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The Biggest Mistake in Program Design

Today's guest post comes from former Cressey Sports Performance intern and current Boston Bruins Head Performance Coach Kevin Neeld. It's timely, as he's a co-creator of the new Optimizing Adaptation and Performance resource that was just released. I've reviewed it and it's outstanding; definitely check it out HERE, as there's a $50 off introductory discount in place this week. -EC

My programs look at a lot different now than they did ten years ago. This is true despite my “big rock” principals and general exercise progression-regression strategies changing very little.

The evolution of my programs has come largely from acknowledging my own biases, recognizing parallel paths to the same training adaptation, and generally trying to avoid the major program design mistake of training the sport, not the athlete.

[bctt tweet="All athletes competing in the same sport do not have the same needs."]

This may seem like a simple statement, but the overwhelming majority of training programs are designed based on the demands of a sport, and not the specific needs of the athlete.

More Than Just Exercise Selection

My first exposure to this concept came early in my career when athletes showed up with a unique injury histories that required finding substitutions for exercises that provoked past injury symptoms.

This is certainly a step in the right direction, but effective program design involves a lot more than just picking exercises that won’t hurt.

Simply, exercise selection does not determine the physiological adaptation; loading parameters do.

The table below displays several common loading parameters, and the adaptation stimulus each creates within the athlete.

The same exercise can be used to groove a specific movement pattern, develop muscle size, increase maximum strength, and improve power.

Using movement-based assessments in conjunction with injury history to find exercises the athlete can perform correctly and safely is an important foundational step, but it won’t dictate the athlete’s training outcome.

Acknowledge Individual Goals

Each athlete trains for a different reason.

Some want to get bigger and stronger. Most want to get faster. Some simply want to be healthy (i.e. durable).

A general program with well-thought out phase progressions may lead to improvements in each of these areas, particularly in young and untrained athletes.

However, a general program is unlikely to optimize the development of the qualities the athlete is most interested in improving.

Several years ago, I started asking myself a simple question: “How would my approach change if my entire career depended on the success of this one athlete?”

Prior to wrestling with this question, I had overlooked opportunities to further individualize training programs because I over-emphasized logistical constraints to athletes following different programs within the same group, and frankly, I didn’t realize the results the athletes were getting weren’t as significant as they could be.

Consider two athletes that both have a 12-week off-season. One has a goal of putting on size and strength, and the other just wants to get faster. Will the same program lead to optimal improvements in both areas?

Unlikely.

Fixating on the Destination, Ignoring the Starting Line

Every time I’ve added a new assessment or test to my intake process, I’ve learned something.

For example, early on I thought all that was required to get an athlete to perform an exercise well was good coaching and a little practice.

When I first started implementing movement assessments, it became immediately apparent that athletes had wildly different structures and movement capacities, and that certain athletes simply could not get into optimal positions to perform specific exercises correctly.

Of course, unique characteristics don’t only apply to movement capacity, but to all physical qualities. This became really apparent when I started analyzing team/group test results using aggregate scores.

Aggregate scores combine performance in different tests of the same quality to create a score for that quality. For example, if a testing protocol involves 3-RMs in three different exercises (e.g. Trap Bar Deadlift, Pull-Up, and Bench Press), performance on the three tests could be combined to create a single “Strength” score.

With an appropriately comprehensive testing battery, these aggregate scores provide a very simple and effective tool for identifying the athlete’s performance profile, and communicating areas of need to the athlete.

The graph below presents four different athlete profiles. From left to the right, each column represents performance in Movement Capacity, Speed, Power, Upper Body Strength, Anaerobic Conditioning, and Aerobic Conditioning.

Red and green bars represent position averages and best performances, respectively.


Should these athletes follow the same program?

This process is extremely important for two reasons.

First, the athlete may not be communicating the most optimal training goal.

Athletes express training goals for different reasons. Ideally, the goal would be based on identifying a limiting factor that is preventing the athlete from earning an opportunity to compete at their desired level.

But frequently training goals are arrived at much more arbitrarily. For example, an athlete may want to get bigger and stronger because they have a friend (or older sibling) that is stronger.

