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Acumobility Self Care for the Neck – Part 5

Today is the fifth and final installment of my video series on self care for the neck and upper extremity with the Acumobility Ball. In this edition, I cover the upper traps with a four-minute video, as this approach isn't right for everyone. Don't forget that you can get 10% off on this great soft tissue tool with the coupon code cressey at www.Acumobility.com.

Thanks for sticking with me for all five videos! I hope you enjoyed them and derived some benefit.

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Acumobility Self Care for the Neck – Part 4

Today is part 4 of my series on how we utilize the Acumobility Ball for self myofascial release in the neck and upper extremity. Here, I cover the coracoid process, an attachment point for pec minor, coracobrachialis, and the short head of the biceps. Don't forget that you can get these great soft tissue resources for 10% off by using the coupon code cressey at www.Acumobility.com.

I've got one more video coming up for you tomorrow, so stay tuned!

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Acumobility Self Care for the Neck – Part 3

It's time for part 3 of my series on how we utilize the Acumobility Ball for the neck and upper extremity. Today, I cover another overlooked muscle: subclavius. Before we get to it, remember that you can get these great soft tissue resources for 10% off by using the coupon code cressey at www.Acumobility.com.

I'll be back soon with another video to keep this series going.

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Acumobility Self Care for the Neck – Part 2

Today, I've got the second video in my series on how we utilize the Acumobility Ball to perform self myofascial release in the upper extremity - and, in particular, the neck. As a reminder, the crew at Acumobility have been kind enough to provide my readers with 10% off by using the coupon code cressey at www.Acumobility.com. Today, we'll talk about the scalenes.

I'll be back soon with another video to keep this series going.

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Acumobility Self Care for the Neck – Part 1

In a recent Instagram post, I discussed how big of a fan I am of the Acumobility ball, and I got a lot of questions about how we integrate it for upper extremity and neck self-care. With that said, I wanted to kick off a series this week with a look at where we start when it comes to implementing this tool. The good folks at Acumobility have been kind enough to provide my readers with 10% off by using the coupon code cressey at www.Acumobility.com.

To kick things off, let's talk about functional anatomy and self myofascial release for the sternocleidomastoid (SCM):

I'll be back soon with a new video to keep this series going.

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Strength and Conditioning Stuff You Should Read: 1/12/18

I hope you're having a good week. I'm shifting this series to later in the week because I'm doing more of my writing on Sundays these days, so look for Thu/Fri "round-up"posts from here on out. Here are some good reads from around the 'net over the past week:

EC on the Seams Legit Podcast - This is a two-part interview I did with Nick Friar. We discuss baseball development and our work with (among others) Corey Kluber, Max Scherzer, and Noah Syndergaard.

8 Lessons from Lab Assisting for PRI Courses - Miguel Aragoncillo offered some awesome insights on how to make the most out of your attendance at continuing education events.

What Your Doctor Never Told You About Arthritis - This was a good guest post from Dr. Michael Infantino for Tony Gentilcore's site.

Top Tweet of the Week

Top Instagram Post of the Week

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Performance Programming Principles: Installment 2

As I promised back in November, I've decided to dedicate a regular series to the principles that govern a lot of our program design at Cressey Sports Performance. Here's the second installment:

1. A few positional breathing drills can be a game changer, but don't let them take over the training session.

Positional breathing drills have really surged in popularity in recent years, largely thanks to the great work of the folks at the Postural Restoration Institute. Forceful exhalation in certain positions can both activate certain muscles and inhibit others. Take, for instance, TRX Deep Squat Breathing with Lat Stretch.

We're firing up several muscles of exhalation: rectus abdominus, external obliques, serratus anterior - and toning down our lats, rhomboids, lumbar extensors, and calves (to name a few). It's not uncommon for folks to get up from this exercise after 30 seconds and feel dramatically different.

That said, as is often the case in the fitness industry, if a little is good, then a lot must be better, right? It didn't take long for us to find the zealots who are spending 30 minutes doing positional breathing at the start of every training session. It's somewhat analogous to the folks who foam roll for an hour every day.

You're better off doing 1-2 breathing drills at the start of a warm-up (and possibly as a cool-down) and then following it up with good resistance training technique to make those transient changes "stick." Patience and persistence always win out over short-term "overindulgence."

2. Follow these two great Selective Functional Movement Assessment (SFMA) strategies.

SFMA was one of the better courses I've taken in the past few years, and two programming principles they discuss really stand out:

a. Chase dysfunctional, non-painful patterns first.

Let's say someone walks in with a cranky shoulder that's limited into internal rotation: a dysfunctional, painful pattern. If you just throw caution to the wind and stretch that shoulder into internal rotation, more often than not, you're going to flare things up even further.

