With football season now officially over, loads of sports fans are now turning their attention to the fact that pitchers and catchers "reported" this week, signifying the start of spring training and a new Major League Baseball season. Truth be told, most college programs will have already started their seasons - and many high school programs will be playing official games - before the big leaguers start having regular season contests.
Unfortunately, with the start of a new season comes injuries...and lots of them. In fact, according to researchers who examined MLB injury statistics from 2002 through 2008, professional baseball players are 10.6 times more likely to get injured in April than they are in September. In other words, they are far more likely to get hurt because they haven't prepared adequately for specificity than because they've had too much specificity.
Think about that for a second. By the time September rolls around, most MLB players have logged 150 games between spring training and regular season play. On a regular basis, they've fouled balls off their feet, gotten hit by pitches, made 100 slides, attempted dozens of diving catches, and sprinted full-tilt when they aren't warmed-up thoroughly after standing around doing nothing for a few innings. Pitchers have logged hundreds of innings, in some cases, and catchers are sick of squatting for hours on end. Yet, guys are dropping like flies in April, when they're supposed to be the most fresh.
Huh?
There are four legitimate reasons that this is happening.
First, rosters expand in September, so teams can easily keep a guy with a minor injury on the roster without putting him on the disabled list, which would make him "officially" hurt. However, this doesn't explain why August injury rates are still dramatically higher than April's.
Second, the weather is colder - which means it's tougher for guys to stay warm and loose during early season games. This doesn't explain the high injury rates we see in spring training, though, as all games take place in Arizona and Florida.
Third, guys may be ramped up too quickly. Too many swings or throws in a short period of time may be the problem - but this really isn't something that can be changed, as guys need to become game ready, getting their timing, coordination, and mechanics down cold while they've got proper coaching at hand.
Fourth (and this is the main message of this article), guys simply aren't preparing correctly in the off-season with their baseball strength and conditioning programs. They may not be showing up with the right mobility and stability in the right places, or they may simply be waiting too long to start throwing, hitting, or sprinting. This happens all the time at the high school, college, and professional levels.
In the high school ranks, kids may be winter sports athletes, and not pick up a ball until a week or two before tryouts. Or, they may have just lifted weights all winter, but not done enough sprinting or mobility work.
In the college ranks, some athletes will skip throwing and hitting altogether over winter break - and then wind up with issues when they return to campus and ramp up quickly to prepare for the start of the season.
Finally, in the professional ranks, many players simply wait too long to start baseball activities. You can lift all the weights you want, throw medicine balls, sprint, take yoga classes, and participate in any of a number of other general training modalities, but nothing prepares you for being in baseball cleats and hitting, throwing, taking ground balls, or shagging fly balls for hours on end - and doing so every day of the week. It's why I encourage our professional baseball crew to always get started on these things well in advance. Guys might start playing catch as early as Thanksgiving, start hitting off a tee in early December, and start working on defensive drills when January rolls around. And, we'll do movement training - sprinting, change of direction drills, ploys - throughout the off-season. We don't add everything at once; instead, we gradually introduce a more and more baseball-specific stimulus as the off-season progresses so that nobody gets surprised when they show up to spring training; it should feel like a breeze.
So, with anywhere from a few weeks to a few months of your off-season remaining, make sure you're not just getting bogged down in the weight room. Keep in mind that you lift weights to stay healthy on the field and improve performance, not just for the sake of lifting weights. Look for more and more specificity in your programming with increased participation in baseball activities - but not so much that it becomes a "too much, too soon" scenario. And, keep an eye out for the media reporting on loads of hamstrings, hip flexor, adductor, and oblique strains in the months to come, as it's a sign of the season!
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Anyone who has ever broken or burned a finger will tell you that you just don't appreciate how much you use your hands until you don't have access to one for a bit. Obviously, you partially lose your ability to do things - but what many folks might not appreciate is that you also lose some of your ability to sense things, as the hands contain a tremendously amount of sensory receptors relative to the rest of the body. In fact, the tiny folds in our skin on the fingertips that comprise the fingertip are there because they increase the surface area of the hands - which allows us to get more sensory receptors where we need them. Cool stuff, huh?
Why then, do we not give the hands any love when it comes to soft tissue work? We'll foam roll our hip flexors, lats, and other large muscle groups (which are certainly valuable), but we'll ignore one of the most sensory-rich parts of our body - and one that is constantly active (and overused, in some cases) throughout the day. We grip, type, and flip people the bird - but we never really pay attention to soft tissue quality in this region...until today, that is.
If you look at the structure of the hand, you'll see that it has a large fascial, the palmar aponeurosis (we'll call it the palmar fascia to keep things simple). This structure has an intimate relationship with the muscles/tendons and ligaments of the hand, and serves as a link between the forearm and fingers.
Based on the size alone, you can see that it has plantar-fascia-caliber importance even if it isn't weight bearing. You see, of the five muscles that attach via the common flexor tendon on the medial epicondyle at the elbow, four cross the wrist joint and palmar fascia on the way to the hand, where they work to flex and abduct or adduct the wrist, and flex the fingers.
