Home 2009 November

Mobility Exercise of the Week: Wall Psoas Hold

For more mobility exercises, be sure to check out Assess and Correct: Breaking Barriers to Unlock Performance.

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Random Friday Thoughts: 11/27/09

1. First off, I hope everyone had a great Thanksgiving.  Before I get to the video footage from yesterday morning, I wanted to give you a couple of quick heads-ups on some seminars at which I'll be speaking in 2010 (just confirmed):
  • January 30, 2010: Mike Boyle Strength and Conditioning 4th Annual Winter Seminar - Winchester, MA
  • March 7-8, 2010: NSCA Personal Trainers Conference - Las Vegas, NV
  • March 27-28, 2010: Vancouver Seminar (click here for details)
  • May 8-10, 2010: Sports Medicine 2010: Advances in MRI and Orthopaedic Management - Boston, MA
Hope to see some of you at one or more of these events! 2. A big congratulations goes out to CP athlete CJ Retherford, who hit the game-winning HR in the championship of the Arizona Fall League (Video HERE).  CJ will be out to Boston to train when January rolls around. 3. And, just when we thought the post-baseball-season celebration was over, we learned that CP athlete Tim Collins was named Toronto Blue Jays Organizational Pitcher of the Year.  Congratulations, Tim!

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4. John Berardi is running a great sale on Precision Nutrition through December 1.  They're offering them the Precision Nutrition System - including Gourmet Nutrition Version 1 and an all-access membership to their private Member Zone - plus a one-year subscription to their Results Tracker program, and free shipping to the US and Canada for just $99.00. If you haven't checked it out - or you have a family member or friend who could use some help on the nutrition side of things - I'd strongly encourage you to check this out.  It's the single-best nutrition resource available on the web today: Precision Nutrition

precision_nutrition 5. We'll have the pictures and videos from the CP Thanksgiving lift posted as soon as possible.  A camera was lost and we're in the process of finding it! 6. In the meantime, here are some recommended readings from the past here at EricCressey.com that might interest you: Hip Injuries in Baseball: My take on the huge increase in hip issues in MLB players. Stagnancy vs. Stability: Even in a dynamic field like strength and conditioning, the status quo is sometimes still just fine. 7. Just got this little bit of feedback on Assess and Correct from Mark Young of markyoungtrainingsystems.com: "As a strength coach myself, I have literally read thousands of studies, textbooks, and articles relating to assessment and correction.  But when I heard that Mike, Eric, and Bill were going to be putting together a product on this very subject I wanted to be first in line to put my hard earned money on the table. I think this product is going to change how people prepare for performance and that owning it is a must for anyone who is absolutely serious about results." Check it out for yourself: Assess and Correct.

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Happy Thanksgiving!

With it being Thanksgiving, I just wanted to take a quick moment to thank all of you for your continued support of EricCressey.com, Cressey Performance, my products, and my career as a whole.  I'm constantly amazed and humbled by the fact that website traffic is up month-after-month; it really is flattering that people care enough to read and view my work on a daily basis in a world of thousands of competing demands for one's attention.  Thank you very much for being such a supportive audience! Best wishes to you all and your loved ones this Thanksgiving.  And, for the many readers of EricCressey.com who aren't celebrating Thanksgiving, I hope you have a helluva Thursday nonetheless! Best, Eric PS - Stay tuned for some video footage of the second annual Cressey Performance Thanksgiving morning training session.  To quote our summer inter, Roger Lawson, "If I was any more excited about it, it'd be illegal."
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Strength Exercise of the Week: Pallof Press

(even though our camera/editing guy spelled it incorrectly)

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Measuring Hip Internal Rotation

Q: Inspired by your articles on T-Nation, I've started to measure IR/ER/Total shoulder rotation deficits using a goniometer.  I did have another question, however: you mentioned in an article that Hip Internal Rotation Deficit (HIRD) is a serious problem among baseball pitchers and hitters due to the asymmetrical front leg blocking in both mechanics. I absolutely agree, and I use corrective exercises and stretches to help alleviate these problems. However, I lack a good way to test for this; do you have any suggestions? A: We check hip internal rotation in the seated position.  Basically, you just have the individual sit up tall at the end of a table, and position the hips and knees at 90 degrees.  Then, without allowing the hip to hike, you internally rotate the femur. This is one of the many assessments on our new DVD set, Assess and Correct, and it's featured on page 50 of the tag-along e-manual.  Check it out:

For more information on how to correct the problem - and assess for other issues like this, check out www.AssessandCorrect.com.

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Slugfest Handout Download

Click the link below to download my Slugfest 2019 handouts.

