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Pitching Injuries: Should Lat Strains Even Be Happening?

Written on May 4, 2016 at 6:07 am, by Eric Cressey

Last week, I came across a meta-analysis that examined the existing body of research on latissimus dorsi and teres major strains in professional baseball pitchers. While the collective sample size was small (30 total athletes), one resounding theme was present:

Lat strains can be pain in the butt to rehabilitate.

In these studies, 29 pitchers were managed conservatively, while one pitcher required surgery for the issue. In the conservative group, the average return-to-pitching timeline was 100 days, whereas the surgical case was 140 days." Perhaps of more significance, though, the researchers noted that "five patients in the conservative group suffered from complications and/or setbacks during their treatment and rehabilitation."

We have to keep the sample sizes in these studies in mind, too. They haven't had a large pool from which to draw, and many researchers might not appreciate how different "return-to-pitching" is than "feeling like your old self." The general consensus among guys I know who have had the surgery seems to be that it's 8-10 months before you're back to feeling 100% in games. 

Let's face it: if you're missing 3.5-5 months with an injury - and adding even more time to get back to 100% - you might as well just cash in an entire season. That's not only a lot of money wasted on disabled list time at the Major League level, but also a lot of lost developmental time in the minor league ranks.

To make matters worse, the rehabilitation process can be delayed because lat strain diagnoses can be somewhat challenging. According to Dr. Leon Scott, a sports medicine physician and Assistant Professor of Orthopaedics & Rehabilitation at Vanderbilt University, "Because lat strain diagnoses aren't all that simple to make, especially if a physician’s exam is limited and relies heavily on an MRI, they are often a missed diagnosis. A standard MRI may not be distal enough to capture the area of injury. Arthrogram images are an even smaller field, leading to a missed diagnosis." He also notes that in one acute lat injury he saw in the past, "With a wide field shoulder MRI, there was acute edema, hematoma seen at the bone-tendon interface. It was hard to miss." In short, ordering physicians may be trying to use a narrow imaging technique for a shoulder injury when they should be painting with a broader brush that would also pick up an upper arm injury.

 Latissimus_dorsi_muscle_animation

 Source: By Anatomography (en:Anatomography (setting page of this image)) [CC BY-SA 2.1 jp (http://creativecommons.org/licenses/by-sa/2.1/jp/deed.en)], via Wikimedia Commons

One professional player I saw struggled with getting a definitive diagnosis that his lat strain needed surgery for two years. At first, they suspected his anterior shoulder pain was occurring because of a labral tear, but a labral "clean-up" surgery didn't change his symptoms. Perhaps more interesting, though, the surgeon didn't even see the lat tear while he was doing the arthroscopic intervention. Five months later, another surgeon went in to repair the lat - which was actually significantly detached from the bone.

The first take-home message here is that if you're a thrower and you have shoulder pain, you need to make sure that you see a sports medicine physician who sees a lot of throwing injuries. A lat strain can be a tricky diagnosis, and even the most well-intentioned physicians may not know to look for it. This is especially because it often presents as pain in the front of the shoulder, in the event of a tendinous injury. You can see this clearly demonstrated by the attachment points in the image above, but I'll take more about this later when we get to functional anatomy.

As I pondered the research article and actually discussed it with a few of my staff members, I realized that we have literally never had a lat strain happen with one of our regular clients at Cressey Sports Performance - and we see a lot of pitchers. I say this not to brag (or jinx us), but rather to just bring to light that success leaves clues - which I'll also get to later on in this article.

That said, I should note that my ideas in this article also draw heavily on our experiences working with a lot of frustrated pitchers who have come to work with us after the injury has occurred because they need help bouncing back. Failures (in this case, injuries) also leave clues.

Before we get to all these observations and potential countermeasures to prevent lat strains, I think it's incredibly important to discuss the functional anatomy of the latissimus dorsi and teres major. And, as an extension, we'll discuss how this functional anatomy understanding needs to be put alongside biomechanics research and anecdotal observations of injured athletes to pull together a hypothesis for the "perfect storm" of lat injury risk.

Functional Anatomy

The latissimus dorsi is a big muscle with huge functional implications.

Latissimus_dorsi

It attaches on the thoracolumbar fascia (lower back) and runs all the way up to the intertubercular groove of the humerus (front of the upper arm). This is why it has to be considered as a differential diagnosis for anterior shoulder pain in throwers - alongside everything from biceps and rotator cuff tendinopathy or tears, to labral injuries, to anterior capsule injuries, to thoracic outlet syndrome.

As an interesting aside, there are a number of anatomical variants present along this lengthy anatomical course. In a small percentage of people, the lat actually attaches on the ilium (top of the pelvis). In just under half of individuals, it has a direct attachment on the scapula. The number of costal (rib) and vertebral attachments also varies from person to person.

Everyone knows about the functions of the lat at the shoulder - extension, adduction, internal rotation, and horizontal abduction - but in consideration of this expansive functional anatomy profile, we have to appreciate that it has several other key roles to consider.

Lat is a key core stabilizer - to the point that it can be heavily overused and pull athletes into a "gross extension" pattern. Notice the big anterior pelvis tilt and lordosis here - but also take note of the position of humeral extension (and the indirect effects on forward head posture).

Ext4

Given its attachment on the scapula in some individuals - and the indirect impacts of "crossing" the scapular region - the lat also contributes to scapular depression.

depressionanteriotilt

Finally, it's been theorized that an aberrant, extension-biased posture would interfere with optimal diaphragmatic function (via loss of the zone of apposition). Because the lat is also an accessory respiratory (inhalation) muscle, you could say that it has to pick up the slack for a problem it actually helps create! My favorable experiences with the Postural Restoration Institute and my own anecdotal observations definitely support this theory.

Zone-of-Apposition-300x220

Source: www.PosturalRestoration.com

For all intents and purposes, you can view teres major as a "mini-lat." It shares the same scapula-to-humerus functional relationship and actions, but doesn't impact the rib cage or lumbar spine directly.

 

Teres_major

 

Implications for Throwers

By appreciating the functional anatomy of the lat, we can recognize just how vital it is to throwing a baseball hard. In short, it connects the lower body to the upper body to allow for force transfer that ultimately leads to arm speed and ball velocity.

Not surprisingly, a 1987 study from Gowan et al. observed that lat recruitment during the acceleration phase of throwing was substantially higher in professional pitchers than in amateurs. Not surprisingly, experienced, accomplished athletes know how to use big-boy muscles (prime movers) to do big-boy jobs (accelerate the arm, which is the fastest motion in all of sports). The amateur pitchers actually continued to heavily rely on smaller, stabilizing muscles - the rotator cuff, biceps, and posterior deltoid - during acceleration. That's not a safe or effective long-term strategy.  

This is likely why we rarely see lat strains in younger athletes; you probably have to throw 90mph+ to effectively "use" the lat, and muscles that don't get used usually don't get strained. The younger kids are more likely to have rotator cuff pain, irritation of the long head of the biceps tendon, or proximal humeral growth plate issues.

There's a bit more to "lat overuse" than just the acceleration phase of throwing, though. During the lay-back (extreme cocking, or maximum external rotation) portion of throwing, the lat and teres major are two of several muscles (including notables like subscapularis pectoralis major) that are working eccentrically to prevent the humerus (upper arm) from flying off the body.

layback

This eccentric pre-stretch also helps to store elastic energy that is subsequently released during the acceleration phase to create ball velocity. Most muscle strains occur - whether it's acutely or chronically - as muscles and tendons are stretched during the eccentric phase of activity. Hamstrings strains usually occur at the terminal swing phase of sprinting. Middle-aged men rupture Achilles tendons when they land on dorsiflexed ankles - where the calves are maximally stretched. The lats and teres major are the most overstretched at this lay-back phase of throwing.

On a chronic note, repeated exposures to aggressive eccentric stress can lead to muscle shortening. Reinold et al (2012) demonstrated this with respect to elbow extension and shoulder internal rotation. My experience has been that pitchers who trend toward the "tight" end of the continuum also lose shoulder flexion and "true" external rotation over the course of the season. As I describe in the video below, this is very likely related to stiffness or shortness in the lats - and the research has demonstrated that it is associated with an increased risk of elbow injuries in pitchers.

