Home 2014 October

6 Reasons Anterior Core Stability Exercises Are Essential

This time of year, I'm doing a lot of assessments on college baseball players who are just wrapping up their seasons.  One of the biggest issues that I note in just about every "new" athlete I see is a lack of anterior core control. In other words, these athletes sit in an exaggerated extension pattern that usually looks something like this:

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And, when they take their arms overhead, they usually can't do so without the ribs "flaring" up like crazy.

This is really just one way an athlete will demonstrate an extension posture, though. Some athletes will stand in knee hyperextension. Others will live in a forward head posture. Others may have elbows that sit behind their body at rest because their lats are so "on" all the time.

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This isn't just about resting posture, though; most of these athletes will have faulty compensatory movement patterns, too. Once we've educated them on what better posture actually is for them, we need to include drills to make these changes "stick." Anterior core drills - ranging from prone bridges, to positional breathing, to dead bugs, to reverse crunches, to rollouts/fallouts - are a great place to start. Here's why they're so important:

1. Breathing

The muscles of your anterior core are incredibly important for getting air out. The folks at the Postural Restoration Institute often discuss how individuals are stuck in a state of inhalation, with each faulty breath creating problematic accessory tone in muscles like scalenes, lats, sternocleidomastoid, pec minor, etc. These muscles aren't really meant to do the bulk of the breathing work; we should be using our diaphragm. Unfortunately, when the rib cage flies up like we saw earlier, we lose our Zone of Apposition (ZOA), a term the PRI folks have coined to describe the region into which our diaphragm must expand to function.

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(Source: PosturalRestoration.com)

Step 1 is to get the ribs down and pelvis into some posterior tilt to reestablish this good zone. Step 2 is to learn how to breathe in this position, emphasizing full exhalation.

Step 3, as you may have guessed, is to strengthen these "newly rediscovered" patterns with good anterior core training.

2. Resisting extension.

This one is the most obvious benefit, as the muscles of the anterior core directly combat too much arching of the lower back. If you aren't controlling excessive lumbar extension, it's only a matter of time until you wind up with lower back irritation - whether it's just annoying tightness, a stress fracture, a disc issue, or something else.

3. Better force transfer and lower back injury risk reduction.

The research on core function is pretty clear: its job is to transfer force between the lower and upper body. Spine expert Dr. Stuart McGill has spoken at length about how spine range of motion and power are positively correlated with injury risk. In other words, the more your spine moves (to create force, as opposed to simply transferring it), the more likely you are to get hurt. How do you prevent your spine from moving excessively? You stabilize your core.

4. Indirect effects on rotary stability.

For a long time, I looked at control of extension as "separate" from control of rotation at the spine. In other words, we did our anterior core drills to manage the front of the body, and our chops, lifts, side bridges, etc. to resist unwanted rotation. However, the truth is that these two approaches need to be treated as synergistic.

As an example, every time I've seen an athlete come our way with an oblique strain, he's sat in an extension posture and had poor anterior core control - even though an oblique strain is an injury that occurs during excessive rotation. All you need to do is take a quick glance at the anatomy, and you'll see that external obliques (like many, many other muscles) don't function only in one plane of motion; they have implications in all threes - including resisting excessive anterior pelvic tilt and extension of the lower back.

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What this means is that you can't simply ignore coaching in one plane when you think you're training in another one. When you do your chops and lifts, you need to prevent lumbar hyperextension (arching) . And, when you do your rollouts, you can't allow twisting as the athlete descends. Finally, you can add full exhales (a predominantly anterior core challenge) to increase the difficulty on rotary stability exercises.

5. Improved lower extremity function and injury risk reduction.

Lack of anterior core control directly interferes with lower extremity function, too. If the pelvis "dumps" too far forward into anterior tilt, the front of the hip can get closed down. As I described at length here, this can lead to hip impingement.

With a squat variation, while some athletes will stop dead in their tracks with this hip "block," others will slam into posterior tilt to continue descending. This is the "butt wink" we've come to see over and over again in lifting populations. When neutral core positioning is introduced and athletes also learn to manage other extension-based compensations, the squat pattern often improves dramatically. This can "artificially" be created transiently elevating the heels, turning the toes out, or by having an athlete hold a weight in front as a counterbalance.

Additionally, athletes in heavy extension patterns often carry their weight too far forward, throwing more shear stress on the knees during lunging and squatting. The more we can keep their weight back to effectively recruit the posterior chain, the better.

