Home Posts tagged "Assessment"

Pitchers vs. Swimmers

I evaluated a baseball pitcher (left) and swimmer (right) back to back yesterday. It should serve as a reminder that not all overhead athletes are created equal - both in terms of the demands of their sports and the way they adapt to those demands.

The pitcher is a classic scapular depression example. Notice how “flat” the clavicle presentation is. He’s very lat dominant and struggles to get scapular elevation as part of upward rotation as the arms go overhead. He needs more upper trap activity.

Conversely, the swimmer is a scapular elevation presentation. Notice the significant upslope of the collarbone. He’s already so elevated that he struggles to get the rotational component of upward rotation. He needs more serratus anterior and lower trap, but less upper trap.

Three huge takeaways:

1. This is yet another reminder that you can’t just have a “rotator cuff program.” Both of these guys could present with the same pathology, but with completely different underlying movement diagnoses.

2.  The same exercises might need to be coached differently for two different athletes

3. Whenever you see tightness, before you stretch it, ask why it’s there. With the pitcher in scapular depression, it’s a protective tension you don’t want to just stretch out. The swimmer could actually benefit.

I cover these topics in great detail in my Sturdy Shoulder Solutions resource; you can learn more at www.SturdyShoulders.com.

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Assessments You Might Be Overlooking: Installment 6

It's been quite some time since I published an update to this series, but some recent professional baseball initial offseason evaluations have had me thinking more and more about how important it is to take a look at lateral flexion.

In the picture above, I'd say that the athlete is limited in lateral flexion bilaterally, but moreso to the left than right. You'll also notice how much more the right hip shifts out (adducts) as he side bends to the left; he's substituting hip fallout for true lateral flexion from the spine. The most likely culprit in this situation is quadratus lumborum on the opposite side (right QL limits left lateral flexion).

As you can see from the picture below, the triangle shaped QL connects the base of the rib cage to the top of the pelvis and spine.

Stretching out the QL isn't particularly challenging; I like the lean away lateral line stretch (held for five full exhales). This is a stretch that can be biased to target the lat, QL, or hip abductors.

That said, the bigger issue is understanding why a QL gets tight in the first place. As Shirley Sahrmann has written, whenever you see an overactive muscle, look for an underactive synergist. In this case, the right glutes (all of them) are likely culprits. If the gluteus maximus isn't helping with extending the hip, the QL will kick on to help substitute lumbar extension. And, if the gluteus medius and minimus aren't doing their job as abductors of the hip, the QL will kick in to "help out" in the frontal plane. This double whammy has been termed a Left AIC pattern by the good folks at the Postural Restoration Institute, and they've outlined many drills to not only address the apical expansion (which creates length through the QL), but also bring the pelvis back to neutral.

Taking this a step further, typically, those with very overactive QLs will also present with limited thoracic rotation (in light of the QL attachment on the inferior aspect of the ribs), so you'd be wise to follow up this stretch with some thoracic mobility work. The athlete in the example at the top of this article had the most limited thoracic rotation (both active and passive) that I've seen in any pitcher this offseason.

That said, here's a good rule of thumb:

If you have a flat thoracic spine athlete with limited thoracic rotation, look at pectoralis major, latissimus dorsi, and quadratus lumborum. If horizontal abduction (pec) and shoulder flexion (lat) both check out well, go right for QL tissue extensibility (as measured by lateral flexion). It will be absolute game changer - particularly in rotational sport athletes.

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

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The Best of 2017: Strength and Conditioning Articles

With 2017 winding down, I'm using this last week of the year to direct you to some of the most popular content of the past 12 months at EricCressey.com, as this "series" has been quite popular over the past few years. Today, we start with the most popular articles of the year; these are the pieces that received the most traffic, according to my hosting statistics.

1. Less Sickness for Better Results - The most important training goal should always be consistency, and getting sick is a big roadblock to that consistent training effect.

2. 5 Reasons to Use "Fillers" in Your Training Programs - "Fillers" are an awesome way for getting in more quality work in your training sessions. This article details the "why" and "how" of their incorporation in strength and conditioning programs.