Loads of people have tendinopathies going on up on the medial elbow (Golfer's Elbow), but they only work on this spot (called a zone of convergence). Meanwhile, the soft tissue quality might be just as bad further down at the wrist and hand, adding tension on an already over-burdended common flexor tendon. Think about it this way: if you had a pulled hamstring up by your glutes, would you only work to improve tissue quality at that spot, or would you work all the way down to the posterior knee to make sure that you'd improved some of the poor tissue quality further down as well?
Below, massage therapist and Cressey Performance coach Chris Howard talks you through two different ways to work out the kinks in the palmar fascia and surrounding regions, but keep in mind that it'll always be more effective to have a qualified manual therapist do the job - and that's certainly someone you should see if you have any symptoms whatsoever.
We've found that quite a few of our pitchers comment on how the ball seems to come out of their hand easier after this work. Usually, they're the guys who have the most stiffness along the forearm, particularly into wrist extension and supination.
Give it a shot at your desk at work and see how it feels.
At Cressey Performance, we're getting to the time of the year when things gradually start to slow down for us. For many business owners, this is a source of frustration, as they worry about paying the bills when things get quieter. I, on the other hand, view it as a source of excitement, as it signifies that the beginning of baseball season is at hand, and our athletes will have an opportunity to put all their off-season hard work into action on the baseball field.
You'd be surprised, however, at how many collegiate and professional players get genuinely worried about how they'll be managed once they get back to school or their organizations. In the private sector, we can individually manage guys with their unique needs in mind, but in collegiate and professional, because of the larger volume of athletes (and fewer coaches per athlete), limited training time, and additional competing demands (i.e., practicing and playing games), player development can be quickly stunted. Believe it or not, 2012 was the first year that Major League Baseball mandated that every minor league affiliate have a strength coach on staff; many teams didn't have anyone (in-person, at least) watching over their highly-touted prospects during critical minor league development periods.
That said, though, there are some colleges and professional organizations who are doing a solid job of managing guys - and I wanted to use today's post to highlight four areas in which they're getting the job done effectively.
1. Synergy - As I outlined in Weight Training Programs: You Can't Just Keep Adding, we have a limited recovery capacity, so if you're going to add something to a program, you have to take something away. Unfortunately, this "give and take" gets overlooked in some team settings. As an example, a strength and conditioning coach, athletic trainer, and pitching coach might all prescribe different rotator cuff exercises for their players without knowing that an overlap is taking place. Or, a strength coach might prescribe a challenging lower body lift, then have a pitching coach send his players to run poles - only to have the head coach tack a very taxing practice on top of an already hefty workload. If you're always adding, but never taking away, it's only a matter of time until athletes break down. As such, communication among coaches, medical and strength and conditioning staffs, and players is absolutely essential for optimal synergy.
2. Individualization - I'm constantly amazed at how - even at the highest levels - players aren't managed on a case-by-case basis. That is, of course, until they get hurt and need unique rehabilitation prescriptions. Just imagine how much less rehabilitation would be needed if players were simply managed more individually on a proactive basis so that injuries didn't occur nearly as often. Additionally, we'd be much more likely to see late-round draft picks and undrafted free agents become MLB superstars if they were managed differently than already-talented players who are just coddled on their way to the big leagues. I think you'd see more stories like Tim Collins'.
I also see this as a huge competitive advantage for college coaches on the recruiting side of things. Not everyone can boast beautiful weather, an amazing baseball complex, a pristine academic reputation, and beautiful girls everywhere when recruiting prospects, but being able to guarantee an individualized approach to development goes a long way in making up the difference.
3. Specificity - You'd be amazed at how many folks in the baseball world have absolutely no knowledge of exercise physiology or the unique demands of baseball - but are still prescribing strength and conditioning programs for baseball players. Some of what I have seen is so atrocious that the players would have been better off doing absolutely nothing. I've seen programs with 10+ mile runs, kipping pull-ups to failure, 1-rep max bench presses, and high rep clean and presses. I seriously can't make this stuff up.
The most common justification for this type of garbage is that coaches want to build mental toughness. Well, I'm here to tell you that there are much better ways of doing that, as your mental toughness won't mean much when your pitchers are having surgeries or throwing 74mph and well on their way to those surgeries.
When we discuss throwing a baseball, we are talking about the single fastest motion in all of sports. General training is absolutely valuable, but if you don't have the specific nature of that throwing motion - and the adaptations it creates - in mind when we implement that general training, you're asking for problems.
4. Effort - The best program on the planet won't do any good if it isn't executed with loads of effort and attention to detail. If you have issues like players skipping warm-ups, athletic trainers refusing to do manual therapy, and coaches showing up late to practice, whatever is written on the paper doesn't matter at all.
At the end of the day, these four factors are just a few of many that will ultimately determine how effective a baseball strength and conditioning program is. Unfortunately, many of these factors are outside of a player's control, so what do you do?
Very simply, control what you can control.
Educate yourself so that you can be your own best coach. Optimize your nutrition and get plenty of sleep. Write down what has and hasn't worked for you so that you can refer back to it down the road and avoid making the same mistakes twice.
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In part 1 of this feature, I talked about how many throwers actually overuse the rotator cuff because they don't appreciate that throwing in itself is a tremendously stressful challenge to the shoulder. I also made the point that cuff timing is more often the problem than cuff strength, so many folks are really training the rotator cuff incorrectly with thousands of reps of band exercises. Let's examine that in a bit more depth.
