Home 2021 April

CSP Elite Baseball Development Podcast: Jimmy Nelson

We're excited to welcome Los Angeles Dodgers pitcher Jimmy Nelson to the podcast. In this episode, Jimmy discusses the impact college baseball had on him; shares insights learned from extensive rehabilitation experiences; speaks to converting from starting to relieving; and reflects on the recovery approaches that have served him best.

A special thanks to this show's sponsor, Owens Recovery Science. Head to http://www.OwensRecoveryScience.com and use discount code CresseyBFR through June 12th to receive $100 off a certification course!

Sponsor Reminder

This episode is brought to you by Owens Recovery Science. Owens Recovery Science is a single source for clinicians looking to learn and implement personalized blood flow restriction exercise and rehabilitation into their practice. Don’t know what BFR is? Looking to learn more about it? Go learn from the ORS crew via their one-day, in-person certification courses, read their blog at OwensRecoveryScience.com, AND, be sure to check out the Owens Recovery Science podcast where Johnny interviews BFR researchers from all over the world, and he and the educational team take some deep dives on specific topics, all with the practicing clinician in mind. Use discount code CresseyBFR through June 12th to receive $100 off a certification course!

Podcast Feedback

If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.

And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.

Thank you for your continued support!

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Cressey Sports Performance – Florida Job Posting: Strength and Conditioning Coach

It's very rare that we post career opportunities publicly for Cressey Sports Performance, but with the growth of our Palm Beach Gardens, FL facility, the time has come.

To that end, we'll be hiring a strength and conditioning coach to join the CSP-FL team beginning September 1, 2021 (although we would bring on the right person sooner than the fall). This position will primarily be involved with the strength and conditioning training of professional and amateur athletes (particularly in the baseball realm), but will also include daily work with general population clients and post-rehab cases.

Responsibilities for this position include:

  • Strength and conditioning coaching in both semi-private and personal training formats
  • Performing assessments
  • Writing programs
  • Participating in staff and intern educational in-services

Qualification Requirements:

  • Experience working with athletic populations, particularly baseball
  • Willingness and ability to collaborate with sports medicine professionals
  • Strong interpersonal skills
  • Proficiency in written communication and with Microsoft Excel
  • Familiarity with social media platforms
  • Nationally recognized certification
  • Desire to work as part of a team

Applicants can submit resumes and cover letters as a single PDF document to CareersatCSP@gmail.com. The deadline for applications is May 31, 2021.

Cressey Sports Performance is an equal opportunity employer. Applicants will be considered regardless of race, gender, creed, sexual orientation, marital status, citizenship status, color, religion, national origin, age, disability, veteran status, or any other status protected under local, state, or federal laws.

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Spring Styles: 2021 CSP T-Shirt Options

We're long overdue for a new CSP T-Shirt debut, so we figured we'd celebrate with a bunch of options! Some are new, and some are reprints of old favorites. All shirts are $24.99 (or 5 for $100) plus shipping. Just click on the bolded hyperlinks below to add them to your cart.

Black Elite Baseball Development (reprint of our most popular t-shirt ever): XXL, Extra Large, Large Sold Out, Medium, Small

Kelly Green Camo (brand new): Extra Large, Large, Medium, Small

Storm Purple Camo (brand new): XXL, Extra Large, Large, Medium, Small

Royal Blue Camo (old favorite): XXL, Extra Large, Large, Medium, Small

Red Camo (old favorite): XXL, Extra Large, Large, Medium, Small

Or, if you'd like to get one of each, you can get five t-shirts for $100 with free shipping. Just add THIS to your cart and let us know what size you want in the comments section of your order.

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Thinking Beyond Diagnostic Imaging

About ten years ago, I was in the operating room to observe my first Tommy John surgery. Much like my time in gross anatomy class during my undergraduate studies, it was an invaluable experience that helped me to appreciate human structure (and, in turn, movement) in a way that anatomy textbooks couldn't offer.

Textbooks typically present a very "neat" anatomy where muscles, tendons, ligaments, bones, and nerves are predictably positioned. You can imagine my surprise, then, when the surgeon made the initial incision along the medial elbow and it yielded a bunch of "stuff" in the way. The fascia, the intermuscular septum, the ulnar nerve, and a host of other unrecognizable structures make you realize that a) every anatomy course or textbook you've ever undertaken hasn't done justice to what's really going on at the elbow (or anywhere else in the body, for that matter), b) it takes a lot of practice to become a great surgeon, and c) you shouldn't let just anyone cut you open for surgery.

Now, let's fast-forward to the post-operative timeline. After the repair is complete and the patient is stitched up, the elbow is splinted at 90 degrees of flexion for a week. Following that week, the arm is put in a hinged brace that gradually allows more motion over the course of weeks 2-6. After six weeks, the brace goes away. In short, it's quite a bit of time with the elbow in a limited range-of-motion situation as a means of protecting the repair.

Not surprisingly, some patients have a lot of trouble getting back their motion - both from the graft gradually stretching out and the musculotendinous structures regaining their length. We'd be crazy to think that the aforementioned fascia structures aren't implicated in the challenges of regaining ROM, though. And, if they've got a role in limiting ROM, they've certainly got a role in the associated stiffness (and, sometimes, pain) that post-operative patients feel. Here's where a variety of manual therapy interventions - ranging from dry needling to instrument-assisted work - have yielded outstanding results. While some folks like to scream and shout in opposition to this fact, it's hard to refute that manual therapy has endured the test of time to the tune of thousands of years.

Only recently have there been technology advancements that allow us to better understand the role of the fascia system with respect to pain and performance (Bill Parisi spoke to this on our podcast a while back; listen here). In a seminar not too long ago, my friend Sue Falsone highlighted some great evidence on the "decompression" that takes place in this regard with a cupping intervention.

Now, let's take a step back and think about the big picture of diagnostic imaging. When we have chronic pain that alters movement patterns, we have adaptive changes of the fascial system. While the diagnostic imaging - MRI, CT scans, x-rays - might pick up on the structural defect, it might overlook the compensatory changes to the fascial system (much of which overlays the actual injury) that can't be appreciated by these types of scans. 

When we look at chronic shoulder pain, is the problem only the rotator cuff tear? Or is that problem magnified by the fascia limitations that arise from years of avoiding various ranges of motion (including at adjacent joints) that would normally be accessible?

I've written extensively about having both a Medical and Movement Diagnosis. The truth is that the discussion of the fascia system is probably a happy medium between the two. We may think too much about the injury the diagnostic imaging identifies and too little about the overlying and surrounding tissues. At the other end of the spectrum, we may be too quick to define a movement limitation as joint, musculotendinous, ligamentous, or motor control without first considering the role the fascial system is playing.

What's the most important lesson here? Professionals from all walks of sports medicine need to work together to thoroughly evaluate injuries and movement competencies in order to design the best performance and rehabilitation programs. And, we need to remain openminded to new technology that may make it easier for us to take an even more accurate and individualized approach to each case.

In this vein, I'd highly recommend checking out my new Thoracic Outlet Syndrome course, as this challenging diagnosis is a great example of how a condition often can slip past common diagnostic imaging.

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