A while back, I wrote up an article, 10 Important Notes on Assessments, that was one of my most popular posts of the year - and I'm ready for a sequel! Here are a few thoughts that came to mind.
1. Just like training, assessments are getting more specialized.
As the sports performance and even personal training worlds get more specialized, the assessments we need to utilize with our clients must be correctly matched up to the people in front of us. As examples, rotator cuff strength tests are huge for a baseball pitcher, but relatively unimportant for a soccer player. We’d “weight” a single-leg squat test result as less significant for a kayaker than we would for a basketball player. The goals of the client and the functional demands of their sport guide the assessments – both in terms of which ones we perform and how we value the results.
However, the challenge is that you can’t test everything, so it’s important to prioritize. If we used every assessment under the sun, the evaluation would last all day – and we’d spend an entire session pointing out everything that’s wrong with someone. I’d much rather use this time to build rapport.
A VO2max test isn’t high on my list of priorities for baseball players even if it might shed some light on their aerobic base. I can probably get the information I need just as easily – and much more affordably – by taking a quick resting heart rate measurement.
2. Every good test that has an unfavorable outcome immediately sets you up for an even more telling retest.
Assessments give you a glimpse into what could potentially be wrong or right about how someone moves. The more important question is: what interventions make a difference? Their squat pattern improves when you give them an anterior counterbalance? Their hip internal rotation improves when you add some core recruitment? Their shoulder pain goes away when the massage therapist works on their scalenes?
One tenet of the Selective Functional Movement Screen (SFMA) system is to always start with dysfunctional, non-painful patterns. What interventions clean up aberrant movement in non-painful areas to give us "easy" adaptations? This not only expands our movement repertoire, but also facilitates buy-in from the athlete/client.
3. Never go to movement screens without first performing a thorough health history and client “interview.”
I think we can all agree that a pre-participation evaluation can dramatically reduce the likelihood in training. And, I'd argue that the single most important part of this evaluation is the health history and conversation you have with them before they even start the movement screen portion of it.
As an example, imagine you have a hypermobile female client with a history of serious anterior shoulder instability that hasn't been surgically treated. If you do thorough paperwork and a detailed conversation with her, you'll quickly ascertain that you have to be careful with anything that involves shoulder external rotation. If you don't do that preliminary work, though, you might very well pop her shoulder out of the socket doing a basic external rotation range-of-motion test.
Summarily: paperwork first, conversation second, movement third!
4. Have assessment regressions for people who can’t perform certain tests due to pain or poor movement competencies.
I like to use a Titliest Performance Institute screen – lumbar locked rotation – to assess thoracic rotation. It requires an individual to get into a lot of knee flexion, though. So, if you have someone who is extremely short in their quads – or has had a knee replacement and permanently lost that motion, then it’s not a solid test.
You’re better off going to a seated thoracic rotation screen with these folks.
As a good rule of thumb, you’ll need more alternatives to general screens (involving more joints and motor control challenges) than you will for specific assessments (involving fewer). So, as you look through your assessment approach, start to consider how you’ll regress things when things don't go as planned.
5. Don’t overlook evaluating training technique as a means of assessing.
During almost every evaluation of someone who has struggled with pain or performance (which is really everyone), I look at technique exercises they commonly perform. For our pitchers, this might be arm care exercises, or a video of a bullpen. For powerlifters, it might be technique on the squat, bench press, or deadlift. As much as our assessment protocols can be thorough, they’ll never fully offer the specificity that comes from watching people actually train.
6. Don’t use tests to embarrass people.
As an extension of the previous point, if you know someone is going to fail miserably on a screen, don’t test it. If you have a 350-pound woman who wants to lose 200 pounds, she’s not going to do well on a push-up test. You can assume that her upper body strength and core stability aren’t sufficient to handle her body weight.
I keep coming back to it:
7. Watch for straining.
This is something I’ve watched for a lot more in recent years after spending time around my business partner, Shane Rye, who’s one of the best manual therapists I have ever seen. He’s a master of watching people move and picking up on where they tend to store their tone. Maybe it’s jaw clenching when you test rotator cuff strength, or making an aggressive fist when you check their active straight leg raise. Watching for changes in accessory tone can give you a glimpse into where you might get the best benefit with your manual therapy work – and how you might coach them differently while they’re training.
