bctt tweet="In tall athletes, push patience, consistency, calories, and perfect technique on fundamentals."]
2. It's not your job to have all the answers.
Earlier this week, I sent along a nutrition question to Cressey Sports Performance's first employee, Brian St. Pierre. Brian is now Director of Performance Nutrition for Precision Nutrition and a tremendous resource we have at our fingertips on everything relating to nutrition and supplementation. Within 24 hours, Brian had sent along a 244-word reply that covered his anecdotal experiences on the topic in question, along with some recommended reading in case I was interested in what the peer-reviewed evidence demonstrated.
I'd love to have all the answers, but I simply don't. As such, I refer out all the time - whether it's a question like this on the nutrition front, or sending a client to a physical therapist. Your job is to deliver the best possible outcomes for your athletes/clients, and referring out regularly usually leads to those ends - and creates learning opportunities for you via the collaborative efforts that occur during the referral.
It's not your job to have all the answers; it's your job to know where you can find them.
3. It's important to understand how much relative strength an athlete needs - and that is sport and position specific.
I'll use my experience with baseball to make this point.
Pitching is a combination of absolute and relative strength and power. From an absolute standpoint, more body weight equates to more force to push off the mound, and more momentum moving downhill; that's why gaining weight can have such a profound impact on pitching velocity.
On the other hand, from a relative strength and power standpoint, you eventually have to "accept" all the force you create. We know that there are substantial ground reaction forces taken on by the front leg, and research has demonstrated that they are (not surprisingly) directly impacted by body weight. Additionally, according to 1998 research on professional pitchers from Werner et al., at ball release, the distraction forces on the shoulder are approximately 108% of body weight. You could also make the argument that these forces are even higher now, as average fastball velocity has crept up significantly since 1998, and the subjects in that study averaged only 89mph. As is the case with body weight increases, as arm speed rises, so do shoulder distraction forces.
In hitting, "accepting" force on the front side isn't as stressful because we don't hit downhill on a mound. However, batters have to run the bases, and that's a significant relative strength challenge.
With all this in mind, you it's important to realize that some athletes need to gain weight, some athletes need to lose weight, and some athletes are good right where they are. Obviously, body composition plays into this as well, but speaking in general terms, understanding strength-to-bodyweight ratios in sport-specific contexts is really important for all strength and conditioning coaches.
4. Use upper body drivers in your lower body mobility work.
This video from Mike Robertson got me thinking a lot:
We've done quite a bit of upper body reaching in our warm-ups with drills like the lateral lunge with overhead reach, but typical, this motion has really only occurred in the sagittal plane:
Conversely, if you look at the bowler squat, the upper body reach drives hip internal rotation, adduction, and flexion on the support leg.
Moving forward, I plan to get a lot more creative with using reaching to challenge folks in the transverse and frontal planes during our warm-ups.
Speaking of Mike Robertson, along with Carolina Panthers strength coach Joe Kenn, he's the co-creator of the Elite Athletic Development 3.0 DVD set. It's a fantastic resource that I'd highly recommend, and it's on sale for $100 off through the end of the day today. Click here to learn more.
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Today's guest post comes from physical therapist, Eric Schoenberg. Eric is an integral part of the Elite Baseball Mentorships team.
A thought came to mind as I was considering how we can work towards reducing the incidence of injury in baseball: we need more specialists.
If we use the field of medicine as a model, the Total Knee Replacement has pretty much been mastered. Of course, there is room for improvement, but over the past 25 years, this surgery has become a massive success. The biggest reason for this is a progression of specialization:
If you need a knee replacement, you don’t go to your primary care physician. Instead, you schedule an appointment with an Orthopedic Surgeon that specializes in TKR. So, if you are a baseball player, why does it make sense to work with a “general” strength coach or physical therapist?
[bctt tweet="Every profession matures into a state of “super-specialization” as it develops."]
Strength coaches and physical therapists have a great opportunity ahead of us to move our professions forward in this manner.
