We're excited to welcome renowned physical therapist, coach, author, and presenter, Dr. Kelly Starrett, to the latest podcast as we kick off a series of podcasts with a sports medicine focus. Kelly shares some awesome insights related to universal performance principles, recovery strategies, "upstream" initiatives, and long-term athletic development.
A special thanks to this show's sponsor, Marc Pro. Head towww.MarcPro.comand enter the coupon code CRESSEY at checkout to receive an exclusive discount on your order.
Sponsor Reminder
This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself and use promo code CRESSEY at checkout at www.MarcPro.com for an exclusive discount on your order.
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This edition random thoughts from around the field of health and human performance is long overdue. Fortunately, more of the world is online more than ever, so at least it'll have a good audience now!
1. Physical maturity and training experience impact pitching stress.
File this one under the "duh" category, but it's good to have a study supporting the concept nonetheless. In this study, Nicholson et al found that while pitching velocity was weakly related to shoulder distraction force, this relationship was only observed in high school (and not college) pitchers. The researchers noted, "These findings suggest that older pitchers may attenuate shoulder forces with increased pitch velocity due to physical maturity or increased pitching mechanical skill in comparison with younger pitchers."
Here's the position (ball release) to which they're referring:
I've seen research in the past that reported shoulder distraction forces were 1.5 times body weight at ball release, but those numbers never made sense to me in light of the kinetic chain concept. Wouldn't a pitcher with better front hip pull-back, core control, thoracic spine mobility, scapular control, and posterior cuff strength have a better chance of dissipating these forces over a longer deceleration arc than someone who wasn't as physically prepared? And, wouldn't different release points (as shown above) relate to different stresses? This study demonstrates that being physically prepared and mature goes a long way in reducing one potential injury mechanism in throwers.
2. "You can’t separate biomechanics from metabolism."
I remembered this quote from Charlie Weingroff years ago when I recently heard White Sox infielder Yoan Moncada discussing how he hasn't felt like himself ever since he came back to playing after having COVID-19. Obviously, this is a more extreme perspective, as we know some cases lead to myocarditis and other challenging complications. It's certainly not out of left field, though. Just think about it:
Your joints often ache when you have the flu.
Many people get neck pain when they're stressed.
And, as Charlie observed in that same presentation, the higher your free cortisol, the poorer neurogenesis is.
I don't think we have to just consider these challenges only when someone is sick or under crazy stress. Rather, we have to appreciate that optimizing our metabolic environment - whether it's building a robust aerobic system or eating well and exercising frequently to improve insulin sensitivity - likely has an impact on how our musculoskeletal and fascial systems feel and perform. And, the nice thing about a lot of these initiatives is that they aren't hard to chase: you can build your aerobic system with some low-key cardio or even mobility circuits.
3. Vary surfaces with plyometric activities.
The latest Journal of Strength and Conditioning Research featured a very intriguing study that compared outcomes of a plyometric program on grass-only versus one that was matched for volume, but spread over six different surfaces: grass, land-dirt, sand, wood, gym mat, and tartan-track. The group that performed the multi-surface program outperformed the grass-only group at post-testing even though the testing took place on grass (which means it was a better program to the point that it also outperformed pure specificity over eight weeks, a relatively short intervention).
This is great because training should always be about providing a rich proprioceptive environment for athletes while still providing specificity. The surfaces were stable and ranged in their ability to challenge the stretch-shortening cycle (i.e., it's harder to "turn over" a jump quickly in sand than it is on a track surface).
Intuitively, it makes sense: give athletes variability across similar exercises and you get better adaptation. And, you could even make the argument that it likely reduces the potential for overuse injuries. Just imagine if they'd also rotated types of footwear: barefoot, minimalist sneakers, cross-trainers, turf shoes, cleats, etc.
Suffice it to say that I'll be leveraging this knowledge heavily at our new Cressey Sports Performance - Florida facility. We've got outdoor turf, indoor turf, grass, and indoor gym flooring - and we could do all three either in shoes or barefoot. There's eight options right there, and it's not hard to get access to sand in South Florida!
4. Exercise selection is the most important acute programming variable.
When you're writing a program, the big rocks to consider are intensity (load), volume, rest, tempo, exercise order, and exercise selection.
You'll see a lot of debates about whether 4 sets of 6 reps works better than 6 sets of 4 reps, and whether you need to do one set or three sets to get optimal gains. People may argue about whether you have to train above 90% of 1RM to get strength gains. And, internet arguments are fierce over tempo prescriptions and whether you should squat before you deadlift, or vice versa.
