Home Posts tagged "Optimal Shoulder Performance"

Shoulder Health: Fine-Tuning Full Can Technique

The "full can" exercise is a popular shoulder prehabilitation/rehabilitation exercise of which I'm not super fond for a number of reasons. That said, if folks are going to utilize it, I think it's important that they understand exactly how to perform the exercise and where they should feel it. Check out today's video to learn more:

Speaking of shoulder performance, I'm excited to announce that Optimal Shoulder Performance - Mike Reinold and my first collaborative product - is now available for the first time as a digital resource. To sweeten the deal, you can get 20% off by entering the coupon code 20OFF at www.ShoulderPerformance.com through the end of the day Sunday.

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Here’s a Black Friday Sale Even Though It’s Not Friday Yet

Everyone on the planet is having a Black Friday sale this week, so we figured we wouldn't even attempt to keep you in suspense on this one. With that in mind, you can save 20% on the following products through Cyber Monday at midnightk by entering the coupon code BF2016 (case sensitive) at checkout. Just click on the links below to learn more and add them to your cart:

Functional Stability Training: Individual Programs or a Bundle Pack

Optimal Shoulder Performance

Understanding and Coaching the Anterior Core

Everything Elbow

The Ultimate Off-Season Training Manual

The Specialization Success Guide

The Art of the Deload

Again, that coupon code is BF2016.

Additionally, my products with Mike Robertson are on sale, too. You can pick up Assess and Correct, Building the Efficient Athlete, and Magnificent Mobility for 20% off (no coupon code needed) HERE.

Enjoy - and thank you for your support!

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Why Wait Until Friday for a Sale?

Everyone on the planet has a sale this Friday, so Mike Reinold and I figured we'd get the week started a few days early.

From now through the end of the day this upcoming (Cyber) Monday, you can pick up any of the Functional Stability Training Products and Optimal Shoulder Performance for 25% off. Just enter the coupon code BF2014 at checkout and the discount will be applied.

Click here to check out the Functional Stability Training series.

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Click here to check out Optimal Shoulder Performance.

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Don't miss out on this great chance to get our popular products at a big discount! And, stay tuned, as I'll have a few more sales later in the week.

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How to Build Back to Overhead Pressing

With all the shoulders I've seen over the years, I've stumbled onto quite a few key "take-home" points. Today, I'd like to share one observation I've made. First, though, I have to tell a quick story to set the stage.

Like a lot of guys with shoulder problems, I miss being able to overhead press, so I've taken to experimenting with a lot of different approaches to see how I can at least "get close" to working it back in.  Last year, I talked about how landmine presses had been working as a nice "bridge" between overhead work and true horizontal pressing exercises.  Check out the coaching cues:

The arm path on a landmine press really isn’t much different than an incline press – so why does the incline press hurt so much more for those with shoulder pain in their injury history?  Having the shoulder blades pinned against a bench limits their ability to freely upwardly rotate; they're stuck in scapular downward rotation. 

This year, to take it a step further, I played around a lot with bottoms-up kettlebell overhead carries and pressing, and my shoulder did great with them.  With this drill, you teach people where an appropriate “finish” position is, and then you can work backward from it.

The next progression would be a 1-arm bottoms-up KB military press:

The unstable bottoms-up position shifts more of the muscular contribution to joint stability than actual force production, so you can get to positions pain-free that would otherwise be really uncomfortable.

Assuming you don't have shoulder pain, these are two good progressions to try to see if you're really cut out for overhead work.

Looking for more shoulder insights?  Check out Optimal Shoulder Performance, our popular DVD set that bridges the gap between rehabilitation and high performance.

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Today’s Sale: All Proceeds Go to the One Fund Boston

It's been a rough week up here in Boston, as I'm sure you all know. For those of you around the country and world that would like to help, Massachusetts Governor Deval Patrick and Boston Mayor Tom Menino have announced the formation of The One Fund Boston to help the people most affected by the tragic events that occurred in Boston last week.