Beyond just the specific roles of the lats during the throwing motion, we have to also appreciate that they're heavily overused during daily life because of their roles as core stabilizers and accessory respiratory muscles. And, given that we don't spend a lot of time in our daily lives with our arms overhead and shoulders externally rotated, they aren't afforded a whole lot of length throughout the day. Take a chronically shortened muscle, overuse it, and then throw it into the fastest motion in all of sports, and you've got a recipe for strains. However, you can't throw hard without it. Hence, this Tweet from me a few years ago:

lats

Why Do These Injuries Take So Long to Heal?

Having established the injury mechanisms, it's important to also consider why lat strains in throwers take so long to rehabilitate. I see four primary reasons that differentiate lat strains from just "any other muscle strain:"

First, as we noted earlier, early diagnosis may not happen. This can occur because the athlete just ignores the issue as normal soreness, or they manage it as "biceps tendonitis." Or, a physician may not recognize that a lat injury could create anterior shoulder symptoms. Finally, a typical MRI might just miss the injury altogether. All these factors can potentially lead athletes down the wrong rehabilitation path.

Second, my experience has been that many of these injuries are far more chronic than they are traumatic. More often than not, when you dig deeper into the history of a pitcher who has a lat strain, he's thrown through some kind of extended soreness/discomfort for weeks, months, or years. Eventually, it becomes too much to stand and begins to significantly interfere with pitching performance. Given that the issue developed over an extended period of time, it isn't going to go away overnight. 

Third, as I discussed in my functional anatomy musings earlier, the lats are heavily involved in multiple planes of motion. I've theorized in the past about how muscles that play crucial roles in multiple plans are more likely to be stubborn rehabilitation projects:

Pull a quad (rectus femoris), and you’ll usually bounce back really quickly. Pull an oblique and it’s much more stubborn. What’s the difference? The rectus femoris is really all about the sagittal plane, whereas the obliques have a big role in controlling excessive motion in the sagittal, frontal, and transverse planes. The more complex the job of the muscle, the more significant the injury – and the longer the rehab. Hamstrings have roles outside the sagittal plane and can be equally stubborn, too.

Fourth, the proximal humerus (upper arm) area really seems to scar down faster than almost any other region in the body - and this is particularly true of throwing shoulders because of the eccentric stress pitchers encounter. There are 17 muscles that attach to the scapula, and most of these structures cross the glenohumeral (ball-and-socket) joint. Perhaps more significantly, eight of these tendons attach in close proximity to the insertion of the latissimus dorsi and teres major. Throw eight tendons in a very small area that experiences a lot of eccentric stress, and you'll wind up with a gritty, fibrotic mess eventually.

Injury Risks

Whether it's a chronic or traumatic onset lat issue in a pitcher, one theme always seems to hold true: symptoms emerge after a dramatic increase in throwing stress.

On multiple occasions, I've seen lat strains that have come about because a reliever pitcher was moved into the starting rotation without a gradual increase in pitch count. 

In other instances, the lat got cranky after a big velocity jump in a single off-season. This is usually the case in a high school kid who jumps from 84 to 94mph in a single winter. As my friend Derek Johnson, the pitching coach for the Milwaukee Brewers has said, the "arm is writing checks the butt can't cash."

delivery5

Sometimes, it may come about after a single outing with an abnormally high pitch count. The pitcher just can't bounce back in time for the next start, and the subsequent start becomes the straw that breaks the camel's back. y experience has been that when you throw the typical "high arm speed" (90mph+) high school pitcher out for back-to-back outings of 100+ pitches - even on a seven-day rotation - things often start to head down the wrong path. This doesn't happen nearly as frequently in the college game, and I think this speaks to the fact that there is clearly something really important that's occurring in terms of work capacity and/or strength improvements for pitchers in the 16-19 age range.

Finally, lat issues seem to be particularly common when you see high school and college starters switch from a 7-day rotation to a 5-day rotation when they enter professional baseball. It isn't as much of a dramatic increase in stress as it is a significant loss in recovery time or capacity. I've heard many guys over the years say that they have to learn to pitch with only 90% of what they're typicaly capable.

Movement Quality 

Beyond just the increase in throwing stress, there are a few things I've found to be common in the lat strain pitchers I've seen in recent years.

1. The lower traps can't keep up with the lat.

The lower traps are very important for providing posterior tilt (slight tipping back) of the scapula and assisting in upward rotation. These two functions make it essential for a pitcher to get his scapula in the right position during the lay-back phase of throwing.

Conversely, the lat has more of a "gross" depression effect on the scapula; it pulls it down, but doesn't contribute to posterior tilting or upward rotation. This might help with an adult rotator cuff pain patient who has an aggressive scapular elevation (shrug) substitution pattern, but it's actually problematic for a thrower who is trying to get his scapula up and around the rib cage to make sure that the ball-on-socket congruency is "flush" when it really matters:

baseball-97898_960_720

As such, you can say that the lat and lower trap "compete" for scapular control - and the lat has a big advantage because of its cross-sectional area and multiple attachment points. It's also much easier to train and strengthen - even if it's accidentally.

To this end, we'll often hear throwers cued "down and back" during their arm care drills. The intension - improving posterior tilt via lower trap activation - is really good, but the outcome usually isn't. Unless athletes are actually put in a position of posterior tilt where they can actually feel the lower traps working, they don't get it. Instead, they pull further down into scapular depression, which feeds the lat-dominant strategy. This is why we teach almost all our throwers to differentiate between depression and posterior tilt on their first day in the gym.

2. The rotator cuff can't keep up with the lat.

As I noted earlier, the lat has numerous functional roles at the shoulder. Because the attachment point of the lat is on the shaft of the humerus and not the ball, the lat really can't have any direct control on the positioning of the ball in the socket. In fact, it actually indirectly destabilizes the throwing shoulder because it contributes to an anterior (forward) gliding of the ball on the socket during the lay-back phase of throwing. This anterior glide is counteracted by the rotator cuff musculature.

image412

Whenever we evaluate movement, we have to consider both osteokinematics (gross movements - flexion, extension, etc. - of bones at joints) and arthrokinematics (subtle movements - rolling, rocking, gliding, etc. - of bones at joint surfaces).

To paraphrase something that physical therapist Shirley Sahrmann has noted many times, whenever you see a strained or overworked muscle, look for a dysfunctional synergist. In this case, the synergists to the lat and teres major are the rotator cuff muscles. We just rarely consider lat strains as a consequence of rotator cuff weakness because it's usually the biceps tendon, labrum, capsule, or rotator cuff itself that winds up cranky before the lat starts barking.

3. Guys usually have a history of doing a lot of lat dominant lifting.

In a baseball population, throwing is lat dominant. Breathing is lat dominant. Core stabilization is lat dominant. When you add in a lot of lat dominant lifting to the mix - particularly during the in-season period - things don't usually go well. I'm just going to put this out there:

I've never met a high-level thrower who had "weak" lats.

I'm speaking with respect to both relative and absolute measures. Relatively speaking, I've never looked at a guy and said, "Well, if he added 50 pounds to his best weighted chin-up, he'd definitely throw harder and be healthier. His rotator cuff and lower traps are too strong." Absolutely speaking, I have yet to see any research examining the relationship between lat strength and throwing velocity. I'm very confident that there is a point of diminishing returns where getting stronger doesn't help add any more velocity. Moreover, it may actually interfere with improvements - and increase susceptibility to injury. This includes elbow irritation, as heavy weighted pull-ups and chin-ups are brutal on the medial elbow in lifters who don't even throw a baseball for a living.

Just like you don't have to squat 800 pounds to have an elite vertical jump - but you probably won't jump high if you only squat 200 pounds - your lats just need to be strong enough to throw hard.

Also worthy of mention is the fact that exercises like deadlifts, farmer's walks, and dumbbell lunges, and any other drill where weights are held in the hands are actually very lat intensive. With the arms at the sides, the lats are almost fully shortened - and the lat is working hard as a core stabilizer against appreciable external loading.