Or they say they want to get faster…because that’s what everyone says, even if it’s not their most pressing need.

A comprehensive testing process can help illustrate the athlete’s strengths and weaknesses so decisions about the best training target can be discussed with better context.

Second, the athlete may not possess the fundamental physical capacity to make optimal progress in their desired training goal.

This comes back to a very straight-forward idea: even if the destination is the same, the starting point is not.

In the most simplistic terms, expressing speed requires creating high amounts of force, quickly, in efficient movement patterns.

If an athlete wants to improve speed, but lacks sufficient strength, creating a program that emphasizes improvements in the athlete’s ability to produce force will be the most effective “speed training” program for that athlete.

Alternatively, an athlete with above average speed but severely limited movement capacity may have the right “engine” to be fast, but can’t get into the optimal positions to express that engine’s capacity within efficient sport movements.

As a third example, another athlete may have above average strength and appropriate movement capacity, but simply can’t apply force quickly. This athlete will benefit from a program that emphasizes speed, power, and rate of force development.

Finally, an athlete may simply be under-trained and benefit from a more general program that addresses multiple qualities of need.

This may seem like a hypothetical scenario, but these are the exact cases presented in the graphs above.

Top Left: Lacks sufficient strength.
Bottom Left: Lacks sufficient movement capacity.
Top Right: Lacks speed/power
Bottom Right: Under-trained

Wrap Up

Optimizing an athlete’s training progress requires having an individualized target, and an in-depth understanding of the athlete’s current capabilities. It’s only with a clear vision of both the starting point, and destination that the most effective path can be determined.

The biggest change to my training programs came when I stopped thinking about how I could design the perfect program, and started asking how I could design the best program for a specific athlete to achieve a specific goal.

I’ll leave you with the question that still guides my program design decisions today: “How would your approach change if your entire career depended on the success of this one athlete?”

To learn more about Optimizing Adaptation and Performance from Kevin, Mike Potenza (San Jose Sharks), and James LaValle (authority in nutrition and supplementation), head HERE. It’s on sale for $50 off as an introductory discount, and I’d highly encourage you to give it a watch.

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CSP Elite Baseball Development Podcast: The Evolution of the MLB Strength Coach with Brandon McDaniel

We're excited to welcome Brandon McDaniel, the Los Angeles Dodgers Director of Athletic Development and Performance Science, to this week's podcast. In this episode, we discuss the how the role of the MLB strength and conditioning coach has changed over the past decade, and Brandon offers suggestions to both up-and-coming players and strength and conditioning professionals.

A special thanks to this show's sponsor, Marc Pro. Head to www.MarcPro.com and enter the coupon code CRESSEY at checkout to receive 10% off on your order.

Show Outline

  • What Brandon’s journey was to become an MLB strength coach, and how he
    has ascended to his current role with the Dodgers
  • How Brandon’s versatility in strength training and baseball related skills impacted the progression of his career and why coaches should strive to wear multiple hats as a professional
  • Why young coaches should work to be generalists and bring value to the organizations they work for by being open to opportunities and striving to understand multiple facets of their work experience
  • What Brandon’s biggest areas for growth were as he progressed to be a big league strength coach
  • What the biggest adjustment was that Brandon had to make as he transitioned from working in the private sector into professional baseball
  • How has the role of strength and conditioning and the world of professional baseball changed in recent years
  • What areas should strength coaches strive to understand outside their field of expertise
  • Why coaches need to delineate between sports tech and sports science and how coaches can use information collected by technology to intervene effectively with athletes
  • How Brandon integrates the implementation of technology and data alongside quality communication and a solid athlete-coach relationship to monitor workload and formulate a recipe for success with each of his athletes
  • Why coaches should avoid being extremist when incorporating sports tech with their players and allow players to explore and find their sweet spot for workload and stress management
  • How strength coaches can handle the challenges they face as athletes return from their off-season
  • What the Dodgers are doing to make the organization a perennial playoff contender
  • How the Dodgers have created consistency and continuity throughout their organization
  • How Brandon and the rest of the Dodgers staff manage the demands of travel for the team throughout the year
  • What wisdom Brandon always try to impart on his professional ballplayers, specifically in nutrition and strength and conditioning
  • What the most impactful lesson Brandon has learned from his athletes is

For more information about the Los Angeles Dodgers Strength and Conditioning Symposium, click here.