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Additionally, Bob Kraft, owner of the New England Patriots has offered to match donations to The One Fund Boston, up to $100,000, if donated through the New England Patriots Charitable Foundation. This is a fantastic opportunity to double any donation you may want to consider giving.

Mike Reinold and I have decided to offer both Optimal Shoulder Performance and Functional Stability Training for the Core for 33% off today only, with all proceeds going to the One Fund Boston. This is the lowest price we have ever offered on both resources.

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For more information go to either www.FunctionalStability.com or www.ShoulderPerformance.com. Be sure to enter coupon BOSTONSTRONG during the checkout process to get 33% off. We will donate all proceeds from today’s purchases.  We'll be donating through the Patriots Charitable Foundation, so your purchase should go even further.

If you would also like to donate directly, head to the The One Fund Boston or click here to double your donation by having the Kraft Family match your contribution through the New England Patriots Charitable Foundation.

Thanks for helping to support our great city!

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I’m Having a Black Friday/Cyber Monday Sale (Just Like Everyone Else on the Planet)

I guess I'm joining in the discount madness this holiday season, even if I didn't have to do any planning!  Here are some options for your holiday shopping at EricCressey.com:

1. Whip: What it is and How You Get it - This was a presentation I did a while back at Ron Wolforth's Pitching Coaches Bootcamp, and it's now available for sale individually. In the presentation, I talk about factors the influence whether you increase throwing velocity and how strength and conditioning programs can have a dramatic impact - either positive or negative - on whether one develops the whip needed to throw harder.  You can either watch this online or get it as a DVD.

2. 20% off all Physical Products at MikeReinold.com - This sale includes Functional Stability Training and Optimal Shoulder Performance, along with many of Mike Reinold's other products.  Just enter the coupon code BLACKFRIDAY2012 at checkout to get the discount.

3. 15% of all Products at RobertsonTrainingSystems.com - This sale includes Assess and Correct, Building the Efficient Athlete, and Magnificent Mobility, along with many other products from Mike Robertson. The discount will automatically be applied at checkout.

We don't put products on sale very often, so be sure to take advantage of these offers before they expire at the end of the day on Monday!

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9 Reasons Pitching Velocity Increases Over the Course of a Season

We're a few months into the college and professional baseball seasons. Not every pitcher's velocity is where it needs to be just yet, and that's no surprise. In today's post, I'll cover nine reasons why pitching velocity increases over the course of a season.

1. Increased external rotation

Over the course of a season, pitchers acquire slightly more external rotation at the shoulder (roughly five degrees, for most).  Since external rotation is correlated with pitching velocity, gaining this range of motion is helpful for adding a few ticks on the radar gun as compared to early in the season. However, this added external rotation comes with a price; it is usually accompanied by increased anterior instability and, in some cases, a loss of internal rotation.  As such, you need to stabilize or stretch accordingly.

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2. Optimization of mechanics

Many pitchers integrate subtle or dramatic changes to their mechanics in the off-season and early in-season periods, but these changes won't "stick" until they have some innings under their belt.  June is often when those corrections start to settle in.

3. Transfer of strength to power

Some pitchers build a solid foundation of strength in the off-season, but take extra time to learn to display that force quickly (power).  In short, they're all the way toward the absolute strength end of the continuum, as described in this video:

4. More important game play

Some guys just don't get excited to pitch in games that don't mean much.  While that is an issue for another article, the point here is to realize that a greater external stimulus (more fans, playoff atmosphere, important games) equates to a greater desire to throw cheddar.  Soon, the high school and college post-seasons will be underway, so you'll start to see some of the big radar gun readings more frequently.

5. Warmer weather

Many pitchers struggle to throw hard in cold weather.  Pedro Martinez was a great example; during his time in Boston, he was undoubtedly one of the most dominant pitchers in the game, yet his Aprils never held a candle to what he did during the rest of the year (good thing his change-up was filthy, too).