3. Making Sense of Exercise Contraindications - If we just looked at MRIs, we could find a reason to contraindicate just about every exercise for just about every person. We need to dig a lot deeper to figure out which exercises are right for each person, though.

4. Simplified Shoulder Solutions - Don't making keeping shoulders any more complex than it needs to be. This article discusses how to "dumb things down" on this front.

5. 10 More Important Notes on Assessments - This one just went up recently, but got a lot of love in the short time it's been available. I guess folks can never get enough on quality assessments.

I'll be back soon with another "Best of 2017" feature. Up next, the top videos of the year!

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10 More Important Notes on Assessments

About 2.5 years ago, I wrote up an article, 10 Important Notes on Assessments, that was one of my most popular posts of the year. And since I’ve spent a good chunk of the past week going through the L2 Fitness Summit Video Series, Dean Somerset’s presentations on the assessment side of things made me realize that I'm ready for a sequel. Here are a few thoughts that came to mind.

1. Just like training, assessments are getting more specialized.

As the sports performance and even personal training worlds get more specialized, the assessments we need to utilize with our clients must be correctly matched up to the people in front of us. As examples, rotator cuff strength tests are huge for a baseball pitcher, but relatively unimportant for a soccer player. We’d “weight” a single-leg squat test result as less significant for a kayaker than we would for a basketball player. The goals of the client and the functional demands of their sport guide the assessments – both in terms of which ones we perform and how we value the results.

However, the challenge is that you can’t test everything, so it’s important to prioritize. If we used every assessment under the sun, the evaluation would last all day – and we’d spend an entire session pointing out everything that’s wrong with someone. I’d much rather use this time to build rapport.

A VO2max test isn’t high on my list of priorities for baseball players even if it might shed some light on their aerobic base. I can probably get the information I need just as easily – and much more affordably – by taking a quick resting heart rate measurement.

2. Every good test that has an unfavorable outcome immediately sets you up for an even more telling retest.

Assessments give you a glimpse into what could potentially be wrong or right about how someone moves. The more important question is: what interventions make a difference? Their squat pattern improves when you give them an anterior counterbalance? Their hip internal rotation improves when you add some core recruitment? Their shoulder pain goes away when the massage therapist works on their scalenes?

One tenet of the Selective Functional Movement Screen (SFMA) system is to always start with dysfunctional, non-painful patterns. What interventions clean up aberrant movement in non-painful areas to give us "easy" adaptations? This not only expands our movement repertoire, but also facilitates buy-in from the athlete/client.

3. Never go to movement screens without first performing a thorough health history and client “interview.”

I think we can all agree that a pre-participation evaluation can dramatically reduce the likelihood in training. And, I'd argue that the single most important part of this evaluation is the health history and conversation you have with them before they even start the movement screen portion of it.

As an example, imagine you have a hypermobile female client with a history of serious anterior shoulder instability that hasn't been surgically treated. If you do thorough paperwork and a detailed conversation with her, you'll quickly ascertain that you have to be careful with anything that involves shoulder external rotation. If you don't do that preliminary work, though, you might very well pop her shoulder out of the socket doing a basic external rotation range-of-motion test.

Summarily: paperwork first, conversation second, movement third!

4. Have assessment regressions for people who can’t perform certain tests due to pain or poor movement competencies.

I like to use a Titliest Performance Institute screen – lumbar locked rotation – to assess thoracic rotation. It requires an individual to get into a lot of knee flexion, though. So, if you have someone who is extremely short in their quads – or has had a knee replacement and permanently lost that motion, then it’s not a solid test.

You’re better off going to a seated thoracic rotation screen with these folks.

As a good rule of thumb, you’ll need more alternatives to general screens (involving more joints and motor control challenges) than you will for specific assessments (involving fewer). So, as you look through your assessment approach, start to consider how you’ll regress things when things don't go as planned.

5. Don’t overlook evaluating training technique as a means of assessing.

During almost every evaluation of someone who has struggled with pain or performance (which is really everyone), I look at technique exercises they commonly perform. For our pitchers, this might be arm care exercises, or a video of a bullpen. For powerlifters, it might be technique on the squat, bench press, or deadlift. As much as our assessment protocols can be thorough, they’ll never fully offer the specificity that comes from watching people actually train.