The take-home message is that you really have to critically examine your entire strength training program for how much lat-dominant work your athletes are doing. My rule of thumb is that an athlete has to have full shoulder flexion and great cuff strength to "earn the right" to do pull-ups in his off-season programming, and we don't use any pull-ups or pulldowns with in-season programs. We can accomplish everything we need with horizontal pulling variations.

4. Guys usually accumulated a lot of innings or appearances without much, if any, manual therapy 

NASCARs require more upkeep that ordinary automobiles. If you're going to push a car to its limits, you better plan on changing the oil and tires more frequently. The same goes for a high level throwing arm. Manual therapy is a game-changer for maintaining or improving range-of-motion and bouncing back between outings.  

manual_therapy_page-300x206-2

The lats and teres major get pushed really hard during the throwing motion, and it's important to do regular routine manual therapy maintenance to keep them "supple" with a variety of soft tissue approaches. I've seen athletes that responded really well to cupping, some to Graston Technique, some to Active Release Technique, some to dry needling, and others to more traditional massage. Everyone is different - but everyone needs it.

Also worth of note, trigger points in the latissimus dorsi may actually relate to discomfort in other regions. Chris Howard, massage therapist at Cressey Sports Performance – MA, notes:

“Trigger points in the latissimus dorsi can refer pain and discomfort to the medial and inferior border of the scapula extending to the posterior shoulder, medial triceps region and down to the pinky and ring finger. Trigger points not only cause pain, but can also mimic nerve symptoms by causing numbness and tingling in their referral zone. Of particular interest to this article is the fact that trigger points, regardless of whether they are active or latent, have the ability to alter muscle activation patterns. In other words, once trigger points are present in muscles of the shoulder girdle, the normal activation pattern is altered, which can lead to abuse of some of the smaller muscles.”

5. Guys have insufficient anterior core control.

The stiffer (or shorter) your lats are, the more you need to have great anterior (front) core control to prevent this from happening:

When the core control isn't present, the lats are never really challenged to approach their end range - which is full shoulder flexion. Learning to add some good stiffness to lock the ribs to the pelvis during overhead motion obviously protects the lower back, but it also has the added benefit of making lats "healthier."

6. They turn all rowing motions into lat dominant movements.

Rather than reinvent the wheel on this point, check out this detailed rowing technique video I filmed a while back. In particular, points #1, #2, #4, and #6 are the most common findings in a very lat-dominant individual. I'd encourage you to watch the entire video, though, as it's not uncommon to see multiple mistakes at a time:

7. Guys have lost shoulder flexion.

If a muscle is fundamentally short, it's going to be more likely to strain. These are usually the ones who have failed miserably on points 1-6 over an extended period of time.

shouderflexion

Prevention

Several years ago, in the heart of the ACL prevention program craze, Mike Boyle made a bold statement, "ACL injury prevention is just good training." In short, if you teach athletes to move well with comprehensive, well-rounded programming and solid coaching to ensure good training technique, you're going to markedly reduce the incidence of ACL injuries. I couldn't agree more - and I'd argue that lat strain prevention training in pitchers is just good training, too. 

1. Maintain tissue quality with regular manual therapy, and complement it with daily foam rolling.

2. Make athletes earn the right to do pull-ups.

3. Don’t do pull-ups/pulldowns during the season.

4. Make sure that the rotator cuff, lower trap, and anterior core are strong enough to keep up with the lats.

5. Be cognizant of overdoing it on drills like deadlifts, farmers walks, and DB lunges/split squats. These are all great exercises that can have their place, but anything done to excess can be a problem.

6. Ensure appropriate training technique. Specifically, don't overuse the lats when you aren't supposed to use them at all.

7. Closely monitor athletes who have seen dramatic jumps in pitching velocity or workload - and avoid building up pitch counts too quickly.

8. Constantly solicit feedback from pitchers so that mild lat soreness is discovered before it can become a full blown injury.

Obviously, once an athlete already has a teres major or lat strain, things are a lot hairier. That's really the point of the article, though: as always, prevention is the absolute best treatment

Related Posts

Does Throwing Really Build "Arm Strength?"
What's with all the Power Arms?

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4 Strategies for Improved Base Stealing Jumps

Written on March 28, 2016 at 6:08 am, by Eric Cressey

Today's guest post comes from former Cressey Sports Performance intern and current University of Washington Strength and Conditioning Coach, Dave Rak. Enjoy! -EC

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Coaches often talk about gaining an extra step when it comes to improving speed. For a baseball player an extra step could be the difference between a stolen base or a jog back to the dugout. There are many ways to gain that valuable extra step. Strength training, drill work, and refining technique all play an important part. As a coach you need to help the athlete feel the correct positions in order to maximize efficiency when stealing bases. Here are 4 simple ways to improve common mistakes.

1. Videotape everything.

With almost everyone having a smartphone or a tablet device on them 24/7, cameras are easily accessible, which leaves no excuse as to why you can’t video tape your athletes. Whether you are working 1-on-1 with an athlete, or with all of your position players at once, video feedback will be crucial. This gives the athlete a view from your perspective as to how they could improve their movements. Video feedback will not only allow you to show the athlete what is going on from a technical standpoint, but in a team setting, it will allow you to work efficiently with large groups. As a coach you will be able to see every rep from each of your athletes. This allows you to go back, take notes, and identify what needs to be worked on for each player. The athlete can use this information to better correct movements and execute proper form.

Most importantly, having video allows you to study the athlete’s movement and learn what corrections need to be made. This grows your knowledge on this specific movement. You may not have all the answers right away, but video will help you and your athletes figure out what can be corrected. Video is nothing new in sports and especially baseball; why not use it when trying to gain an extra step on your steal jump?

Video programs such as Hudl Technique (formerly known as Ubersense) and Coach’s Eye are great apps that can be used on a smartphone or tablet to record video It can then be played back in different speeds for the athlete.

2. Overload the movement. 

After breaking down video of my athletes I noticed some players were over reaching or stepping too high with their right foot on their initial leg drive. This is wasted movement that does nothing but prolong the steal jump, and put the athlete in a poor position to accelerate from. The photo below is an example of an ineffective directional step. The foot comes up too high, which prolongs the movement:

steal

By taking a smaller and more direct step the athlete will achieve a better position for acceleration. Below is a video that shows an example of a more efficient step.

To help with this common mistake, you can physically pull the runner towards second base and overload the movement using a bungee cord attached at the waste as seen in the video below.

Lee Taft suggested told me about this drill, and it has been very helpful with allowing my athletes to figure out how to make that direction step more efficient. The pull of the bungee cord forces the runner to be quicker and more direct with their step. The pull of the cord will cause the athlete to shift their weight towards second base and onto the right foot. Once they take a directional step they have to replace the foot quickly, if they don’t they will fall. The bungee cord allows the athlete to feel their mistakes in the moment. After a few repetitions the athlete should be able to make the adjustment on their own.

NOTE: Bungee cords work better than jump stretch bands for these drills.

3. Gently resist the movement.

A lot of time is spent on developing power and becoming more explosive in the weight room. The initial push of the steal jump is a great place to show off these attributes. Using video feedback, you can easily see if an athlete is lacking that “push” when they take off for second base. Yelling “triple extension”, or “push harder” may not always work. Instead give the athlete something to push against. To do this take the bungee cord from our previous drill and instead of overloading the sprint, gently resist the start. This will make the athlete have to overcome the resistance of the bungee cord when they make their first move. This should force the athlete to get better extension with their left leg. The video below is an example.

Again, the bungee cord will work better than a pair of jump stretch bands.

The athlete should feel the resistance of the cord before they start their sprint. This will force them to be aggressive when they push off. The goal is for the athlete to feel how hard they need to push with the lower body. It is also important to note that too much resistance will change the outcome of the drill. We are not weighing down the runner and having the partner get dragged behind. The runner should have to overcome the resistance on the push off and then be able to run normally as they accelerate.