The current entry point for a strength coach is minimal. Most commonly, entry into the field falls somewhere between a fitness certification and a 4-year degree. In some cases, you will see dual degrees, Master’s degrees, and the occasional PhD.
However, there is no direct path available to niche into a “baseball specialist.” Instead, we have private sector, college, and even some professional strength coaches that may have seen baseball players by chance, but have no more experience with them than any other sport. It’s not a criticism of them, though; there simply isn’t an established “curriculum” they can pursue. As a result, in most cases, highly “specialized” baseball players are being managed by “general” strength coaches.
I have to believe that this is as much of a contributing factor as any to the high incidence of injury in the baseball world. By the time these athletes make it far enough in their careers to have access to “baseball specialists,” they are often too damaged for even the experts to manage.
Here are five tips to establish yourself as a trusted resource in the baseball community:
1. Watch baseball.
Don’t just watch it for entertainment value. Study the movements. Use slow motion and rewind on your TV. Watch video online and gain a better understanding of the actions and positions unique to the sport. Once you think you have it figured out, you are only just scratching the surface. Keep studying! Start to recognize why faulty mechanics can lead to improper distribution of stress and ultimately injury. By doing this, you can pair this knowledge with your individual assessment of the athlete to create a more optimal training program.
2. Spend time on a field.
Baseball players are unique in their habits and tendencies. Gain a “feel” for the game. Understand the culture of the game. Learn how to identify with and communicate with athletes that are much younger than you. Understand that most of their time on the field is spent standing around and waiting. Educate your players on how to optimize this time to prepare mentally, hydrate, properly warm up, etc. It is not enough to say you used to play baseball 20 years ago; nobody cares. My credibility and effectiveness in managing baseball players increased 10x once I started spending time at the field as part of a team. Create an angle to quickly establish trust and common ground with the athlete and watch your results dramatically improve.
3. Understand the unique physical characteristics and demands of baseball players.
Baseball players have physical characteristics that differ from other sports. Educate yourself for the benefit of your athletes. Learn about humeral retroversion, gross extension patterns, laxity, valgus stress, dynamic stability, rotator cuff timing, etc. Work towards understanding the importance of stability of the landing leg, proper hip hinge pattern, and the importance of tri-planar single leg balance. Don’t “stretch” a guy that is already too loose. Instead, give him some stability and watch his pain go away. The baseball player’s anatomy is a long way from “neutral.” Do your best to bring them closer to the middle and not further away. For example, your ability to recognize that a baseball player should not be cued to pull their shoulder blades “down and back” because their shoulder blades are ALREADY down and back may save dozens of careers.
4. Master functional anatomy and human movement.
Understand the critical role of the scapula. Train the rotator cuff in the throwing position through the entire range of motion (especially end-range external rotation). Learn how the kinetic chain applies specifically to baseball. Hitting and throwing are highly coordinated, precisely timed, multidirectional movements. Don’t train your athletes with single joint exercises that only occur in the sagittal plane. Learn about hip/trunk separation to maximize power and explosiveness. Be able to educate the athlete on what it means to have a labral tear or understand the specifics of an ulnar nerve transposition. If you can’t explain these pathologies, then how can you minimize risk when working with these athletes? Take pride in your job on this front.
5. Be willing to respectfully challenge the “institution of baseball.”
CSP coach Tony Bonvechio wrote a blog post a while back where he warned about the dangers of the phrase “this is how I’ve always done it.” I find myself observing on a daily basis that regardless of level – little league, high school, college, pro ball – at least 80% of the player’s warm up routine is exactly the same. How can that be? We have progressed as a profession; however, kids on baseball fields across the world are all doing the same useless warm-up routine.
An example of progress is Joe Maddon and the Chicago Cubs. He has softened the traditional stance of getting to the ballpark at 1pm for a 7pm game. Instead, they have created a culture that emphasizes more sleep, nutrition, and recovery and his players love him for it. (and, by the way, the team is doing pretty well, too).
If we want different results, we have to continue to move towards a different approach. The efforts of strength coaches and physical therapists to move towards becoming baseball specialists will go a long way in helping to reach this goal.