First, I should preface this piece by saying that I think there are definitely places for utilizing bands to strengthen the rotator cuff in a baseball training context. They obviously provide outstanding convenience for on-field work and travel circumstances, as well as scenarios where players may not have qualified professionals at hand to help with manual resistance work and rhythmic stabilizations. Some cuff work is better than no cuff work! Additionally, many players swear by bands during the warm-up phase to help with getting blood flow to the shoulder complex with a bit of activation at the same time.
However, there are two primary issues with relying exclusively on bands:
1. In an external rotation variation, the resistance is actually greatest at the point (near maximal external rotation) where the athlete is weakest. In other words, the band doesn't ideally accommodate the strength curve. This is a huge concern for me, as one of the biggest things I notice in athletes is that when training in a position of somewhat significant external rotation, they can't "pick up" the resistance quickly enough. More on this later.
2. Most people simply overlook eccentric control. This is something that is coachable, no doubt, but most people do band exercises for so many reps per set that the athlete can quickly lose focus and resort back to bad habits.
As you can imagine, these are shortcomings that also exist - albeit to a slightly lesser extent - with cable and dumbbell/plate external rotation rotator cuff strength exercises:
So, how do we overcome these shortcomings while helping to address rotator cuff timing? You have two great options.
1. Rhythmic Stabilizations
The true role of the rotator cuff is to stabilize the humeral head (ball) in the glenoid fossa (socket). And, during throwing, it does a ton of work, as the humerus goes through extreme ranges of motion in all three planes. Rhythmic stabilization drills are a great way to train the cuff to fire quicker, and they're particularly valuable because you can train them at various points in the range of motion, modifying the challenge depending on how stable an individual is in a given position. Plus, this is an outstanding way of monitoring cuff function over the course of weeks and months with athletes you see regularly; regular improvements are easily perceived.
You'll notice that I don't crank him back to extreme external rotation in this video; rather, we stop short of it and just assume that we'll get some carryover in stability a bit further (as per previous research on carryover of isometric exercise).
The sky is really the limit in terms of how you train this one; we have about a dozen variations that we use on a daily basis. A few quick guidelines:
a. The more congenital or acquired laxity an athlete has, the less aggressive you'll want to be with your perturbations. When someone is less proficient, gently destabilizer, and apply the prturbations closer to the shoulder. When someone is more stable, perturbate a bit more firmly, and apply it further down the arm.
b. I sometimes start those with significant laxity with closed chain exercises so that they can draw some stability from the floor or wall.
c. Make sure that the scapula is positioned appropriately; it certainly shouldn't be protracted, but don't crank it into excessive retraction, either. Just keep it from winging off the rib cage.
d. I like 2x/week rhythmic stabilizations during off-season training. We typically integrate it between sets on lower-body strength training days.
2. Manual Resistance External Rotations
These drills are "where it's at." On one hand, they are the best strength-building exercise for the cuff because they train it in its most function context: eccentric control. However, more specific to today's point, they are great for improving cuff recruitment at the most vulnerable point in the throwing motion: lay-back.
When we do a drill like this, I encourage the athlete to "pick it up early." In other words, I won't apply downward pressure (eccentric overload) until they apply some external rotation force into my hand).
Some quick guidelines for manual resistance external rotations:
a. Emphasize eccentric overload, but make sure you aren't pushing all the way down, as most people will go into scapular anterior tilt as they are more internally rotated. Pushing someone all the way down puts the shoulder in a pretty vulnerable position, as scapular stability is lost and the subacromial space is closed down.
b. Given that you have to apply the force further down the arm, make sure that the athlete isn't cheating by just utilizing the wrist extensors.
c. In the manual resistance external rotations at 90 degrees in the scapular plane, your other hand should "cup" the elbow to make sure that the rotation is taking place at the shoulder (as opposed to horizontal adduction/abduction).
d. I like to utilize manual resistance external rotations twice a week during the off-season, usually toward the end of upper body strength training sessions. We'll use less manual resistance work in this regard, though, when guys start to ramp up their throwing, as it tends to create a bit more soreness.
In a recent presentation in front of a bunch of baseball coaches, I made the following statement - and it turned a lot of heads:
I think most people overtrain the rotator cuff nowadays, and they do so with the wrong exercises, anyway.
To illustrate my point, I'm going to ask a question:
Q: What is the most common complication you see in guys as they rehabilitate following a Tommy John Surgery?
A: Shoulder problems - generally right around the time they get up to 120 feet.
Huh? Shoulder pain is a post-operative complication of an elbow surgery? What gives?
First, I should make a very obvious point: many of these guys deal with shoulder stiffness as they get back to throwing simply because they've been shut down for months. That I completely expect - but remember that it's stiffness, and not pain. They always throw their way out of it.
The more pressing issue is what is taking place in their rehabilitation - and more specifically, what's taking place with the synergy between their rehabilitation and throwing program. Let me explain.
Rehabilitation following a UCL reconstruction is extensive. While different physical therapists certainly have different approaches, it will always be incredibly heavy on rotator cuff strength and timing, as well as adequate function of the scapular stabilizers. Guys always make huge strides on this front during rehab, but why do so many have shoulder pain when they get further out with their long tossing? The answer is very simple:
Most people don't appreciate that throwing a baseball IS rotator cuff training.
