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Why Rhomboids Probably Aren’t Your Best Friend

Today, I've got an excerpt from my new course, Sturdy Shoulder Solutions. I discuss the functional anatomy of the rhomboids, a commonly misunderstood muscle group with big implications.

For a lot more functional anatomy insights like these - as well as a comprehensive look at shoulder assessment, programming, and coaching - be sure to check out Sturdy Shoulder Solutions.

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Strength and Conditioning Stuff You Should Read: 7/13/18

Happy Friday the 13th! Hopefully none of this recommended reading is bad luck.

ASMI Injuries in Baseball Course - Mike Reinold just put this great course on sale, and it's an absolute steal compared to what you would have had to pay to travel and attend it. There's some excellent information from some of the top baseball sports medicine professionals in the world, so I'd call it "must watch" for anyone who trains or treats baseball players. It's on sale for 50% off through this Sunday (the discount is automatically applied). You can check it out HERE.

The 11 Best Books for Smart Meatheads - T-Nation pulled together this compilation of reading recommendations from several of its contributions. My recommendation was (without hesitation) Legacy

Make the Back Squat Feel and Look Better - This was an outstanding guest post from Dr. Nicholas Licameli for Tony Gentilcore's site. It's a longer read, but well worth it, as it's super thorough and links out to some good additional reading/viewing.

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I used my last set of pull-ups the other day as a tutorial on one of the most common mistakes I see. 👇 Compare the first four reps (correct) with the last four reps (intentionally incorrect). 🤔 You'll notice that on the good ones, there is good scapular movement on the rib cage through upward and downward rotation, and no forward head posture. The elbows don't dive behind the midline of the body, either. 👍 On the last four reps, notice how the elbows dive back and the scapula "dumps" forward into anterior tilt. This puts a lot more stress on the front of the shoulder. Additionally, this goes hand-in-hand with the head jutting forward (upper cervical extension). This faulty head/neck/scapula positioning under load is one reason why you'll frequently see people tweak their necks doing pull-ups. 👎 Pull-ups can be an amazing exercise, but just make sure 1️⃣the neck is in neutral; 2️⃣the shoulder blades are rotating up/down and not tilting forward/back; and 3️⃣the elbows aren't shooting too far back.👏#cspfamily #sturdyshouldersolutions

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2018 CSP Elite Baseball Development T-Shirts Now Available!

I’m excited to announce that the 2018 edition of the Cressey Sports Performance Elite Baseball Development t-shirts (powered by New Balance Baseball) are now available for sale.  Here's the design:

These shirts are insanely comfortable and run true to size.

Each shirt is $24.99 + S&H. Click the links below to add shirts to your cart:

XXL

Extra Large

Large

Medium - sold out!

These usually sell very quickly, so don’t delay if you’re interested in picking one up. Enjoy!

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5 Reasons for the Increase in Lat Strains in Baseball Pitchers

There have been some noteworthy lat strains in MLB this year, and this trend isn't showing any signs of letting up. Here are a few reasons why they're occurring at such an alarming rate.

1. Better Diagnosis

Any time a diagnosis becomes more "accepted," doctors know to look for it more immediately. In 2011, Jake Peavy was the first player to actually tear the lat off the humerus and have surgery on it, but now we're actually seeing 1-2 of these each year in guys who come to Cressey Sports Performance for consultations (on top of guys who have lower grade lat strains). In the past, a lot of doctors would mistake lat strains for rotator cuff injuries or biceps tendon issues (because the lat attaches on the front of the humerus). Sometimes, lat injuries would be missed on MRIs because the attachment is far enough down the humerus that a regular shoulder MRI wouldn't cut wide enough. In short, better identification and subsequent diagnosis are always a big reason why a class of injuries "surges."

2. Harder Throwers

Lat recruitment during acceleration is substantially higher in high level throws than it is in amateur pitchers. In particular, as lot of elastic energy is put into lat during the lay-back phase of throwing while it works as an anterior stabilizer of the shoulder as it prepares to unleash that energy into powerful internal rotation and horizontal adduction.