If you are interested in learning more about our approach to managing baseball athletes, we'd love to see you at one of our Elite Baseball Mentorships. The next three-day course - this one focused on the lower-extremity - is August 21-23, with Thursday, July 21 serving as the early-bird registration deadline. You can learn more HERE.
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With this week's release of Mike Robertson and Joe Kenn's Elite Athletic Development 3.0 DVD set, Cressey Sports Performance coach Nancy Newell and I put our heads together to highlight 12 of the key takeaways from this great new resource.
1. Coaching jump and landing technique is a must.
The “athletic position” occurs in every sport. If you want athletes to apply force, they also need to understand how to absorb force. With ACL injuries on the rise, it’s no surprise that 60-70% of these injuries result from non-contact incidences. This means that kids are getting hurt because they haven’t learned or practiced this technique.
Try these approaches:
a. Deceleration on two legs (Vertical Jump with Stick)
b. Deceleration on one leg (Heiden with Stick)
c. Upper body deceleration (Medicine Ball Work)
2. Don’t count the reps; make the reps count.
It can be challenging for a youth athlete to perform a set of ten bodyweight squats with perfect technique.
[bctt tweet= "Remember: the single-most transferable trait of an excellent program is confidence."]
If you start to see their form going down the drain, break the reps up into smaller pieces of success. Instead of performing one set of ten reps, you might perform five sets of two reps. The athlete will gain confidence, learn and retain HOW to perform the movement.
3. Teach athletes to “push,” not “pull.”
A common mistake athletes make is having the mentality to “pull” weight off the floor. When we pull weight off the floor, a large portion of that force produced comes from our lower back. If you can teach an athlete to apply force into the ground by “pushing,” a large majority of that force comes from our posterior chain and creates a strong, stable base for our bodies to produce force.
4. Use single leg strength to achieve stability and control, not maximal strength.
While incredibly important, single-leg work is not the best way to get “globally” strong. In a bilateral exercise such as the squat and deadlift, you have a larger base of support to move more weight using mostly prime movers (hamstrings, quads, glutes). A single leg exercise with a smaller base of support places more emphasis on owning and controlling our bodies through multiple planes of motion. Use single-leg exercises to fill in the gaps between maximal strength and stability.
5. Attitude controls your efforts.
One of the most impactful quotes Joe Kenn had during Elite Athletic Development 3.0 was, “You’re not giving good effort with a bad attitude.” Young athletes feed off coaches’ energy, so if you're upset about something personal that happened and you bring that to the weight room, your athletes will likely adopt that same poor attitude about today.
[bctt tweet="Your attitude is the number one dictator of the success of your program."]
You need to have the utmost confidence in yourself to achieve what you set out to complete for each day.
6. Get young athletes proficient in fundamental movements.
This may seem like a no brainer; however, many coaches are willing to place an external load on an athlete before they can confidently control their own bodyweight. Fundamentals are the building blocks for getting stronger, performing better and – most above all – staying injury-free. Youth training should not be about a “quick fix.” It should be about developing efficient motor patterns, skills, and confidence to form a robust foundation for long-term athletic development.
7. “Once relative strength is compromised, continuing to focus on maximal strength becomes an issue.” -Loren Landow
Robertson and Kenn highly urged everyone to over-emphasize general basic strength qualities because strength is a skill. Once you start to “own” this skill, you can start to add layers to challenge your mental and physical strength. Use layering to prepare your athletes for the next phase of training. As an example:
Phase 1: Bodyweight w/3second quasi ISO hold
Phase 2: KB Goblet Squat w/3second lowering/ Explosive concentric
Phase 3: 2KB Squat
8. “There is no elevator to success; you have to take the stairs.”
In your personal life, career, athletics you can’t be afraid to work hard. The most valuable teaching tool is experience, and experience comes from jumping on opportunities to learn from smarter, more experienced people than you. Set your goals high, but don’t jump stairs.