Your cuff is working tremendously hard to center the humeral head in the glenoid fossa. It controls excessive external rotation and anterior instability during lay-back.
It's fighting against distraction forces at ball release.
And, it's controlling internal rotation and horizontal adduction during follow-through.
Simultaneously, the scapular stabilizers are working incredibly hard to appropriately position and stabilize the scapula on the rib cage in various positions so that it can provide an ideal anchor point for those rotator cuff muscles to do their job.
A post-op Tommy John thrower - and really every player going through a throwing program - has all the same demands on his arm (even if he isn't on the mound, where stress is highest). And, as I wrote previously in a blog about why pitchers shouldn't throw year-round, every pitcher is always throwing with some degree of muscle damage at all times during the season (or a throwing program).
Keeping this in mind, think about the traditional Tommy John rehabilitation approach. It is intensive work for the cuff and scapular stabilizers three times a week with the physical therapists - plus many of the same exercises in a home program for off-days. They're already training these areas almost every day - and then they add in 3-6 throwing sessions a week. Wouldn't you almost expect shoulder problems? They are overusing it to the max! This is a conversation I recently had with physical therapist Eric Schoenberg, and he made another great point:
Most guys - especially at higher levels - don't have rotator cuff strength issues; they have rotator cuff timing issues.
In throwing - the single-fastest motion in all of sports - you're better off having a cuff that fires at the right time than a cuff that fires strong, but late. Very few rotator cuff exercise programs for healthy pitchers take that into account; rather, it's left to those doing rehabilitation. Likewise, most of the programs I see altogether ignore scapular stability and leave out other ways to train the cuff that are far more functional than just using bands.
Now, apply this example back to the everyday management of pitchers during the season. Pitchers are throwing much more aggressively: game appearances, bullpens, and long toss. They need to do some rotator cuff work, but it certainly doesn't need to be every day like so many people think.
I'll cover how much and what kind in Part 2. In the meantime, if you'd like to learn more about the evaluation and management of pitchers, check out Optimal Shoulder Performance.
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In Part 1 of this series, I outlined the first three reasons that I'm opposed to baseball pitchers using year-round throwing programs. Here are the next four:
4. They need to get their shoulder and elbow range of motion back.
As I noted in Part 1, throwing a baseball is the single-fastest motion in sports. With the crazy arm speeds one encounters, you have to keep in mind not only the muscles trying to accelerate the arm, but also the ones trying to slow it down. This "braking" challenge is called eccentric stress - and I'll talk more about it in a second.
What you need to know now, though, is that when left unchecked, significant eccentric stress can lead to tissue shortening. If you need further proof, Reinold et al. reported that immediately after a pitching outing, pitchers lose an average of 9.5° of shoulder internal rotation and 3.2° of elbow extension - and that these losses persisted at 24 hours post-throwing.
Now, imagine these acute range of motion losses being left unchecked for an entire season - or a season that simply never ends because pitchers are always throwing. That's how elbows wind up looking like this:
Fortunately, we can prevent losses in range of motion during the season with appropriate mobility exercises, manual therapy, and breathing exercises - but the truth is that not everyone has access to these initiatives in terms of expertise, finances, or convenience. So, while we work to educate the masses on arm care, emphasizing time off from throwing programs is also a key component of an overall strategy to reduce injury risk.
One last thing on this topic: it is a nightmare to try to improve shoulder or elbow range of motion in a pitcher during a season, as the very nature of throwing works against everything you're trying to achieve. The off-season is "where it's at" in terms of optimizing range of motion in throwers.
5. They need to “dissipate” eccentric stress.
Okay, here's where I take #4 and geek out a bit. I apologize in advance.
Sometimes, you have to get away from the baseball world in order to learn about the baseball world. To that end, I need to think Mike Reinold for bringing this great 2004 study from Tomiya et al to my attention.
These researchers created eccentric stress in muscle tissue of mice using an electrical stimulation model, and monitored blood markers of muscle damage for a period of time thereafter. What you'll see in the graph below is that myofiber disruption really peaks at three-days post-exercise, then start to return down to baseline, yet they still aren't even there at seven days post-intervention.
Source: Tomiya A, et al. Myofibers express IL-6 after eccentric exercise. Am J Sports Med. 2004 Mar;32(2):503-8.
Now, let's apply this to the world of pitching. Every single pitcher who throws more than once every 7-10 days is surely pitching with some degree of muscle damage. And, I can tell you that the two toughest challenges pitchers have reported to me are:
a) moving from starting to relieving
b) going from a 7-day high school or college rotation to a 5-day professional rotation
I'm firmly believe that pitchers need to throw in-season to stay strong, but I also know that we can't trump physiology. Sure, we need to have optimal nutrition and regeneration strategies in place, as we can't just baby guys and expect them to get better. However, make no mistake about it: high-level pitchers simply have to get good at pitching at 90% capacity (at best) if they are going to succeed.
If I already have a guy whose arm is working at a deficit for 8-9 months of throwing, the last thing I want to do is beat him up for the other three months with the same kind of volume and stress.