Let's say that individual also has a pronounced scapular anterior tilt and very limited thoracic extension and rotation. If you do some soft tissue work on pec minor and work in some thoracic spine mobilizations, there is a  very good chance that when you go back to retest shoulder internal rotation, it'll be improved and pain-free. Sometimes, the best way to get from A to B is through C or D.

b. Find and address areas were passive range-of-motion far exceeds active ROM.

There's a reason a lot of gymnasts and dancers retire with stress fractures in their lower backs; they have a lot of passive range-of-motion, but not always much motor control to stabilize those ranges of motion. This is why it's important to have assessments that test both passive and active ROMs (straight leg raises and supine vs. standing shoulder flexion are great examples). And, you need to have training initiatives that build control in those passive ranges.

3. Check out the Acumobility Ball.

I posted this on my Instagram and thought it might be of interest. The Acumobility Ball has been a game changer for us. You can save 10% on it at www.Acumobility.com with the coupon code cressey.

Here's a little example of how we'd use it on the pec minor/coracobrachialis/short head of biceps attachments on the coracoid process.

4. There's nothing that says you have to progress or regress programming - and there are many different ways to make lateral moves.

As few years ago, Charlie Weingroff coined the term "lateralizations" for times when you don't progress or regress an exercise, but rather, move laterally.

An example would be something along the lines of going from a standing 1-arm cable row to a split-stance 1-arm cable row. There really isn't any change to exercise complexity, but it does give the trainee some variety in their programming.

I'd say that lateralizations are the most useful with adult clients who don't have crazy lofty fitness goals - and therefore aren't interested in taking on a ton of risk in their training programs. They might not crave being sore all the time from all the innovative new exercises you can throw at them. Lateralizations can keep training fun via novelty without adding a steep learning curve.

Additionally, remember that exercise selection isn't the only way to progress or regress the challenge to the athlete or client in front of you. You can increase or decrease volume, alter the tempo, modify the load, or adjust the rest intervals.

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The Best of 2017: Baseball Articles

With baseball athletes being the largest segment of the Cressey Sports Performance athletic clientele, it seems only fitting to devote a "Best of 2017" feature to the top baseball posts from last year. Check them out:

1. 6 Key Factors for Developing Pitchers - In this article, I look at some things I've learned from some of our peak performing pitchers at the MLB level - and how they can help up-and-coming players.

2. Are Pitching Mechanics Really That Repeatable? - We hear the phrase "repeat your mechanics" pretty often, but you'll be surprised at how hard (or impossible) that really is to do.

3. Sports Performance: Study the Majority, and Stop Cherrypicking Exceptions to the Rule - The baseball community loves to try to build theories off of small sample sizes when we all should be looking at the majority to see what works.

4. A Letter to This Year's MLB Draft Picks - There are lots of life lessons in here for more than just baseball players.

5. Overlooked Uses for a J-Band: Part 1 and Part 2 - Here are some innovative ways that we use this awesome piece of equipment.

We've got one last "Best of 2017" list running tomorrow, so stay tuned for the closer!

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Should We Really Contraindicate ALL Overhead Lifting?

At a seminar a few weeks ago, a college pitching coach said to me, "Well, I know that you don't like overhead lifting for pitchers, so what do you do instead?"

It's something that's falsely been attributed to me in the past, so let me go on the record by saying that I don't think all overhead lifting is created equal. Rather, I think there is a continuum we have to appreciate as we select exercises for our clients and athletes.

At the most aggressive end of the spectrum, we have overhead pressing with a barbell or dumbbells. They allow a lifter to take on the most load, and in the case of the barbell, they have the least freedom of movement (especially if we're talking about a Smith machine press). Moreover, they generally lead to the most significant compensatory movement, particularly at the lower back. I don't love these for baseball players, but don't have any problems with using them in healthy lifters from other walks of life.

However, in these more at-risk populations, we have some options as more shoulder friendly exercises that can deliver a great training effect. The bottoms-up kettlebell military press delivers a slightly different training effect more safely because more of the work is devoted to joint stability. And, I've found that the bottoms-up set-up helps the lifter to engage serratus anterior more to get the scapula "around" the rib cage.

Landmine presses are another good alternative, as I see them as a hybrid of horizontal and vertical pressing. The torso angle and "lean" into the bar help to optimize scapular upward rotation with less competing directly against gravity.

Bottoms-up carries and waiter's walks are also good options for driving overhead patterning without beating up on the joint. We use them all the time.

Regressing even further, something like a yoga push-up is technically an overhead lift because of the finish position.

So, the take-home message is that I'm not against overhead lifting; in fact, we do it all the time on a number of fronts. Moreover, these examples don't even take into account things like TRX Ys, pull-ups, and overhead medicine ball throw/stomp variations - all of which we incorporate on a daily basis with our athletes and general population clients. Not all overhead work is created equal!