Sprinters who run fast pull hamstrings more often. Basketball players who jump high increase their risk of Achilles ruptures. It shouldn't be a surprise that harder throwers have a higher incidence of lat strains.

3. Inappropriate Strength Training

With each passing day, weight training gets more and more "accepted" in baseball populations, and I absolutely love it. Unfortunately, that means a lot of inferior programs get implemented, and nothing is more inferior in a baseball strength and conditioning setting than programs that are way too lat dominant. If you're doing pull-ups, bench presses, heavy deadlifts, farmer's walks, walking dumbbell lunges - and then coaching all your rows and arm care exercises to be very lat dominant, you're really just exacerbating all the negative adaptations we see in throwers. If you look around your weight room and see a ton of guys with limited shoulder flexion, that should be a red flag.

4. Poorly Executed Arm Care Programs

Lats are sneaky, as they'll find a way to creep into a lot of arm care exercises. You'll see people "tug down" (extension/adduct) the humerus (upper arm) during external rotation exercises using the lat when it should be relaxing to allow the arm to externally rotate.

You'll see hands creeping toward the midline (shoulder internal rotation) during wall slide variations - when the lat should be relaxing to allow "clean" overhead motion to take place.

You'll see individuals lock the scapula down into depression during prone trap raises instead of allowing it to posterior tilt.

And, in the most commonly butchered exercise by every lat strain pitcher I've ever seen, you'll see the humerus tugged down during the prone horizontal abduction (when it should be at 90 degrees).

These examples should help to demonstrate that we've had a lot of success bringing lat strain injuries back to full function not only because of our quality manual therapy, but also because we know how to prescribe and meticulously coach the exercises that are so important for these individuals to master.

5. Weighted Balls

Weighted ball programs increase external rotation quickly (particularly in hypermobile throwers) and the lat - as one of the anterior stabilizers of the shoulder - is one structure that takes on the brunt of the load. When external rotation increases quickly and high speeds are involved, the lat at lay-back is analogous to the Achilles tendon of a basketball player that lands on a heavy dorsiflexed ankle; it just can't "give" any more. If you're a visual learner (and don't have a weak stomach), check out the 1:40 mark in this video to see what crazy eccentric stress at the end-range of a joint can do.

Now, imagine he's an untrained 14-year-old working at these speeds and you put a 100-pound weight vest on him; do you think it'll turn out well?

Weighted balls are awesome - when they're integrated at the right times, at the right loads, in the right dosages, with the right athletes who have earned the right to use them.

Closing Thoughts

If you look at these five contributing factors - and exclude the one (better diagnosis) that's actually a good thing - you'll realize that we have three that are completely in our control. Coach exercises correctly, prescribe strength and conditioning exercises appropriately, and integrate weighted baseball work the right way. If we do these three things correctly - and make sure to take care of tissue quality and length in our throwers - I firmly believe we can completely prevent lat strains, and that's been verified by our experience at Cressey Sports Performance.

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Strength and Conditioning Stuff You Should Read: 7/6/18

I hope you all had a great holiday week. Here's some recommended reading and listening from around the 'net over the past week:

The Best Team Wins - This was an awesome recommendation from my buddy Josh Bonhothal. Adrian Gostick and Chester Elton provide some outstanding strategies for both sports team settings and businesses alike. The section on Baby Boomers vs. Generation Xers vs. Millenials was particularly fascinating.

Matej Hocevar on the Physical Preparation Podcast - Matej is an absolutely awesome guy with a wealth of information to share, and this podcast is an excellent example. He was also an amazing host to my wife and me when we visited Slovenia a few years ago.

7 Ways to Increase Your Training Density - I reincarnated this post from the archives earlier in the week and it was a hit, so I wanted to give it a mention here as well.

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Random Thoughts on Sports Performance Training – Installment 31

With summer training in full swing at both Cressey Sports Performance facilities, I've had all sorts of thoughts rattling around my head on a daily basis, so it set the stage for a new installment of this series on sports performance training.

1. Where an athlete feels an exercise is important, but not on all exercises.

I recently put up two Instagram posts that would appear to contradict one another, to the naked eye.


On one hand, you should always ask athletes where they feel an exercise. And, on the other hand, you sometimes don't want to feel it in one specific place. The answer (as is almost always the case) is "it depends."