6. Improved shoulder function and injury risk reduction.

The lats can be your best friend and worst enemy. On one hand, they have tremendous implications for athletic performance and aesthetics. On the other hand, if they're "on" all the time (as we often see in extension-based postures), you can't get to important positions with the right movement quality. Overactive lats will limit not only shoulder flexion (overhead reaching), but also upward rotation of the shoulder blades. I covered this in quite a bit of detail in Are Pull-ups THAT Essential?. Moreover, with respect to elbow function, overactive lats can be a big issue with allowing throwers to get true external rotation, as I discussed here:

If you're using your lats as an "all the time" core stabilizer, you aren't just at risk of extension-based low back pain, but also problems at the shoulder and elbow. If you can get your anterior core control under control and normalize the length and tone of the lats, your "healthy exercise pool" for the upper body expands dramatically. Getting overhead is easier, and you'll feel stronger in that position. The same goes for external rotation; not surprisingly, pitchers always say that their lay-back feels smoother after soft tissue work on the lats, as an example.

Wrap-up

These are just six benefits of training the anterior core, but the truth is that they could have been broken down in much more detail as they relate to specific injuries and functional deficits. If you're looking to learn more on this front - and get a feel for how I like to train the anterior core - I'd encourage you to check out my presentation, Understanding and Coaching the Anterior Core.

AnteriorCore

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Strength and Conditioning Stuff You Should Read: 10/27/14

Happy Monday, everyone. I hope you had a great weekend. We're hard at work getting Cressey Sports Performance's new facility in Jupiter, FL ready. As such, I haven't had time to do any blogging, but I do have some great content from around the web to recommend for you. Check it out:

Crawling Your Face Off - I recently wrote a post about how I'm a big fan of bear crawls. Here, Dean Somerset introduces some great progressions you can incorporate on this front once you've master the basics.

Fish Oil and Omega-3 Fats: How to Be Safe with Your Supplements - The folks at Precision Nutrition do a great job of discrediting a review suggesting that fish oil is useless and may actually be harmful. Just as importantly, though, they make some excellent recommendations on ensuring that you have high quality fish oil.

There's a Reason Your Kids Aren't Playing; They're Not Good Enough - Bill Speros wrote up this candid piece for the Boston Globe. If you work in youth sports in any capacity, you'll like it.

Hopefully, I'll have some pictures of the new facility for you later this week!

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Quick and Easy Ways to Feel and Move Better: Installment 60

This installment of quick training and nutrition tips comes from Cressey Sports Performance coach Miguel Aragoncillo.

1. Spread the floor...correctly.

Spreading the floor is a cue that can get butchered very easily. For a new lifter, there is no easily understandable point of reference for what "spreading the floor" even means. Simply barking external cues such as “spreading the floor” may elicit incorrect movement patterns that are better understood with visual cuing, which saves time to begin with.

Watch and listen to this video for more detail:

2. Focus on the bigger picture.

Whether you’re a frequent gym goer, or a trainer or coach looking to help your clients, the following tip is useful when using new exercises and programs. If you’re using this information for yourself to help improve your approach to lifting, just replace the title of “athlete” with “you!"

Say a younger athlete walks into your facility on Day 1 after an assessment. This is their Day 1, and their first exercise after warm-ups is Trap Bar Deadlifts.

How heavy do you tell the athlete to go?

1. As heavy as the rep scheme will allow.
2. As heavy as they think they should go.
3. As heavy as possible, as long as the movement looks clean.
4. Teach that athlete the requisite movement patterns before progressing.

Choice number 4 is a safe bet!

If someone comes in and does not understand the concept of a Trap Bar Deadlift, it is unlikely that you will go as heavy as the rep scheme will allow, all for the simple fact that this person does not even understand the movement, let alone how to properly prepare for a max rep.

The good thing is that you can reinforce a hip hinge movement pattern in a number of ways, and it does not have to be a strict “you can only do this exercise if you have it on your sheet."

Further, sometimes, clients can come in feeling good, bad, sore, or any of a host of other sensations. While these feelings are very subjective and it is a case by case basis, the idea is that you want to keep movement quality above all else despite the external factors that you cannot control.

If a specific movement does not “feel” good due to external factors, regress appropriately. Live to fight and train another day, as opposed to blindly continuing in the fashion of “Well, it’s on the paper.”

In the case of the athlete, performing a kettlebell deadlift in a sumo stance can be appropriate depending on their training experience, especially if you have heavier kettle bells to teach a hip hinge pattern.

To put this statement in another light - how many times will any given athlete perform a deadlift, squat, or lunge? If an athlete begins an appropriately designed strength training program at the age of 14, and continues this program effectively until he is 18, you have over four years of consistent lifting to improve a specific number.

To extrapolate further, given a 4-day lifting program over 52 weeks in a year add up to 208 opportunities to practice a specific movement pattern. Take out holidays, vacation times, finals and midterms for school, and random weeks where there are snags in scheduling (likely about 7-8 weeks of "off time"), and you have a whopping 44 weeks to train a wide variety of movement patterns.

I’m in it for the long haul, so when you have an athlete hell-bent on getting a specific number, it is helpful to remember that the point is to improve in the gym in order to improve on the field.

