Home 2008 April

Question for the day…

Did you ever see a caveman wear orthotics? And, did the cavewomen ever rock high heels? Hmm...
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Labral Tears and Pitchers

Q: I've developed some issues with my right shoulder due mostly to pitching in baseball. I've had an MRI done recently and I've been working with an ART specialist as well. So here's the email I just received from my chiropractor: I just got your MRI results in, it shows tendonitis of the supraspinatus tendon and a small "hot spot" on the anterior/superior aspect of the glenoid labrum, which might represent a small tear. The radiologist has recommended an arthrogram, which is an MRI with contrast injected directly into the joint capsule instead of intravenously. You have two options: We could try some more ART and more laser treatments. If your pain decreased after one treatment, than I think it would definitely help. Option two is referral to an orthopedist. He would in turn probably refer you for 4-6 weeks of physical therapy. In any event, the possibility of a major labral tear is slim as a large tear should have been visible on the MRI. Based on the MRI results what do you recommend as far as the options he layed out for me? The ART has helped some but it is still very painful to throw hard. I have no clue what to do and I'm afraid of getting in over my head with medical bills and still having a hurt shoulder. A: Congratulations! You have the same MRI that every pitcher I've ever seen has ever had! I can pretty much tell you that your labrum is frayed regardless of whether or not you get the MRI. According to the research, the main difference between those in pain and those not in pain is internal rotation ROM. Get the PT - and bring this list with you: 1. Scapular stability 2. Thoracic spine range of motion 3. Glenohumeral (ball-and-socket joint) range of motion 4. Overall soft tissue quality (especially posterior capsule) 5. Rotator cuff strength 6. Cervical spine function 7. Mobility of the opposite hip 8. Mobility of the opposite ankle. 9. Core stability/force transfer 10. Breathing patterns Tell them that you want to address each of these 10 factors (in this order) in your rehab. In particular, tell them to check internal rotation ROM, and even print this out for them, if need be: http://www.jaaos.org/cgi/content/full/14/5/265/JA0008404FIG9


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Quad Pulls in Baseball

Q: There have been a few quadriceps pulls in MLB this year. Have you seen these before in baseball players? What gives? A: This is why I love baseball; it's probably one of the most at-risk sports you'll ever see (particularly in pitchers). Here's a little excerpt from a slide in a recent presentation I gave on training for overhead athletes: -Very Long Competitive Season >200 games as a pro? >100 College/HS? -Unilateral Dominance/Handedness Patterns Asymmetry is a big predictor of injury Switch hitters – but no “switch throwers!” -The best pitchers – with a few exceptions – are the tallest ones. The longer the spine, the tougher it is to stabilize. -Short off-season + Long in-season w/daily games = tough to build/maintain strength, power, flexibility, and optimal soft tissue quality Specific to the quad pulls, I'd add to this list that baseball guys rarely hit top speed; all of their sprint work is done in acceleration, where the quads are dominant. Factor in that they spend a lot of time sitting on airplanes/buses, and it's no surprise that they'd get tight anteriorly. It's why it's so important to really hammer on hip mobility in any population that sits a lot.

The stop and go nature of the sport also dictates that strains would be common, whether they are groins, hip flexors, hamstrings, or quads (likely rectus femoris, which is a hip flexor that can get overactive, particularly alongside poor psoas function). So, all that said, before anyone jumps to conclusions and tries to criticize some strength coach, it's important to consider: a) the certain amount of happenstance that occurs with any baseball player due to the nature of the game and the season b) what that athlete does on his own in the off-season In terms of "b," I’ve seen some pretty bad stuff, unfortunately. For many guys, it becomes a leg extensions and curls off-season if they're on their own - or they do nothing. I'd like to think that our success in working with baseball guys is not just in the fact that we've made the programming good, but also in the fact that we've changed the culture a bit in our guys: they appreciate what lifting is doing for them and look forward to getting after it in the gym. Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches used by Cressey Performance Pitchers after they Throw!
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Confessions of an Ex-Ironman