When motion is actually taking place, muscles are working concentrically to create that motion. When a muscle shortens, you'll usually develop that "feel" in a certain spot.

Conversely, on an isometric exercise like a carry, there isn't a chance in tissue length, so you won't usually get that same sensation.

Also, keep in mind that the position you're in plays into this as well. If you're squatting, don't expect to "feel" your glutes, hamstrings, or quads specifically in the bottom position or mid-range - but you definitely could feel them a lot at the top as you approach the end of knee and hip extension, as the muscles shorten fully.

In short, "feel" matters - but not all the time.

2. Consider an athlete's age when you're trying to determine why they have a mobility restriction.

One-size-fits-all mobility approaches rarely work because of the way the body changes over the course of the lifespan.

Early on in life, kids are very hypermobile, so you don't really see mobility restrictions. If something seems out of whack, it's probably because they lack adequate motor control at an adjacent joint.

As they hit growth spurts, bones lengthen faster than muscles and tendons can keep up, so restrictions often become more musculotendinous in nature.

As the athletic lifespan continues, those muscular restrictions - in combination with the stress of sports participation or faulty postural habits - can lead to bony blocks and cemented joints. In the years that follow, capsular stiffness can emerge as a problem.

Over time, ligamentous laxity falls off and arthritis becomes more common, limiting range-of-motion even further.

Beyond a lifelong focus on preserving mobility, this knowledge of ROM "regressions" can remind to look to different places at different times. That 14-year-old athletic probably doesn't have capsular stiffness, nor is arthritis a concern. And, that 64-year-old client with the cranky hip probably isn't *only* dealing with muscular problems.

3. Strong guys need longer to train.

Imagine two lifters. Lifter A has one year of training experience and has a personal record deadlift of 315 pounds. Lifter B has 15 years of lifting under his belt and deadlifts 700 pounds. Let's assume both lifters are working up to ~90% of their 1RM in a training session.

Lifter A Warm-up

135x8
185x5
225x3
255x1
275x1
Work sets at 280-285

Lifter B Warm-up

135x8
225x5
315x3
405x3
455x1
495x1
545x1
585x1
605x1
Work sets at 630

Lifter A can get to his working weight in five warm-up sets while lifter B needs nine sets to do so. And, this is just the tip of the iceberg. Lifter B will take more time to unload his plates after finishing his work sets - and he'll probably need an additional warm-up set or two on subsequent assistance exercises. Additionally, chances are that given his time "under the bar" over the years, he'll be a bit older and more banged up (especially at those strength levels), so he'll need to devote more time to the general warm-up before he even gets to deadlifts. Lifter B will also be far more neurally efficient and therefore need more rest between heavy sets than Lifter A even if they've got similar aerobic capacity to facilitate recovery. You're really comparing apples and oranges.

The list goes on and on, and we arrive at the realization that every lifter will have a different optimal training time. This is why I always disagree when I hear things like, "You're working against yourself if you train for longer than 60 minutes." Meanwhile, just about every accomplished strength sport athlete on the planet trains for longer than 60 minutes in just about every training session. And, many of them are extremely lean and muscular.

Don't waste time in the gym, but don't try to race the clock in every session, either. Do what you need to get to get your work in to deliver a quality training effect.

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Strength and Conditioning Stuff You Should Read: 6/26/18

I hope you're having a great week. Here is some recommended reading and listening from the strength and conditioning world over the past week:

EC on the Athlete CEO Podcast - I joined the Athlete CEO podcast to talk about everything from entrepreneurship, to the origins of Cressey Sports Performance, to off-field habits that athletes can employ for success in their sport. This is a great new podcast that I'll be following closely myself.

Some Squat Stumbling Stones and Solutions for Successful Squat Supremacy - Dean Somerset outlines some common squat faults as well as some potential solutions for them.

Tone and Message in Coaching - The Resilient Performance crew never disappoints with their writing, and while this is a quick read, it's an excellent one.