3. Check out "The Obstacle is the Way."

One habit that I’ve gained over the past few years is learning how to pick up a book that is outside of my comfort zone in order to expand my mental horizons and challenge my current thought processes. Fortunately for me, many of the staff at CSP crush audiobooks and regular books alike, and not just anatomy and physiology minded books either.

A school of thought with which I’ve aligned my mentality is the stoic philosophy - not just a Dead Poets Society rant on free thinking, but rather the attitude on valuing action over non-action and pontificating on the “Coulda, Woulda, Shoulda’s” of life. One book that exemplifies this actionable philosophy is The Obstacle is the Way by Ryan Holiday, and I have recommended this book to every staff member here to gain a better understanding of how to approach work, life, and other situations.

obstacle

To give a primer on the book, it essentially boils down to the aptly named title - that is, if there is an obstacle, then there is no other way around it but to simply stare it down and get to work on whatever that available solutions present themselves.

It is not quick, nor easy, but it is simple enough to understand, with possible long lasting effects, which can provide guidance in the face of adversity for any individual, not just athletes.

4. Try Greek yogurt, peanut butter, and whey protein.

Barring fancy names for a quick snack, I’ve been crushing yogurt ever since I started working at Cressey Sports Performance. Consuming Greek yogurt has allowed me to capitalize on macros, and depending on the brand of yogurt you get, you can get upwards of up to 22g of protein per cup. Add in a scoop of whey protein, and some powdered peanut butter (powdered peanut butter is used to aid in the consumption of the yogurt, and doesn’t take away from the flavor, but enhances upon it), and you have yourself a delicious snack.

I have been going with Greek yogurt, with vanilla whey protein powder, and finally adding in powdered peanut butter. It tastes like peanut butter cheesecake, which is an unreal thought in the first place.

5. Utilize a variety of movements in an exercise program.

There are hidden benefits to varying the position that you perform an exercise within your program. When you’re training the anterior core or the various anti-rotation, flexion, or extension movements, utilize different lower body positions to maximize movement variability. This will allow your body to build a stable foundation from which it can improve and build upon as you progress from one exercise to the next.

Here's a basic 3-4 month progression for cable chop variations, where you'll send 3-4 weeks on each step. This will allow a better foundation to be met prior to simply performing all exercises in a standing position.

1. Tall Kneeling Cable Chop - 3 sets of 10 reps per side
2. Half Kneeling Cable Chop (Inside Knee Up) - 3 sets of 10 reps per side
3. Standing Cable Chop - 3 sets of 10 reps per side
4. Split Stance Cable Chop - 3 sets of 10 reps per side

Further, you can vary the breathing patterns that you use within these contexts in order to optimize their effectiveness. When teaching this pattern to athletes, it is important to first allow a constant stream of inhalations and full exhalations, while watching for mechanical positioning of the lower ribs and pelvis, as ideal positioning involves reducing anterior pelvic tilt and lumbar extension (arching of the lower back). As you find yourself learning how to "own" this specific exercise, introduce a full exhale while maintaining your position as you perform the concentric portion of the exercise.

About the Author

Miguel Aragoncillo (@MiggsyBogues) is the newest strength coach at the Hudson location of Cressey Sports Performance. More of his writing can be found on www.MiguelAragoncillo.com.

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7 Ways to Make Your Strength Training Programs More Efficient

I'm a big believer in pursuing maximum efficiency in our training programs. We want exercises and training strategies that deliver the biggest "bang for our buck," as most people don't have all day to spend in the gym. That said, supersets, compound exercises, and other well-known approaches on this front are staples of just about all my programs.

Unfortunately, sometimes, the typical strategies just don't get the job done sufficiently. There are periods in folks' lives that are absurdly busy and require approaches to kick the efficiency up a notch further. With us opening a new facility right as our busiest season is upon us - and my wife pregnant with twins - you could say that this topic has been on my mind quite a bit these days. With that in mind, here are seven strategies you can utilize to get a great training effect as efficiently as possible.

1. Switch to a full-body split.

Let's face it: you might never get in as much work on a 3-day training split as you do on a 4-day training split. However, you can usually get in just as much high quality work. I've always enjoyed training schedules that had me lifting lower body and upper body each twice a week. However, usually, the last few exercises in each day are a bit more "filler" in nature: direct arm work, secondary core exercises, rotator cuff drills, and other more "isolation" drills. In a three-day full-body schedule, you should really be just focusing on the meat and potatoes; it's the filler you cut out.

Additionally, I know a lot of folks who actually prefer full-body schedules over upper/lower splits. This was one reason why I included 2x/week, 3x/week, and 4x/week strength training options in The High Performance Handbook.