6. They need to allow any undetected low-grade injuries to heal.
As I discussed in an old blog, Pitching Injuries: It's Not Just What You're Doing; It's What You've Already Done, most injuries (especially ulnar collateral ligament tears) come from the accumulation of chronic, low-level stress. Maybe you get some calcification on your ulnar collateral ligament or a low-level rotator cuff tendinosis, and it takes a few years and hundreds of innings before something finally "goes."
Old, low-level injuries are less likely to reach threshold if you give them some downtime and work on redistributing training stress. By strengthening the rest of your body in the off-season, you're dramatically reducing the demands on your rotator cuff with throwing.
You can't teach other joints to share the burden if the burden is never removed temporarily.
7. They need a chance to prioritize other competing demands.
Throwing is a good 20-30 minute endeavor each time you do it - and possibly even more. When I think about all the things that pitchers can be doing to get better in the off-season from a strength and conditioning standpoint, I have a really hard time justifying giving away that much time and recovery capability. There are other things that need to be prioritized at this time - and year-round throwing is an especially tough pill to swallow when you know that throwing is working against many of the very qualities - rotator cuff strength, scapular stability, mobility, and tissue quality - that you're trying to establish.
Closing Thoughts
The lack of downtime from throwing is especially problematic in younger populations, as they are skeletally immature and weaker. I’d argue that a really weak 15-year-old kid throwing 74-76 mph does far more damage to his body on each throw than a moderately strong professional player throwing 90-92 mph, especially given that the pro pitcher’s mechanics are more optimized to protect the arm. This underscores the importance of "syncing up" mechanics, throwing programs, and the overall baseball strength and conditioning program.
Last, but certainly not least, remember that two weeks doesn't constitute "time off." Rather, I firmly believe that pitchers need the ball completely out of their hands for at least two month per year, preferably continuously. In other words, eight one-week breaks throughout the year is far from ideal, as it doesn't really allow for positive adaptations to occur.
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When Thanksgiving rolls around, many of our professional baseball players at Cressey Sports Performance will start up their winter throwing programs after a full 10-12 week break from throwing. They're always a bit rusty in the first week of tossing after the layoff, but every single one of them always "figures it out" in a matter of a few weeks - and still has plenty of time to get in a solid throwing program prior to heading off to spring training. And, because they've been working hard in the gym on their strength, mobility, and soft tissue quality, they're always better off in the end.
Still, there are those who insist that baseball pitchers don't need time off from throwing.
I couldn't disagree more.
I'm sure this will rub some folks the wrong way, but I can't say that I really care, as most of those individuals can't rationalize their perspectives outside of "guys need to work on stuff." I, on the other hand, have seven reasons why baseball pitchers need time off from throwing:
1. They need to lose external rotation to gain anterior stability.
Having external rotation - or "lay back" - when is important for throwing hard, and research has demonstrated that simply throwing will increase shoulder external rotation range-of-motion over the course of a season. This does not mean, however, that it's a good idea to just have someone stretch your shoulder into external rotation, as I wrote previously: Shoulder Mobility Drills: How to Improve External Rotation (if you even need it).
You see, when you externally rotate the humerus (ball) on the glenoid (socket), the humeral head has a tendency to also translate anteriorly (forward). In a well-functioning shoulder girdle, the rotator cuff musculature should prevent anterior instability, and it's assisted by adequate function of the scapular stabilizers, which offer the dynamic stability to reposition the scapula in the right place to "accommodate" the humeral head's positioning. For the athletic trainers and physical therapists out there, this is really what you're testing with an apprehension/relocation test.
The apprehension comes about because of either anterior instability or actual structural pathology (SLAP tear, rotator cuff impingement, or biceps tendinosis). The relocation component is just the clinician posteriorly directing the humeral head to create the stability that should otherwise be created by the rotator cuff and scapular stabilizers.
The take-home message is that while just going on year-round throwing programs in hopes of increasing external rotation seems like a good idea on paper, it's actually a terrible idea in the context of injury prevention. Pitchers should actually lose a few degrees of external rotation each off-season intentionally, as it affords them an opportunity to improve their stability. This leads us to...
2. They need a chance to get their cuff strength and scapular stability up.
Baseball pitching is the single-fastest motion in all of sports, as the humerus internally rotates at velocities in excess of 7,000°/second. So, it should come as no surprise that at the end of a season, the strength of the rotator cuff and scapular stabilizers is significantly reduced. Having dealt with many of our players for up to five off-seasons now, I have a unique appreciation for how they each respond differently to not only the stress of the season, but also to arm care programs that we initiate at season's end.
It's important to remember that improving rotator cuff strength is no different in terms of adaptation than improving a bench press or squat. Adding 10% to a guy's bench press might take three months in an intermediate population, or 12 months in a high-level lifter! Adaptation of the rotator cuff and scapular stabilizers is comparable. I need every minutes of those three months without throwing to get guys back to at least baseline, and hopefully a bit above it.
Can you imagine if some clown trying to improve his bench press went out and benched an additional 4-5 times a week on top of his regular strength and conditioning program?
His progress would be minimal, at best, and he'd be at a dramatically increased risk of injury. Throwing during a dedicated, appropriate structured early off-season arm care program is no different.