4. Use a towel to teach arm movement.

After speaking with Lee Taft about what I was seeing with my athletes I began to realize how important the arms are, especially in the initial move. Lee helped me to realize that by achieving better arm action, common mistakes will be corrected on their own. These mistakes include: popping up on their first move, weak initial push-off, inability to stay low through the acceleration phase, and not turning the body quick enough to get into a linear sprint.

To help get the athlete to become more aggressive and throw the arms on their initial move we can hold a towel or shirt behind him. One of my former players actually came up with this idea on the spot during a training session. We told him to knock the towel out of his partner’s hand, which forced him to drive his arm back in a more aggressive manner. Originally this athlete did not have an aggressive arm action from the start position, preventing him for getting his body turned efficiently. This drill is an exaggerated movement; keep in mind the goal is to get a feel for what his arms should be doing.

Throwing the arms too much can be a bad thing and can cause the runner to over rotate. Make sure to find a good middle ground.

In addition to the actual action of the arms, the hand placement is also important. Longer arms require a greater distance to be traveled which takes up more time. Instead of letting the arms dangle near the knees, try to move the hands to belt level. This shortens the path of the hands, therefore allowing the runner to drive their arms back faster. This will get he body turned in a quicker fashion.

The purpose of these drills is to allow the athlete to feel mistakes and then provide an opportunity to self-correct. When the runner gets out of position the bungee cords will provide instant feedback. The video will provide visual feedback as well. The towel drill forces the athlete to accomplish a movement with the arms that they previously may not have done. The ultimate goal is for the athlete to feel the correct technique for themselves and carry it over into game time situations.

About the Author

David Rak is in his third year as an assistant strength & conditioning coach at the University of Washington. David directly oversees sports performance for Baseball, Men's & Women's Golf, and Men's Tennis. He can be reached at davidrak25@gmail.com.  

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Simplicity, Confirmation Bias, and Specific vs. General Programs

Written on October 4, 2015 at 2:41 pm, by Eric Cressey

 Confucius once said, "Life is really simple, but we insist on making it complicated." You could say that I modernized and expanded on this quote in the context of the fitness industry a few weeks ago with my post, 6 Ways to Simplify Your Coaching for Better Results.

While I'd encourage you to read this piece in full (if you haven't already), the premise was very simple (for lack of a better term): our programming and coaching almost never needs to be complex. Both research and anecdotal observations have shown time and time again that people thrive on simplicity in various aspects of their life - including exercise and nutrition.

Why, then, do we as coaches constantly find ourselves needing to avoid the complexity trap? The answer is very simple: confirmation bias.

Confirmation Bias

This term simply means that we're wired to automatically prefer information/solutions that confirm what we believe and prefer/enjoy doing.

Confirmation bias is why almost every Olympic lifter I've met who has shoulder problems thinks they can just tinker with their jerk or snatch technique to make things feel better.

Confirmation bias is why some Crossfit coaches will try to convince baseball players that their training can prepare these athletes for the unique demands of their sport.

layback

Confirmation bias is why some strength and conditioning coaches who work only with athletes have actually forgotten how to help a general fitness client lose 20 pounds of body fat.

Confirmation bias is why we still have some nutritionists advocating for the Food Guide Pyramid.

Our goals - whether it's for our own programs or those we coach - is to avoid confirmation bias as much as possible. Being open-minded to new ideas and approaches enables us to constantly improve our programming.

Specific vs. General

To me, avoiding confirmation bias is a (surprise) simple process. Assume that your absolute best proficiency constitutes a general approach. For me, this is training baseball players. For a powerlifter, it's powerlifting. For a Crossfit coach, it's coaching Crossfitters. It's considered general (even though the training may be highly specific) because it's the overwhelming majority of folks with whom you work, and because you're most familiar with it.

With each new client you see, ask yourself whether this person fits into your general paradigm, or whether it's actually a very specific case. For instance, at Cressey Sports Performance - Florida, we train Atlanta Falcon Matt Bosher, who is currently leading the NFL in average yardage on kickoffs and punts. His program is dramatically different from what we might prescribe for our baseball players; we can't fit the athlete (specific) to the program (general).

CSP-florida-021

If Major League Baseball players are training at facilities other than CSP, though, they are the specific case. They have specific injury mechanisms that might be unfamiliar to those coaches. Just any general program won't adequately address things.

"General" fitness training - improving body composition, functional capacity, and quality of life - is (as the name implies) something that general programs can usually accommodate quite easily, particularly in beginner clients. This is why general programs can work great for untrained young athletes, too; young players may derive great injury prevention and performance enhancements with general training early on.

However, when clients become advanced, they may need something more specific. Perhaps a casual fitness enthusiasts builds appreciable strength and shows and interest in competing in powerlifting or Olympic lifting. Or, maybe an athlete shows great potential in one sport and decides to hone in on that path. Our training has to get more specific to accommodate the evolution of these athletes' abilities and goals. This is even why we set up a female powerlifting team at Cressey Sports Performance - Massachusetts; we had some strong women who wanted to take things to the next level.

What's the take-home message? Don't take specific solutions to general problems - or vice versa.

Have a great Sunday! 

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What Albert Pujols Taught Me About Swing Mechanics

Written on September 7, 2015 at 9:27 pm, by Eric Cressey

Today, I've got a guest post from Bobby Tewksbary. Bobby has quickly established himself as one of the premier hitting instructors to professional and amateur hitters alike over the past few years. You might also recognize him as the guy who threw to Josh Donaldson at this year's Home Run Derby. I enjoy Bobby's stuff, and I'm sure you will, too! Be sure to check out his Elite Swing Mechanics E-Book, if you haven't already; it's fantastic stuff.

A lot of folks heard my name for the first time after this year’s Home Run Derby, where I pitched to Josh Donaldson. However, I never would have had that opportunity if I hadn't seen this swing of Albert Pujols in 2009. That was when I first saw Pujols doing something with his swing mechanics that most people don’t realize.

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Even if you have studied the swing, you might be shocked or surprised at what you can see Pujols doing. It defies so much of what passes as "common wisdom" among hitters.

Over the last 6+ years, I’ve studied tens of thousands of hours of hitting video to better understand the swing and what makes Pujols’ (and all the other all-time greats) so special. I’m excited to share some of the most important things I’ve learned so you can improve your timing, power and batting average!

Albert Pujols’ Swing Mechanics

What exactly are we talking about? We are talking about swing mechanics and the movement Pujols uses to create consistent timing while being able to hit for power and for average.

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When Pujols’ rear knee and hips are turning forward, his hands aren't going down… they are going up and back. Watch this clip a few times - study the hands, the hips opening, the rear knee.

This is very different than what I thought was right and it is very different than what most hitters are taught! Conventional instructions call for things like “take your hands/knob to the ball”, “stay inside the ball”, “stay on top of the ball.” In the big picture, these aren’t completely bad things but they are very incomplete.

I still remember how I felt when studying the swing the first time: How I swung the bat was very different than how Pujols and other great hitters swing. If Pujols was doing something different then me, then I was definitely the one doing it wrong!

A Deeper Look at Albert Pujols’ Swing Mechanics

The really special part of Albert Pujols swing is revealed in his barrel path. This is the secret behind his elite mechanics and what creates his good timing and his ability to hit for power and average.

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Before, we saw how Pujols’ hands were working up and back while the hips were opening. Now we can see how his barrel is moving! When his hips are opening, his barrel is not moving toward the ball; rather, it is working deeper and flatter.

This is where Pujols is creating his timing for his swing. Instead of the barrel working TOWARD the ball, he is creating time by getting his barrel into the zone deeper. And because his barrel is working back and not forward, he is able to stop his swing if the pitch is not a strike. This gives him very adjustable timing.

Another key component to this movement is how short and quick his swing becomes. The lower body has already opened/cleared and the barrel already has speed. The swing's finish is very short, quick and explosive.

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Look at how fast this is - and how hard it is to see this movement in "real time!"

Hitting for Power and Average

We know Pujols’ barrel moves deeper to start the swing, but how does this help him hit for both power and average?