6. Don’t use tests to embarrass people.

As an extension of the previous point, if you know someone is going to fail miserably on a screen, don’t test it. If you have a 350-pound woman who wants to lose 200 pounds, she’s not going to do well on a push-up test. You can assume that her upper body strength and core stability aren’t sufficient to handle her body weight.

I keep coming back to it:


7. Watch for straining.

This is something I’ve watched for a lot more in recent years after spending time around my business partner, Shane Rye, who’s one of the best manual therapists I have ever seen. He’s a master of watching people move and picking up on where they tend to store their tone. Maybe it’s jaw clenching when you test rotator cuff strength, or making an aggressive fist when you check their active straight leg raise. Watching for changes in accessory tone can give you a glimpse into where you might get the best benefit with your manual therapy work – and how you might coach them differently while they’re training.

8. The best outcome of an assessment might actually be a referral for a more thorough assessment.

At least once a year, I have an assessment come in - but without doing any training, I refer them on for further evaluation. Usually, it's because something very "clinical" in nature presents, and I feel that they need to see a medical professional before we start working with them. It doesn't happen often, but I'm never shy about "punting" when I feel that someone else is better equipped than I am to help the person in front of me.

9. Don’t take their word for it on body weight.

I once had a 6-8 pitcher tell me that he weighed 235 pounds. The next day, he walked in and remarked, “Coach, I actually weighed in this morning. I was 253 pounds.” Now, 18 pounds isn’t as huge a percentage of total body mass on a 6-8, 253 guy as it is on a 14-year-old, 110 pound female teenager, but it’s still tell us a lot that he could actually swing 18 pounds without even feeling it. That’s a sign of an athlete with poor body awareness and a lack of nutritional control (they definitely weren’t a good 18 pounds). You're better off measuring than just asking.

A side note: this applies to male athletes only; I never weigh female athletes for obvious reasons.

10. Take meticulous notes.

I often find myself looking back on notes we have on long-term clients to see how their movement (and prescribed training) has evolved over the years. It wouldn't be possible if I wasn't very detailed in my note-taking - and this is something I'm always striving to improve upon, as we want to create sustainable systems in our business.

Employees move on, so a client's programming responsibilities may be shifted to other staff members. Sports medicine professionals may want to work from some of our notes. Teams and agents might want information on what we discovered with a player and how we plan to manage them. The more you document, the more prepared you'll be in these situations when collaboration is necessary.

Most importantly, though, whenever I write a new program for a client, I have their evaluation form and their previous program open on my computer. I want to see what I initially noticed and put it alongside the up-to-date programming to verify where we are in our progressions. It's this kind of documentation that allows me to program for dozens of athletes who are not only in our facility, but across the country and overseas.

Wrap-up

I've been assessing athletes for close to 15 years, and I find that our evaluations evolve every single year. If you're looking to stay on top of some of the latest developments on this front, I'd strongly encourage you check out the L2 Fitness Summit Video Series, the new resource from Dean Somerset and Dr. Mike Israetel. It's available at an introductory discount through Sunday at midnight.  You can learn more HERE.

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Random Thoughts on Sports Performance Training: Installment 27

 I didn't get a chance to write a February installment of this series, so I'll do my best to over deliver with an extra few bulletpoints in this March edition.

1. Use video even if you don't think you need to use video.

A few weeks ago, I decided it was about time I learn how to use iMovie on my iPhone. What better way than to film pieces of my training session and put them all together?

Interestingly, beyond proving that I’d actually entered the 21st century from a technology standpoint, there was an added benefit: I identified some subtle technique issues that I could address. I didn’t like the inconsistent way I unracked the bar from set to set on squats, and I was slipping into more forward head posture than I would have liked on my TRX fallouts. These aren’t epic technical faults, but over time, they’d certainly detract from an optimal training effect. I wouldn’t have known if I hadn’t videoed. And, this is coming from a guy who uses video regularly with his athletes.

On the whole, I think folks video TOO MUCH nowadays. A phone on the training floor is usually a distraction and interferes with the training process. However, used correctly, video can be a tremendous resource – and one I’ll be using more with my own training.