3. They need an opportunity to do dedicated manual resistance rotator cuff exercises.
Ask anyone who has worked with throwers for any length of time, and they'll always tell you that manual resistance exercises are the single-best option for improving rotator cuff strength. This rotator cuff exercise approach allows you to emphasis eccentric strength better than bands, cables, and dumbbells allow. It also keeps athletes more strict, as the one providing the resistance can ensure that the athlete isn't just powering through the exercise with scapular stabilizers or lower back.
The only downside to manual resistance rotator cuff exercises, though, is that because they generally prioritize eccentric strength, they will create more soreness. With that in mind, we use them much more in the off-season than in the in-season, as we don't want a pitcher throwing with added soreness. They're a great initiative in a comprehensive off-season baseball strength and conditioning program, but guys just don't seem to like them as much in-season, presumably because both throwing and manual resistance rotator cuff exercises can be too much eccentric stress when combined. As such, we used them a lot during the September-November periods, and then hold back in this area the rest of the year.
Of course, if you throw year-round, then you can forget about getting these benefits, as the last thing you want is to be sore while you're "working on stuff" in the off-season. That was sarcasm, in case you weren't picking up on it.
In Part 2, I'll be back with four more reasons baseball pitchers shouldn't throw year-round.
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September 6 might seem like just another Tuesday to most folks. Many people probably despise it because the day after Labor Day serves as an unofficial end to summer. Kids go back to school, teachers go back to work, and many seasonal businesses lose customers and employees as the season winds down.
Not me, though. Today, the madness begins for me – and I love it.
You see, today is the start of the professional baseball off-season, as some minor leaguers played their last games yesterday. Between now and the start of spring training in February/March, Cressey Performance will likely see over 50 guys either in the big leagues or trying to make the big leagues.
We get a special type of ballplayer, too. Trekking to Hudson, MA in the winter isn’t for everyone – and certainly not for guys who want to be coddled. Our guys love to work smart and hard – and that makes my job incredibly fun.
People are often surprised to learn that I never even played baseball in high school. Being an “outsider” to the game would seemingly make it harder to enter the world of baseball strength and conditioning, but I actually used it to my advantage. To put it bluntly, I had no preconceived notions of what people think works, so it made it easy for me to “buck” stupid baseball traditions and focus on what I know works. In short, as some of the world’s smartest marketing advisors have recommended, I did the opposite of what others do, and the Cressey Performance Elite Baseball Development Program thrived.
Given that baseball players are among the most often-injured athletes in sports, many “experts” in the industry baby them with “do no harm, but do no good” strength training programs. We show guys that it’s possible to get strong in an intelligent way while decreasing the risk of injury – both acutely and chronically.
Conversely, many strength and conditioning coaches alienate players by looking, acting, and programming like football coaches. We don’t Olympic lift, back squat, or bench press with our baseball players – and we’ve gone to great lengths to bring in equipment that enables us to modify traditional strength exercises and make them safer for a baseball population.
Many coaches who have played the game before rely exclusively on their experiences playing the game to dictate how players prepare nowadays. What they fail to appreciate is that the modern game is far different: more off-field distractions (e.g., heavier media attention, social networking), heavier travel schedules (more teams = more travel), more competing demands (e.g., strength and conditioning), and more pressure to succeed (larger organizations = more levels of minor leaguers pushing to take your job). As a result, I do a lot more listening to my athletes than I do talking - and much less assuming than other coaches do.
Loads of coaches run their pitchers into the ground, thereby ruining guys’ mobility, sapping their power, and abusing their endocrine systems in an ignorant attempt to improve recovery. Our guys never run more than 60 yards – and they get healthier and more athletic in the process.
Many organizations hand out the same strength and conditioning programs to all their players – regardless age, training experience, dominant hand, and position on the field. A lot of facilities are no better; one training program on the dry erase board dictates what everyone in the gym does on a given day. In a sport where each body (and injury) is unique – and asymmetry is overwhelmingly problematic – we give our guys a competitive advantage with a strength and conditioning program that is individualized to each player.
While some facilities were aligning themselves with companies who were trying to be “everything to everybody” by catering to loads of different sports, we allied with New Balance, a Boston-based and not only has a heavy baseball focus (225+ MLB players under contract), but a strong commitment to various charitable causes, American workers, and the education of up-and-coming players.
Walk into any professional baseball clubhouse, and you’ll see a lot of different “cliques.” Guys of a wide-variety of ages come from different states and countries, speak different languages or have different accents, and play different positions. On a 25-30 man roster, a player might only hang out with 2-3 teammates off the field at most during the season. We’ve made camaraderie an insanely important piece of the CP professional baseball approach, introducing guys to each other, setting up out-of-the-gym events for our guys, and creating a culture where everyone roots for everyone else. I’ve had guys at my house for Thanksgiving and at my wedding – and guys have held back on referring other players because they didn’t feel that their work ethics or attitudes would be a good fit for CP. In short, we’ve created a family and an experience – and given our athletes an ownership stake in it – while others just “worked guys out.”
Although it is a point Pat Rigsby, Mike Robertson, and I heavily emphasize in our Fitness Business Blueprint product, the concept of “doing the opposite” to succeed isn’t just applicable to business.