You know what doesn't get debated? The simple question, "Does an exercise hurt?"
This is why exercise selection will always be the most important acute programming variable to consider. If it causes pain, all the other variables don't matter, because it's a harmful training stimulus. This is why it's tremendously important for coaches to not only understand progressions, but also regressions and "lateral moves."
Squatting hurts your hips? Let's try a reverse lunge with a front squat grip.
Deadlifting isn't agreeing with your low back? Let's try a hip thrust instead.
Bench press is making your shoulder cranky? Let's pivot to a landmine press instead.
These quick and easy adjustments can absolutely save a program - and make all the other programming variable important actually matter. This is a big reason why I included an Exercise Modifications Library in The High Performance Handbook; they enable an individual to keep the core benefits of the program intact even if they have to modify a few exercises along the way.
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The Most Important Coaching Responsibility - I wrote this last year, but in light of how many people are acting on social media these days, it seemed like a good time to reaffirm the importance of staying away from negative influences.
One reason why many athletes have poor routines is that they often jump from one methodology to the next without a) giving adaptation time to occur and b) reflecting on what did/didn't work. To assist, coaches must preach patience, consistency, process, and self-evaluation.
After an Instagram post of mine last week generated quite a few inquiries on how to manage ulnar nerve hypermobility, I thought I'd record a follow-up video to dig in a bit deeper on the topic.
If you're looking to learn a bit more about the structure and function of the elbow (particularly throwing elbows), my presentation, Everything Elbow, would also be worth checking out.
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We're excited to welcome physical therapist Mike Reinold to this week's podcast. Mike has extensive experience working with baseball players. In this episode, we take on two controversial topics in the world of managing throwers: the sleeper stretch and weighted baseballs. Mike and I collaborate to discuss whether they belong in your training and rehabilitation programs, and if so, how?
In lieu of a sponsor for this podcast, we're instead going to highlight our Functional Stability Training sale that's ongoing. Through this Sunday at midnight, you can get 25% off on this popular series with coupon code ALLSTAR2022 at www.FunctionalStability.com.
Show Outline
Why baseball players lose internal rotation in their throwing shoulder
Why professionals should care more about total range of motion at the shoulder as opposed to just ER vs. IR
How Mike teaches professionals to assess shoulder range of motion and what common mistakes are being made when testing for this information
How clinical research has progressed our understanding of the loss of IR in throwing shoulders and how previous notions (such as a thickening of the posterior capsule) could not be further from the truth
Why giving baseball players more internal rotation may not be the answer for building healthy arms and why this strategy may cause more harm than good in throwing populations
What Mike’s thoughts on the sleeper stretch are and how his perspective on the drill have evolved since the beginning of his career
What is happening mechanically at the shoulder joint during the sleeper stretch
What the true occurrence of internal rotation deficit cases in Mike’s practice is and how he goes about resolving the issue
Why there is so much hype about weighted balls and how can we implement them safely in athletes’ throwing programs
What Mike’s research demonstrated with respect to weighted balls and what insights can we gain from Mike’s breakdown of the study and its execution
What specific physical adaptations throwing weighted balls creates and how the weight of the balls thrown impacts these outcomes
What immediate physical changes throwing weighted balls creates and how these changes may increase the risk for injury
Why athletes need to be well-trained and prepared to withstand the stress of throwing weighted balls before looking to push the limits of their physiology
How injuries in baseball have evolved from repetitive to traumatic and why the next generation of baseball is in danger
Why the answer for the abuse of arms across baseball calls for the education of coaches and how we can continue to find the right balance in throwing volume, frequency, and intensity for our athletes
You can follow Mike on Twitter at @MikeReinoldand on Instagram at@MikeReinold, and learn more about Functional Stability Training at www.FunctionalStability.com. Again, the coupon code for 25% off is MLB2020EC.
Podcast Feedback
If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.
And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.
Thank you for your continued support!
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We're back with Episode 61 of the Elite Baseball Development Podcast. In this solo episode, I speak about considerations relating to injuries as the baseball world opens up across multiple levels.
A special thanks to this show’s sponsor, Rawlings. We’re ecstatic to announce a new partnership between Rawlings and Cressey Sports Performance, and they’ve set up a 20% off discount code on select products for our listeners. Just head to www.Rawlings.com and enter coupon code CRESSEY20 and you’ll receive 20% off on your order. Certain items are excluded, but there’s still a ton of great baseball training gear to make you a better player and coach.
