Home Posts tagged "Arm Care"

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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CSP Elite Baseball Development Podcast: Building a Better Throwing Program with Alan Jaeger

We're excited to welcome highly regarded pitching consultant Alan Jaeger to this week's podcast to discuss long toss and both performance and rehabilitation throwing programs. A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 20-pack of Athletic Greens travel packets with your first order.

Show Outline

  • How Alan became known as “the long toss guy”
  • How experience as a young junior college arm led him to developing his throwing strategies
  • How Alan defines long toss and what the specific priorities of a quality long toss session are
  • How long toss facilitates self-organization of the body and intuitive feel for how to throw the ball efficiently
  • How stretching it out and working back to your partner with conviction gives pitchers the variance they need to remain athletic and free on the mound rather than repeatable and robotic
  • What big mistakes Alan sees in athletes’ daily catch play as well as the programming of their throwing sessions
  • How Alan liked to structure throwing for pitchers on 5- and 7-day rotations
  • Where Alan sees room for improvements in rehabilitation throwing programs
  • How the conversation about long toss has evolved over the last 20 years, specifically in professional baseball
  • How some MLB organizations still resist long toss, but why young front office phenoms are playing an influential role in transforming baseball into a more progressive era
  • How understanding a player’s background gives great insight into how they’ll function at a high level
  • How players can learn to respectfully say no to complete overhauls in their abilities and be prepared to stand their ground to preserve the longevity of their career
  • You can follow Alan on Twitter at @JaegerSports  and on Instagram at @JaegerSports.

Sponsor Reminder

This episode is brought to you by Athletic Greens. It’s an all-in-one superfood supplement with 75 whole-food sourced ingredients designed to support your body’s nutrition needs across 5 critical areas of health: 1) energy, 2) immunity, 3) gut health, 4) hormonal support, and 5) healthy aging. Head to www.AthleticGreens.com/cressey and claim my special offer today - 20 FREE travel packs (valued at $79) - with your first purchase. I use this product daily myself and highly recommend it to our athletes as well. I'd encourage you to give it a shot, too - especially with this great offer.

Podcast Feedback

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

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

Thank you for your continued support!

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Random Thoughts on Sports Performance Training – Installment 34

It's been a while since I published one of these compilations, so I've got quite a "brain dump" for you today. Here goes!

1. Correct "overhead lifting" work is especially important for volleyball players.

After this Instagram post on the importance of correct overhead lifting exercises and coaching cues, a volleyball coach reached out to ask if I felt the same overhead principles would apply to volleyball as with baseball. His point was that the arm-swings are very similar, but being in the air may make a difference.

The short answer is that YES, these strength training principles would apply to volleyball players as well. I'd even argue they'd apply MORE for two reasons:

a. Volleyball players are generally a hypermobile population who can benefit even more from the enhanced motor control that proper weight training affords. Effectively, you're giving them stability through the (potentially excessive) range of motion they have.

b. The fact that the violent arm actions happen in mid-air means that you don't have a lower half to help with deceleration (as is the case with baseball players). The upper extremity needs to be that much more well timed and strong.

2. Red light therapy might be the next big sports science breakthrough.

I first came across red light therapy when some clients commented on how they'd utilized it for a variety of health and human performance initiatives - both focal (sore wrist) and diffuse (chronic disease). I dug deeper, and the research was super compelling. There are clinical applications for everything from sleep quality/quantity, to cognitive function, to migraines, to improved hormonal status, to exercise recovery. I've started utilizing it myself and I can see it becoming an integral part of our sports science approach at Cressey Sports Performance.

Joovv is a company that's at the forefront of the application of red light therapy, and they actually sponsored this week's podcast. If you head to www.Joovv.com/eric, you can learn more - and get a free gift with your purchase.

3. Sports are random practice.

I've been a big advocate for avoiding early sports specialization if your goal is not only a positive experience with exercise to build lifelong habits, but also long-term athletic success. Supporters of playing multiple sports rarely outline the specific "mechanism of action" for why multiple sports really works for development, though.

In my opinion, these benefits are mediated because most sports are the very definition of random (unpredictable and varied) practice. You change direction a ton with soccer, basketball, and tennis - but you're usually responding to an opponent or making strategic calls on the fly on your own. You use both hands and feet in unique ways. These experiences are markedly different than going out and just throwing 30 pitches off the mound in baseball, something that's entirely closed loop and only has a small amount of variance: blocked practice. The research on motor learning has clearly demonstrated that random practice outperforms blocked practice with longer-term retention tests and the associated skill acquisition.

Also, this should serve as a good reminder of how awesome playgrounds are.