Go to any gym, and look at how many people are on the treadmills year-after-year, none of them getting any leaner. Get some of them to head across the gym to a weight room and they’ll transform their bodies in a matter of a few months. Switch someone from a high-carb, low-protein, low-fat diet to a high-protein, high-fat, low-carb diet, and they’ll often drop a lot of fat in a short amount of time.
With all that said, the answers for me will never be the right answers for you. Look at what you’re doing – whether it’s in training, business, or life – and think about how doing the exact opposite may, in fact, be the best way to improve your outcomes.
For those of you interested in taking a peek inside what goes on with the Cressey Performance Elite Baseball Development Program on a daily basis – from training videos to footage of guys goofing off in the office – I’d encourage you to follow @CresseyPerf on Twitter.
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Q: I know that you work a ton with baseball players and that medicine ball workouts are an integral part of their training at Cressey Sports Performance. However, I'm not a baseball player - or a competitive athlete in any discipline, for that matter - and I'm wondering if I should still consider adding medicine ball workouts to my strength and conditioning program. Are there benefits that I can't get from a traditional strength training program with comprehensive mobility drills?
A: This is a great question - and I'll start off by saying that we actually have quite a few athletes at Cressey Sports Performance who aren't baseball players. Plus, we firmly believe that everyone has an athlete in them, so our training mandates a functional carryover to the real world for everyone. Integrating some medicine ball workouts - even if the volume and frequency aren't as high as in our rotational sport athletes - can definitely add some benefits to a strength and conditioning program. Here are seven of those benefits:
1. Real World Transfer - Regardless of how effectively a strength and conditioning program is designed, it'll usually be very sagittal plane dominant. Integrating some rotational medicine ball training immediately increases the number of movements from which you can choose in the transverse and frontal planes.
2. Low-Impact Fat Loss Medleys - Look at all of the fat loss programs out there, and the overwhelming majority of them require a lot of impact - whether it's from sprinting/jogging, jumping rope, or taking step aerobics. Performing medleys of various medicine ball throws not only allows you to increase volume in a program while minimizing stress on the lower extremity, but also affords some much appreciated variety in a program that might otherwise be dominated by a lot of boring cardio equipment.
3. Better Integration of the Core -With a correctly executed rotational med ball throw, the power should come predominantly from the lower half - which means that it should be transmitted through a stable core so that the energy will be appropriately utilized with thoracic rotation to get to the arms and, in turn, the ball. This sequencing is no different than lifting a bag of groceries, swinging a golf club, or going up on one's tip-toes to grab something on the top shelf. If you move in the wrong areas (lumbar spine), you'll eventually wind up with back pain - but if you've handled the rotational challenges of medicine ball workouts with perfect technique, you'll be protected in the real world.
4. Improved Ankle, Hip, and Thoracic Spine Mobility - When performed correctly, medicine ball exercises serve as an outstanding way to "ingrain" the mobility you've established with a dynamic warm-up prior to training. Additionally, we utilize mobility and activation "fillers" between sets of medicine ball drills to not only slow people down between sets, but also address issues they have that might warrant extra attention.
5. A Way to Train Power Outside of the Sagittal Plane - Research has demonstrated that the biggest problems with folks as they grow older are not just the loss of strength, muscle mass, and bone density, but the loss of power - or how quickly they can apply force. It's this reduction in power that makes elderly individuals more susceptible to falls. We can't always train power "optimally" in some older adults because of ground reaction forces being too stressful, but most can learn to apply a significant amount of force to a medicine ball - whether it's rotationally or with an overhead stomp/throw variation. Everyone should obviously build a solid foundation of strength and mobility before undertaking these options, but when the time is right, they are great additions. On a related note, here's a video I filmed a while back that shows how medicine ball workouts fit into our overall approach to developing power in athletes.
6. Reduction of Asymmetry - Most of us are very one-side dominant, and while I have no aspirations of ever expecting folks to be completely symmetrical, I think that training with rotational medicine ball drills can go a long way in ironing out prominent hip and thoracic spine asymmetries. This has been one reason why they comprise such an integral part of our off-season baseball training programs; these players spend their entire lives in an asymmetrical sport.
7. A Way to Blow off Some Steam - Lifting weights is great for letting out some aggression after a bad day, but throwing a medicine ball is on a whole different level. In most cases, I encourage folks to try to break the medicine balls on every single throw. As you can see, we've broken quite a few...
When we integrate medicine ball workouts with our adult fitness clients, it's usually a matter of three sets two times per week between the mobility warm-ups and strength exercises. If it's used for fat loss, though, we'll include medleys at the end of the strength training programs.
As for a specific brand of medicine balls that we use, we've now made the switch to the Perform Better Extreme Soft Toss Medicine Balls. I've found that the rebound is optimal on these, and they still provide great durability (which has been an issue with not only other "padded" options, but also other rubber models that are using more filler materials). This is what our preferred option looks like:
With all that in mind, how many you break will be heavily dependent on how much you incorporate medicine ball workouts and how powerful your clients are. The medicine ball lifespan will be a lot longer in a facility catering to middle-aged women than it will be at Cressey Performance, where 85% of clients are baseball players executing 240-360 medicine ball throws per week during certain portions of the year.
If you're looking for a lot more detail on the specific medicine ball exercises and workouts we do with our clients, be sure to check out my Medicine Ball Master Class.