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Source: Andrew Malone

Warmer weather makes it easier to warm up, and many guys - especially the more muscular, stiff pitchers - need to lengthen the pre-game warm-up early in the season.  If you're a guy who typically doesn't see your best velocity numbers until you've got several innings under your belt, extend your pre-game warm-up, dress in layers, and don't pick up a ball until you're sweating.

6. New desire to prove oneself

For many pitchers, summer ball is a new beginning.  This might be in the form of a Cape Cod League temp contract, or a situation where a player is transitioning from a smaller high school that doesn't face good competition on to a program that plays a challenging summer schedule.  Again, that external stimulus can make a huge difference, as it often includes better catchers, better coaching, more fans, better mounds, and more scouts behind the plate. 

7. Mechanical tinkering

Piggybacking on the previous example, some pitchers may find their mechanics thanks to help from summer coaches.  So, a change in coaching perspective can often bring out the best in guys.

8. Freedom to do one's own thing.

I know of quite a few pitchers who've thrived in the summer time simply because their pitching coaches haven't been in the way.  Usually, this means they can go back to long tossing rather than being restricted to 90-120 feet all season.  It's a great way to get arm speed back.

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9. Different pitch selection

There are quite a few college coaches who have guys throw 75% sliders in their outings - and wind up ruining plenty of elbows in the process.  Summer ball is a chance for many guys to take a step back and really work on commanding their fastballs, so it's not uncommon to see a few more mph on the radar gun.

In an upcoming post, I'll outline the reasons why pitching velocity may decrease over the course of a season. 

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Strength Training Programs: Are Pull-ups THAT Essential?

The pull-up is among the most sacred strength exercises in the history of weight training programs, ranking up there with squats, deadlifts, and bench and overhead presses.  This is one reason why I expect there to be burning Eric Cressey effigies in various strength and conditioning circles after they read the following sentence:

Some people would be wise to leave out pull-ups - at least temporarily.

Before you rip me a new one, please give me a few minutes to explain.

First off, I get it: pull-ups train the lats, and the lats are huge players in athletic function and the quest to get strong and gain muscle.  They're the biggest player in force transfer between the lower and upper body, and play key roles in core stability and breathing.  Specific to my baseball work, lat recruitment is higher during acceleration in professional pitchers than amateurs, showing that reliance on this big muscle helps generate increase pitching velocity, too.  I actually wrote an entire article back in 2006 about just how extensive the lat's role is, if you'd like to read more: Lats: Not Just for Pulldowns.

However, the "expansive" presence of the lats - running from the thoracolumbar fascia all the way up to the humerus - can make them a problem as much as they are a solution.  To that end, here are four reasons you may want take a break from pull-ups/chin-ups/pulldowns in your strength training program:

1. Heavy pull-ups can make the elbows very cranky - This is really the shortest and least complex of my arguments, so I'll get it out of the way early.  My personal best three-rep max chin-up is 321 pounds, at a body weight of about 188 pounds (so, the external load was 133 pounds).  My best raw three-rep max bench press is about 330 pounds, but what you might find surprising is that going heavy on the bench press is dramatically easier on my joints (particularly my elbows) than pull-ups/chin-ups are.  What gives?

First, when you bench press, you're doing a full-body movement.  There is leg drive and loads of core stability involved on top of the upper extremity activity that's taking place - so the stress is more easily distributed.  When you do a pull-up, your upper extremity is relatively isolated, so the stress is more concentrated.

Second, a pull-up is a traction exercise; it pulls the humeral head out of the socket, and essentially pulls the lower and upper arm apart at the top. When you lose bony congruence - one of the most important, yet overlooked components of joint stability - you have to pick up the slack with the active restraints (muscles/tendons) acting at the joint.  Low-level traction can be tremendously helpful in situations like external impingement at the shoulder, or intervertebral disc issues.  However, under extreme load, it can be pretty darn stressful to the soft tissue structures around the joint.  Conversely, a bench press is an approximation exercise, so you can actually draw some stability from the joint alignment itself to take some of the stress off the soft tissue structures.

