Baseball Strength and Conditioning Programs: How Much Rotator Cuff Work is Too Much? – Part 2
Written on January 10, 2012 at 9:34 pm, by Eric Cressey
In part 1 of this feature, I talked about how many throwers actually overuse the rotator cuff because they don’t appreciate that throwing in itself is a tremendously stressful challenge to the shoulder. I also made the point that cuff timing is more often the problem than cuff strength, so many folks are really training the rotator cuff incorrectly with thousands of reps of band exercises. Let’s examine that in a bit more depth.
First, I should preface this piece by saying that I think there are definitely places for utilizing bands to strengthen the rotator cuff in a baseball training context. They obviously provide outstanding convenience for on-field work and travel circumstances, as well as scenarios where players may not have qualified professionals at hand to help with manual resistance work and rhythmic stabilizations. Some cuff work is better than no cuff work! Additionally, many players swear by bands during the warm-up phase to help with getting blood flow to the shoulder complex with a bit of activation at the same time.
However, there are two primary issues with relying exclusively on bands:
1. In an external rotation variation, the resistance is actually greatest at the point (near maximal external rotation) where the athlete is weakest. In other words, the band doesn’t ideally accommodate the strength curve. This is a huge concern for me, as one of the biggest things I notice in athletes is that when training in a position of somewhat significant external rotation, they can’t “pick up” the resistance quickly enough. More on this later.
2. Most people simply overlook eccentric control. This is something that is coachable, no doubt, but most people do band exercises for so many reps per set that the athlete can quickly lose focus and resort back to bad habits.
As you can imagine, these are shortcomings that also exist – albeit to a slightly lesser extent – with cable and dumbbell/plate external rotation rotator cuff strength exercises:
So, how do we overcome these shortcomings while helping to address rotator cuff timing? You have two great options.
1. Rhythmic Stabilizations
The true role of the rotator cuff is to stabilize the humeral head (ball) in the glenoid fossa (socket). And, during throwing, it does a ton of work, as the humerus goes through extreme ranges of motion in all three planes. Rhythmic stabilization drills are a great way to train the cuff to fire quicker, and they’re particularly valuable because you can train them at various points in the range of motion, modifying the challenge depending on how stable an individual is in a given position. Plus, this is an outstanding way of monitoring cuff function over the course of weeks and months with athletes you see regularly; regular improvements are easily perceived.
You’ll notice that I don’t crank him back to extreme external rotation in this video; rather, we stop short of it and just assume that we’ll get some carryover in stability a bit further (as per previous research on carryover of isometric exercise).
The sky is really the limit in terms of how you train this one; we have about a dozen variations that we use on a daily basis. A few quick guidelines:
a. The more congenital or acquired laxity an athlete has, the less aggressive you’ll want to be with your perturbations. When someone is less proficient, gently destabilizer, and apply the prturbations closer to the shoulder. When someone is more stable, perturbate a bit more firmly, and apply it further down the arm.
b. I sometimes start those with significant laxity with closed chain exercises so that they can draw some stability from the floor or wall.
c. Make sure that the scapula is positioned appropriately; it certainly shouldn’t be protracted, but don’t crank it into excessive retraction, either. Just keep it from winging off the rib cage.
d. I like 2x/week rhythmic stabilizations during off-season training. We typically integrate it between sets on lower-body strength training days.
2. Manual Resistance External Rotations
These drills are “where it’s at.” On one hand, they are the best strength-building exercise for the cuff because they train it in its most function context: eccentric control. However, more specific to today’s point, they are great for improving cuff recruitment at the most vulnerable point in the throwing motion: lay-back.
When we do a drill like this, I encourage the athlete to “pick it up early.” In other words, I won’t apply downward pressure (eccentric overload) until they apply some external rotation force into my hand).
Some quick guidelines for manual resistance external rotations:
a. Emphasize eccentric overload, but make sure you aren’t pushing all the way down, as most people will go into scapular anterior tilt as they are more internally rotated. Pushing someone all the way down puts the shoulder in a pretty vulnerable position, as scapular stability is lost and the subacromial space is closed down.
b. Given that you have to apply the force further down the arm, make sure that the athlete isn’t cheating by just utilizing the wrist extensors.
c. In the manual resistance external rotations at 90 degrees in the scapular plane, your other hand should “cup” the elbow to make sure that the rotation is taking place at the shoulder (as opposed to horizontal adduction/abduction).
d. I like to utilize manual resistance external rotations twice a week during the off-season, usually toward the end of upper body strength training sessions. We’ll use less manual resistance work in this regard, though, when guys start to ramp up their throwing, as it tends to create a bit more soreness.