 

2. Do your foam rolling at another point during the day.

There has been a lot of debate about when the best time to foam roll is. While we generally do it pre-training with our athletes, the truth is that the best time is really just whenever it's most convenient - so that you're more likely to actually do it! If you'd rather foam roll first thing in the morning or at night right before bed, that's totally fine. As long as you get it in, over the long haul, you really won't see a difference if you compare pre-training to another point in the day.

3. Do a second, shorter session at home. (Waterbury, PLP program example)

Remember that not all training sessions have to actually take place in a gym. Rather, you might find that it's possible to get in 1-2 of your weekly training sessions at home. As an example, I have an online consulting client who has a flexible schedule on the weekends, but a crazy schedule during the week. He does two challenging sessions with heavier loading on the weekends (lower body on Saturday and upper body on Sunday). Then, he'll work in some filler work with body weight, band, and kettlebell exercises on Tuesday and Thursday. He's still getting in plenty of work in during the week, but he doesn't have to set aside extra time to drive to and from the gym. Obviously, a home gym alone can make for more efficient programs, too!

4. Move to multi-joint mobility drills.

If you're in a rush to get in a great training effect - and abbreviated warm-up - don't pick drills that just mobilize a single joint. Rather, pick drills that provide cover a lot of "surface area." Here are a few of my favorites, as examples:

Typically, you're going to want to do fewer ground-based drills and more drills where you're standing and moving around.

5. Dress in layers.

Speaking of warm-ups, it'll take you longer to warm-up if you dress lightly - especially as the winter months approach. Athletes always comment that they get (and stay) warm better when they wear tights underneath shorts, or sweatshirts and sweatpants over t-shirts and shorts. Of course, you can remove layers as you warm up.

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Additionally, if you're an early morning exerciser, you can expedite the warm-up process by taking a hot shower upon rising. A cup of coffee can help the cause as well.

6. Add in mobility fillers.

If you're going to shorten the warm-up a bit, you can always "make up" for it by working in "fillers" between sets of your compound exercises. I actually incorporate this with a lot of the programs I write, anyway. If you look at our baseball athletes, they're often doing arm care drills in between sets of squats, deadlifts, and lunges. They get in important work without making the sessions drag on really long, but at the same time, it paces them on the heavier, compound exercises so that they aren't rushing.

7. Use "combination" core movements.

Usually, the word "core" leads to thoughts of unstable surface training, thousands of sit-ups, or any of a number of other monotonous, ineffective, flavor-of-the-week training approaches. In reality, the best core training exercises are going to be compound movements executed in perfect form. Overhead pressing, Turkish get-ups, 1-arm pressing/rows/carries, and single-leg movements (just to name a few) can deliver a great training effect. Complement them with some chops/lifts, reverse crunches, dead bugs, and bear crawls, and you're pretty much covered.

There are really just seven of countless strategies you can employ to make your training programs more efficient. Feel free to share your best tips on this front in the comments section below. And, if you're looking to take the guesswork out of your programming, I'd encourage you to check out The High Performance Handbook, the most versatile strength and conditioning program on the market today.

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Strength and Conditioning Stuff You Should Read: 10/20/14

It's a big week for us at Cressey Sports Performance, as we're in the home stretch and about to get into our new training facility in Jupiter, FL. If you want to follow along, I'll be posting some progress pics on my Instagram account. While I won't have much time to pull together new content this week, I can definitely tell you the following articles will be well worth your time!

Widening the Aerobic Window - Mike Robertson has published some excellent stuff on energy systems development in the past, and this article does a great job of building on them.

The Six Characteristics of a Good Dynamic Warm-up - I reincarnated this old post on Twitter yesterday, and it was a big hit. So, I thought I'd remind the EricCressey.com readers, too.

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How You Make Decisions Says a Lot About How Happy You Are - I always love reading research on social phenomenons and how people behave. This Wall Street Journal article highlights some entertaining stuff in this realm.

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Timing Adjustments and Their Impact on the Pitching Delivery: A Case Study

Today's guest post comes from Matt Blake, the pitching coordinator at Cressey Sports Performance in Massachusetts. Matt is an integral part of the Elite Baseball Mentorships team.

I recently Tweeted out a picture of some mechanical changes a pitcher had made and it received a lot of responses. As such, I decided I would follow up with a little more depth and context to this particular picture to help shed some light on the thought process that goes into making mechanical adjustments. So, for starters, here’s the picture in question, with the left side being the original delivery and the right side being the revised version.

delivery1

Typically, when discussing pitching mechanics, I avoid using still shots, because they can be very misleading. In this particular case, there were some substantial changes that were made in this landing position, which I thought encapsulated a lot about the enhanced movement quality of the delivery as a whole, which we’ll unpack in further detail here.