8. The best outcome of an assessment might actually be a referral for a more thorough assessment.
At least once a year, I have an assessment come in - but without doing any training, I refer them on for further evaluation. Usually, it's because something very "clinical" in nature presents, and I feel that they need to see a medical professional before we start working with them. It doesn't happen often, but I'm never shy about "punting" when I feel that someone else is better equipped than I am to help the person in front of me.
9. Don’t take their word for it on body weight.
I once had a 6-8 pitcher tell me that he weighed 235 pounds. The next day, he walked in and remarked, “Coach, I actually weighed in this morning. I was 253 pounds.” Now, 18 pounds isn’t as huge a percentage of total body mass on a 6-8, 253 guy as it is on a 14-year-old, 110 pound female teenager, but it’s still tell us a lot that he could actually swing 18 pounds without even feeling it. That’s a sign of an athlete with poor body awareness and a lack of nutritional control (they definitely weren’t a good 18 pounds). You're better off measuring than just asking.
A side note: this applies to male athletes only; I never weigh female athletes for obvious reasons.
10. Take meticulous notes.
I often find myself looking back on notes we have on long-term clients to see how their movement (and prescribed training) has evolved over the years. It wouldn't be possible if I wasn't very detailed in my note-taking - and this is something I'm always striving to improve upon, as we want to create sustainable systems in our business.
Employees move on, so a client's programming responsibilities may be shifted to other staff members. Sports medicine professionals may want to work from some of our notes. Teams and agents might want information on what we discovered with a player and how we plan to manage them. The more you document, the more prepared you'll be in these situations when collaboration is necessary.
Most importantly, though, whenever I write a new program for a client, I have their evaluation form and their previous program open on my computer. I want to see what I initially noticed and put it alongside the up-to-date programming to verify where we are in our progressions. It's this kind of documentation that allows me to program for dozens of athletes who are not only in our facility, but across the country and overseas.
Wrap-up
I've been assessing athletes for close to 15 years, and I find that our evaluations evolve every single year. If you're looking to stay on top of some of the latest developments on this front, I'd strongly encourage you check out our Functional Stability Training series.
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Today's guest post comes from Dean Somerset. In reviewing his outstanding resource, The L2 Fitness Summit Video Series (which is on sale for $50 off this week), I thought Dean did a great job discussing active vs. passive range of motion, and asked if he'd be willing to expand on the topic in a guest post, and he kindly agreed. Check it out! -EC
Mobility training is a hop topic right now. Head over to Instagram and you’ll see incredible feats of flexibility that don’t seem like something humans should be able to do without calling 911 due to some terrible accident having taken place.
While these feats are undoubtedly cool to see, there’s also the big question of “why should you even do that stuff? Is it beneficial to health, longevity, or physical performance? Is it something that helps you achieve a specific goal, or prevent injury or get hot dates for the weekends?”
First, let’s look at what is involved in being flexible and having some solid mobility.
Flexibility is typically defined as the available range of motion available to a joint or specific motion.
Mobility is typically defined as the usable range of motion available to an individual.
Another way to look at it, flexibility is your passive range of motion, whereas mobility is your active range of motion, and each is very important, as is their interplay with one another.
The passive range of motion is the theoretical limit of your available range that you could move through for funky stuff like splits, squats, overhead presses, or other movements you’d want to do on a daily basis in the gym. It can be expanded with some “unlocking” options if it’s restricted by motor control issues like guarding tension, or by prolonged static stretching to adapt the tissues that might impede further mobility, such as the joint capsule, ligaments, fascia, or other tissues.
For these tissues to adapt to static stretching, it typically takes a very long time in the stretch (think 5-30 minutes on a daily basis for months on end), and also works best in younger individuals versus older. Odds are, once your epiphyseal plates at the ends of your bones fuse, expanding your passive range is going to be fairly limited.
Now if you have the passive range of motion, you should be able to use it. The active range of motion should be relatively close to what the passive available range currently is. If you can’t use that range, there’s a problem.
While much of the limits to passive range of motion may be structural, the limits to active range of motion are usually more neural. The efferent division of the nervous system controls motor function, including developing sufficient strength across entire ranges of motion or within portions of that range commonly used.