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Last summer, a college pitcher came up to Cressey Performance from the South to train for a month before his summer league got underway. He was seven months post-op on a shoulder surgery (Type 2 SLAP) and had been working his way back. Unfortunately, his arm was still bothering him a bit when he got up to see us.
After the first few days at CP, though, he told me that his arm felt as good as it’s felt in as long as he could remember. He’d been doing a comprehensive strength and conditioning program, but the “impact” stuff for him had been soft tissue work, some Postural Restoration Institute drills, an emphasis on thoracic mobility, and manual stretching into internal rotation, horizontal adduction, and shoulder flexion. From all the rehab, his cuff was strong and scapular stabilizers were functioning reasonably well – which led me to believe that his issues were largely due to tissue shortness and/or stiffness.
This realization made me immediately wonder what he’d been doing in the previous months for mobility work for his arm – so I asked. He then demonstrated the manual stretching series that every pitcher on his team went through every day on the table with their athletic trainer. Each stretch was done for 2x20s – and two of those stretches took him into extreme external rotation and horizontal abduction. I was pretty shocked.
Me: “You’re probably not the only guy on your team rehabbing right now, huh?”
Him: “No; there are actually too many to count.”
Me: “Elbows, too, I’m sure.”
Him: “Yep.”
Want to irritate a labrum, biceps tendon, or the undersurface of the rotator cuff? Stretch a thrower into extreme external rotation and simulate the peel-back mechanism. This also increases anterior capsular laxity and likely exacerbates the internal impingement mechanism over the long-term. To reiterate, this is a bad stretch!
Want to make an acromioclavicular joint unhappy? Stretch a thrower into horizontal abduction like this (again, this is a BAD stretch that is pictured):
Want to irritate an ulnar nerve or contribute to the rupture of an ulnar collateral ligament? Make sure to apply direct pressure to the forearm during these dangerous stretches to create some valgus stress. This is a sure-fire way to make a bad stretch even worse:
These stretches are very rarely indicated in a healthy population – especially pitchers who already have a tendency toward increased external rotation. The shoulder is a delicate joint that can’t just be manhandled – and when you’re dealing with shoulders that are usually also pretty loose (both from congenital and acquired factors), you’re waiting for a problem when you include such stretches. In fact, I devoted an entire article to this: The Right Way to Stretch the Pecs.
Everyone thinks that shoulder external rotation and horizontal abduction alone account for the lay-back in the extreme cocking position.
In reality, though, this position is derived from a bunch of factors:
1. Shoulder External Rotation Range-of-Motion – and this is the kind of freaky external rotation you’ll commonly see thanks to retroversion and anterior laxity:
2. Scapular Retraction/Posterior Tilt
3. Thoracic Spine Extension/Rotation
4. Valgus Carrying Angle
So, how do you improve lay-back without risking damage to the shoulder and elbow?
1. Soft tissue work on Pec minor/major and subscapularis – Ideally, this would be performed by a qualified manual therapist – especially since you’re not going to be able to get to subscapularis yourself. However, you can use this technique to attack the pecs:
2. Exercises to improve scapular retraction/depression/posterior tilt – This could include any of a number of horizontal pulling exercises or specific lower trap/serratus anterior exercises like the forearm wall slide with band.
3. Incorporate specific thoracic spine mobility drills – In most pitchers, you want to be careful about including thoracic spine mobility drills that also encourage a lot of glenohumeral external rotation. However, when we assess a pitcher and find that he’s really lacking in this regard, there are two drills that we use with them. The first is the side-lying extension-rotation, which is a good entry level progression because the floor actually limits external rotation range-of-motion, and it’s easy to coach. I tell athletes that they should think of thoracic spine extension/rotation driving scapular retraction/depression, which in turn drives humeral external rotation (and flexion/horizontal abduction). Usually, simply putting your hands on the shoulder girdle and guiding them through the motion is the best teaching tool.
A progression on the side-lying extension-rotation is the side-lying windmill, which requires a bit more attention to detail to ensure that the range-of-motion comes from the right place. The goal is to think of moving exclusively from the thoracic spine with an appropriate scapular retraction/posterior tilt. In other words, the arm just comes along for the ride. The eyes (and head) should follow the hand wherever it goes.
Again, these are only exercises we use with certain players who we’ve deemed deficient in external rotation. If you’re a thrower, don’t simply add these to your routine without a valid assessment from someone who is qualified to make that estimation. You could actually make the argument that this would apply to some folks in the general population who have congenital laxity as well (especially females).
4. Throw!!!!! – Pitchers gain a considerable amount of glenohumeral external rotation over the course of a competitive season simply from throwing. Sometimes, the best solution is to simply be patient. I really like long toss above all else for these folks.
In closing, there are three important things I should note:
1. You don’t want to do anything to increase valgus laxity.
2. You’re much more likely to get hurt from being “too loose” than you are from being “too tight.” When it comes to stretching the throwing shoulder, “gentle” is the name of the game – and all mobility programs should be as individualized as possible.
3. Maintaining internal rotation is a lot more important than whatever is going on with external rotation. In fact, this piece could have just as easily been named "The Two Stretches Pitchers Shouldn't Do, Plus a Few That Only Some of Them Need."