For those familiar with the pitching delivery, the first thing that should jump out at you is the extremely late arm action in the initial delivery. This could be classified as an “inverted arm action” at landing, where in this case, the elbow isn’t necessarily hyper-abducted (elevated) above the shoulder, but the hand is definitely below the elbow. In a Cliff's Notes version, this positioning is generally regarded as increasing stress on the shoulder and elbow. This is in part due to the orientation of the humeral head in the socket at landing, as it’s in a position of excessive internal rotation and pinned into the front of the socket. As a result, we’re not in an optimal position to get the rotator cuff to function to center the head for a clean ball in socket rotation.

This is coupled with the fact that we’re adding more torque to the joint since we have more range of motion involved in getting the hand to full lay-back before accelerating to release. That being said, there are plenty of pitchers who throw very hard and have successful big league careers pitching with an inverted pattern, and the reason they throw so hard may very well be due to their inverted pattern, so you have to constantly weigh the risk/reward of making mechanical adjustments for pitchers.

As an example, Billy Wagner had an inverted pattern and multiple injuries, but was hitting 100mph before it was industry standard to hit 100mph - and he accumulated 422 saves in a successful big league career.

wagner1024px-Billy_Wagner_on_September_15,_2009

When weighing this potential risk/reward, some of the questions might include:

  • Where is this pitcher currently in the developmental process?
  • What type of stress does he currently report during or after throwing?
  • What can we gain by making adjustments?
  • What do we have to lose by adjusting this current delivery?

These are important questions to consider, because you’re obviously not going to take a big leaguer at the tail end of his career, and adjust what has got him to that point. Conversely, you might adjust a 15yr old high school pitcher, who throws hard, but has erratic command and reports a high level of stress after he’s done throwing.

In this particular case, we had a sophomore in college, who had a track record of success in high school, and was looking to establish his role in a very competitive program with a strong history of winning. His contributions as a freshman were limited in part due to command issues and his velocity would be erratic going anywhere from 82-90mph on any given day.

With these considerations in mind, it became apparent in looking at the the delivery in its current state, that these mechanics might be a limiting factor in commanding the ball at a competitive level, as well as sustaining his velocity on a consistent basis. On the flip side, though, if we reduce the inversion in his arm action, we may lose a mph or two of velocity initially, as we learn to “re-tension” the delivery and create force in a different manner. In order to fully comprehend these issues, let’s take a look at this delivery in full:

As I stated in the video, the crazy thing about this delivery is that for how extremely late that arm action looks in that still shot, it’s really a misrepresentation for how much I like the feel of this delivery as a whole. There’s a lot of quality movement that’s “loose” in nature, and this athlete has a good feel for creating “extension” in the throw, so we really don’t have to adjust the integrity of his movements, but more the timing associated with some of the actions, and at the crux of it, the athlete’s mindset for creating leverage in his throw.

If you look at where this delivery starts to break down, it’s in the excessive “counter-rotation” of his shoulders that creates too much length in the throwing arm and that couples with an exaggerated extension of the back leg into landing.

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As a result, the hand can’t catch up and “get on top of the ball” at landing and our pressure into the ground ends up being poor. This combines to create an issue for the stabilization pattern as a whole now, because the front leg can’t brace to create a fixed point of rotation to anchor the throw, as it has to allow for the torso to translate forward in an effort to create time for the hand to get into position behind the ball. So, as you can see, by the front knee ending up working into a more flexed position, we’re diffusing the ground force reaction we’re trying to convert into rotational power, and the pelvis loses its leverage on that front hip, flattening out our rotation. When this happens, you’ll notice that the path of the hand is actually diverted wide instead of keeping an efficient driveline through the target. Without a firm landing position that allows us to accept force properly, and keep the rhythm of our sequencing intact, our command and velocity will continue to be erratic in nature.

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Once we identified these issues, we had to rule out that there wasn’t a mobility or stability issue that was limiting our ability to move through more functional positions. In this particular case, mobility definitely wasn’t the issue, and even though the stabilization pattern was currently poor, the athlete did have the ability to stabilize. It really just came down to his awareness for what he was trying to accomplish. So, once we came to agreement that these were things that could be fixed and would be beneficial to his development in the long run, we had to start re-organizing the focus of his repetitions.

Anytime you’re making changes, it’s essential to understand root causes and not just symptoms. For me, the inverted arm action was a symptom of a misdirected focus in the delivery. We needed to make the focus less on length and extension in the throw and more on strength in the landing and properly sequencing his rotations through the chain. By creating a stronger stride pattern and tying the timing of the arm path into the lower half sequencing, we would have a more connected and repeatable delivery that had a more efficient stabilization pattern. Let’s take a look at what shook out over the next seven weeks and then we’ll discuss some of the altered components.

As discussed in the video, the first thing that should stand out in the revised delivery is the compactness of the arm action, and from there, the angle of the ball flight out of his hand. And, to be honest, I could run through every drill that we did to get him to this point, but I don’t know if it’s really the drills themselves that are important. I think we could have accomplished this in a multitude of ways, as long as we kept the focus on cueing him to be “strong into the floor.”