Coming back to the original question of this post, should you even stretch? That depends on whether you need more passive or active range of motion, and what methods of development are best for improving those characteristics.
If you have enough flexibility to do all of the things you want to do in life, you don’t need to develop more flexibility. Would more be good to have if you needed it? Sure, but at current time, you’re golden.
If you can get enough hip flexion to squat to depth for a powerlifting meet, more range won’t give you more white lights.
If you can’t get to this range of motion needed for the activities you want to do, that’s when stretching could be beneficial. Progress tends to be slow for this, but can happen relatively easily if you’re patient. It may mean watching The Walking Dead or Game of Thrones while holding a stretch, but you can do it.
If you have the range but can’t access it, that’s when active mobility comes into play. A basic approach would be to put the joint into a range of motion it wouldn’t normally be able to get into on its’ own with the help of either external loading or some supportive structure, and then developing muscle tension in that new position.
Creating agonist and antagonist muscle tension in the new position can help develop range-specific strength while also training the motor pattern to create activity in that range that it’s not used to developing, which can help you to access later.
Another option would be to take off the brakes from the system to see if that helps. Some higher threshold core activation exercises seem to help reduce resting neural tone into the distal tissues, and helps expand the available range of motion effectively.
Once you have access to that range in both passive and active capabilities, it’s time to train it. Use big ranges of motion with max contractile ability, then add loading to it to help cement that ability to use through all the challenges you can throw at it.
So this comes back to the original question: Should you even stretch? I have a simple flow chart to explain the basis of this post and give some direction on what you should do.
If you have both the flexibility and control through the range of motion to do what you want to do, you don’t need to stretch.
If you have the flexibility but not the control, you need to do more active controlled tension drills to help access that range of motion. If you don’t even have the range of motion to do the activity you’re looking to do, that’s where things like static stretching, PNF style contractions, high threshold strategies, joint mobilization or self-myofascial release (foam rolling) can come in very handy.
Haphazardly stretching everything for everyone is rarely ever a beneficial way of training, let alone a good use of time for many individuals with whom it may not be recommended. More range of motion is often not necessary, or even attainable in the case of structural restrictions, but if you enjoy stretching and it makes you feel good, that’s reason enough to continue if you like. However, if it’s not giving you any specific benefits, it may be worth choosing any of the other options we went through today and see if they produce more of a benefit to your training.
Along with Dr. Mike Israetel, Dean is the co-creator of the L2 Fitness Summit Video Series, which was released today. I'm in the process of working my way through this new continuing education resource; Dean offers a nice glimpse into some assessment components that go beyond typical movement screens, and Mike's presentation on hypertrophy mechanisms and strategies was insightful as well. These are some seemingly minimally-related topics, but they did a good job of pulling everything together. It's on sale for $50 off this week, and definitely worth a look - especially with it being the end of the year and NSCA CEUs being available for the resource. Check it out HERE.
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Happy Monday! It's been two weeks since my last recommended reading compilation, as I took a little blog hiatus last week in light of some travel and the chaos that is the professional baseball offseason. The good news is that it gave me time to stockpile some good content for you. Here goes...
Tinkering vs. Overhauling - and the Problem with Average - One of our interns asked me about my thoughts on the "average" range of motion at a particular joint, and it got me to thinking about this article I wrote last year. There are big problems with using averages in the world of health and human performances, so I'd encourage you to give it a read to learn more.
Using extra conditioning to make up for poor diet is a definite path to continuing to use extra conditioning to make up for poor diet for a long time. Slippery slope. You're better off plugging the leak in the roof (diet) than you are buying more buckets to collect the water.
"Don't assume; it makes an ASS out of U and ME." It's one of the most hackneyed expressions of all time, but it's a lesson many folks in the fitness industry - and casual observers to this industry - will never seem to learn. Assuming an exercise or methodology will help or hurt someone is one of the biggest mistakes I see across all training programs. Perhaps the most readily apparent example is in individuals with back pain.
“Your back hurts? You should try yoga.”
“Back pain? Just give up squats and deadlifts and only do single-leg work instead.”
"Your low back is cranky? Try McKenzie press-ups and it'll fix you right up."