The barrel is working onto the plane of the pitch earlier so the barrel stays in the zone for a very long time. This gives a very “long” zone in which he can hit the ball hard. Plus, when his barrel is going back, his lower body opening. This is creating an ideal swing sequence where the lower body’s turn happens first which transfers energy “up the chain” and all the way to the barrel.

In addition, the barrel is “inside” the ball later and works through the zone with great swing direction. The barrel gets behind and through the ball without having to guide or steer the bat. If you play golf, think of this as getting a good swing path and driving through the ball and not cutting or hooking!

Here is one more look:

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The swing is built to hit the ball with power to all fields!

Teaching These Swing Mechanics to Other Hitters

Most hitters are taught a swing to either “push” the bat to the ball (linear hitting) or to pull/rotate the bat to the ball (rotational hitting.) Both of these swing styles create issues for hitters with their timing. Push/linear hitters tend to make more contact but lack power. Pull/rotational hitters will have more power but hit for lower average.

I call the pattern Albert Pujols uses "Elite Swing Mechanics." I use the word “Elite” because it is the swing the all-time great hitters use and continue to use. I’ve worked with Josh Donaldson, Chris Colabello (Toronto Blue Jays) and Cressey Sports Performance Client A.J. Pollock (Arizona Diamondbacks) - and hundreds of youth, high school and college players others on developing these Elite Swing Mechanics.

The first and most critical step is to developing better swing mechanics is to understand swing mechanics. The more you understand the swing, the more deliberate you can be about how you work. And when you improve your swing, you increase your abilities and performance as a hitter!

One thing that I really try to communicate to people is that I’ve never tried to invent anything with the swing. I’ve studied tens of thousands of hours of video to try to understand what the best hitters in the history of the game have done. The game tells showns us what works and the all-time great hitters all use the same swing mechanics. Whether I'm working with a pro guy or a younger hitter, the goal is the same: I try to help hitters understand the swing. If a hitter doesn’t understand the swing, then they are taking a huge risk with this very important skill. When a hitter understands how their swing works, it causes a few really good things to happen.

1. Increased Accountability - The hitter will take ownership of their swings in their training and games.

2. Learn from Failure Faster - Hitters will diagnose their failure faster and be able to make adjustments faster.

3. Trust in the Process - Hitters will trust their long-term plan. Go to work each day knowing you are building in the right direction.

The single most common comment I hear from professional hitters is, “Why didn’t anybody tell me this sooner?” Technology has made is possible to gather video and study hitters in ways that haven’t been possible before. The game is advancing and pitchers are currently WAY ahead of hitters. The first step toward building this knowledge is my Elite Swing Mechanics E-Book + Instructional Videos.

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About my Elite Swing Mechanics Book + Instructional Videos

I wrote my book to help share what I’ve learned about the swing. This book isn’t a traditional book though. I’ve tried to create a product that takes advantage of technology to help reach hitters with all learning styles. This is what makes up my book:

*120+ page Elite Swing Mechanics PDF eBook
*Video instruction of keys points and drills with over 2 hours of total video instruction
*Audio version of book so you can listen to the book on your iPod/iTunes
*14-day follow up email program walking you through the information with videos and articles
*Lifetime Updates
*Bonus Articles & Exclusive Offers
*Money Back Guarantee - If you don't learn from this product, I'll give you a full refund.

Don't Take My Word For It

"I was introduced to Tewks' stuff two years ago and what he teaches has helped me progress as a hitter. I look at the swing with a completely different perspective now. I wish I knew the TRUTH in high school!" - A.J. Pollock

"Want to understand your swing? Bobby was one of the first guys who helped me understand the true mechanics! I 100% believe in his philosophy and I know it’s the TRUTH!” - Josh Donaldson

“The information was a game changer. What Bobby showed me taught me to do things I couldn’t do before. I learned how to swing better and it enhanced everything about me as a hitter.” - Chris Colabello

NOTE: The lifetime updates is a big reason why this is a digital product. I constantly perform research and learn more ways to communicate the movements of the swing. When I find new details or new wording that helps hitters, a digital product allows me to issue an update in ways that a printed book or physical DVD cannot. This is all about helping hitters, so this digital product format allows me to do that best.

Click here to learn more and purchase!

If you have any questions, you can reach me at bobby@tewkshitting.com. 

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Random Thoughts on Sports Performance Training – Installment 12

Written on July 30, 2015 at 6:27 am, by Eric Cressey

With only one day to spare, here's the July edition of "Random Thoughts on Sports Performance Training."

1. One of the things I really heavily emphasize to our staff is that we should always be assessing. Obviously, during an initial assessment, we're going to review injury history, evaluate movement quality, and work to build rapport with the new client. However, I'm a huge believer that the initial evaluation should also include an actual training component. This is for three reasons:

a. I want the client to feel like they've actually started working toward their goals, as opposed to just hearing about all the things they need to work on.

b. We have many clients who come from out of town for short-term consultations, so we need to make the most of every training session.

c. I want to actually get a feel for what their work capacity is before I actually write a program for them.

You can measure resting heart rate, ask about training history, and take a whole bunch of other indirect measures of work capacity, but there is no substitute for seeing it first-hand. I've seen pro athletes in the early off-season who are completely deconditioned and struggle to get through incredibly abbreviated, basic sessions with lengthy rest periods. You really have to be able to take a step back and separate yourself from what you are expecting to see on the work capacity front so that you can observe what's really going on. If they are too deconditioned to put in the work you need to optimally effect positive changes with their performance, then your programming better reflect it.

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2. I often talk with my baseball guys about how every throwing session either makes you tighter or looser. This sadly hasn't been recognized very well when it comes to individualizing recovery modalities to players' arms.

If you've got a lot of joint hypermobility (collagen deficiency), you'll get looser. If you're a naturally "tight" individual, you'll get tighter and tighter.

If you're loose-jointed, you'll respond well to low-level stabilization drills that essentially "remind" your nervous system of how to create good stiffness and optimal movement at joints (particularly the shoulder).

These looser-jointed athletes also seem to respond better to mild compression (arm sleeves, not aggressive compression). Even a cut-off tube sock works just fine.

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Conversely, "tighter" throwers will generally do better with manual therapy and mobility drills. Static stretching after throwing is definitely appropriate, whereas you can skip it with the hypermobile crowd.

Regardless, these two "camps" share a lot in common. They both need great nutrition and hydration and optimal sleep quality and quantity, and they respond well to foam rolling and positional breathing drills. And, keep in mind that most pitchers don't fall to one extreme; they're usually somewhere in the middle, and can therefore benefit from a bit of everything. This is why recovery from throwing is an individualized topic; we have our theories on what works, but always have to get feedback from the athletes on what has yielded the best results for them.

3. Building on point #2, I never quite understood why some pitchers insist on doing their band work after starting pitching outings. It doesn't match up with either the "loose" or "tight" scenarios from my previous point, as fatigue changes everything. Fatigue is the enemy of motor learning - or re-learning, in this case. In my opinion, post-game band work is pretty silly.

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If you're tight, get right to your manual therapy and mobility/stretching work. If you're loose, throw on a compressive arm sleeve and do your low-key band work the next day as part of that "stabilization re-education" I outlined earlier.

4. Good coaching isn't just about making clients and athletes move well; it's about doing so efficiently.

To me, there is a hierarchy in play in the coaching progression. First, a coach must know what an exercise is, and then understand how to coach that exercise. The third step is to learn to assess so that one knows when to include the exercise in a program. This last step is key, because to do an accurate assessment, one must understand what quality movement really looks like, how relative stiffness impacts things, and which compensation patterns an individual might resort to during that exercise. If you appreciate and follow this hierarchy, you continue to refine your ability to make technique perfect - but you can do so far more efficiently. 

Once you get to this point, it's all about coaching as many individuals as possible so that you have a giant sample size of incorrect patterns from which to draw. How do hypermobile folks compensate differently than those who don't have as much laxity? Why do individuals with long femurs struggle with an exercise, while those with "normal" anthropometry do just fine? Eventually, answering questions like these becomes second-nature, and that's where the efficient coaching happens, particularly when you learn about internal/external focus cues, and kinesthetic/visual/auditory learning styles.