9. Building a more robust athlete comes from the bottom of the pyramid.
If you want to maximize your training results, you have to maximize recovery. One way to kick start recovery is to be consistent with the little things at the bottom of the pyramid (sleep, nutrition, and soft-tissue work). These variables can have a dramatic impact on one's ability to feel good and stay healthy for the long haul. For example, take an athlete who works out 3x/week for one hour. That’s three hours out of 168 hours in a week. Your training makes up less than 3% of your week, but those "tiny" elements at the base of the pyramid that make up a big chunk of the remaining 97%.
10. An efficient warm up has three broad components:
a. Physiology - We want our athletes to warm-up to increase tissue temperature, improve joint lubrication (especially for the older athletes), and fire up the nervous system.
b. Biomechanics - We aim to optimize alignment; isolate then integrate; and sync up the nervous and musculoskeletal systems.
c. Specific - We want to reflect the actual nature of the activities that follow, whether we're incorporate lifting weights or training speed/power.
11. High-intensity/anaerobic exercise is built from a low-intensity/aerobic base.
Focusing year-round on just high-intensity work with your athlete will result in a less than impressive work capacity and performance. Instead, use various forms of cardiac output work to expand your pyramid base and help your reach higher anaerobic peaks.
12. Everybody is an athlete.
Regardless of age and training experience, everyone can benefit from training power. Power is vital for overall athleticism, but it is unfortunately one of the first physical qualities we lose as we age. By respecting all the elements on the force-velocity curve you can help anyone get stronger, faster, and more explosive.
Here's an extended warm-up example that would constitute power training in these individuals:
-Low amplitude/high velocity (jump rope)
-Upper body throw (overhead med ball stomp)
-High amplitude/low(er) velocity (Heidens)
As I noted earlier, Mike Robertson and Joe Kenn's new Elite Athletic Development 3.0 seminar DVD set is on sale for $100 off through this Friday (7/22) at midnight. I would consider it an outstanding investment for any strength and conditioning professional. For more information, head HERE.
About the Co-Author
Nancy Newell (@NancyNewell2) is a strength and conditioning coach at Cressey Sports Performance in Hudson, MA. Nancy earned her Bachelors Degree in Fitness Development from the State University of New York at Cortland. You can read more from her at www.NancyNewell.com.
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I hope everyone had a fantastic weekend. I was on the road for the Providence Perform Better Summit this weekend, but luckily, I've got some great content lined up for you from other folks around the 'net. Check them out:
Elite Athletic Development 3.0 - I'm in the process of reviewing this collaborative effort from Mike Robertson and Joe Kenn, and it's excellent (as were the first two installments). These two outstanding coaches have lots of wisdom to share from the private, collegiate, and professional strength and conditioning worlds - and the resource is on sale at an introductory discount this week.
Maybe You Shouldn't Deadlift from the Floor - This article actually serves as a really good follow-up to the guest post Dean Somerset authored for my site a few weeks ago. Some people are better served not deadlifting from the floor, and Dean outlines why, as well as some alternatives.
I haven't posted an update to this popular coaching cues series since December, so I figured this article was long overdue. Here are a few coaching cues we use regularly with our clients at Cressey Sports Performance:
1. "Keep your hips in the hallway."
Birddogs are a fantastic exercise for building core stability and educating individuals on how to differentiate between hip and lumbar spine (lower back) movement. Usually, though, folks just discuss differentiating these motions in the sagittal plane, so the focus is on hip flexion/extension vs. lumbar flexion/extension. In the process, a lot of folks overlook what is going on in the frontal and transverse plane. A lot of side-to-side movement is a good sign that the athlete doesn't have sufficient rotary stability (control of the center of mass within a smaller base of support).
A cue I've found to work great is to put my hands about 1" outside the hips on both sides, and to cue the athlete, "Keep your hips in the hallway." If the outside of the hips contact my hand, it's a sign that they've lost control of the frontal and transverse plane.
2. "Scaps to the sky."