Cressey_Slugfest2019-handouts

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Random Friday Thoughts: 11/20/09

1. Exciting week around here, as it's getting to be that time of the year when our high school ballplayers - both 2010 and 2011 - finalize some of their plans. Last weekend, RHP Barrett O'Neill (2011) verbally committed to the University of Virginia on a baseball scholarship, and on Tuesday, RHP Travis Dean (2010) signed his letter of intent to pitch at Kennesaw St. University in Georgia.  A few weeks earlier, RHP/3B Joe Napolitano (2011) had verbally committed to Boston College.  These three comprise 3/8 of our current 90mph+ high school crew - and I suspect that the other five will be following soon! Also this week, 2B Erik Watkins (2010) committed to Skidmore and CF Billy Bereszniewicz (2010) committed to Binghampton.  Previously, catcher James Alfonso (2010) had accepted a scholarship to play at the University of Hartford.  Plenty more to come soon, no doubt... 2. Speaking of Travis, here is something I love about him: he has INTENT on every single medicine ball throw he makes.  It isn't just about "tossing" a ball to a wall and rotating your hips.  It's about getting your entire body into the effort - to the point that you're trying to break the ball (or wall!) on every single drill.

Once we have taught our guys the technique for the drill, it's about getting after it.  If you aren't training rotation aggressively, you might as well not do it at all. 3. I got a lot of great comments from readers on my A Few Days in Arizona on Monday; I'd encourage you to check it out. 4. One of the key points I made was that respiratory function was essential for ideal performance and posture, and I recognize that the concept might be completely foreign for a lot of my readers.  To that end, I'd encourage you check out The Anatomy of Breathing.

anatomyofbreathing

It's a pretty quick read that gives you good insights into the anatomy of the respiratory system and common dysfunctions that occur.  Once you start getting an appreciation for the muscles involved, you can start to see how poor diaphragmatic function can easily lead to overactivity of sternocleidomastoid, scalene, pec minor, intercostals - basically, a lot of muscles commonly implicated in upper extremity dysfunction.  You can just stretch and massage those areas, but it's just like putting a bucket on the floor when the roof is leaking; it's better to just fix the roof (aberrant breathing patterns).

5. I also touched on breathing patterns a bit in my seminar this past weekend.  Check out a few great reviews of the event:

Review #1: Bill White

Review #2: Joe Schafer

Review #3:

Yes, it was so exciting that it startled people.

6. Some interesting findings HERE that shows that there may be a strong link between childhood obesity and the development of multiple sclerosis later on in life.  One hypothesis is that it may be linked to the low levels of Vitamin D that one sees in overweight kids, and another that it could be related to the fatty tissue itself.   One more reason to take Vitamin D!

7. We're all headed to Providence tonight to watch CP client and pro boxer Danny O'Connor try to run his professional record to 10-0.  I think we'll be setting a world record for the number of professional baseball players in attendance at a boxing match.  Let's go, Danny!

oconnor

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Recap: Testing, Treating, and Training the Shoulder

As many of you know, Mike Reinold and I put on a seminar that was "everything shoulder" this past Sunday at Cressey Performance.  The event sold out within 36 hours back when we first announced it in early October, and we had strength and conditioning and rehabilitation specialists come from the likes of Canada, Texas, and the Midwest on only a month's notice.   Our goal was to keep the seminar more intimate to allow for more speaker-attendee interaction, Q&A, and easy viewing - as we also recorded the event on DVD. While production won't be complete until December at the earliest, I thought I'd give my loyal readers a little taste of some of what was discussed on Sunday.  Our primary goals were to introduce some current concepts in evaluation of both symptomatic and asymptomatic populations as well as ways to treat/train them during and after injury.  Above all else, we wanted to show how rehabilitation specialists and strength and conditioning specialists could work hand-in-hand to improve outcomes - but that this successful interaction hinged on whether all parties involved were willing to commit to learning about how the shoulder functions.

You can call this my "Random Thoughts" for the week: 1.The side-lying external rotation (SLER) has the highest EMG of any rotator cuff exercise, and the adducted position is the safest position for most "testy" shoulders.  So, if you have to pick one cuff exercise to get you a safety and a great return on investment, roll with the SLER:

2. Simply providing a small amount of "propping" to put the humerus in a slightly more abducted position actually increases EMG of the posterior rotator cuff muscles by 23%.

3. Shoulder evaluations rarely work completely independently of one another.  For example, poor thoracic spine mobility directly impacts function of the scapula and, in turn, range of motion at the glenohumeral joint.  So, rather than hanging your hat on 1-2 assessments, you need a barrage of assessments that cover glenohumeral range-of-motion, scapular stability/positioning, thoracic spine mobility, breathing patterns, and forward head posture.  Then, once you've got all your information, you can look at each test as one piece in an individualized puzzle.

4. There are a ton of superior labrum anterior-posterior (SLAP) tests out there.  It's because none of them are particularly great - but the better ones out there simulate the injury mechanism (e.g. pronated load and resisted supnation external rotation tests for overhead throwing athletes).