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Checks and Balances in the Shoulder of the Throwing Athlete

For today's guest post, I've collaborated with physical therapist Eric Schoenberg, one of my co-presenters at the Elite Baseball Mentorship. Enjoy! -EC

The #1 reason why a player or team does not succeed in baseball is injury. Today, there is a surplus of information, but at the same time a lack of basic understanding of how to keep a baseball player healthy. When in doubt, you can never go wrong by understanding and relying upon anatomy and quality human movement.

One key principle to understand in this regard is that there is a tremendous system of checks and balances working at the shoulder girdle to make sure that we control both the big movements (osteokinematics) and subtle joint movements (arthrokinematics) in a small window for health and performance. If we look to anatomy, we can appreciate a very important concept by looking at the attachment points for the deltoid, latissimus dorsi, and pectoralist major: your three biggest prime movers in the upper extremity. You'll notice that all three attach on the shaft of the humerus, not the humeral head. Take a look at their attachment sites on this anatomical chart, and then compare them to where the rotator cuff (supraspinatus, subscapularis, teres major, and teres minor) attach further up on the humeral head.

Source: http://howtorelief.com/humerus-anatomy-bony-landmarks-muscle-attachment/

You can appreciate that all these big muscles attach on the anterior (front) aspect of the humerus, which means that they have powerful pulls into internal rotation that have to be counteracted by fewer, smaller muscles that attach on the posterior (back) aspect of the shoulder.

Here are three specific implications of these anatomical observations that relate to how you manage your throwing athletes:

1. The Deltoid is strong/active enough!

The deltoid works in conjunction with the supraspinatus to form a “force couple.”

Source: www.MikeReinold.com

If the strength, recruitment, or timing of the deltoid is greater than the supraspinatus, then the result will be superior migration of the humeral head in the glenoid. This results in superior humeral head stress (chondral defect), undersurface rotator cuff tear, labral pathology, among other structural injuries to the glenohumeral joint.

Tip: Be sure that athletes feel rotator cuff strengthening exercises in the cuff and not the deltoid or biceps.

2. The lat is strong/active enough!

The lat (as it acts on the scapula) is opposed by the serratus anterior, lower trapezius, and upper trapezius to control scapular rotation. Increased relative stiffness of the lat results in excessive scapular depression and downward rotation at rest.

Additionally, if you have decreased activation or muscle performance of the scapular upward rotators and elevators with overhead motion, the outcome will be inferior migration of the glenoid on the humeral head.

This results in superior humeral head stress (chondral defect), undersurface rotator cuff tear, labral pathology, among other structural injuries to the glenohumeral joint.

Tip: Be sure that the athlete’s programs have a good balance of overhead reaching tasks done with proper mechanics and timing of the glenohumeral and scapulothoracic joints.

3. The pecs are strong/active enough!

Pectoralis major's impact on the anterior glenohumeral joint is opposed by the rotator cuff to prevent anterior humeral glide. Effectively, the pec and lats want to pull the ball forward on the socket as the arm goes through gross movements, and the rotator cuff works hard to prevent this gliding at the joint level.

Dominance of pec major over the rotator cuff muscles (namely subscapularis) will play a role in an athlete presenting with anterior humeral glide. We often hear the athlete report “tightness” in the front of the shoulder and their first option is to "stretch it."

This can lead to anterior shoulder pain and potential structural pathology including anterior joint laxity, biceps tendon pathology, and labral pathology – all common injuries in throwing athletes.

Tip: Rather than trying to decrease the “tightness” in the front of the shoulder by aggressively stretching—instead, focus on improving static alignment, proprioceptive awareness, and recruitment of the cuff. If you couple this with some self-massage work, this approach will yield far more favorable results.

In closing, the shoulder joint is happiest when alignment is optimal. Injury will occur if preferred alignment is altered. Examples of altered alignment at rest or with movement are the humeral head is riding too high in the socket, the socket is riding too low on the humeral head, or the humerus is gliding too far forward. The resultant stress to the active or passive restraints of the shoulder leads to injury and loss of playing time. Do yourself (and the players that you work with) a favor and master the basics to help improve success on the field.

Looking to learn more about our unique approach to assessing and managing throwing athletes? Check out the upcoming Elite Baseball Mentorship Upper Extremity Course on January 14-16, 2018. For more information, click here.  The early-bird registration discount ends tonight at midnight.

About the Co-Author

Eric Schoenberg (@PTMomentum) is a physical therapist and strength coach located in Milford, MA where he is co-owner of Momentum Physical Therapy. Eric is addicted to baseball and plays a part in the Elite Baseball Mentorship Seminars at Cressey Sports Performance. He can be reached at eric@momentumpt.com.
 

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