You know what? I’ve seen people whose back pain got considerably worse when they took up yoga. I’ve also seen people whose low backs feel better when they avoid single-leg work and stay with bilateral exercises like the deadlift. And I've seen extension-intolerant individuals integrate McKenzie press-ups on a friend's recommendation and flare up their symptoms.
That doesn't mean any of these recommendations are inherently bad, or that the ones giving the recommendations aren't well intentioned. It's just that you're going to a podiatrist to get dental advice; it isn't a qualified recommendation, nor is it backed by a solid sample size of success.
Sometimes, the exercise selection is the problem (the wrong yoga poses).
Other times, it’s the technique is the problem (your squat form is horrific).
Occasionally, the timing is the problem (disc pain is worst first thing in the morning, so it's probably not the time to test out deadlifting for the first time in six months.
Often, the volume is the problem (maybe it would have been good to run 1/2 mile pain-free before trying to jog ten miles).
Rarely does an entire discipline (ALL of yoga or ALL of strength training) need to be contraindicated.
We need to avoid assuming that all back pain is the same and instead dig deeper to find out what works for each individual. The same can be said for shoulders, hips, knees, ankles, necks, and just about every other musculoskeletal malady we encounter. Good assessment and a solid library of knowledge from which to draw both help to solidify recommendations as sound.
Injuries and conditions are usually very multifactorial. We rarely hurt simply from an isolated traumatic incident; rather, it's the accumulation of various aberrant movements over the course of time that bring us to a symptomatic threshold. And that's why we need to build broad skillsets that encompass assessments, programming strategies, coaching cues, and an appreciation for how all the pieces fit together in determining whether someone hurts or not.
That's what Mike Reinold and I aimed to do with our Functional Stability Training resources; give both rehabilitation specialists and strength and conditioning professionals the tools they need to help keep people healthy - or, in the clinical sense, help them get healthy in the first place. This four-part series is on sale for 25% off through Monday at midnight by using the coupon code BF2022 at checkout; for more information, check out www.FunctionalStability.com.
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With the holiday shopping season upon us, I wanted to highlight some goodies we have for sale from the Cressey Sports Performance clothing line. As a little Black Friday/Cyber Monday bonus, we'll do free domestic shipping on all orders over $50 (we'll refund your shipping charge after the order is placed). Just click on the link of whatever you'd like an it'll automatically be added to your cart (and you can keep clicking to add multiple items).
Note: If you'd like to purchase one, please just add the appropriate color you'd like (teal, black, or pink) in the comments section at checkout. An important note: these tank tops run a bit big, so you'll want to order a size smaller than you'd normally get.
A while back, I posted on social media about how I think the concept of balancing pushes with pulls in your programming is outdated. It received some hefty debate, so I thought I'd delve into the topic a bit further in today's video.
To learn more about how I assess, program, and coach at the shoulder joint, be sure to check out Sturdy Shoulder Solutions.
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I hope you had a great weekend. Before I get to the recommended reading for the week, I wanted to give you a heads-up that with it being Thanksgiving week, we're kicking off our Black Friday/Cyber Monday sales early so that you have an entire week to take advantage of them. From now though Monday, November 27, you can get 25% off on any (or all) of the Functional Stability Training resources from Mike Reinold and me. You can check them out at www.FunctionalStability.com. No coupon code is necessary.
6 Principles to Improve Your Coaching - Speaking of Functional Stability Training, here's an excerpt from the latest offering on this front, FST: Optimizing Movement.
NFL Teams Address Fatigue Factor - We've worked a lot with Fatigue Science to monitor sleep quantity and quality with our athletes, and this article goes into detail on how they're impacted NFL teams as well.
Why We Use End-Range Lift-off - Cressey Sports Performance coach Frank Duffy discusses how to build active control of your passive range of motion.
Top Tweet of the Week
10 yrs ago, I was training a few HS guys. I'd only played baseball until 8th grade and couldn't have even told you what PFP stood for.
Now, we train both Cy Young award winners - and guys in every MLB organization. Coaches: ask more questions and do more listening; it pays off.
We're excited to announce our next Elite Baseball Mentorship offering: an upper-extremity course that will take place on January 14-16, 2018 at our Hudson, MA facility.