 
 
 
 
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Watching our daughters grow up has been a remarkable lesson on when to coach and when to take a step back and observe. Early on in parenting, you watch your kids take big tumbles where you think they have a concussion or torn ACL. Then they giggle, get back up, and keep playing. They’re far more resilient than we think, and it demonstrates that failure can often be the best teacher. Coaches - once you’ve established rapport and foundational movement quality with your athletes, seek opportunities for them to fail SAFELY in training, when there aren’t physical or psychological consequences. Parents - don’t protect your kids from failure. Rather, embrace its remarkable ability to teach and prepare them for whatever challenges await them in sports and life. Kids - don’t let your parents pave the way for you so that you avoid failure. And be sure to seek out coaches who consistently challenge you even if it results in the aforementioned failures. Swipe left to watch our girl crushing it on the playground in spite of a little taste of failure.💪 #cresseytwins #cspfamily #coaching

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4. Our rotator cuff care approaches have three broad components.

I recently hopped on Mike Robertson's podcast, and one topic we covered was how we structure our arm care programs with respect to rotator cuff training. The whole interview is a good listen, but tune in at the 39:20 mark for this specific section.

Speaking of Mike Robertson, he's launching his own certification really soon. I've reviewed it and it's outstanding. He's got an early-bird list going to get folks a discount when it's launched; you can learn more HERE. Highly recommend!

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Why I’ve Gotten Away from the “No Money” Drill (Video)

I first came across the "No Money" drill for scapular control and rotator cuff activation/strength back around 2008, and introduced it to a lot of people when I included it in my first book, Maximum Strength.

At the time, I was working heavily in the general population segment and hadn't gotten as entrenched in the baseball world as I am now. So, like a carpenter who only had a hammer, I started thinking everything was a nail - and logically applied the No Money Drill with all our baseball athletes.

The more time I spent around baseball players, though, the more I realized that the No Money Drill was actually feeding into the negative adaptations we saw in them: a loss of scapular upward rotation, lat stiffness, lumbar extension syndrome, etc. As a result, we've gotten away from the drill with most of our overhead athletes (depending on what we see in an evaluation). Check out this video to learn more:

If you're looking to learn more about how we assess, program, and coach at the shoulder girdle, be sure to check out my popular resource, Sturdy Shoulder Solutions.

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Exercise of the Week: Quadruped 1-arm Trap Raise to Swimmer Hover

I recently started implementing the quadruped 1-arm trap raise to swimmer hover with some of our baseball guys, and it’s quickly become one of my favorites.

This drill addresses several important needs in a throwing population:

1. scapular posterior tilt

2. scapular upward rotation

3. tissue extensibility of the long head of the triceps and lat

4. the quadruped (all fours) position really reaffirms the good convex-concave relationship between the scapula and rib cage

You should not feel this at all in the front or top of the shoulder. Rather, the movement should be felt in the lower traps (mid back) and serratus anterior (add a full exhale at the top of each rep to intensify that activation). Some individuals will feel a good stretch through the triceps.

To learn more about how we assess, program, and coach at the shoulder girdle, be sure to check out Sturdy Shoulder Solutions.

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Strength and Conditioning Stuff You Should Read: 11/9/18

I hope you've had a good week. To kick off your weekend on the right foot, I've got some good reading from around the strength and conditioning world.

First, though, I just wanted to give you a heads-up that I'll be speaking at Pitchapalooza near Nashville in early December as part of an awesome lineup. You can learn more HERE.

Maximum Strength Training for Tennis: Why You Should Do It - Matt Kuzdub authored a great guest post for EricCressey.com a few months ago, and this was another recent post of his in the tennis world. Much it it could be applied to other sports as well.

Your Glutes Probably Aren't to Blame for Sore Knees, but They Could Still Be Stronger - Here's a solid dose of reality with some actionable strategies from Dean Somerset.

5 Great Analogies for Training Baseball Players - A big part of getting results is clearing communicating with athletes, and analogies are an invaluable way of doing so. This article outlines some of my favorites for working with a baseball population.

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5 Reasons for the Increase in Lat Strains in Baseball Pitchers

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

1. Better Diagnosis

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

2. Harder Throwers

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

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

3. Inappropriate Strength Training

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

4. Poorly Executed Arm Care Programs

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

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

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

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

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

5. Weighted Balls

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

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

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

Closing Thoughts

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

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Strength and Conditioning Stuff You Should Read: 5/18/18

Happy Friday! I'm a few days late with this post in light of our spring sale as well as some speaking-related travel I had this week. The good news is that the travel gave me some time to do some reading/viewing/listening and come up with some additional recommendations for you. Check them out:

Complete Youth Training - This is Mike Boyle's great new resource for those who work with young athletes. He touches on everything from the problems with early specialization to age-specific training stages. It's a good investment for parents and coaches alike. I loved how his perspective as a parent coalesced with his commentary as a strength and conditioning coach and business owner. It's on sale for $50 as an introductory discount.