Sponsor Reminder

This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself with their new "Try Before you Buy" program, and use promo code CRESSEY at checkout at www.MarcPro.com for 10% off on your order.

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!

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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Strength and Conditioning Stuff You Should Read: 10/28/19

I hope you had a great weekend. It's that time of the week again! Here's a little recommended reading and listening to kick off your week:

Optimizing Adaptation and Performance -This is a new resource from Mike Potenza (San Jose Sharks), Kevin Neeld (Boston Bruins), and James LaValle (authority in nutrition and supplementation) that provided some excellent insights for any health and human performance professional. I was fortunate to receive advanced access, and it's been fascinating. It's on sale for $50 off this week as an introductory discount.

EC on the Complete Sports Performance Podcast - Lee Taft interviewed me to learn more about how I got into the baseball niche, and what important considerations are present with this population.

Is Authenticity Overrated? - Pete Dupuis is my business partner at CSP-MA, and he's got a keen eye for culture in light of how ours has developed over the years. This writeup on authenticity fits right into that world.

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CSP Elite Baseball Development Podcast: Refining Rehab Approaches with Eric Schoenberg

We're excited to welcome physical therapist Eric Schoenberg to this week's podcast. Eric has extensive experience working with individuals from all walks of life, but specializes in working with baseball players. He'll serve as the physical therapist at the soon-to-open Cressey Sports Performance location in Palm Beach Gardens, FL starting on November 1 as well. In this episode, we discuss the typical challenges baseball players can see movement-wise, as well as how the rehab process can be improved across all populations.

A special thanks to this show's sponsor, Marc Pro. Head to www.MarcPro.com and enter the coupon code CRESSEY at checkout to receive 10% off on your order.

Show Outline

  • How Eric has evolved as a physical therapist since graduating from PT school
  • How learning to never settle for mediocrity and working to be more familiar with the world of strength and conditioning through CSP has allowed Eric to advance his physical therapy career
  • How being a high quality physical therapist involves appreciating the art of physical therapy as much as the science of the field
  • How Eric became an early adopter of Shirley Sahrmann’s work on movement system impairment syndromes
  • Why young physical therapists and health professionals should work to create their own philosophy for analyzing movement proficiency and how having a model for analyzing movement can help them make better decisions for their clients
  • Why has Eric deviated from the standard time-restricted, semi-private PT model and instead adopted a one-on-one, private model
  • Why the rehabilitation world should move away from its generalist perspective and encourage practitioners to specialize and refer out to others who have more experience rehabilitating a specific injury
  • Why experts need to drop their ego and be open to working with other professionals across the scope of health and human performance
  • What the most common movement impairments Eric sees in baseball players are
  • Where the biggest mistakes occur in the interaction between rehab specialists and strength and conditioning coaches
  • How being a father has influenced Eric’s perspective on youth athletics, the little league experience, and lifelong movement health
  • What big mistakes Eric is seeing in post-op baseball cases
  • How Eric manages transitioning athletes from being completely in the rehab setting back to training at full health over the course of the rehab process
  • What research Eric has been studying to continue to advance his career, and what books he recommends to all health professionals

You can follow Eric on Twitter at @CSP_PhysTherapy and on Instagram at @CSP_PhysTherapy. To contact him directly, you can email eric@diamondphystherapy.com.

Sponsor Reminder

This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself with their new "Try Before you Buy" program, and use promo code CRESSEY at checkout at www.MarcPro.com for 10% off on your order.

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!

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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Strength and Conditioning Stuff You Should Read: 10/21/19

With the crazy baseball offseason underway and us in the thick of construction for the new facility in Palm Beach Gardens, FL, I haven't had a ton of time to write up new content. I have, however, continued to consume a lot of other peoples' stuff! Check out some good reads and listens from around the 'net:

Boo Schexnayder on the Complete Sports Performance Podcast - I thought this was an outstanding interview by Lee Taft with Boo, as they delved into topics like acceleration programming and plyometric progressions. It was a good reminder that one of the best characteristics of an elite coach is the ability to simplify even the most complex topics.