5. The true function of the cuff is - very simply - to center the humeral head within the glenoid fossa.  So, rather than train it purely concentrically and eccentrically, we need to also work its isometric/stabilization function with rhythmic stabilization exercises.  Here's a really entry level one we use quite a bit with our pitchers:

6. MRIs and x-rays can only tell you so much about a shoulder.  For instance, 79% of professional baseball pitchers have "abnormal labrum" features.  Likewise, a huge chunk of asymptomatic people in the general population are walking around with partial and even FULL thickness tears of the rotator cuff.  It actually makes you wonder if abnormal is actually normal!  The take-home message is that having adequate mobility, stability, and tissue quality in the torso and upper extremities matters more than anything else. You have to ASSESS, not assume!

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7. We talk a lot about glenohumeral internal rotation deficit (GIRD) - and it certainly is important - but you have to appreciate that it's just one part of the total motion equation.  Some internal rotation deficit is completely normal, and working to fix it may actually hurt some athletes.  Look to total motion first, and then work backward to see whether IR, ER, or both need to be changed.  It is better to be too tight than too loose!

8. If you have an athlete with good shoulders, thoracic spine, scapular stability, and tissue quality who has rehabbed and long-tossed pain-free, but has shoulder/elbow pain when he gets back on the mound, CHECK THE HIPS! Staying closed and flying open will be your two most common culprits, and this cannot be seen in a doctor's office or on an MRI.

9. Anytime you see an individual with a pronounced shrugging pattern as they try to reach overhead, it's wise to have them checked for a rotator cuff tear.  The reason is that with a cuff tear, the deltoid's vertical action overpowers the cuff's compressive action.  In a healthy shoulder, the supraspinatus "cancels out" this deltoid pull.  Never, ever, ever, ever train through a shrugging pattern with overhead reaching!

deltoidsupraspinatus

10. External impingement and internal impingement are completely different "syndromes" that must be managed completely differently.  Simply saying "impingement" is no longer acceptable with how far sports medicine has come!  Both are generally multi-factorial issues that mandate a more specific diagnosis and comprehensive treatment/training plan.  If you understand why/how they occur, you can understand how to train around them (and the same can be said about just about any shoulder condition).

UPDATE: The Optimal Shoulder Performance DVD set is now available!  Check it out at www.ShoulderPerformance.com.

shoulder-performance-dvdcover

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Mobility Exercise of the Week: Wall Hip Flexor Mobilization

For more exercises like this, check out the Assess and Correct DVD set.

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A Few Days in Arizona…

Sorry, everyone, for being a bit MIA of late.  I'll use today's post as a quick catch-up on what's been going on, and what is on tap for EricCressey.com in the months to come. Last week, I flew out to Phoenix on Tuesday to attend a seminar with Dr. Pavel Kolar.  With the exception of just a few of us, everyone in attendance was a strength and conditioniong coach, athletic trainer, or physical therapist with a major league organization.  For those who aren't familiar with Kolar, he is somewhat of a "rehabilitation rockstar"  in the Czech Republic, with "clients" that include Jaromir Jagr, Roger Federer, Petr Korda, countless world-class track and field athletes, multiple Czech Olympic teams, and the president of the Czech Republic himself.  Needless to say, he's a really smart dude; otherwise, people all around the world wouldn't be paying to hear him give seminars in Czech (yes, the majority of the seminar was through a translator). All of us in attendance are probably still trying to wrap our heads around his ideas, but Kolar presented a very interesting perspective on dynamic neuromuscular stabilization (DNS) based on developmental kinesiology.  The "Cliff's Notes" version is that the central nervous system and muscular system it governs are immature at birth, and must go through a very specific adaptation process to achieve anatomical maturation.   In rehabilitation down the road, examining this sequence of events during the first few years of life - from rolling over, to crawling, to standing up, to walking - can help us to understand how we must re-educate the nervous system to optimize function in those with aberrant patterns. According to Kolar, one can have altered stabilization patterns for any of three reasons: 1) abnormal early development, 2) abnormal training methodology, and 3) trauma.  Sounds simple, right? Unfortunately, it's not that easy.   Sequencing of patterns - from the feet all the way up to the head (and including things like diaphramatic breathing and optimal tongue positioning) - is what's important...NOT recruitment of specific muscles. So, while EMG of the vastus medialis, posterior rotator cuff, lower trapezius, transversus abdominus, and loads of other muscles that's important, it's how all those muscles work together that's important. All in all, it was an awesome seminar that really tested those in attendance.  A pessimist would have walked away from it saying that it was too complex and that it couldn't be applied right away.  The optimist (and I'd include myself in this camp) left realizing that there were a lot of things I'm anxious to research and integrate in one's programming to get our clients back to their "roots" of rolling and moving from ground-based to upright movements (think sprint-start from the ground and Turkish Get-ups). We're also looking a ton more at breathing patterns in all our athletes - especially after spending a few days in AZ with my buddy Neil Rampe, a great manual therapist with the Arizona Diamondbacks.  Most people don't realize that the diaphram is both a respiratory and postural muscle, so if you're not using it properly, it'll interfere with both oxygenation and muscular activity. Fun stuff.  Just trying to get better...
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