Ideally, the chin/neck/head should remain in neutral and the scapula should retract and depress in sync with humeral movement.

Of course, these problems don't just occur with rowing motions; they may be seen with everything from deadlifts, to push-ups, to chin-ups.  So, be cognizant of how you're doing these strength exercises; you may just be making bad posture worse!

10. Get regular soft tissue work. I don't care whether it's a focal modality like Active Release, a mid-range modality like Graston Technique, or a more diffuse approach like general massage; just make sure that you get some sort of soft tissue work!  A foam roller is a good start and something that you can use between more targeted treatments with a qualified professional.  A lot of people really think that they are "breaking up scar tissue" with these modalities, and they certainly might be, but the truth is that I think more of the benefits come from altering fluid balance in the tissues, stimulating the autonomic nervous system, and "turning on" the sensory receptors in the fascia.

For more thoughts along these lines, check out my recap of a Thomas Myers presentation: The Fascial Knock on Distance Running for Pitchers.

11. Recognize that lower body postural improvements will be a lot more stubborn than upper body postural improvements. Most of this series has been dedicated to improving upper body postural distortions (forward head posture and kyphosis).  The truth is that they are always intimately linked (as the next installment will show) - however, in the upper body, bad posture "comes around" a bit sooner.  Why?

We don't walk on our hands (well, at least not the majority of the time).

Joking aside, though, the fact that we bear weight on our lower body and core means that it's going to take a ton of time to see changes in anterior pelvic tilt and overpronation, as we're talking about fundamentally changing the people have walked for decades by attempting to reposition their center of gravity.  That's not easy.

So why, then, do a lot of people get relief with "corrective exercises" aimed at bad posture?  Very simply, they're creating better stability in the range of motion they already have; an example would be strengthening the anterior core (with prone bridges, rollouts, etc.) in someone who has a big anterior pelvic tilt and lordosis.  You're only realigning the pelvis and spine temporarily, but you're giving them enough time and stability near their end range to give them some transient changes.  The same would be true of targeted mobility and soft tissue work; it acutely changes ROM and tissue density to make movement easier.

Long-term success, of course, comes when you are consistent with these initiatives and don't allow yourself to fall into bad posture habits in your daily life.  In fact, I have actually joked that we could probably improve posture the quickest if we just had people lie down between training sessions!

12. Add "fillers" to your weight training program. Mobility drills aimed at correcting bad posture are often viewed as boring, and in today's busy world, they are often the first thing removed when people need to get in and out of the gym quickly.  To keep folks from skipping these important exercises, I recommend they include them as "fillers."  Maybe you do a set each of ankle and thoracic spine mobility drills between each set of deadlifts (or any strength exercise, for that matter) - because you'd be resting for a couple of minutes and doing nothing, anyway.  These little additions go a long way in the big picture as long as you're consistent with them.

I'll be back next week with Part 4 of the Correcting Bad Posture series.

5. Make sure you're continuing to foam roll the area and getting the occasional treatment on them with that same manual therapy you had during your rehabilitation.  Here's a great self myofascial release option with the foam roller:

Q: I read with great interest your recent review of Muscle Imbalances Revealed, and in particular, your comments on Mike Robertson's presentation that touched on factors related to excessive pronation.  I have this excessive foot pronation, plus a spondylolisthesis, a history of ankle sprains, double-jointed elbows and knees, and hips that move around like John Travolta's in Saturday Night Fever. Basically I should have given up my career and gone into the Cirque de Soleil.

What I want to know is that specifically with my feet if wearing a supportive shoe with orthotics is such a bad thing. Everyone is on this barefoot kick, but it just doesn't work for me. If I go barefoot my hips move out of correct position and my ankles and calves ache. In fact, when I was a child, my dad had to massage my calves and arches at night because I'd be in tears from the pain of being flat-footed. Once I got my first orthotics at age 7, I was so much more comfortable. I feel that orthotics and a nice flat shoe for me helps me use my feet correctly and allows me to stay away from internal rotation of the tibia and femur, and reduces pelvic tilt, etc.

Or, I could be mistaken? What do you think, and have you heard anyone else talk about this? Other hypermobile people and I have talked about this and we all seem to feel the same: barefoot is not the way to go for us.

A: Extensive barefoot stuff is definitely not for everyone, and if you were having issues that significant at such a young age, you're probably just someone with a structurally different foot type.  There are definitely scenarios where orthotics are indicated, and the fact that you've gotten so much symptomatic relief from them tells me that they're a good thing in your case.

That said, you might still benefit from just a bit of barefoot training - like deadlifting barefoot and doing some bowler squats and the like.  Basically, just use it for situations where foot positioning doesn't change.  Then, you don't have to mess around with how it affects the gait cycle.  I think you'll get some of the benefits of strengthening the small muscles of the feet and improving proprioception (in light of your history of ankle sprains) without all the unfavorable compensations further up.  And in folks who don't have your hypermobility, improving dorsiflexion ROM would be an added benefit.