Be Like the Best - Anthony Renna did an amazing job pulling together this compilation of career advice from around the fitness industry. I'm was one of the interviews, and am currently working my way through it - and am picking up some great nuggets myself!

Yoga for Athletes: What Activation and Inhibition Matter More Than Stretching - I got a question about my thoughts on yoga for baseball players the other day, and it immediately reminded me that I should reincarnate this old article from my friend Dana Santas. She does a great job of relating the most important concepts for athletic populations when they undertake yoga.

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CSP Elite Baseball Development Podcast: Making Sense of Supplements with Angie Asche

We're excited to welcome sports dietitian Angie Ashe to this week's podcast. Angie does an outstanding job with nutritional counseling for a variety of athletes, and has a lot of experience working with baseball players in particular. In this episode, we delve into the controversial topic of nutrition supplementation.

A special thanks to this show's sponsor, Marc Pro. Head to www.MarcPro.com and enter the coupon code CRESSEY at checkout to receive 10% off on your order.

Show Outline

  • How Angie goes about starting nutritional conversations with her athletes and teaching them what they can do before looking to dietary supplements
  • Why athletes should be maximizing what they are eating and drinking before worrying about what supplements they should be taking
  • What supplement story initially sparked Angie’s interest in the world of supplements as a dietician
  • Where athletes can be misguided by the hype around supplements
  • What supplements Angie sees as must-haves in all peoples’ diets
  • What boxes Angie looks to check before recommending dietary supplementation in youth athletes
  • Why individuals need to be aware of the post-market testing model exploited by the supplement industry in order to understand the importance of buying third party verified products
  • How being conscious of ingredients on supplement labels can make it easier for consumers to identify safe and ethical supplements
  • What supplements are a complete waste of money
  • What athletes need to know about popular supplements such as BCAAs, collagen powders, probiotics, and glutamine
  • What to look for and stray away from when investing in protein powders
  • What guidelines Angie recommends for consuming creatine and how it can be used to improve athletic performance
  • With the heightened popularity of preworkout and energy drinks, why athletes should be cognizant of the source of their caffeine consumption and what Angie recommends for caffeine intake in one’s diet
  • What research says about the benefits of drinking coffee and how obtaining caffeine from healthy sources is often overlooked for healthy living and improving human performance
  • How individuals should be concerned about consuming more processed protein sources as more people are moving away from animal consumption and towards alternative diets
  • Where Angie goes to learn more about nutrition and stay up to date on the research of the field
  • What Angie’s go-to smoothie is for skinny individuals looking to gain weight
  • Where Angie sees future research in the nutrition community heading

You can follow Angie on Twitter at @EleatNutrition and on Instagram at @EleatNutrition.

Sponsor Reminder

This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself with their new "Try Before you Buy" program, and use promo code CRESSEY at checkout at www.MarcPro.com for 10% off on your order.

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!

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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Strength and Conditioning Stuff You Should Read: 10/14/19

We're long overdue for a recommended reading/listening feature, so here goes!

Does "Feel" Matter with Core Stability Exercises? - I had a good conversation with one of our adult clients on this one just last week, and it reminded me to reincarnate this from the archives.

Ian Kadish on Athleticism, Work Capacity, and Arm Care in Baseball - This was a great podcast from Mike Robertson with my buddy, Ian Kadish. Ian did a great job in his first year as strength and conditioning coach for the Minnesota Twins in 2019.

The New Frontier in Baseball Rehab: Part 1 - This was a good podcast that serves as an excellent follow-up to my chat with Alan Jaeger a few weeks ago. Alan and Josh Heenan delve in further on the topic of rehab throwing programs on the Robby Row Show.

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CSP Elite Baseball Development Podcast: Rick Ankiel

We're excited to welcome retired MLB pitcher and outfielder Rick Ankiel to this week's podcast. Rick's incredible story has been the feature of multiple documentaries, and he has some awesome insights to share for players, coaches, and parents. A special thanks to this show's sponsor, Marc Pro. Head to www.MarcPro.com and enter the coupon code CRESSEY at checkout to receive 10% off on your order.