5. Earlier this week, we had a 6-7 athlete doing stability ball rollouts - and the exercise was (unsurprisingly) pretty challenging for him. The combination of long arms and a long spine put him at a very mechanically disadvantageous position. It got me to thinking about how everyone seems to think about how tall guys have it tough when they squat and deadlift, but nobody seems to carry this thinking over to most core exercises. Imagine being seven-feet tall and trying to perform a stir the pot, where the forearms are a great distance from the feet:

Even on cable chops and lifts, the center of mass on a tall athlete is considerably further up from the base of support. The external loading that can be used is going to have to be lower if you don't want compensations to kick in.

One thing that can actually help a bit in this regard is athletes putting muscle mass on in the lower half of the body. It has a "grounding" effect as the center of mass is shifted slightly lower on the body.

Regardless, though, core stability exercises may need to be modified for taller athletes, especially initially. This might be in terms of regressing (e.g., going to prone bridges instead of rollouts), limiting range of motion (e.g., shortening the excursion on a rollout), or reducing the external loading relative to your "typical" expectations of where an athlete can start. 

6. Speaking of core stability exercises, have you checked out Mike Reinold and my Functional Stability Training? These resources have been our most popular collaborations, and we have modules covering our approach to rehab and training of the upper body, lower body, and core. It’s essentially a snapshot of how we think when designing our programs. You can learn more and purchase HERE.

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What is a “Big League Body?”

Written on July 8, 2015 at 11:24 am, by Eric Cressey

You might be surprised to know that I'm an "outsider" to baseball. I played up through 8th grade, but was actually a much better tennis player. Since they were both spring sports, the decision to go the tennis route was effectively made for me even though I loved baseball as both a player and fan.

Years later, in my first three years of strength and conditioning during graduate school at the University of Connecticut, I actually spent most of my time working with basketball and soccer players. I still loved baseball, but hadn't really been exposed to it "from the inside."

It just so happened that when I went to the private sector after graduate school, some of my first clients were high school baseball players. They had some good results and my phone started ringing off the hook. Now, almost ten years later, Cressey Sports Performance has facilities in both FL and MA, and we work with players from all 30 Major League Baseball organizations. 

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I'd argue that if I had been an "insider" from the get-go, we never would have been able to differentiate ourselves so quickly. Why? As an outsider, I had to do a lot of listening and observing. I had to ask a lot of questions. And, I was fortunate to NOT be married to personal biases of what baseball training programs should look like.

Distance running for pitchers didn't make sense to me. It was absurd to hear that players shouldn't lift because it'd make them "bulky and inflexible." The list goes on and on - but the point remains the same: good baseball strength and conditioning mandates logical thinking, not just reliance on tradition and personal biases. 

This doesn't just apply to baseball insiders' perspectives on what players should look like, though. Rather, it also must apply to how strength and conditioning coaches - baseball outsiders like me - view what players should look like. And, my decade in baseball strength and conditioning has taught me that you have to emotionally separate yourself from what an athlete "should" look like, especially when dealing with pitchers.

While you might think that every athlete - regardless of sport - needs to be 7% body fat with a 500+ pound squat and 18-inch biceps, you have to throw that perception out the window when you're dealing with baseball players (and many other athletes, for that matter). The truth is that big leaguers come in all shapes and sizes.

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I've seen pitchers with 16-inch vertical jumps who throw 95mph. I've seen guys at 25% body fat win Gold Gloves and hit over .300 in the big leagues. I'm not saying that you should just "allow" your athletes to be unathletic, but rather that you need to recognize the following:

Players are often successful because of traits and not just athleticism. 

Maybe a hitter has tremendous sports vision. Maybe a pitcher was blessed with freaky congenital laxity (joint hypermobility) to contort his body into crazy positions to create better deception and get on top of hitters faster. Maybe a pitcher has really long fingers that enable him to throw a great change-up or splitter. 

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The point is that natural selection definitely plays a big role in success, and it's your job to make sure your training doesn't interfere. Bartolo Colon has pitched in parts of 18 years in the big leagues and won 213 games, and he's making $10 million this year. He throws more than 85% fastballs and walk less than one batter per nine innings. 

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He is also clinically obese and probably has about 50-60 pounds of body fat to lose. Conventional wisdom says that shedding that excess body weight would make him a better athlete, but as I wrote with respect to CC Sabathia, that's a very slippery slope. That extra body weight may help him with absolute power development, and he may also be so accustomed to that larger frame after all these years that his mechanics might negatively impacted if you took a lot of weight off him, especially in a short amount of time. I've actually seen this quite a bit over the years in athletes who have come our way to sort out their struggles: try to get a guy too lean, and you'll deliver a six-pack - and a poop arm to go with it. For Colon, fastball command (and velocity) is clearly more of a priority than flab (or lack thereof).

I'm not telling you that you should let your guys get fat. I'm not telling you that you shouldn't train them for strength. I'm not telling you that we should just assume that the freaks will make it and hard work won't take a non-freak to the big leagues. I'm just telling you that you need to take a step back and consider exactly what makes an athlete a) successful and b) durable. 

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Guys aren't getting hurt because they only deadlift 450 and not 500 pounds. And, they aren't stuck in Triple A instead of living the big league dream because they're 10% body fat and not 9%. There are such things as strong enough, lean enough, and flexible enough. If they don't meet the minimum standards and they aren't at the level at which they hope to compete, you need to improve these qualities. If they don't meet these minimum standards, but they're already competing at the highest level, then you have to be very careful about how you tinker with things. Subtle changes are the name of the game, and extremes should be avoided. And, you should look for easy gains first.

Improving a pitcher's cuff strength is a lot quicker and easier than adding 100 pounds to his deadlift. Adding 10 degrees of hip internal rotation or thoracic rotation can make a hitter feel far more confident at the plate. Getting 10 minutes of soft tissue work on a gritty shoulder or elbow can be absolutely game-changing for a pitcher who has thrown through chronic pain.

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These aren't the sexy training exercises or boast-worthy gains that make for YouTube videos that go viral, but they're the ones that can take athletes to the next level - or keep them at the highest level. I'll take a good serratus anterior over a good six-pack, even if it makes for lame Instagram content. I'll take great end-range rotator cuff strength over big arms, even if it won't make the ladies go wild.

Our athletes are still going to lift heavy weights, sprint, throw med balls, do plyos and agility drills - but it's all part of a larger plan where we appreciate them as individuals with unique needs. If you try to fit baseball players into a physical mould that you've built in your mind, you'll waste training time as you study for the wrong test. And, more importantly, you'll miss out on key performance benefits and opportunities to keep them healthy.

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Random Thoughts on Sports Performance Training – Installment 11

Written on June 12, 2015 at 7:20 am, by Eric Cressey

Earlier this week, the Major League Baseball Draft took place, and when all was said and done, 27 Cressey Sports Performance athletes had been selected. To that end, I thought it was a good time to type up this month's Random Thoughts on Sports Performance Training installment, as the draft has been what's on my mind. Point #1 is a lead-in to the points that follow.

1. I actually posted this on my Facebook page and was surprised at how many "likes" it got, so I'm sharing it here - especially since I think it'll serve as a jumping off point with respect to culture.

The biggest compliment a client can pay to CSP is when a parent trusts us to train their son/daughter during the teenage years when they're young and impressionable and need good role models to model positive behaviors.

The second biggest compliment a client can pay to us is when a professional athlete trusts us with his/her career.

The annual MLB Draft is the time of year when these two compliments coincide, and we get to see how point #1 can lead to point #2 as dreams come true. Congratulations to the 27 CSP athletes drafted over the past three days; thank you very much for having us along for the ride.

It's always awesome to see guys we've trained through their high school years transition to professional athletes. These scenarios not only provide lessons on long-term athletic development, but also the importance of creating a culture at the facility that makes training fun over the long haul.