We coach our wall slides with upward rotation and lift off a bit differently for just about everyone that comes through our doors. Really, it comes down to appreciating what their starting scapular positioning is. If someone is really anteriorly tilted, we'll guide the scapula into posterior tilt. If they have more of a "scaps back" (adducted) military posture, we'll help the shoulder blades to get out and around the rib cage. If someone starts in a more depressed (low shoulder) position as in the video below, we might cue them to incorporate a shrug to facilitate better upward rotation.
When you teach the drill, though, you want to make sure that the motion is coming from not just movement of the humerus (upper arm) on the scapula (glenohumeral movement), but moreso from movement of the scapula on the rib cage (scapulothoracic). I love the "scaps to the sky" cue for this reason. Usually, I'll manually help the shoulder blades up a bit, too.
3. "One inch per second."
I blatantly stole this one from Shane Rye, one of my business partners at Cressey Sports Performance - Florida. When athletes foam roll, they always seem to have a tendency to race through each "pass." It's far better to slow down, recognize areas that need more attention, and gradually work your way along. The "one inch per second" cue always seems to get athletes to pace themselves better.
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Tomorrow is the early-bird registration deadline for my upcoming shoulder seminar in Chicago, so I thought I'd use today's post to throw out some thoughts on training the shoulders.
1. In the upper extremity, the assessments are often the solutions, too.
Imagine you're assessing an athlete, and their squat pattern is absolutely brutal. Usually, the last thing you're going to do is go right to a squat as part of their training. In other words, simply coaching it differently usually won't improve the pattern immediately. Rather, you typically need "rebuild" the pattern by working with everything from ankle and hip mobility to core control, ultimately progressing to movements that replicate the squatting pattern.
Interestingly, the upper extremity is usually the opposite in that the assessment might also be the drill you use to correct the movement. For instance, an aberrant shoulder flexion pattern like this...
...might be quickly corrected with some of these three cues on a back to wall shoulder flexion pattern.
This is also true of push-up assessments and shoulder abduction and external rotation tests we do; funky patterns are usually cleaned up quickly with some subtle cueing. This just isn't the case as much in the lower body, though. Why the difference?
My theory is that because we're weight-bearing all day, the lower extremity is potentially less responsive to the addition of good stiffness in the right places. Conversely, a little bit of stiffness in serratus anterior, lower trap, or posterior cuff seems to go a long way in quickly improving upper extremity movement. My experience with the Postural Restoration Institute also leads me to believe that creating a good zone of apposition can have lead to a more pronounced transient movement in the upper extremity than it does in the lower extremity. This is likely because the rib cage is directly involved with the shoulder girdle, whereas the relationship with the lower extremity (ribs --> spine --> pelvis) is less direct.
These differences also seem to at least partially explain why upper extremity posture is much easier to change than lower extremity positioning. It's far more common to see a scapular anterior tilt change markedly than it is to see an anterior pelvic tilt substantially reduced.
Just thinking out loud here, though. Fun stuff.
2. Anterior shoulder pain usually isn't "biceps tendinitis."
First off, true tendinitis is actually quite rare. In this landmark paper, Maffulli et al. went to great lengths to demonstrate that the overwhelming majority of the overuse tendon conditions we see are actually tendinOSIS (degenerative) and not tendinITIS (inflammatory). It may seem like wordplay, but it's actually a very important differentiation to make: if you're dealing with a biceps issue, it's probably tendinosis.
Second, if you speak with any forward thinking orthopedic shoulder specialist or rehabilitation expert, they'll tell you that there are a lot of differential diagnoses for anterior (front) shoulder pain. It could be referred pain from further up (cervical disc issues, tissue density at scalenes/sternocleidomastoid/subclavius/pec minor, or thoracic outlet syndome), rotator cuff injury or tendinopathy, anterior capsule injury, a lat strain or tendinopathy, labral pathology, nerve irritation at the shoulder itself, arthritis, a Bankart lesion, osteolysis of the distal clavicle, AC joint injury, and a host of other factors.
3. Thoracic outlet surgery really isn't a shoulder surgery.
With Matt Harvey opting for thoracic outlet surgery this week, I've seen just about every major sporting news outlet call it "shoulder surgery." Sorry, but that really isn't the case unless you have a very expansive definition of the word "shoulder."