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Now, that being said, we definitely used versions of the “stride drill” to coordinate the rhythm of the back-hip rotation and arm action, and we did our share of step-behind shuffles to speed up his timing and learn to accept force properly upon landing, but if the focus on trying to create force into the ground and working from “top-to-bottom” on the baseball wasn’t in place, I don’t think either of those drills would have mattered.

Changing his focus and “pre-throw vision” for what his ball flight should look like helped him organize his body into this revised delivery. By placing the importance on being “strong into the floor”, it didn’t allow him to put himself into these overly extended positions, whether it be the lower half or the arm action, as he came to understand these weren’t “strong” positions. Ultimately, understanding the importance of landing in a position that allowed him to accept the force and transfer it up the chain was crucial in this process.

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At the end of the day, the most important part of making any type of delivery change is getting “buy-in” from the athlete himself. It doesn’t matter what I think a delivery should look like unless the athlete understands and accepts why it’s important for him to make these changes, because ultimately he’s the one who has to throw the baseball.

In this particular case, we had a college pitcher who is on the cusp of turning himself into an impact pitcher in a competitive college program. If getting himself into more efficient positions in his delivery allows him to command the baseball more consistently, and he can reduce the erratic nature of his velocity, he’ll give himself a real chance to be a reliable college performer and we can begin to entertain the possibility of becoming a pro prospect.

All in all, I’m really proud of the work this athlete put in over the summer and I think these rapid changes speak volumes about the level of commitment he has to his development, as changes of this magnitude aren’t common in this time frame and they certainly don’t happen by accident. Needless to say, there’s still a lot of work to be done to “own” this remodeled delivery. It needs to become second nature and highly repeatable in order for this athlete to be able shift into a narrow-minded focus on just competing in the strike zone, but I’m certainly excited to see where his continued effort leads him.

For more pitching discussion, you can follow Matt on Twitter.

Looking for more video analysis and training insights like this? I'd encourage you to sign up for one of our upcoming Elite Baseball Mentorships. We have an upper extremity course in November, and you won't find a more intensive baseball educational experience.

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Strength and Conditioning Stuff You Should Read: 10/15/14

For this week's installment of "Strength and Conditioning Stuff You Should Read," we've got something for just about every taste in the health and human performance industry: nutrition, sports performance, and psychology/mentality:

Blood Sugar Management: What Your Doctor Doesn't Know About Glucose Testing - Dr. Brian Walsh of Precision Nutrition discusses how monitoring blood glucose is more complex than one might think.

17 Helpful Things Hyper-Neurotic People Can Do for a Better Life - Miguel Aragoncillo is the newest edition to the Cressey Sports Performance team, and here, he talks about ways to relax instead of overanalyzing.

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Exercise of the Week: Heidens with External Rotation Stick - We were talking about this exercise in quite a bit of detail yesterday at our Elite Baseball Mentorship, as it's one I really like to work in with our pitchers to teach them to accept force. 

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The Overhead Lunge Walk: My Favorite “Catch-All” Assessment

We spend a good chunk of our lives standing on one-leg. Obviously, that means we need to train on one leg, but it's also important that fitness professionals and rehabilitation specialists assess folks when they're in single-leg stance, too. Enter the overhead lunge walk, which is likely my favorite assessment because of just how comprehensive it is.

Why is it so great? Let's examine it, working from the upper extremity to the lower extremity.

First, you can evaluate whether someone has full extension of the elbows. Just tell folks to "reach the fingers to the sky." In a baseball population, as an example, you can quickly pick up on an elbow flexion contracture, as it's quick and easy to make a comparison to the non-throwing side.

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Additionally, you can screen for congenital laxity, as a lot of hypermobile (loose jointed) folks will actually hyperextend the elbows during the overhead reach.

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At the shoulder girdle, you can evaluate whether an individual has full shoulder flexion range of motion:

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You can also tell whether the aforementioned hypermobile folks actually move excessively at the ball-and-socket joint of the shoulder, as they'll actually go too far into flexion instead of moving through the shoulder blades.

You can determine whether an individual has an excessively kyphotic, neutral, or extended thoracic spine. If they're kyphotic, they'll struggle to get overhead without compensation (arching the lower back or going into forward head posture). If they've got an excessively extended thoracic spine, they'll actually go too far with the overhead reach (hands will actually wind up behind the head if it's combined with a very "loose" shoulder).

You can tell whether an individual is able to fully upwardly rotate the shoulder blades in the overhead position.

You can tell whether someone preferentially goes into forward head posture as a compensation for limited shoulder flexion, poor anterior core control, or a lack of thoracic spine extension or scapular posterior tilt.