Show Outline

  • What Rick’s experience was like as he battled command issues as a young pitcher for the St. Louis Cardinals
  • What the initial stages of Rick’s mental struggles as a pitcher were
  • How Rick made his comeback from the yips as a pitcher in 2005, and what strategies and routines he implemented that were most impactful for his consistency on the mound
  • How identifying what variables he could and couldn’t control and keeping baseball simple helped Rick find mental stability as a player
  • How organizations are evolving in how they prepare their young draft picks to be successful baseball stars of the future
  • What the mental concerns are for young stars as they ascend to the big league stage
  • Why players need to establish their circle of trust to be successful in professional baseball, and what strategies young players can implement to find security in their early career
  • What Rick’s advice is for the young draft picks and prospects
  • How the obsessive pursuit of excellence in baseball leads players to being consumed by their shortcomings and defined by their career on the field
  • How a player’s reluctance to care can be a defining factor of their likelihood to succumb to the mental dilemmas like the yips
  • What the biggest misconception about the yips is
  • How coaches and teammates of a struggling athlete can work to better identify those who need help and implement steps to make a real difference
  • How being genuine with ballplayers and asking “What can I do to help you?” can start a powerful conversation towards aiding in someone’s mental state
  • What was the difference for Rick was in preparing for games as a pitcher and a hitter
  • How Rick approached his throwing program as he transitioned from being pitcher to an outfielder
  • What the biggest adjustment Rick had to make as he has transitioned to a career in broadcasting

You can follow Rick on Twitter at @TheeRickAnkiel and on Instagram at @TheeRickAnkiel. And, be sure to check out his awesome book, The Phenomenon.

Sponsor Reminder

This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself with their new "Try Before you Buy" program, and use promo code CRESSEY at checkout at www.MarcPro.com for 10% off on your order.

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!

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

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Random Thoughts on Sports Performance Training – Installment 35

It's a new month, so here's a new installment of Random Thoughts on Sports Performance Training. This month, it won't be quite so random, as I want to hone in on shoulder stuff because today is the last day to get $40 off on my popular resource, Sturdy Shoulder Solutions. Just head to www.SturdyShoulders.com and enter coupon code OFFSEASON19 to get the discount.

Now, let's get to the new content:

1. The neck is the easiest place to start with cleaning up shoulder movement.

I've written a lot in the past about how our arm care programs work proximal to distal, meaning that we focus on the center of the body before the extremities. Usually, the right proximal changes yield immediate distal improvements both via reducing protective tension and reducing stiffness in the muscles we're trying to "overpower" to create good movement. Usually, though, when it comes to proximal changes, folks look at the thoracic spine and rib cage only. In reality, the cervical spine ought to take precedence over both of them - particularly because all the nerve of the upper extremity originate from the brachial plexus, which ranges from C5 to T1.

Fortunately, while it might be anatomically correct, coaching optimal positioning in the neck is actually very simple in the context of weight training and arm care drills: get it to neutral and keep it there. In 99% of cases, that means getting people out of upper cervical extension, which fires up the levator scapulae (which competes against all the scapular upward rotation we want). Here's a video that walks you through what you need to know:

The thoracic spine and rib cage are sexy right now, but the cervical spine is an older, reliable option for cleaning up movement quickly in just about everyone.

2. Whenever possible, get core control integrated in your arm care drills.

I often come across arm care protocols that literally have athletes laying on a table for 30 minutes worth of "exercise." This not only leads to a disengaged athlete, but also overlooks the fact that the entire kinetic chain needs to be synced up to keep a shoulder healthy. We'll often use predominantly table-based exercises in month 1 to make sure athletes are picking up the technique in a controlled environment, but in almost all scenarios, these table drills are actually "fillers" between sets of strength training exercises that have the athletes up and around in the gym.

More importantly, after that first month, I try to make sure that at least half of our arm care exercises are done separate from the table. Maybe we do our horizontal abductions in a side bridge position, or integrate more bottoms-up carries or bear crawls for serratus activation. Perhaps the prone trap raises take place on a stability ball, or we shift to a TRX Y instead. Or, we could move the athlete to half-kneeling, split-stance, or in a rear-foot elevated position for their 90/90 external rotation holds.