The Cressey Sports Performance Elite Baseball Mentorships provide an educational opportunity to become a trusted resource to this dramatically underserved athletic population. Through a combination of classroom presentations, practical demonstrations, case studies, video analysis, and observation of training, you’ll learn about our integrated system for performance enhancement and injury prevention and rehabilitation in baseball athletes. Cressey Sports Performance has become a trusted resource for over 100 professional players from all over the country each off-season, and this is your opportunity to experience “why” first-hand at our state-of-the-art facility.
Course Description:
This Cressey Sports Performance Elite Baseball Mentorship has a heavy upper extremity assessment and corrective exercise focus while familiarizing participants with the unique demands of the throwing motion. You’ll be introduced to the most common injuries faced by throwers, learn about the movement impairments and mechanical issues that contribute to these issues, and receive programming strategies, exercise recommendations, and the coaching cues to meet these challenges.
Course Agenda
Sunday
Morning Session: Lecture
8:30-9:00AM – Registration and Introduction (Eric Cressey)
9:00-10:00AM – Understanding the Status Quo: Why the Current System is Broken (Eric Schoenberg)
10:00-11:00AM – Common Injuries and their Mechanisms (Eric Schoenberg)
11:00-11:15AM – Break
11:15AM-12:15PM – Flawed Perceptions on “Specific” Pitching Assessments and Training Modalities (Eric Cressey)
12:15-1:00PM – Lunch (provided)
Afternoon Session: Lecture and Practical
1:00-3:00PM – Physical Assessment of Pitchers: Static and Dynamic (Eric Cressey and Eric Schoenberg)
3:00-3:15PM – Break
3:15-5:15PM – Prehabilitation/Rehabilitation Exercises for the Thrower (Eric Cressey and Eric Schoenberg)
5:15-5:30PM – Case Studies and Q&A
5:30PM Reception (Dinner Provided)
Monday
Morning Session: Lecture and Video Analysis
8:00-9:00AM – Strength Training Considerations for the Throwing Athlete (Eric Cressey)
9:00-10:00AM – Key Positions in the Pitching Delivery: Understanding How Physical Maturity and Athletic Ability Govern Mechanics (Christian Wonders)
10:00-10:15AM – Break
10:15-11:30AM – Video Evaluation of Pitchers: Relationship of Mechanical Dysfunction to Injury Risk and Performance (Christian Wonders)
11:30AM-12:00PM – Lunch (on your own)
Afternoon Session: Observation at Cressey Sports Performance – 12PM-5PM*
Tuesday
Morning Session: Practical
8:00-9:00AM – Preparing for the Throwing Session: Optimal Warm-up Protocols for Different Arms (Eric Cressey and Eric Schoenberg)
9:00-11:00AM – Individualizing Drill Work to the Pitcher and Live Bullpens from CSP Pitchers (Christian Wonders)
11:00-11:30AM – Closing Thoughts and Q&A (Eric Cressey, Eric Schoenberg, and Christian Wonders)
11:30AM-12:00PM – Lunch (on your own)
Afternoon Session: Observation at Cressey Sports Performance – 12PM-5PM*
* The afternoon observation sessions on Monday and Tuesday will allow attendees to see in real-time the day-to-day operation of the comprehensive baseball training programs unique to Cressey Sports Performance. This observation of live training on the CSP floor with our professional, college, and high school baseball players will allow you to experience firsthand our approaches to:
• Programming
• Proper coaching cues for optimal results
• Soft tissue techniques
• Activation and mobility drills
• Strength/power development
• Medicine ball work
• Multi-directional stability
• Metabolic conditioning
• Sprint/agility programs
• Base stealing technique
In addition, you will experience:
• Live throwing sessions
• Biomechanical video analysis
• Movement evaluation
• Live evaluations of attendees with Eric Schoenberg
Location:
Cressey Sports Performance
577 Main St.
Suite 310
Hudson, MA 01749
• No prerequisites required.
• Participants will receive a manual of notes from the event’s presentations.
• Space is extremely limited
• We are keeping the size of this seminar small so that we can make it a far more productive educational experience.
•This event will not be videotaped.
For details about travel, accommodations, and other logistics, please email cspmass@gmail.com.
I'm long overdue for a new installment on this series, so here are some thoughts that have been rattling around my brain on the business side of fitness.