With this intervention, the surgeon is removing the first (top) rib to provide "clearance" for the nerves and vascular structures to pass underneath the clavicle.
Additionally, surgeons may opt to perform a scalenectomy, where they surgically remove a portion of the anterior scalenes, which may have hypertrophied (grown) due to chronic overuse. Again, this is not a "shoulder" procedure.
Finally, more and more surgeons are also incorporating a pec minor release as part of the surgical intervention. This is because the nerve and vascular structures that may be impinged at the scalenes or first rib can also be impinged at the coracoid process of the scapular if an individual is too anterior-tilted. While the coracobrachialis and short head of the biceps both attach here, the pec minor is likely the biggest player in creating these potential problems.
This, for me, is the only time this becomes somewhat of a "shoulder" surgery - and it's an indirect relationship that doesn't truly involve the joint. We're still nowhere near the glenohumeral (ball-and-socket) joint that most people consider the true shoulder.
All that said, many people consider the "shoulder girdle" a collection of joints that includes the sternoclavicular, acromioclavicular, glenohumeral, and scapulothoracic articulations. In this case, though, the media just doesn't have a clue what they're trying to describe. With that in mind, hopefully this turned into somewhat of an educational rant.
4. Medicine ball scoop tosses tend to be a better than shotputs for cranky shoulders.
Rotational medicine ball training is a big part of our baseball workouts, and it's something we try to include as an integral part of retraining throwing patterns even while guys may be rehabilitating shoulder issues. When you compare rotational shotputs with rotational scoop tosses...
...you can see that the scoop toss requires far less shoulder internal rotation and horizontal adduction, and distraction forces on the joint are far lower at ball release. The shotput is much more stressful to the joint, so it's better saved for much later on in the rehab process.
5. Adequate rotator cuff control is about sufficient strength and proper timing - in the right positions.
To have a healthy shoulder, your cuff needs to be strong and "aware" enough to do its job in the position that matters. If you think about the most shoulder problem, there is pain at some extreme: the overhead position of a press, the lay-back phase of throwing, or the bar-on-your back position in squatting. For some reason, though, the overwhelming majority of cuff strength tests take place with the arms at the sides or right at 90 degrees of elevation. Sure, these positions might give us a glimpse at strength without provoking symptoms, but they really don't speak much to functional capacity in the positions that matter.
With that in mind, I love the idea of testing rotator cuff strength and timing in the positions that matter. Here's an example:
Obviously, you can make it even more functional by going into a half-kneeling, split-stance, or standing position. The point is that there are a lot of athletes who can test pretty well in positions that don't matter, but horribly in the postures that do.
6. Pre-operative physical therapy for the shoulder is likely really underutilized.
It's not uncommon to hear about someone with an ACL tear going through a month or so of physical therapy before the surgery actually takes place. Basically, they get a head start on range-of-motion and motor control work while swelling goes down (and, in some cases, some healing of an associated MCL injury may need to occur).
I'm surprised this approach isn't utilized as much with shoulder surgeries. It wouldn't be applicable to every situation, of course, but I think that in some cases, it can be useful to have a pre-operative baseline of range-of-motion. This is particularly true in cases of chronic throwing shoulder injuries where regaining the right amount of external rotation is crucial for return to high level function. Adding in some work on cuff strength/timing, scapular control, and thoracic mobility before hopping in a sling for 4-6 weeks probably wouldn't hurt the case, either. And, as an added bonus, if this was more common, I think we'd find quite a few people who just so happen to become asymptomatic, allowing them to cancel their surgeries. It's probably wishful thinking on my part, but that's what these random thoughts articles are all about.
For more information on my July 31 seminar in Chicago, click here.
Have a great weekend!
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We're excited to announce that on August 14, 2016 Greg Robins will be delivering his one-day seminar, “Optimizing the Big 3″ alongside fellow Cressey Sport Performance Coach Tony Bonvechio. This event, which will take place at our Hudson, MA location, is a a great chance for strength and conditioning professionals to learn from the best. And, it's also been very popular with athletes who have an interest in improving the squat, bench press, and deadlift.
