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!
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!
From 2007 to 2009, I was a big sleeper stretch guy. All our throwing athletes did this stretch at the end of their training sessions, and we meticulously coached the technique to make sure it accomplished what we *hoped* it would accomplish. I featured it in the program in my first book, Maximum Strength, and this picture of me even shows up in the first row of photos on Google Images if you search for "sleeper stretch."
Then, in March 2010, I attended my first Postural Restoration Institute (PRI) event and "saw the light." I left the course with some great new positional breathing drills that often delivered quick results in terms of improving shoulder internal rotation - without having to actually stretch the shoulder, a joint that doesn't really like to be stretched. Looking back, we were probably trying to "stretch" out an alignment issue - and that never ends well.
We've since progressed our approach, complementing PRI exercises with thoracic spine mobility drills and manual therapy at the shoulder in those who present with true internal rotation deficits. Only after they've still come up short following these initiatives do we actually encourage stretching of the glenohumeral (ball and socket) joint. And, even when that happens, it's gentle side-lying cross-body stretching with the scapula stabilized; this has proven safer and more beneficial for improving internal rotation.
The three preceding paragraphs about my experiences with the sleeper stretch could really be summed up in three words:
I was wrong.
It's not the only time I've been wrong, either.
I wish I'd done more barefoot work and ankle mobility training with the basketball players with whom I worked early in my career.
I wish I'd not just assumed that all athletes needed more thoracic mobility when, in fact, there are quite a few who have hypermobile t-spines.
I wish I'd focused more on the benefits of correct breathing - especially full exhalation - with athletes sooner in my career.
In my own powerlifting career, I wish I'd spent more time free squatting and less time box squatting. And, I wish I'd competed "raw" instead of with powerlifting equipment.
I've made some errors in the ways I evaluated, trained, and programmed for athletes. I've made dumb decisions in both my business and personal life. However, at the end of the day, I can attribute a lot of my improvements as a person and a professional to the fact that I was completely comfortable admitting, "I was wrong." Heck, I'm so comfortable recognizing my mistakes that I've written entire posts on the subject!
This is trait just about every successful strength and conditioning coach generally shares. Humility is an essential trait for personal and professional advancement, especially in a dynamic field like strength and conditioning where new research and training techniques emerge on a daily basis.
This isn't just limited to strength and conditioning, though. If you asks a lot of the best surgeons in the country, they'd admit that they were wrong in doing a lot of lateral release (knee) surgeries and thermal capsule (shoulder) shrinkage procedures earlier in their careers. And, they'd probably admit that they misdiagnosed a lot of cases of thoracic outlet syndrome as ulnar neuropathy. If they aren't willing to admit their past mistakes, you probably ought to find a different doctor.
If you're an athlete, the same can be said of seeking out a strength and conditioning coach. If the person writing your programs hasn't learned from his/her mistakes, are you really getting a "modern" or forward-thinking program that has been tested in the trenches? We've all seen those programs - both in training and rehabilitation - that have been photocopied so many times over the years that they're barely legible.
Likewise, if you're an up-and-coming strength and conditioning coach, you want to seek out mentors that'll admit their past mistakes and reflect on how they learned from them. Only then can they help you avoid making them, too. You're better off learning under someone who has 15 years of strength and conditioning experience than someone who has 15 years of the same year of experience.
Finally, if you're an established professional, the only way to grow is to get outside your comfort zone. Five years from now, if you're not looking back on your current approaches and wondering what the heck you were thinking, then you're stuck in the bubble on the left.
You need to visit other facilities, talk with other coaches, and empower your employees/co-workers with a voice that challenges the norm. I learn a lot from my staff on a daily basis. And, looking back on that first PRI event I attended, I was the only "non-clinician" in the room. I was surrounded by PTs, PTAs, respiratory therapists, pelvic floor therapists, and ATCs. I got out of my element and it changed the course of my career dramatically.
Looking back on these experiences when I was clearly wrong, part of me wants to send individual apology notes to all the athletes I saw early in my career. By that same token, though, I feel like thank you notes might be more appropriate, as these mistakes played an essential role in my growth as a coach and person.
If you're looking for an up-to-date look on how we manage shoulders - including a look at identifying and addressing internal rotation deficits - be sure to check out my new resource, Sturdy Shoulder Solutions.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
What You Need to Know About GIRD - Mike Reinold put together a great review of the literature and outlined the common mistakes he sees with respect to glenohumeral internal rotation deficit (GIRD). This is stuff that Mike and I discuss literally every week, so I'm glad he's finally put it into a comprehensive article. If you're a coach who is universally prescribing sleeper stretch to all your players, this is must-read material; you'll reconsider it after you're done.
Injuries are an Opportunity - Andrew Ferreira is a CP pro guy in the Twins system, and he offered this great insight on how you can't just have a pity party when you get hurt; you have to use it as an avenue through which you can get better.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
We see a lot of baseball players, so a lot of these guys come to use with elbow problems. In most cases, the doctors they’ve seen have said, flat-out, “NO LIFTING WEIGHTS.” This drives me nuts for a variety of reasons:
1. They’ve still got two good legs, one good arm, and a bunch of core musculature that needs to be strong and functional.
2. This recommendation implicitly means “Stay away from personal trainers and strength coaches.” It’s probably due to the fact that there are a lot of bonehead personal trainers out there who could do more harm than good, but the truth is that these services comprise more than just lifting weights. We do a lot of mobility and activation work and self-myofascial release on the foam roller.
Collectively, #1 and #2 demonstrate that this blanket recommendation includes an insanely ignorant omission, as the majority of elbow problems can be attributed to mobility and strength deficits at the shoulder. You can train a shoulder a thousand different ways without even involving elbow motion – let alone challenging it sufficiently to cause a problem. In fact, I'd estimate that you could prevent 90% of elbow problems in baseball guys if we simply taught all of them how to sleeper stretch in their early teenage years:
I'd strongly encourage you to check out this article I wrote, where I go over the common mistakes folks make when performing the sleeper stretch.
3. This recommendation flat-out ignores the specific nature of the overwhelming majority of elbow problems in throwing athletes. Let me elaborate..
In my estimation, 95% of baseball players with elbow pain couldn’t elicit their pain in a weight room if they wanted to; seriously! The reason is that this elbow pain is typically mechanical in nature; that is, it’s only aggravated by specific activities (in their case, throwing).
Believe it or not, I have had guys do everything from pull-ups, to dumbbell bench presses, to rows, to push-ups, to grip work just days out from elbow surgery. It isn’t true in every case, but it’s definitely the majority. And, they can all get diesel in the lower body during this time period.
Some great related reading for you:
Inefficiency vs. PathologyLay Back to Throw GasSign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches
used by Cressey Performance Pitchers after they Throw!