Sponsor Reminder
This episode is brought to you by Rawlings. If you want to develop faster, and train better, you need the best gear. Well, we have some good news for you. The #1 baseball brand in the world, Rawlings, has partnered with Cressey Sports Performance to make getting the best training gear for you more affordable. Simply head to www.Rawlings.com and use the code, CRESSEY20, at checkout and you’ll save 20% off your order! This offer is only valid on select items, but there’s a ton of great gear you’ll save 20% on that will help you become a better player, so shop now!
Podcast Feedback
If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.
And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.
Thank you for your continued support!
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Today's guest post comes from Cressey Sports Performance - Florida Associate Pitching Coordinator, Mark Lowy. This post comes on the heels of Mark’s appearance on Episode 51 of the CSP Elite Baseball Development Podcast. During it, he discusses some of the intricacies of release point data and how he uses the numbers to help understand a pitchers delivery. This discussion in the podcast kicks off at the 20:30 mark. -EC
Back in the fall, Eric put together a great Instagram post on the similarities in upper body positioning between Oliver Drake and Adam Cimber, despite their incredibly different release points.
What we know from looking at video is that most pitchers release the ball in the neighborhood of 90 and 110 degrees of shoulder abduction. This is backed up by various studies over the years, and corroborated by current motion capture setups such as Simi and Kinatrax.
Therefore, we know that when looking at deliveries, we can hold shoulder abduction relatively constant across players, and understand that the lateral trunk tilt (right) a pitcher displays during the delivery is going to be a key contributor as to where they release the ball.
By understanding this, we can appreciate that the arm slot and ball release for any given pitcher is a result, and not a process in and of itself. If we can agree on this, it begs the question: what helps determine where in space a pitcher releases the ball?
To help answer this, we need to work backward. If you have ball release data available, a good place to start is with the vertical release point, the horizontal release point, and (if possible) the extension (how far down the mound the ball was released) of a given pitch. These three data points tell you where the pitch is coming in from. Rapsodo will give you the first two, while Trackman will give you all three.
If you do not have access to ball release data, don’t worry! It’s still important to coach with your eyes and understand the root cause when you notice something amiss with someone’s arm slot.
To break down the delivery effectively, we need to start from the ground up to understand what affects ball release. It’s important to recognize that each section could serve as its own article, but for time’s sake, we will hit on the big rocks in each group. From start to finish, we can identify:
A. Back leg direction and upper half positioning
B. Stride length to lead leg landing position
C. Trunk tilt into and through ball release
A. Back leg direction
This is an area that is frequently talked about in the pitching world, and with good reason. Since we understand that pitching is a series of highly-coordinated movements, we have to be able to consistently own the first one, as it sets up all events later in the chain.
A main goal of the back leg is to provide a) stability as the body begins to create and store energy and b) provide direction as the body begins to move down the slope. Some factors to take into account when breaking down the back leg of a pitcher can include:
Ankle mobility into dorsiflexion and eversion
Hip mobility in ER, IR, and flexion
Anatomical structure of the hip (retroversion vs. anteversion)
Postural tendencies of the upper half
For the sake of this article, we are going to look at the first and last bullets, as they are easier to identify on video. It’s worth mentioning that when breaking down a delivery, we always prefer video over still shots. However, pictures can be useful for comparison’s sake.
If you have an athlete with above average dorsiflexion (knee over toe range of motion), he may be able to get away with more forward knee translation while still maintaining contact with the ground during his load phase. Conversely, an athlete with stiff ankles may struggle to keep the foot anchored in the ground when the knee drifts forward, and will need to maintain a more vertical shin during their load. This can be determined in simple ankle mobility screen, and should also be looked at dynamically during a movement screen to see how well the athlete controls (or doesn’t control) the range of motion he has available to him.
As the back leg starts to bend, the lower half and upper half start to work together. On the right, a more flexed ankle/knee help bring the torso forward. On the left, a more stacked knee and ankle helps keep the trunk more upright.
This is where the postural tendencies of an athlete come into play. Athletes who are more extended and flat through the lumbar and thoracic spine generally take a more upright torso position as they begin to work down the slope, while athletes who are more neutral/rounded through the upper back may prefer to hold more torso lean forward.