You can evaluate whether an individual has enough anterior core control to resist extension of the lumbar spine (lower back) during overhead reaching. This is a great test of relative stiffness of the rectus abdominus and external obliques relative to the latissimus dorsi.

You can evaluate whether an individual is in excessive anterior or posterior pelvic tilt from the side view.

Also from the side view, you can determine whether the athlete hyperextends the knees in the standing position.

With the lunge, you can see if an athlete is quad dominant - which is clearly evidenced if the stride is short and the knee drifts out past the toes of the front leg. You can also venture a guess as to whether he or she has full hip extension range of motion.

Also with the lunge, you can determine how much control the athlete has over the frontal and tranverse planes; does the knee cave in significantly?

You can make a reasonably good evaluation of foot and ankle function. Does the ankle collapse excessively into pronation? Or, does he stay in supination and "thud" down?

Does the athlete handle the deceleration component effectively, indicating solid eccentric strength in the lower extremity?

As you can see, this assessment can tell you a ton about someone's movement capabilities and provide you with useful information for improving your program design. Taking it a step further, though, it goes to show you that if you select the right "general" assessments, you can make your assessment process much more efficient.

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7 Random Thoughts on Corrective Exercise and Post-Rehab Training

If you've read much of my stuff (most notably this article), you likely appreciate that I think it's really important for fitness professionals to understand corrective exercise and post-rehab training. Folks are demonstrating poorer movement quality than ever before, and injuries are getting more and more prevalent and specific. For the fitness professional, corrective exercise can quickly become a tremendous opportunity - or a huge weakness. To that end, given that Dean Somerset put his great resource, Post-Rehab Essentials, on sale for $50 off through the end of the day, I wanted to devote some thoughts to the subject with these seven points of "Eric Cressey Randomness."

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1. Refer out. - With more and more certifications and seminars devoted to corrective work, the industry has a lot more "corrective cowboys:" people who are excited to be able to "fix" everything. Unfortunately, while this passion is admirable, it can lead to folks taking on too much and refusing to refer out. To that end, I think it's important for us to constantly remind fitness professionals to not work outside their scope of practice.

Referring out is AWESOME. I do it every single day - and to a wide variety of professionals. It provides me with more information, and more importantly, helps me toward the ultimate goal of getting the client/athlete better. Trainers often worry that if they refer out, they'll lose money. This generally isn't true, but even if it was, it's a short-term thing. If you appreciate the lifetime value of the client, you'll realize that getting him/her healthy will make you more profitable over the long-term.

Additionally, I've developed an awesome network of orthopedic specialists in the greater Boston area. As a result, I can generally get a client in to see a specialized doctor for any joint in about 24-48 hours. It's an awesome opportunity to "overdeliver" to a client - but it never would have come about if I hadn't been willing to refer out. As an added bonus, we'll often get referrals from these doctors as well.

2. Ancillary treatments are key. - For my entire career, I've been motivated by the fact that I absolutely hate not knowing something. It's pushed me to always continue my education and not get comfortable with what I know, and it's helped me to be open-minded to new ideas. However, I'm humble enough to recognize my limitations. I know a lot about elbows, but I'm not going to do your Tommy John surgery. I've worked with more pitchers than I can count, but I'm not a pitching coach. And, even if I was able to do all these things, there's no way I'd have time to do them all and leverage my true strengths. In other words, I rely heavily on competent professionals around me for everything from sport-specific training, to manual therapy, to diagnostic imaging, to surgery, to physical therapy, to nutritional recommendations. Surround yourself with great people with great skillsets, and corrective exercise quickly becomes a lot easier.

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3. Soft tissue work is effective.

Here's what I know: people feel better after they foam roll, and their range of motion improves. Additionally, soft tissue treatments have been around for thousands of years for one reason: they work!

For some reason, though, every 4-6 months, somebody with a blog claims that foam rolling is the devil and doesn't work, and then dozens of people blow up my email address with questions about whether the world is going to end.

The truth is that we know very little about why various soft tissue approaches work. I recall a seminar with bodywork expert and fascial researcher Thomas Myers from a few year back, and he commented that we "know about 25% of what we need to know about the fascial system." If Myers doesn't have all the answers, then Johnny Raincloud, CPT probably hasn't found the secrets during his long-term stay in his parents' basement.

With that in mind, I do think it's safe to say that not all people respond the same to soft tissue work, and certainly not all soft tissue approaches are created equal. Foam rolling doesn't deliver the same results as an instrument-assisted approach, and dry needling likely works through dramatically different physiological avenues than cupping. As a result, we're left asking the client: "does it make you feel and move better?" If the answer continues to be "yes," then I'll keep recommending various soft tissue treatments - including foam rolling - until someone gives me a convincing contrarian argument with anecdotal evidence.