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A little deload can go a long way - especially if you’ve never taken one. #cspfamily

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Mobility Exercise of the Week: Supine Banded Shoulder Flexion on Roller

The supine banded shoulder flexion on roller is a new shoulder mobility drill I came up with that is really growing on me quickly. Effectively, it's an alternative to a back to wall shoulder flexion for those who may struggle to "compete against" gravity as they take the arms overhead in the standing position.

In this drill:

1. The foam roller provides feedback for posterior pelvic tilt, thoracic extension, and a more neutral cervical spine posture.

2. Gravity assists the individual into overhead motion to overcome stiffness through the lats, teres major, long head of triceps, inferior capsule, pec minor, etc.

3. The fact that the roller doesn't impede scapular motion (like the wall or floor would) makes it easier to achieve some scapular posterior tilt as the arms go overhead.

4. The supinated grip drives some shoulder external rotation, placing the lats on stretch in the transverse plane so that folks can't "cheat" the movement by letting their hands drift toward the midline.

5. The band creates some posterior rotator cuff recruitment,

I'll take this over a few sets of ugly band pullaparts any day. What's not to like?

Looking for more cutting-edge shoulder strategies like these? Check out my new resource, Sturdy Shoulder Solutions at www.SturdyShoulders.com.

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Strength and Conditioning Stuff You Should Read: 6/21/18

I hope you're having a great week. I'm gearing up for a weekend of presenting in Colorado, but the good news is that having some flights opens up some time for distraction-free reading and writing on the plane. Here are some good reads from around the 'net from the past week:

New Rules for Being a Strength Coach - Todd Hamer wrote this great piece up for EliteFTS, and I love the concept of continuous improvement in strength and conditioning. Todd's a guy who is always seeking to get better, no matter how long he's been in the industry.

Having an Approach to Having an Approach - This was a guest blog I wrote for my business partner, Pete Dupuis, a few years ago. I cover some fitness business concepts, including networking and lifetime value of a customer.

5 No-Diet Ways to Get Lean - I really liked this article from Dani Shugart on behavior modifications for nutritional success.

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Stop Thinking About “Normal” Thoracic Spine Mobility

Two years ago, I published a post, Tinkering vs. Overhauling - and the Problems with Average, where I discussed the pitfalls of focusing on population averages, especially in the world of health and human performance. I'd encourage you to give it a read, but the gist is that you have to be careful about overhauling a program because you see someone as being outside a "norm" that might have been established for an entire population when they are unique in so many ways.

Thoracic spine mobility is an excellent example. What would be considered acceptable for an 80-year-old man would be markedly different than what we'd want from a 17-year-old teenage athlete in a rotational sport. This athlete, for instance, had some marked negative postural adaptations that contributed to two shoulder surgeries during his time as a baseball pitcher. If he was far older with different physical demands, though, he might have never run into problems.

Lumbar locked rotation is a great thoracic spine rotation screen I learned from Dr. Greg Rose at the Titleist Performance Institute. Briefly, you put the lumbar spine in flexion (which makes lumbar rotation hard to come by) and the hand behind the back (to minimize scapular movement). This allows you to better evaluate thoracic rotation without compensatory motion elsewhere. Check out the high variability among three athletes who are all roughly the same age:

On the left, we have a professional baseball pitcher. In the middle, we have an aspiring professional golfer. And, on the right, we have a powerlifter who's moved well over 600 pounds on both the squat and deadlift. Adaptation to imposed demand is an incredibly important part of this discussion of "normal." The hypertrophy (muscle bulk) that benefits the powerlifter could possibly make the baseball pitcher and golfer worse, but at the same time, I wouldn't necessarily say that the powerlifter is "lacking" in thoracic rotation because you don't need a whole lot of movement in this area for a successful, sustainable powerlifting career.

I should also note that these are all active measures. If we checked all three of these guys passively, we'd likely see there's even more thoracic rotation present than you can see here. And, that can open up another can of worms, as having a big difference between active and passive range of motion can be problematic, too.

The take-home message is that if you're going to call someone's movement quality "abnormal," you better have a clear designation of what "normal" is for their age and sport, as well as what's required for their athletic demands.

For more information on how we assess and train thoracic mobility, I'd encourage you to check out my new resource, Sturdy Shoulder Solutions.

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