B. Stride length to lead leg landing position
As the pitcher begins to move down the mound, there are a lot of factors to look at regarding his stride length and direction. From an assessment standpoint, we hone in on a few things:
Adductor length (hip abduction range of motion)
Hip internal rotation
Thoracic spine mobility (active and passive)
These are three pieces among many that are going to influence a pitcher’s movement down the mound. It’s important to note that we do not coach guys to “push” or “drive” off the rubber – this commonly leads to early and aggressive hip extension, which throws off the timing and sequencing of the delivery. Instead, we want the front leg to land in a position that is a) comfortable for the pitcher and b) allows him to decelerate properly. This will look very different based on the points above.
Athletes with limitations in hip abduction are generally going to benefit from a shorter stride, as the longer the lead leg continues to search for distance, the tougher it is for the back leg to maintain tension into the ground. The flip side are hypermobile/loose pitchers who can get into whatever positions they want, and when trained to be able to create stability in these positions, they can be very effective.
Hip internal rotation can be looked at through a similar lens. Athletes with higher degrees of IR (anteverted hips, hypermobile, etc.) can get away with (and often find success with) a more closed off stride, as it allows them to create more tension and stability into the ground upon landing. They have the requisite room in the hip joint to be able to decelerate their upper and lower half in a closed off position. For athletes with hip IR limitations, a more closed off stride can be problematic down the road, as it forces them to adopt a deceleration pattern that does not dissipate stress as effectively as the hip and torso do when working together.
Stride length and path considerations should be taken into account for the upper half as well. For athletes who are less mobile through their thoracic spine, the longer the lead leg is floating in space, the more demand there is for them to resist torso rotation. The same can be true for someone with high degrees of passive thoracic range of motion, but low degrees of active. Those athletes crave stability, so the longer the lead leg is in the air, the less stability they have.
On the right, note the slightly closed off lead leg, versus the more open lead leg on the left. This is a function of the initial move with the back leg, and the following path of the front leg (and also gloveside). In these examples, we can see that when the torso follows the path of the lead leg, it helps the pitcher hold his line to the plate. If we swapped the lower halves in the two pictures, it would be very difficult for consistently create velocity while finding the strike zone.
C. Trunk tilt into and through ball release
As we are beginning to understand, every step in the delivery influences and sets up the next one. In the comparisons from above, we see how back leg direction can shape both front leg path and upper half direction as the pitcher moves down the slope.
As we get to ball release, the final picture now makes sense. On the left, the more upright torso, stacked lower leg position, and more open stride help pull the trunk up, raising the arm with it. On the right, initial back leg direction shapes a more closed landing position and more level shoulders through ball release.
It’s important to reiterate that this article is not an attempt to determine “right vs. wrong,” but look at different deliveries that exist on the spectrum of high performance. As coaches, the overall takeaway should be to find and create a delivery that recognizes individuality while also understanding how a pitcher’s anatomy plays a large role in how he looks on the mound.
About the Author
Mark Lowy serves as a Strength and Conditioning Coach and Associate Pitching Coordinator at CSP-FL. He completed his internship in the spring of 2018. Prior to joining the staff, Mark trained and coached high school and college athletes in the New York and New Jersey area. He also served as an assistant baseball coach at Ridgewood High School (NJ). Mark graduated from Gettysburg College in 2014. You can follow him on Twitter at @Mark_Lowy and on Instagram at @CSPFL_Pitching.
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We’re excited to welcome physical therapist Stan Conte to this week’s podcast for a detailed discussion of expectations surrounding Tommy John surgery. Stan is not only an experienced clinician, but also a prolific researcher in the baseball sports medicine world. With the prevalence of ulnar collateral ligament injuries in today's game, this podcast is a must-listen.