“Optimizing the Big 3” is a one-day seminar for towards those looking to improve the squat, bench press, and deadlift.
Split into both a lecture and hands-on format, the event will provide attendees with practical coaching on the technique of the classic power lifts. Additionally, Greg and Tony will cover how to individualize movement preparation, utilize supplementary movements, and organize their training around a central focus: improved strength in these “big three” movements. Furthermore, they'll touch upon the lessons learned in preparation for your first few meets to help you navigate everything from equipment selection to meet-day logistics.
The value in learning from Greg is a matter of perspective. He has a wealth of knowledge, and has experience stemming from various experiences as a coach and lifter. Greg will effectively shed light on how he has applied movement principles, athletic performance modalities, and anecdotal evidence from working with a wide variety of different populations to optimize the technique, health, and improvements in strength of amateur lifters.
9:00-11:00AM: Maximal Strength Training Theory – The main lecture of the day will be focused on the principles of how to assess where you (or your athletes) are in terms of training history and how that determines what kind of training loads should be used. Furthermore, this lecture will focus on principles of managing stressors and how to assign proper loading parameters for different level lifters. Last will be a discussion of the cornerstones of training vs. planning, as well as a look at the commonalities and differences of different training approaches.
11:00AM-12:00PM: Managing the Strength Athlete: Assessing and Meeting the Demands of the Lifter – Learn what demands a high amount of volume in the classic lifts puts on the body; how to assess for it in others and yourself; and what you can do to manage the stress associated with these demands.
12:00-12:30PM: Group Warm-up
12:30AM-1:15PM: Squat Hands-on Session
1:15-1:30PM: Squat Recap, Programming Considerations, and Video Review
1:30-2:15PM: Lunch (on your own)
2:15-3:00PM: Bench Press Hands-on Session
3:00-3:15PM: Bench Press Recap, Programming Considerations, and Video Review
3:15-4:00PM: Deadlift Hands-on Session
4:00-4:15PM: Deadlift Recap, Programming Considerations, and Video Review
4:15-5:00PM: Final Q&A
Sunday, August 14, 2016
Cressey Sports Performance
577 Main St.
Hudson, MA 01749
Note: we’ll be capping the number of participants to ensure that there is a lot of presenter/attendee interaction – particularly during the hands-on workshop portion – so be sure to register early, as the previous offerings have both sold out well in advance of the early-bird registration deadline.
On the fence? Here is what previous attendees have to say...
"Greg Robins has constructed one of the most comprehensive seminars that I have ever attended. I’ve had the opportunity to not only attend The Big 3, but host it at my gym as well. I truly believe that every coach and/or individual who's interested in mastering the squat, bench, and deadlift absolutely must attend this workshop. Greg is loaded with knowledge and learning directly from him has greatly impacted my ability to coach my clients and athletes."
Co-Owner, War Horse Barbell - Philadelphia, PA
"Attending the Big 3 Workshop with Greg Robins and Tony Bonvechio was the best thing to happen to my barbell training. After taking close to 20+ years off from working with a barbell I decided to attend the Big 3 workshop to receive excellent coaching and guidance in training. In my experience as a healthcare provider (ATC) a strength coach and a kettlebell instructor this course has helped myself and my clients significantly. I was able to relate all the movements to rehabilitation, strength training and kettlebell training I perform with clients and this helps me to give them a better transition back to sport and training. I would happily attend this workshop again to continue to learn and dial in the Big 3 movements. Just one day with these two professionals is not enough time to soak in all the knowledge!"
Co-Owner, Iron Body Studios
"Greg Robins is the epitome of high integrity, an unparalleled work ethic, and a true passion and dedication toward making those around him better. His Optimizing The Big 3 Workshop is no different. After attending this workshop while also being a personal client of Greg's, I've increased numbers in all 3 lifts, and improved my overall strength by leaps and bounds in the process. Greg is the real deal. Don't hesitate - just go."