I remember Jason Ferruggia writing recently about how heavy chin-ups/pull-ups can really beat up on older lifters - and it's safe to say that the reason isn't so much tissue degeneration, but simply that it took time for them to build appreciable enough strength to get to the point where the overall stress was too much.

2. The lats overpower the lower traps - The overwhelming majority of the baseball athletes I see (and most extension/rotation sport athletes, in general) live in lordotic postures.  The lat is a strong extensor of the spine - but it also attaches to the rib cage and scapula on the way to the upper extremity.  The end result is that many lordotic athletes wind up with a very "gross" extension pattern.

The rib cage flairs up, and the lower traps do little to pull the shoulder blades back and down on the rib cage - because the lats have already gotten an athlete to the position he/she wants to be in via lumbar extension.  You can see from the picture below that the line of pull of the two muscles is actually very comparable - but given cross sectional area and length, the lat will always have the upper hand, especially if it's constantly being prioritized in a strength training program due to exercise selection and faulty lifting technique.

Effectively, we need to learn to move our scapulae on our rib cage, as opposed to just moving our entire spine into extension.  Interestingly, you'll find a lot of flexion-bias in the Postural Restoration Institute (PRI) and Dynamic Neuromuscular Stabilization (DNS) schools of thought because they clearly appreciate that getting folks out of "gross extension" is a way to get/keep people healthy.  Having ultra short/stiff lats can cause issues ranging from extension-based back pain (e.g., spondylolysis) to shoulder pain (e.g., external or internal impingement).  As I've written previously, too, this global dysfunction may also be the reason we're seeing more femoroacetabular impingement in athletes.

As another interesting aside, I see a lot of throwers with low right shoulders and incredibly short/stiff lats on that side.

This is secondary to faulty rib positioning and the scapular anterior tilt that ensues (as per the PRI school of thought), but one additional thing we've found (thanks to great feedback from physical therapist Eric Schoenberg) is that overhead shrugging variations on the low shoulder have helped these throwers to not only feel better, but minimize these asymmetries.  Effectively, creating a bit more stiffness in the upper trapezius helps it to counterbalance the aggressive downward pull of the lat on the scapula.

These folks sit in scapular depression, and for that reason, we'll often leave out any exercises (e.g., deadlifts, dumbbell lunges) that involve holding heavy weights in the hand until scapular positioning is better controlled.

3. The humeral attachment portion of the lat is part of a significant zone of convergence at the posterior shoulder - The back of your shoulder is another one of those claustrophobic areas in your body.  You've got tendons for the lat, teres major, teres minor, infraspinatus, long head of the triceps, and posterior deltoid all coming together in a very small area, creating friction over each other as their individual forces come together (regions like this are called "Zones of Convergence" by myofascial researcher Luigi Stecco.

The latissimus dorsi is, without a doubt, the largest and strongest of all the involved structures.  It also has the longest tendon, which makes it the biggest candidate for nasty tissue quality in the region.  The problem is that muscles/tendons don't deform evenly; rather, they move a lot where the tissue quality is good, and very little where it is dense.  So, when you're super dense in the posterior shoulder and try to go do pull-ups, as I noted earlier, the entire shoulder girdle wants to move (humeral extension and internal rotation, and scapular depression) together, as opposed to a nice synergy of the humerus with the scapula on the rib cage.  When some is stiff in the posterior shoulder and wants to use the lat for everything, a seated cable row looks like this.  Notice how the elbow winds up behind the body, and the scapula anterior tilts - and also how old the video is; I look like I am 12 years old and weigh 120 lbs.

Rowing like this over time will eventually irritate the anterior shoulder.  However, watch this standing one-arm cable row where the humeral head (ball) maintains a good alignment with the glenoid fossa (socket) as the shoulder blade moves on the rib cage.  The humerus doesn't extend unless the scapula moves with it.