2. I recently finished up the audiobook, Unmarketing, by Scott Stratten.

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One of the key messages Stratten drills home is that customers have to like you before they can get to know you, and they have to know you before they can trust you. Obviously, in the strength and conditioning field, our athletes/clients are our customers. This "like-know-trust" is an important message, because long-term athletic development - and certainly working with professional athletes (or those trying to become pro athletes) is all about trust. They need to trust that you're giving them the appropriate programming and cues they need for success.

He goes on to discuss how many businesses put the carriage in front of the horse on this point. They don't work to build a relationship with their customers before trying to monetize them. It's like asking someone to marry you in the middle of the first date. I immediately thought about how our business model has impacted our training model.

When a new athlete comes to CSP, they're individually assessed and we have a chance to spend anywhere from 20-60 minutes getting to know them. It's not only a chance to review injury history and go through a movement evaluation, but also an opportunity to build rapport by learning about goals, training history, and common interests. It also gives us a chance to subtly demonstrate our expertise and relate a plan of attack for how we can help. In short, an initial evaluation is about learning about so much more than just whether an athlete has sufficient hip internal rotation!

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Conversely, think about what happens when an athlete walks into a facility where every athlete does the same program on the dry erase board, and there isn't an assessment to kick things off. In these scenarios, the trainers/coaches really haven't done anything to get to know the athletes, and they certainly haven't gotten these athletes to "like" them. The road to building trust has gotten started with a pretty messy detour - and it'll take a long time to build things up.

3. We really go out of our way to create context for our athletes when we're coaching. In other words, our coaching cues need to build on what an athlete already knows. A front squat is easier to learn when you've already done a goblet squat, and a rotational medicine ball shotput can build upon what an athlete knows from baseball hitting. However, I don't think people ever recognize the importance of creating context for success - and I'm a big believer that it's been a huge part of the results we've gotten.

Everyone knows that for years and years, the world dreamed of having someone run a sub-4-minute mile. Then, in 1954, Roger Bannister accomplished this great feat - and thereafter, it became very commonplace. Granted, the sports media somewhat unfairly sensationalized the "quest" for the 4-minute-mile, but the message is still very much the same: once you've seen someone accomplish something that appeared very daunting, you're more likely to be able to accomplish it yourself. The 27 CSP guys drafted this year have watched over 50 guys get drafted in the three years ahead of them - and, just as importantly, they've had a chance to rub elbows with them during training. Success leaves clues - and clues help to create context for more success.

4. On the whole, at young ages (younger than 16), I think the notion of "Sports-Specific Training" is actually pretty silly. We can all agree that good movement is good movement, regardless of whether a young athlete plays soccer, football, lacrosse, or basketball. Overhead throwing athletes, though, are - at least in my opinion - a very important exception to the rule.

In all these other sports, we can adequately prepare for the most common injury mechanisms with well coached general training exercises in our strength and conditioning program. However, how many weight room exercises do you see that help an athlete build stability in this position?

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If you have an athlete that goes through this kind of lay back - whether it's with baseball/softball, swimming, tennis, or any other overhead sports - you need to train them to build stability in this position.

5. In all, there were 1,215 players drafted earlier this week over the 40 rounds. That's astronomically higher than any other professional sport - and in no other sport do you more quickly go from being a big fish in small pond to being the small fish in a big pond. As of right now, only two of the 41 first round (plus supplemental round) picks in last year's draft have made it to the big leagues. Conversely, if you're a first rounder in the NFL or NBA, you're in "the show" right away pretty close to 100% of the time.

In other words, there is a lot of time for things to go wrong for draft picks while in minor league baseball. Injury rates are at all-time highs, players may get into trouble, and others might just discover that they don't have the talents necessary to compete at the highest level. Scouting baseball players is an imperfect "science" - and, sadly, 90% (or more) of these 1,215 players won't "make it."

For this reason (and many others), I heavily emphasize to our staff and athletes that our #1 job is actually to educate our minor league guys on how to be advocates for themselves and understand what is unique about how they move. If we can give them the best training and nutrition insights possible - and teach them how to practically apply them throughout a long season - they stand much better chance of making it to the big leagues. Strength and conditioning coaches may not be able to impact talent (at least not directly), but we can impact one's ability to display it consistently. In fact, this is what the wall of our assessment room looks like:

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6. I've talked in the past about how all our arm care programs work proximal to distal. In other words, we focus on core control, rib positioning, and thoracic spine mobility, then move to scapular control, then to the glenohumeral (ball and socket) joint, and then down to the elbow. It's because there is somewhat of a "downstream" effect. Improving thoracic rotation can improve shoulder internal rotation. Getting an athlete out of a heavily extended core posture can get the latissimus dorsi to calm down, which takes stress off the elbow. Taking care of scapular control might even relieve nerve impingement that's causing symptoms into the hand. The possibilities for this "downstream" effect are really endless.

Conversely, though, there isn't an "upstream" effect. Nobody's thoracic spine mobility improves if you do some soft tissue work and stretching to get some elbow extension and supination back. Improving rotator cuff strength won't get rid of lower back pain.

This is why I think improving anterior core control in baseball players can be such an unbelievable game changer. We know that improving function in the sagittal plane is generally easier than improving it in the frontal or transverse planes, and the anterior core is really responsible for resisting lumbar extension.

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Additionally, the core is the furthest "upstream" option to impacting function. So, if you're a believer in the concept of minimum effective dose (and I am), your goal should be to work on the easiest, most impactful stuff first. Anterior core is that option in a baseball population.

In fact, it's so important that I did an entire 47-minute presentation on the topic. If you haven't checked out Understanding and Coaching the Anterior Core yet, I'd encourage you to do so.

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Congratulations again to all this year's MLB draft picks! Have a great weekend, everyone.

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4 Keys to Making the Most of Summer Baseball

Written on May 5, 2015 at 7:19 am, by Eric Cressey

Today's guest post comes from Cressey Sports Performance - Florida coach, Tim Geromini. Tim has seen summer baseball on both the collegiate and professional levels, and today, he shares his insights on how players can thrive between June and August. Enjoy! -EC

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The topic of whether or not to play summer league baseball has been debated quite a bit over the last few years. Eric wrote a great article about it (HERE). This article is not designed to make the case for or against playing summer league baseball, but rather to give some points on how to make the most out of your experience if you decide to play. With four seasons in summer league ball under my belt, I’ve heard the phrase “this was the best summer of my life” more times than I can count. Assuming it is the right timing and situation for you, here are four keys to making it the best summer of your life on and off the field.

1. Get your mindset right before you arrive, and stick with it.

This might seem like an easy one, but you’d be surprised how many guys come in with the wrong mindset every year. Summer league baseball should not be what it’s made out to be (party time!) in movies like Summer Catch. Rather, it’s a chance to become a better player and person. I’m not saying you have to be sound asleep in your bed right after the game ends, but you should understand the true reason you are there.

You are there to learn more about the game and become a more complete player. Some coaches will not do much teaching, but rather let you play your style and make some adjustments. Others will be incredibly critical and teach you until the day you leave. I’ve seen both coaching styles work. What are the common traits of players who’ve thrived under both circumstances? The players were open minded, incredibly positive, and wanted to get better. If you’re willing to accept another way of thinking, keep a good attitude about it, and do it with a determination to be better, you are doing everything you can to improve on and off the field.

2. Be part of your host-family.

Most players will live with a host family, and you are lucky to have that opportunity. Be part of that family for the summer and beyond. If you have a host-brother or host-sister, you have an opportunity to positively impact that person’s life. They look up to you, just as you would have when you were younger. Hang out with them, teach them, and learn something from them. I always loved seeing my players playing with their host families on the field after games. Whether its dinner with the host-parents, running the bases with their host-brother, or playing a round of mini-golf with them after the game, it’s a great way to spend your summer. On a related note, most of our Major League Baseball guys at Cressey Sports Performance keep in close contact with their host families from their college and minor league days, as they’ve built life-long friendships.

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Remember that you also represent the town for which you play. Be a gentleman on and off the field.