2. Think of assessments as descriptive, not predictive.

There is a ton of research out there on how to predict sports injuries. When it really boils down to it, though, we learn that:

a. the single best predictor of future injuries is a previous injury (duh)

b. predicting injuries is really, really hard

Why is predicting injuries so challenging? Very simply, injury risk is incredibly multifactorial. Injuries occur because of a remarkable interplay of systemic, biomechanical, and physiological factors – and they’re mixed in with pure happenstance: collisions, hit-by-pitches, poor weather conditions, and equipment malfunctions.

As such, it’s challenging to say that any single assessment will ever truly be a gold standard in predicting injuries. Accordingly, we should think of the assessment process as descriptive above all else. In other words, what we see when we first encounter an individual is their “default pattern:” how they’ll respond to a chaotic environment in the real world “fight-or-flight” scenarios.

For example, consider one of my favorite assessments, the overhead lunge walk:

When first challenged with an overhead lunge walk, many athletes dive into knee valgus, use a short stride, and slip into lumbar extension and forward head posture. Sure, we can clean a lot of these things up in a matter of less than 15 seconds, retest, and get a better outcome. That doesn’t fundamentally mean we’ve improved their movement quality or reduced their risk of injury, though. Effecting lasting changes takes time and lots of high-quality reps. However, the descriptive nature of the assessment guides our program design, which gives us a road map for these efforts.

3. Go unilateral to progress anterior core stability drills into rotary stability challenges.

When we categorize our core stability drills, we’ll break them down into the following designations:

a. anterior core (resisting extension of the lower back): rollouts, fallouts, etc.
b. rotary core (resisting rotation of the lower back): chops, lifts, etc.
c. lateral core (resisting lateral flexion – or side bending – of the lower back): 1-arm farmer’s walks, side bridges

With both rotary and lateral core “dominant” exercises, we can appreciate that the anterior core is also working to resist extension as we do a chop, lift, or farmer’s carry. In other words, we’re always controlling the sagittal plane above all else.

However, when we perform anterior core challenges – rollouts, fallouts, bodysaw drills, and basic prone planks/bridges – we really don’t get much of a challenge to rotary or lateral core stability. With four points of contact (two feet/knees and two arms/hands), the challenge outside the sagittal plane is minimal.

Fortunately, we can quickly and easily “bias” our anterior core work to get us additional challenges in the frontal and transverse planes by simply going to unilateral or asymmetrical set-ups. This is one (of many) scenarios where a TRX suspension trainer can be a game-changer. Here are two favorites: the 1-leg TRX fallout and TRX flutters:

 


4. Coaches need to train.

I don’t compete in powerlifting anymore. Life as a husband, dad, and owner of multiple businesses is hectic enough that competition was pushed out. And, my shoulder doesn’t love back squats these days.

Still, I lift a lot, get out and sprint, do interval training, and even mix in some rec softball and pick-up beach volleyball. This isn’t just because it’s hard-wired into my brain’s perception of a “normal day,” but also because I firmly believe that every training session allows me to evolve as a coach and have more empathy for our athletes.

Understanding how to modify your own training when you’re super busy at work or sick kids kept you up all night gives you an appreciation for how athletes feel when you ask them to get an in-season lift in after a weekend with four games.

Getting in a lift after a late cross-country flight makes you appreciate that it might be a better idea to score an extra few hours of sleep – rather than imposing more fatigue – in the middle of a road trip.

Putting yourself through 8-12 weeks of challenging training with a new program allows you to experiment with new principles to see if there are better methods for serving your athletes.

You don’t get these lessons if you don’t continue to train throughout your professional career. At age 25, I had no idea what our 35-year-old athletes felt like after training sessions. Now I understand it on a personal level – but more importantly, I’m keenly aware that our 45-year-old athletes probably have it even harder, so I need to ask a lot more questions and do a lot more listening in that demographic.

If you’re a strength and conditioning coach, the gym isn’t just where you work; it’s also where you experiment and learn. Don’t miss those opportunities to grow.

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Random Thoughts on Sports Performance Training – Installment 23

It's time for the October edition of this sports performance training series. I've been doing a lot of early off-season evaluations for pro guys, so a lot of conversations and assessments on that front are at the top of my mind.