How Stan’s career in professional baseball has evolved from the clinical setting into more research based work
How Stan was a part of the group that began the Health and Injury Tracking System (HITS), the first injury surveillance system in Major League Baseball
How the disabled list had long been utilized as more of a roster management tool than an injury prevention system
Why DL data is still nonetheless relied upon when analyzing medical history in pro baseball
What studies Stan has been a part of regarding Tommy John surgery, and how this research is shaping the way players are managed
How the increase in pitching velocity throughout the game of baseball has redefined the pressure put on prospects and led to throwing injuries in younger arms
Why no one really knows how long it takes a UCL graft to mature and what conclusions Stan has drawn from research and working alongside rehabilitating athletes
When the best time to begin throwing after Tommy John surgery is
Why having pain when throwing during Tommy John rehab is not normal and what protocols players can look to when setbacks arise
When flat grounds, bullpens, and simulated games should fit into a return from TJ throwing program
When Stan recommends the reincorporation of off speed pitchers in return to throwing programs
What the true success rate of UCL reconstruction surgery is
What common Tommy John perceptions are actually myths
Why the number of Tommy John revisions is rising and how long post-op are the majority of these revision surgeries occurring
What the difference is between UCL repair and UCL reconstruction, and when each is an option for patients
Despite the high success rate for pitchers with TJ surgery, why catchers see the lowest success rate from Tommy John
Where Stan would like to see more research done in the baseball performance industry
This episode is brought to you by Athletic Greens. It’s an all-in-one superfood supplement with 75 whole-food sourced ingredients designed to support your body’s nutrition needs across 5 critical areas of health: 1) energy, 2) immunity, 3) gut health, 4) hormonal support, and 5) healthy aging. Head to www.AthleticGreens.com/cressey and claim my special offer today - 20 FREE travel packs (valued at $79) - with your first purchase. I use this product daily myself and highly recommend it to our athletes as well. I'd encourage you to give it a shot, too - especially with this great offer.
Podcast Feedback
If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.
And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.
Thank you for your continued support!
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Today's guest post comes from Eric Schoenberg, the physical therapist at Cressey Sports Performance - Florida and a great resource to the entire CSP team. Enjoy! -EC
To get right to the heart of what I'm covering today, I think it's best that we start with a video:
So, as you can infer, the reason we're still talking about "down and back" is because we need to! Athletes are coming into the gym every week after multiple surgeries or drops in performance with postures and movement patterns that are faulty and easily correctible.
Obviously, the down and back concept is not the only reason for this, but the idea of driving our scapulae into maximal adduction (retraction), downward rotation, and depression is certainly something that we can control and improve upon.
To set the record straight, the only time an athlete should receive this cue is when their arms are by their side (Deadlifts, farmer’s walks, heavy dumbbell holds for lower body lifts). Once the humerus starts to move away from the side more than 20-30 degrees, the scapula needs to start moving in the appropriate direction to keep ball on socket congruency and reduce mechanical stress to the neighboring soft tissue structures (labrum, rotator cuff, neurovascular structures).
On the performance side of things, the “down and back” posture (scapular adduction, downward rotation, and depression) limit the ability to get the hand out in front or overhead. This has obvious implications in overhead athletes.
In the case of throwers, the difference in extension at ball release can vary by 3-4 inches depending on the position of the scapula. (as you can see in the comparison pics above and the video below).
When we don’t get full extension at ball release, any variety of downstream stresses can occur (aggressive elbow extension, lack of full pronation through the baseball) that result in increased injury risk and decreased performance.
As mentioned in the introduction video, we are bringing bad cues to good programming and it continues to result in faulty movement and injury. Even worse is when this “down and back” cue is brought into the rehabilitation setting and athletes that have already had surgery continue to experience symptoms similar to their pre-surgery presentation.
In conclusion, let’s continue to look at our cues and consider where the arm is in relation to the body when we decide to cue down and back. When the arms are by the side, then go ahead and cue the scaps down and back. However, when the arm is abducted to the side, overhead, layed back into ER, or out in front at ball release, we need to cue a degree of upward rotation and elevation to make sure the joint is aligned for success.
About the Author
Eric Schoenberg is a Physical Therapist and Strength Coach and the Owner of Diamond Physical Therapy located inside Cressey Sports Performance – Florida. Eric’s approach is to help athletes move more efficiently to reduce injury and improve performance. You can follow him on Twitter and Instagram at @csp_physicaltherapy, or email him at eric@diamondphystherapy.com.
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For this week's podcast, in lieu of a guest, I'm going to do a Q&A on a collection of baseball training questions that were submitted by listeners.
A special thanks to this show's sponsor, Marc Pro. Head towww.MarcPro.comand enter the coupon code CRESSEY at checkout to receive 10% off on your order.
Show Outline
How bullpen arms can arrange their lifting schedule to optimize their performance and feel prepared for each outing
How hitters can mitigate the stressors placed on the lead shoulder of their swing
What recent history and research says about bicep tenodesis and recovery and what baseball players should be aware of when considering this procedure
What high school coaches can do to best prepare their pitchers for week one of spring season
Sponsor Reminder
This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself with their new "Try Before you Buy" program, and use promo code CRESSEY at checkout at www.MarcPro.com for 10% off on your order.
Podcast Feedback
If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.
And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.
Thank you for your continued support!
Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!