3. Rest and Recover.

In many cases, players are playing competitively 8-10 months out of the year. Summer league is at the tail end of this run, when your body is exhausted. Sleep and nutrition are your keys to be able to perform every day. It’s difficult to play your best and be mentally in the game on a few hours of sleep every night. A hidden form of recovery is to get yourself out of the sun when you can. Baseball camps, practices, and games can make for upwards of 8 hours in the sun all day. Get yourself in the shade or in a cool, dark area when you can. Some teams will have a rule where your host family provides a certain amount of meals for you each day. Take advantage of this to get your calories in and make healthy decisions. The most successful players I have seen took rest and recovery seriously.

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4. Train!

There’s no way I could write this article without highlighting the importance of training during the summer. If you follow this website, I trust you know the benefits of training and are proof of the results. I must say, however, that many athletes think the summer away from their college strength coach is their opportunity to not see a weight room. You don’t have to train every day. In fact, trying to train 6 days per week while playing 5-6 days per week can do more harm than good. I always shot for 2-3 training sessions per week for my guys, depending on their situation; this kept them fresh and strong. The non-training days are just as important to improving tissue quality and maintaining mobility. Whether it’s doing it yourself by foam rolling and going through some dynamic flexibility drills, or seeking manual therapy elsewhere, it’s important to get your work in on these fronts.

Conclusion

There are a number of ways to make summer league baseball an enormous success and something you will always remember. These four always stuck out to me and I hope it can help some of you in the future. I’d love to hear your feedback and thoughts on other important factors in summer baseball in the comments section below.

About the Author

Tim Geromini is a strength and conditioning coach at Cressey Sports Performance in Jupiter, FL. Prior to joining the CSP team; Tim spent time with the Lowell Spinners (Class A Affiliate of the Boston Red Sox), Nashua Silver Knights (Futures Collegiate Baseball League), Cotuit Kettleers of (Cape Cod Baseball League), and UMass-Lowell Sports Performance. You can contact him at timgero@gmail.com and on Twitter.

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Changing Baseball Culture: A Call to Action

Written on April 28, 2015 at 9:25 am, by Eric Cressey

Today's guest post comes from physical therapist Eric Schoenberg, who is an integral part of the Elite Baseball Mentorships team. Enjoy! -EC

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Baseball is a game of ritual and tradition: lucky socks, pre-game meals, stepping over lines, special handshakes, and on-deck habits are all part of the “rhythm” of the game. Unfortunately, other “old-school” traditions are still the norm when it comes to the management and prevention of injury on the diamond. It is clear that we are moving in the right direction with new technologies and smarter training; however, injuries continue to pile up. A difficult question to answer is: are any of these injuries avoidable or are players already “damaged goods” by the time they get to the professional ranks? Some things are out of our control, but clearly we can do better.

Here are four opportunities for us to make a difference:

1. Identify the signs before there are symptoms.

The best form of treatment is prevention. The best rehab for a pitcher is one that does not exist at all. To support this point, a sign is a warning that something bad is about to happen. Some examples of objective signs in an at-risk pitcher are a decrease in velocity, loss of location/command, and ROM changes. This might be a loss of total glenohumeral ROM, internal rotation, or shoulder flexion; scapular upward rotation; elbow extension; forearm supination; and hip rotation. Or, it may be a significant increase in shoulder external rotation (see here and here for details). Some examples of subjective signs are poor body language, lack of confidence, altered communication, and working slower on the mound – just to name a few. Once a pitcher does become symptomatic, we need to take it seriously. I am not implying that we need to baby our athletes (there is enough of that going on!), but on the flip side, the solution is not to ignore the pain and “pitch through it.” As always, the truth is often found somewhere in the middle. In 15 years, I have yet to come across a pitcher that ended up needing surgery that did not first have signs and symptoms that were either missed or ignored.

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2. There is no such thing as “normal soreness.”

To piggyback on point #1, the expectation is not that a pitcher will be pain-free 100% of the time. That is unrealistic. There is unavoidable stress and tissue breakdown associated with pitching. If there isn’t, my guess is the pitcher is not throwing very hard! However, I would like to make this point loud and clear: There is no such thing as “normal soreness.” By definition, if things were normal, then there would not be soreness (and certainly not pain). To this point, one could argue that throwing a baseball 100x at 85-100MPH is not “normal,” either, so what can we do about it? Let’s follow this rule: if a pitcher presents with pain, tightness, or fatigue in the front of his shoulder or the inside/outside of their elbow or forearm following an outing, then he needs an evaluation and treatment. If a pitcher presents with soreness in their glutes, core, and posterior cuff, then he needs some rest and a pat on the back for a job well done. Remember, just because the pain or soreness is common doesn’t make it right.

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3. One size never fits all.

I can’t think of a situation in baseball (or life) where one approach works for everyone. For example, not every baseball player needs to stretch or “loosen up.” Most players are already too loose or lax and need to gain stiffness and stability with their pre-game routine. They need to warm-up and activate. Yet, at every level, we see teams line up and stretch before games. This robs their bodies of the good stiffness that they have worked to develop in the gym and during the off-season. We need to warm the tissues up and take the body through the appropriate ranges of motion to prepare to play; however, we don’t need to stretch these tissues right before asking them to generate massive amounts of force. For these loose-jointed individuals, throwing, sprinting, and hitting will provide all of the “stretching” that’s needed.

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Another example that needs to be looked at is too many reps of strengthening or band exercises done right before activity on the field. If we don’t want to overstretch an athlete prior to playing, then we certainly don’t want to fatigue them. A fatigued pitcher has a 36x higher chance of getting injured than a non-fatigued pitcher. Let’s save the fatigue for the innings on the field and not with hundreds of band reps or a 50-pitch bullpen session before the 1st pitch is even thrown.

4. Avoid this question.

The worst question you can ever ask a pitcher on a mound visit or in the dugout is “How are you feeling?” This same question is asked every day on fields across the world and yields no valuable information. Any pitcher, at any level, will answer, “I’m good, coach.” If they don’t, they are playing the wrong sport.

Instead of asking this question, we should be using our experience as professionals to make unemotional decisions to best help our players stay healthy for the entire season.

It is our job is to acquire as much information as we can through experience and observation to make the best decision possible with the data that we have at that moment. Players lie. It is a way of showing their competitive spirit to stay in games and try to help their teams win. It’s called adrenaline. It’s not their fault. It is our fault for asking bad questions that have no good answers. The pitcher’s job is to get outs, not to decide what soreness is “normal.” That is what what we get paid to do.

Let’s close by comparing injury management in baseball to one of the world’s most successful companies. Apple talks about avoiding the “sameness trap.” This is the thought that if you ask a consumer what they want, they will tell you to do what other popular companies are doing. Steve Jobs worked to avoid this by not asking his customers what they wanted, but instead, giving them what they didn’t know they needed. So, let’s stop asking the same questions and getting the same generic answers and worked towards continuing to change the culture in baseball and help our athletes get better results.

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.

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The Best of 2014: Baseball Articles

Written on January 4, 2015 at 3:30 pm, by Eric Cressey

With baseball athletes being the largest segment of the Cressey Sports Performance athletic clientele, it seems only fitting to devote a "Best of 2014" feature to the top baseball posts from last year. Check them out:

1. No Specialization = National Championship? - I posted this article right after Vanderbilt won the College World Series, and it was my biggest "baseball hit" of the year. There are some great lessons on long-term athletic development in there.

2. 6 Key Qualities for Long-Term Athletic Development - I wrote this post right after 18 Cressey Sports Performance athletes were selected in the 2014 Major League Baseball Draft. As with our #1 baseball post from the year, long-term athletic development was a hot topic!

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3. Are Pitchers Really Getting "Babied?" - Many baseball "traditionalists" insist that pitchers are getting injured because we're babying them in the modern era. I disagree completely, and this article summarizes my thoughts on the subject.

4. Long-Term Success: What You Can Learn from Corey Kluber - Long-time CSP client Corey Kluber won the 2014 American League Cy Young, and a lot of the points I make in this article on his work ethic help to explain why. It was featured on Gabe Kapler's website.

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5. Draft Q&A with Eric Cressey: Part 1 and Part 2 - This two-part article was actually an interview of me for Baseball America. I think it delves into a lot of important topics for up-and-coming players as well as coaches and parents.

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