I wouldn't say that it's specific to hypermobile individuals, though.  A lot of them probably have issues with barefoot training because they lack the strength and underlying stability required at the lower leg and hip to take the ground reaction force stress off the feet.  Remember that mobility and stability are always working at odds with one another; if you've got too much of one, you have to train the other one to pick up the slack.  My hunch is that most of these people don't have structural pronation; they have excessive functional pronation because the anti-pronators - specifically the hip external rotators - aren't strong enough to decelerate that pronation.  Check out the valgus (poor) positioning on the left here:

Of course, in the general population, we see it for this reason, as well as the fact that most people walk around in terrible cinder blocks footwear that completely "tunes out" the joints and muscles of the feet.

A lot of the folks that try barefoot training and wind up in pain get that way because they're idiots and jump right in full-tilt.  You can't go from wearing cross-trainers to wearing thin pieces of cloth/rubber overnight.  And, as Nick Tumminello wisely pointed out recently, while our ancestors were barefoot all the time, they weren't barefoot on CONCRETE for loads of mileage.  And, they weren't as overweight as today's society is, with such low relative strength. As always, people get hurt because they are stupid and not because a specific training modality is bad.

Typically, in a broad sense, I recommend that people do their 1-leg (pistol) squats, all deadlifting variations, and box squats without sneakers.

As long as they aren't really overweight - or presenting with a history of foot problems - we'll also have them do their warm-ups without sneakers.

Everything else (including more quad dominant squatting variations) are done with footwear. I'm a big fan of the New Balance Minimus; you can read my full review at the following link: The New Balance Minimus: The Best Minimalist Training Shoe on the Market.

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You can see that Beckett is just short of stride foot contact here - which means that he's at just about maximal hip external rotation on the lead leg...in open chain motion.  The femur is rotating on the acetabulum.

Meanwhile, he's riding out his trailing leg...in closed chain motion.  The acetabulum is rotating on the femur.

I've trained Blue Jays left-handed pitching prospect Tim Collins for the past three seasons.  At a Double-A game earlier this year, Tim introduced me to his good buddy Trystan Magnuson, a right-handed pitching prospect who is also in the Jays system.  While Tim was a whopping 5-5, 131 pounds when he was signed right out of high school (now 5-7, 170), Trystan stands 6-7.  Check out this picture I recently came across from spring training:

Anyone who thinks these two are going to throw a baseball with velocity and safety via the same mechanics is out of his mind. As an aside, if you're interested in watching both of them throw, there is some decent warm-up footage of both HERE.

Changing these mechanics could take away everything that makes these pitches successful, so you have to look to the other three factors to prepare them physically and protect them from these stresses.  It's like making sure you give a guy a helmet if he is going to be banging his head against a wall!

All that said, finding the right mechanics is important for little leaguers and professionals alike - and it's the first step in protecting the elbow in a throwing situation.  As we realize that the very issues that increase elbow stress happen to be the same ones that a) increase velocity and b) are often demonstrated by elite pitchers, we appreciate once again just how unnatural an act throwing a baseball really is!

It's not just about what you do before an outing, either.  It's also about what you do in the 24 hours after an appearance that determines how you'll bounce back in your subsequent outing.  While the schmucks out there are doing "flush runs," the #1 thing I am worried about after a start is regaining lost range of motion.  Reinold et al. found that pitchers lost both shoulder internal rotation and elbow extension range-of-motion during a competitive season when an adequate stretching routine was not implemented.  It's no surprise, when you consider the overwhelmingly high eccentric stress that's placed on the shoulder external rotators and elbow flexors as they try to decelerate the crazy velocities we see with pitching.  As such, following an outing, the first thing we want our guys to do is get back their shoulder and elbow ROM (and get the hips loosened up).  There are some athletes who don't need to be stretched into internal rotation, so be careful about using this as a blanket recommendation (more on that in our Optimal Shoulder Performance DVD set).

For a bit more information on what we recommend for our pitchers between outings, check out A New Model for Training Between Starts: Part 2.

In closing, an important note I should make is that pitchers rarely get hurt because of just one of these factors; it's usually a combination of all of them. So, when evaluating a pitcher's health and performance, be sure to broad perspective.

We've got four down and two to go in this elbow series.  Stay tuned for more!

Enough said.

By the way, when I was watching this video on YouTube, one of the recommended videos was Will Ferrell's 2003 Harvard Commencement speech.  It is absolutely hilarious; talk about a way to make a graduation actually interesting!

We still have to plan our honeymoon soon as well, so it's going to be a very sunny year for a couple of Bostonians!

The funniest part is that Sahil is now pitching consistently over 90mph - and doing so at Stanford.  He's 1-0 with a 0.00 ERA through six outings in his freshman year. It's amazing that he's had this success just "training for football!"

Click here for more information on Optimal Shoulder Performance.

29. I already knew I had the greatest girl in the world, but when she took me to a Sox game last night for my birthday for the third year in a row, I was reminded once again!  Here we were last year - when I had more hair.