4. Overactive lats can decrease the subacromial space - The lat extends, adducts, and internally rotates the humerus.  In order to get overhead the right way, we need flexion, abduction, and external rotation of the humerus.  So, you can see that it's a direct antagonist to healthy, overhead movement.  If you think about your biggest players for pain-free overhead movement, two of them have to be the posterior rotator cuff and lower trapezius.  The lat overpowers both of them in a "gross" extension pattern.

Here's a test: position yourself supine, bend the knees, flatten the lower back, and then let your arms hang freely overhead.  Then, have someone take a picture looking down at the top of your head.  A "pass" would be full shoulder flexion with no arching of the back, and no shoulder pain along the way.  A fail would be pain, or something that looks like this:

If your photo looks like this, you better hope that you have outstanding posterior rotator cuff and lower trapezius function (adequate stiffness) to overpower some very short lats if you intend to train overhead pain-free (especially with overhead pressing).  Otherwise, your shoulder flexion will really just be lumbar extension and forward head posture substitutions (this one has a nice left rib flair, too).

In other words, you need adequate anterior core stability and good recruitment of the deep neck flexors, too, but those are blogs for another day.

Closing Thoughts

This post has gone on far too long, and to be honest, I've probably just used the last 1300+ words to piss a lot of you off.  You'll be happy to know, however, that we still use a ton of pull-ups/chin-ups in our strength training programs at Cressey Performance.  In fact, they're a mainstay.  Here are some modifying factors, however:

1. The risk:reward ratio gets a little out of whack once you get very strong with pull-ups.  You'd be better off adding sets and reps, as opposed to adding load - and you may want to push the heavy stuff less frequently than you would with compound exercises.

2. Get regular manual therapy at the posterior shoulder and entire elbow to stay on top of tissue quality. At the very least, make sure you're foam rolling a ton and using The Stick:

3. Strengthen the anterior core and deep neck flexors so that you don't substitute lumbar hyperextension and forward head posture, respectively, for shoulder flexion.

4. Strengthen the lower traps so that the lats can't overpower them.  I like wall slides at 135 degrees abduction, as it allows one to work in the direct line of pull of the lower traps.  Make sure to cue "glutes tight, core braced" so that folks can't substitute lumbar extension ("gross extension") for movement of the scapulae on the rib cage.  Make sure there is no forward head posture, too.

Prone 1-arm trap raises off the table are also a popular one.  Just make sure you continue to cue "glutes tight, core braced, and no forward head posture."

4. Maintain adequate length in the lats. In warm-ups, I like the bench t-spine mobilizations and side-lying internal external rotation as a means of getting some shoulder flexion.

In terms of static stretching, a lat stretch in the power rack is great.

If this gives you an impingement feeling, regress it a bit, stabilize the scapulae with the opposite hand, and gently dip into a wall lat stretch with stabilization.

Many folks will also benefit from this classic overhead stretch in order to reduce stiffness in the long head of the triceps, a synergist to the lats in humeral extension.

5. Make sure you're including plenty of horizontal pulling (rowing) strength exercises as well - and executing them with the correct form.  This means moving humerus and scapula together on rib cage, not just yanking the humerus into extension on a fixed scapula.

6. If you have terrible shoulder flexion and can't get overhead without substituting forward head posture and lumbar hyperextension, spend some time addressing the underlying issues before you start cranking on pull-ups.  We actually don't do any pull-ups/chin-ups with some of our professional baseball players for 4-8 weeks following the season, as we need to spend time building rotator cuff, lower trap, and anterior core strength. I like to use the back-to-wall shoulder flexion exercise as a "pass/fail test." If you can get the thumbs to the wall without losing the flat-back posture on the wall or bending your elbows, then you can probably start going to pull-ups.

7. Above all else, listen to your body, and hold back if pull-ups/chin-ups hurt.

I'd love to hear your thoughts on this post and your experiences with heavy and/or high-volume pull-ups/chin-ups in the comments section below.