I have a confession to make: I'm an ex-Ironman. Sure, in late July, 2006, in Lake Placid, NY, I crossed the line following a 140.6 mile endurance event, but, following that race, mental weakness prevailed. This story shouldn't take away from the accomplishments of those who have tried and missed, succeeded once, or succeeded many, it's a lesson I learned from the heart of sport (not just triathlon). You see, training for any event takes many successfully repeated steps, over a long period of time; nothing of merit can be accomplished in short bursts of over-enthused effort. The mental divide between these two approaches is immeasurable. The ability start a long-term training program months to years before the true pay-off is a hurdle in and of itself, but, an athlete must package that with the same mental strength to overcome the tests of each daily workout. 52 weeks from your first event, pulling only five reps when you sat down for six might not seem like too much of a miss, but 52 reps later... you've missed a lot. Ask yourself: When you've set your mind on six and you come away with five... we're you listening to your body or your mind? Is it the same? There's the rub. The most successful people accomplish their goals by delaying gratification; as a species that has survived by seeking instant gratification, this is no easy feat. The strength effects, from that one missed rep may be minimal but that mental decision, to avoid a second... or two.. of pain, creates another mental brick that must be broken. Not only are you not getting that strength benefit, you're actually working backwards in the mental game. The mental game is hard enough, there's no need to make it harder. Leading up to my 2006 Ironman, I had days where I set the bar down early, took a bit too much time between sprints, or didn't bring my "A game" to my training hours. With 13 miles left in the closing marathon, I thought I had passed the brick wall... then it hit me. I was dehydrated, hungry, and my legs ached more than words could describe; my mind told me to stop running. I should've been prepared for it... 13 miles... the last few reps, but I started walking... and I wouldn't get back to running until that last half mile to the Olympic Oval. Eventually crossing the line, the glory was still there [and still is], but the mental defeat would keep me away from triathlon over a year. So here I am, a year and a half later, building back to register as a born again Ironman. Watch for mental bricks. Long term, dedicated training is more about the metal accomplishment than anything else; it's a commitment to your goal. - Jon Boyle jb@ericcressey.com Is your plan structured for long-term success? LearnThe Art of The Deload
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A Great Read on Being Barefoot

Just came across this excellent article: Feet Hurt? Stop Wearing Shoes
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Just another afternoon at Cressey Performance…

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Preventing Plantar Fasciitis

Q: Another guy from my favorite basketball team went on the injured list with plantar fasciitis this week. What can be done to prevent this? A: Welcome to professional basketball! The average NBA player has very little dorsiflexion range of motion (ankle). The only way the epidemic of plantar fasciitis, Achilles tendinosis, high ankle sprains, and patellofemoral pain is going to stop is if the players quite wearing 10-pound high top sneakers and taping their ankles. Or, at the very least, lose the tape and focus on barefoot training, low-top shoes off the court, and plenty of ankle mobility work. Just ask Shaun Livingston:
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George Bush Agrees with Me

Bush adviser Hadley says it would be a 'cop-out' to skip opening ceremony
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Listen Up, Hillary