Regardless of what we choose, the buy-in from athletes is definitely better - and just as importantly, the resulting training effect has a more specific carryover to sporting success.

3. Yet another study reminds us that GIRD is a measurement and not an actual pathology.

Glenohumeral internal rotation deficit (GIRD) was all the rage in the baseball sports medicine community for decades. Unfortunately, what many practitioners fail to appreciate is that GIRD can be a completely normal finding as long as an individual's total motion is symmetrical between throwing and non-throwing shoulders. We expect to see less internal rotation and more external rotation in a throwing shoulder because of retroverion in the throwing shoulder; the arc is just shifted. Here's a glimpse at what it looks like:

 

Today is Day 12 of #30DaysOfArmCare. Thanks to #Tigers pitcher @adamrav12 for the assist! Key takeaways: 1. Retroversion is a common finding and throwing shoulders. It gives rise to greater lay-back at max external rotation. 2. The more passive range of motion you have, the more consistently you must work to maintain active stability of that ROM. ROM without stability is injury risk. 3. Perform your cuff work in the positions that matter - and keep in mind that individual differences in passive ROM may be present. 4. Don't stretch throwers into external rotation, especially if they already have this much lay-back! Follow #30DaysOfArmCare and @cresseysportsperformance for more tips to keep throwing arms healthy. #cspfamily #armcare #baseball #mlb

A video posted by Eric Cressey (@ericcressey) on

Anyway, we are now at a point in time where more and more research on GIRD is out there, and it's pretty resounding: it doesn't predict injury as well as we once thought. And, more importantly, the opposite seems to be true: a loss of external rotation (usually from a combination of less retroversion and soft tissue limitations) equates to a greater injury risk. We need to get more of the "GIRD? So What?" literature into the hands of doctors who aren't familiar with the latest research, as many are still making "GIRD" diagnoses when they really are just range-of-motion measurements. I delve into this in great detail in the Sturdy Shoulder Solutions product, but figured another study reiterating the point can't hurt. This one - Relationship Between Glenohumeral Internal Rotation Deficit and Medial Elbow Torque in High School Baseball Pitchers - just found that GIRD wasn't associated with medial elbow torque in high school pitchers.

It's time to move on from GIRD!

4. If you're about to have shoulder surgery (or any surgery), get your Vitamin D checked.

For years, we've known that having an adequate Vitamin D status was important for a myriad of biologic functions. Perhaps the most well known among observations on this front was a 2015 study of NFL players that demonstrated that players with inadequate preseason Vitamin D levels were more likely to have suffered a lower extremity or core muscle injury. In fact, the likelihood of a hamstrings injury was 3.61 higher in those with inadequate vitamin D levels! As such, it's become a big area of focus in the nutrition and supplementation world for athletes.

However, I've honesty never heard of an orthopedic surgeon looking at it for those who either have chronic pain or are about to undergo a surgical intervention to treat a structural defect. We need to change that, though. A recently published study, Preoperative Vitamin D Deficiency Is Associated With Higher Postoperative Complications in Arthroscopic Rotator Cuff Repair, should help in that goal, though. Patients with pre-operative Vitamin D deficiency were 1.54 times more likely to require a revision surgery and 1.16 times more likely to require manipulation under anesthesia to overcome post-op stiffness.

Clearly, Vitamin D has a huge link to soft tissue health, so don't overlook it!

Wrap-up

I'm a shoulder nerd and could ramble on all day on this stuff, but instead, I'll direct you to check out Sturdy Shoulder Solutions, particularly at the great $40 off discount we've got in place through tonight at midnight. You can learn more at www.SturdyShoulders.com.

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Should You Chase Shoulder External Rotation – And If So, How?

Each time I run an Instagram Q&A, I get a few high school baseball players who ask how they can increase shoulder external rotation for throwing. The answer really depends on a few things, so here's a video to walk you through them.

Also, as a friendly reminder, Sturdy Shoulder Solutions is on sale for $40 off through this Sunday at midnight. Just enter coupon code OFFSEASON19 to receive the discount at checkout at www.SturdyShoulders.com.

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