For more information on the role of the lats in upper extremity health and function, I'd encourage you to check out our Optimal Shoulder Performance DVD Set.

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Baseball Strength and Conditioning Programs: How Much Rotator Cuff Work is Too Much? – Part 2

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.

This wraps up our look at a different perspective on how to attack rotator cuff exercises with timing - and not just strength - in consideration.  For more information, I'd encourage you to check out Optimal Shoulder Performance: From Rehabilitation to High Performance.

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Baseball Strength and Conditioning Programs: How Much Rotator Cuff Work is Too Much? – Part 1

In a recent presentation in front of a bunch of baseball coaches, I made the following statement - and it turned a lot of heads:

I think most people overtrain the rotator cuff nowadays, and they do so with the wrong exercises, anyway.

To illustrate my point, I'm going to ask a question:

Q: What is the most common complication you see in guys as they rehabilitate following a Tommy John Surgery?

A: Shoulder problems - generally right around the time they get up to 120 feet.

Huh?  Shoulder pain is a post-operative complication of an elbow surgery?  What gives?

First, I should make a very obvious point: many of these guys deal with shoulder stiffness as they get back to throwing simply because they've been shut down for months.  That I completely expect - but remember that it's stiffness, and not pain.  They always throw their way out of it.

The more pressing issue is what is taking place in their rehabilitation - and more specifically, what's taking place with the synergy between their rehabilitation and throwing program. Let me explain.

Rehabilitation following a UCL reconstruction is extensive.  While different physical therapists certainly have different approaches, it will always be incredibly heavy on rotator cuff strength and timing, as well as adequate function of the scapular stabilizers.  Guys always make huge strides on this front during rehab, but why do so many have shoulder pain when they get further out with their long tossing?  The answer is very simple:

Most people don't appreciate that throwing a baseball IS rotator cuff training.

Your cuff is working tremendously hard to center the humeral head in the glenoid fossa.  It controls excessive external rotation and anterior instability during lay-back.

It's fighting against distraction forces at ball release.

And, it's controlling internal rotation and horizontal adduction during follow-through.

Simultaneously, the scapular stabilizers are working incredibly hard to appropriately position and stabilize the scapula on the rib cage in various positions so that it can provide an ideal anchor point for those rotator cuff muscles to do their job.

A post-op Tommy John thrower - and really every player going through a throwing program - has all the same demands on his arm (even if he isn't on the mound, where stress is highest).  And, as I wrote previously in a blog about why pitchers shouldn't throw year-round, every pitcher is always throwing with some degree of muscle damage at all times during the season (or a throwing program).

Keeping this in mind, think about the traditional Tommy John rehabilitation approach.  It is intensive work for the cuff and scapular stabilizers three times a week with the physical therapists - plus many of the same exercises in a home program for off-days.  They're already training these areas almost every day - and then they add in 3-6 throwing sessions a week.  Wouldn't you almost expect shoulder problems?  They are overusing it to the max!  This is a conversation I recently had with physical therapist Eric Schoenberg, and he made another great point:

Most guys - especially at higher levels - don't have rotator cuff strength issues; they have rotator cuff timing issues.

In throwing - the single-fastest motion in all of sports - you're better off having a cuff that fires at the right time than a cuff that fires strong, but late.  Very few rotator cuff exercise programs for healthy pitchers take that into account; rather, it's left to those doing rehabilitation.  Likewise, most of the programs I see altogether ignore scapular stability and leave out other ways to train the cuff that are far more functional than just using bands.

Now, apply this example back to the everyday management of pitchers during the season. Pitchers are throwing much more aggressively: game appearances, bullpens, and long toss.  They need to do some rotator cuff work, but it certainly doesn't need to be every day like so many people think.

I'll cover how much and what kind in Part 2.  In the meantime, if you'd like to learn more about the evaluation and management of pitchers, check out Optimal Shoulder Performance.

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