1. Unique skill sets help you fill in the cracks.
I'm going to let you in on a little secret: most of the strength and conditioning resumes that come across my desk are painfully similar. Seriously, they are 90% the same. Here's an excerpt from a presentation I gave earlier this year when I touched on the topic:
As you can probably infer, experience like this is really abundant - and what is abundant is rarely coveted. I'm not saying any of things are bad to have on a resume; I'm just saying that they're prerequisites, not differentiating factors.
So how does an up-and-coming strength and conditioning professional stand out from the crowd? Here are a few examples:
a. Fluency in another language (Spanish is incredibly useful at CSP, where we train quite a few bilingual baseball players)
b.Technology proficiency beyond the "norms" (I can't tell you how many times long-time CSP employee Chris Howard has helped out with everything from Powerpoint issues to wiring speakers)
c. A demonstrated history of lead generation and conversion (Have you built and grown a business? Have you found value where others missed it?)
d. An internship at an established facility (I'm going to look more fondly on someone who's interned at IFAST, Mike Boyles, EXOS, or something comparable - as opposed to the person who chose a random YMCA on the other side of the country)
e. Playing AND coaching baseball (have you seen it from both sides of the lens?)
The possibilities are endless, but the point is that these unique skill sets are differentiating factors that make it easier for someone to justify hiring you.
2. Your bio is probably more important than you think.
Most of the time, when someone posts their bio on a website, it's to make sure that prospective clients review it and recognize two things:
a. This person is qualified (Allison graduated from XYZ university with ABC degree, and has achieved these certifications)
b. This person is relatable (In his spare time, Doug enjoys walking his two pet schnauzers and eating ice cream with his wife of 27 years, Peggy.)
An experience the other night reminded me that it's important to give equal attention to each.
Just tried to "vet" a rehab specialist for a pro athlete. Read his bio & ALL it said was that he did ART, was a father of three, & competed in triathlons. Couldn't tell if he was a PT, DC, or ATC. A bio does matter; if you want referrals, make it easy to perceive your expertise.
This guy lost out on a pretty big time client because he focused too much on being relatable; almost his entire bio was targeted toward potential patients, but not other practitioners who might be looking to evaluate his clinical skill set for the purpose of referrals.
When you write your bio, make sure you include components of both - and that might mean you have to trim the fat on some of the non-essentials.
3. Slow and steady still wins the race.
Have you ever heard the story of the small company who gets a big breakthrough to get their product on the shelves of Wal-Mart or Target - and then goes out of business just months later because they didn't have the short-term cash flow to keep up with a huge surge in production demands and inventory needs? Their systems couldn't keep up with their lead generation.
Many trainers would kill to add 20 new clients, but most fail to realize that they don't have the systems in place to take on that many new people and still deliver a high quality product. This is a classic story when a fitness bootcamp runs a Groupon to bring in a surge of new prospects - only to see their long-term members get irritated at crowded classes, watered down programming, and "flightly" training partners who go from one gym to the next each month. The systems weren't ready for the surge in leads.
Last summer, my business partner, Brian Kaplan, co-founded The Collegiate League of the Palm Beaches near our Jupiter, FL Cressey Sports Performance location.
In a matter of weeks, we added over 60 new college baseball players as 3-5 days/week clients for a two-month period. It took months of planning to make sure that we were staffed accordingly, and included loads of email outreach to schedule evaluations. It even meant that there were a few cases when we had to turn away "drop-in" evaluations from college guys who hadn't scheduled in advance. I even flew down from Massachusetts for a week to help out with the initial surge.
As Aaron Ross and Jason Lemkin wrote in From Impossible to Inevitable, "Speeding up growth creates more problems than it solves." It only makes sense that this would be a huge issue in the fitness industry, where we have people who are often skilled technicians, but not very savvy entrepreneurs and managers. So, unless you have your systems fine-tuned, be careful what you wish for when it comes to expanding your offering to new markets or within the existing market.
4. Read this post from my business partner, Pete Dupuis.
This is an excellent lesson that can apply to any endeavor in business and in life.
I hope everyone had a great weekend. Here's a little recommended reading and viewing to check out:
Complete Core - This is Mike Boyle's new core training/programming resource. I'm working my way through it, and so far, so good! It's on sale for 50% off this week.