The Best Team Wins - This was a recommendation from my buddy Josh Bonhotal, who's spent the past several years at the Purdue basketball strength and conditioning coach. Whether you're a coach or involved in a business in any way, this is a great book that'll teach you a lot about your interactions with athletes, fellow coaches, employees, and co-workers.

Prioritization and Success for Strength and Conditioning Success - I was reminded of this older post of mine this week when chatting with an up-and-coming strength and conditioning coach about how I've approached career development since I entered the industry.

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I think the long head of the triceps is a really overlooked structure in the development of both shoulder and elbow pain in throwers. Many people forget that it crosses the shoulder joint - and therefore effectively links the scapula to the lower arm. 🤔 In the late cocking phase of throwing, it's working eccentrically to prevent excessive elbow flexion while storing elastic energy that can be released on the subsequent elbow extension of the delivery. In other words, you can view the long head of the triceps as somewhat of a "mini-lat," as the lat serves this similar store-release function (albeit with different functions) - and they both work as shoulder extensors. 💪 It's also interesting in that it's one of the few muscles where the trigger point referral patterns can work up and down, as opposed to just down. I've seen some throwers where treating triceps has been a game changer in terms of everything from elbow, to shoulder, to neck pain. 👇 The long story short is that you have to give the triceps some love with quality self-myofascial release/manual therapy and make sure that you preserve tissue length (by stretching into shoulder flexion and elbow flexion simultaneously). Swipe right for some ideas. Thanks to @andrewmillettpt for the dry needling and manual therapy and @oneilstrength and @sooo_deep for the exercise demos. #cspfamily

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Strength and Conditioning Stuff You Should Read: 3/10/18

Here's a special Saturday edition of Stuff to Read!

Bought-In - I posted a guest blog from Brett Bartholomew earlier in the week in light of the release of this new coaching resource from him. I've since had a chance to spend some time going through it, and it's been excellent. I'd highly recommend you check it out if you'd like to delve more into the coach-athlete relationship and optimizing adherence from your athletes.

EC on the Physical Preparation Podcast - It's been over a year since I joined my good friend Mike Robertson on his podcast, so we have plenty of good stuff to catch up on.

The Right Way to Stretch the Pecs - I saw someone really cranking on a pec stretch the other day, and it reminded me of this article I wrote for T-Nation nine years ago. The content still applies, even if I'm getting really, really old.

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This #tbt is a video of alternating serratus slides on the @trxtraining suspension trainer, with a great demo from #mets pitcher @nsyndergaard. Some thoughts: 1️⃣One of the things we worked a lot on with Noah this offseason was differentiating between glenohumeral (ball on socket) and scapulothoracic (shoulder blade on rib cage) movement. Most pitchers get too much motion from the upper arm, and not enough from the shoulder blade. Notice how the scapula upwardly rotates around the rib cage - which takes stress off the front of the shoulder. 2️⃣ serratus anterior also helps to drive some thoracic flexion in a throwing population that often presents with a flat/extended thoracic spine (upper back). 3️⃣in a general sense, you could call serratus anterior the “anti-lat.” The latissimus dorsi drives a gross extension pattern and can be heavily overused in throwers; the serratus anterior works in opposition (scapular upward rotation, intimate link with the anterior core, accessory muscle of exhalation). 4️⃣add a full exhale at the “lengthened” position on each rep 5️⃣you could’ve observed the shoulder blades better if he was shirtless, but I figured Thor has already hit his weekly quota for shirtless social media cameos.😜 👍💪#cspfamily

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Strength and Conditioning Stuff You Should Read: 1/24/18

I hope your week is off to a great start. Just in case it isn't, though, here are some recommended reads to turn it around!

10 Nuggets, Tips, and Tricks on Energy Systems Development - Mike Robertson hit a bunch of nails on the head with this excellent article.

When: The Scientific Secrets of Perfect Timing - I just finished up this new book from Daniel Pink, and it was outstanding. He covers everything from nutrition, to exercise, to career success, to economic ups and downs, to sleep quantity/timing. It was a really entertaining read with many applications to the strength and conditioning field.

Organic vs. "Forced" Lay Back in the Pitching Delivery - This mechanics discussion from CSP-MA pitching coordinator Christian Wonders is very important stuff to understand if you work with pitchers.

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