4. Strength can be corrective.

Ever had a friend with anterior knee pain (patellar tendinopathy) who went to physical therapy, did a bunch of leg extensions, and somehow managed to leave asymptomatic? It was brutally "non-functional" and short-sighted rehab, but it worked. Why?

Very simply, the affected (degenerative or inflamed) tissues had an opportunity to rest, and they came back stronger than previously. A stronger tissue is less likely to become degenerative or inflamed as it takes on life's demands.

Good rehab would have obviously focused on redistributing stress throughout the body so that this one tissue wouldn't get overloaded moving forward. In the patellar tendon example, developing better ankle and hip mobility would be key, and strength and motor control at the hip and lumbar spine would be huge as well. Certainly, cleaning up tissue quality would be a great addition, too. However, that doesn't diminish the fact that a stronger tissue is a healthier tissue.

This also extends to the concept of relative stiffness. As an example, a stronger lower trapezius can help to overcome the stiffness in the latissimus dorsi during various upper extremity tasks.

And, a stronger anterior core can ensure corrective spine and rib positioning during overhead reaching - again, to overcome stiff lats.

Don't ever forget that it's your job to make people stronger. If you get too "corrective" in your mindset, pretty soon, you've got clients who just come in and foam roll and stretch for 60 minutes, then leave without actually sweating. You still have to deliver a training effect!

5. Minimalist sneakers might be your worst nightmare if you have high arches.

I love minimalist sneakers for my sprint and change-of-direction work. I don't, however, love to wear them on hard floors for 8-10 hours a day. I'm part of the small percentage of the population that has super high arches and doesn't decelerate very well, so cushioning is my best friend. Throwing in a $2 "cut-to-fit" padding in my sneakers has done wonders for my knees over the years, and I'll actually wear through them every 4-6 weeks.

The New Balance Minimus 00 is a sneaker I've been wearing recently to overcome this. It's a zero drop shoe (no slope down from the heel to the toe), and while lightweight, it offers a bit more cushioning (and lateral support, for change of direction) than typical minimal options.

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All that said, just don't force a round peg in a square hole with respect to footwear. Some people just aren't ready for minimalist footwear - and even if they are ready to try them out, make sure you integrate usage gradually.

6. The pendulum needs to swing back to center with respect to thoracic spine mobilizations. - Thoracic spine mobility deficits are a big problem in the general population, given the number of people who spend too much time sitting at a computer. Athletes are a bit of a different situation, though, as some actually have flat (excessively extended) thoracic spines and don't need more mobility. As an example, check out the top of this yoga push-up before we corrected it.

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This athlete has a flat thoracic spine, limited shoulder flexion, and insufficient scapular upward rotation. So, he'll logically go to the path of least resistance: excessive thoracic motion (as evidenced by the "arch" in his upper back). The shoulder blades don't rotate up sufficiently, and he's also "riding" on the superior aspect of his glenohumeral (shoulder ball-and-socket) joint. Here is it, "mostly" corrected a few seconds later:

yoga1

By getting him to "fill up" the space between his shoulder blades with his rib cage (encouraging more thoracic flexion) and cueing better upward rotation of his scapula, we can quickly recognize how limited his shoulder flexion is. In the first photo, he's forcing shoulder ROM that isn't there, whereas in the second one, he's working within the context of his current mobility limitations.

If we just feed into his thoracic spine hypermobility with more mobilizations, we'll just be teaching him to move even worse.

7. You'll never address movement impairments optimally unless nutrition and supplementation are spot on. - It never ceases to amaze me how many athletes will bust their butts in the gym and in rehab, following those programs to a "T" - but supplement that work with a steady diet of energy drinks and crappy food. I'm not talking about debating whether grains and dairy are bad, and whether "paleo" is too extreme for an athlete; those are calculus questions when we should be talking about basic math. A lot of athletes literally don't eat vegetables or drink enough water. That's as basic as it comes. Movement quality will never improve optimally unless you're healthy on the inside, too.

This article was actually a lot of fun to write, so I'll probably turn it into a series for a bit down the road. In the meantime, though, I'd encourage you to check out Dean Somerset's Post-Rehab Essentials resource to learn more in this regard. I don't hesitate to endorse this comprehensive corrective exercise resource, as the content is fantastic, Dean is an excellent teacher, and the product provides some continuing education credits. The $50 off just sweetens the deal. Check it out HERE.

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Strength and Conditioning Stuff You Should Read: 10/6/14

It's time for this week's list of recommended strength and conditioning reading:

Elite Training Mentorship - In this month's update, I include an in-service on the top 10 mistakes I see with medicine ball training. I also have two new exercise demonstration videos, and an article on how to prevent "training boredom."

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5 Thoughts on Sprinting - This informative post from Mike Robertson draws on insights from his own experience and what he's learned from others.

Squatting Semantics - Charlie Weingroff presents a quick, but informative look at the different kinds of squats and benefits that each affords - assuming technique is correct.

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