Warning: this is as political as I will ever get in a blog or newsletter. Today, I read this article about Hillary Clinton advocating a partial boycott of the 2008 Beijing Olympics by the U.S. in light of China’s “reaction to recent protests in Tibet and its lack of action in the troubling Darfur region of the Sudan.” Frankly, this gesture from Clinton made me want to puke in my mouth. You see, I interact with Olympic hopefuls on a daily basis. These are people that sacrifice everything for the sports they love – and the opportunity to compete in the single-most prestigious sporting event the world has ever seen. They often struggle to make ends meet financially as their hectic training schedules compete with real jobs and school. They leave their spouses for months at a time to travel all over creation to train and compete. Meanwhile, Bill and Hillary Clinton's 2000-2006 tax returns report that they earned a “not-so-financially-stricken” $109 million during that time period. I have a hard time believing that the Clintons have even the slightest semblance of a clue to realize what a huge deal an Olympic appearance means to someone who is making the sacrifices to which I alluded above. Don’t get me wrong; I am all for human rights and sincerely hope that these issues are resolved quickly and peaceably - and I know that she was just recommending a partial boycott. However, Mrs. Clinton, if you need to make a political statement, stop wearing clothes that were made in China. Don’t buy cars of Chinese origin. Or, stop ordering Chinese takeout; take up your beef with General Tso. But, DO NOT even attempt to use a political spectacle to compromise anything for which all these athletes have devoted their lives. They deserve every bit of glory that comes to them.
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Combat Core Review: Taking “Ab Training” to a Whole New Level

This morning, my girlfriend turned on Regis and Kelly. Now, before you start giving me a hard time, I’ll make it known that a) it was her choice and b) I was checking my emails, and my computer happens to be in the neighborhood of my television. My attention shifted from emails to the TV when I saw that they were featuring a transformation contest where a bunch of ordinary weekend warriors went to different personal trainers to get “toned” (I knew I was in for it when I heard that word). In the minutes that followed, I heard the word “core” mentioned approximately 487 times as trainers put clients through all sorts of stuff: 1. interval jogging on a treadmill (nearly made me vomit in my mouth) 2. playing basketball (You can charge for that? I would have gone with dodgeball so that I could throw stuff at my trainer for ripping me off.) 3. Curls while standing on a BOSU ball in a pair of Nike Shox (yes, you can actually find a way to make unstable surface training MORE injurious by exaggerating pronation even more) Incidentally, this third trainer was featured with some hardcore Kelly Clarkson blaring in the background. I not only got dumber (and angry) by watching this segment; I also realized that if I ever go nuts and decide to write my suicide note, you’ll hear “SINCE YOU’VE BEEN GONE!!!!” blaring in the background as I sob over my pen and paper. Normally, my reaction wouldn’t have been so pronounced, but after this weekend, I was all about REAL “core stability.” You see, I got to catch up with my buddy, Jim Smith (of Diesel Crew fame), while in Pittsburgh to give a seminar. “Smitty” and Jedd Johnson gave an awesome presentation outlining their innovative and effective methods on everything from sled dragging to grip work – and most specific to the discussion at hand, they both raved about how much they love Kelly Clarkson! Plus, they’re HUGE Regis and Kelly fans. Okay, so that last little bit wasn’t entirely accurate; I’m pretty sure that these guys would have Hatebreed or some other angry, belligerent, “my-mother-didn’t love me” music blaring in the background when they finally get their moment in the spotlight on Regis and Kelly. Anyway, they DO know a ton about non-traditional means of training “core stability.” In addition to watching a great presentation, on the plane ride home, I finally got a chance to read through Smitty’s new e-book, Combat Core: Advanced Torso Training for Explosive Strength and Power. To say that I was impressed would be the understatement of the year.
You see, I spend a ton of money each year on seminars, books, DVDs, etc. – and if I can take away even one little thing from each of them, I’m thrilled. In many cases, it’s “same-old, same-old.” Smitty has quickly built a reputation for overdelivering, and this resource was no exception. In the 133 pages of photos and descriptions of loads of exercises you’ve surely never seen, I found: -13 sweet modifications to exercises I’m already doing -16 completely new exercises I can’t wait to incorporate to my own training and that of my athletes -seemingly countless “why didn’t I think of that?” moments. So, to put it bluntly, I think it’s an awesome read – and well worth every penny, especially when you factor in all the bonuses he’s incorporated (including lifetime updates to keep you up to speed on his latest bits of insanity). If you’re interested in some effective, fun, innovative ways to enhance TRUE core stability, definitely check it out: Combat Core: Advanced Torso Training for Explosive Strength and Power
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