1. Communication can be good and bad.

One of the biggest complaints I hear from professional athletes about their "employing" organizations is that the communication isn't good. They get mixed messages from different coaches and don't know where they stand on a variety of things. More than any of the amenities they could request, they really just want everyone to be on the same page and for the plan of attack to be related to them - and with frequent updates.

Interestingly, though, in the gym, athletes (especially more advanced athletes) usually want you to communicate less. They need clear, concise coaching cues so that you don't overwhelm them or kill the training environment with "nit-picking." Too much communication can actually be just as problematic as too little.

If you look at the typical training session for one of our athletes, I think you'd find that 80% of all the words spoken occur during the arrival, warm-up, and post-training cooldown periods. During the training session, it's time to get after it. Those 20% of words are implemented tactfully.

2. Many athletes don't have "clean" hip extension - and your exercise selection should reflect that.

Around this time last year, I posted this video of an MLB pitcher who was just starting up with us:

After seeing quite a few guys who look like this, it's really made me reconsider whether going directly to a Bulgarian split squat (rear-foot-elevated split squat) in these guys is a good bet in the early stages of the offseason. This exercise requires a lot of not only hip extension range of motion, but also the core stability to make sure that ROM is actually used (the concept of relative stiffness in action). This is something we touched on on in Mike Reinold and my recent release, Functional Stability Training: Optimizing Movement

With all this in mind, I've been using more regular split squats - which require less hip extension range-of-motion - in the first month of the offseason for even some of our advanced guys as they work to reestablish cleaner lumbopelvic movement strategies in the early off-season. That said, regular split squats can be a little harder on the trailing leg toes than the rear-foot-elevated version, so individualization (as always) is super important.

3. Sometimes, efficient transfer of force - and not joint-specific coaching - delivers the good positions for which you're looking.

I've often written about how we have both specific and general assessments in our training arsenal, but it's actually somewhat of a continuum. Specific assessments would be more along the lines of classic joint range-of-motion measurements. Shoulder abduction or flexion would be slightly more general, as these screens involve multiple joints. Finally, an overhead squat, overhead lunge walk, or push-up would all be very general screens that look at multiple joints and help to evaluate how well an athlete transfers forces.

Interestingly, though, very often, we see coaches and rehabilitation specialists who only have specific correctives even though they utilize a load of general assessments. The goal should be to ultimately get athletes to the point that efficient movement on general tasks delivers the positions you're hoping to safely achieve. As an example, we will use wall slide variations as part of our warm-ups to teach athletes how to get upward rotation of the scapula. A progression would be landmine press variations; usually in half-kneeling or standing:

Eventually, though, athletes are ready to "sync" these movements up in a scenario where transfer of force from the lower body up through the core and to the arm allows that upward rotation to happen.

In short, a good reminder is:

[bctt tweet="As is the case with your assessments, your correctives should range from specific to general."]

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The Best of 2015: Strength and Conditioning Articles

With 2015 winding down, I'm using this last week of the year to direct you to some of the most popular content of the past 12 months at EricCressey.com, as this "series" has been quite popular over the past few years. Today, we start with the most popular articles of the year; these are the pieces that received the most traffic, according to my hosting statistics.

1. 12 Questions to Ask Before Including an Exercise in Your Training Program - I drafted up this article to outline all the things that go through my brain as I'm writing up a strength and conditioning program.

2. 10 Important Notes on Assessments - I'm a big believer in the importance of assessments in the fitness industry, but it's really important to make sure that these assessments are performed correctly - and matched to the population in question. Here are ten thoughts on the subject.

serratuswallslide

3. How to Build an Aerobic Base with Mobility Circuits - I just posted this article a few weeks ago, and it already received enough traffic to outpace popular posts that were posted much earlier in the year. Suffice to say that folks were excited about the fact that you can improve movement quality while improving conditioning. 

4. Is One-on-One Personal Training Dead? - In spite of the direction of the fitness industry with respect to semi-private training, I'm still a big fan of one-on-one training - and I think every fitness professional should be proficient with it.

semiprivate

5. 5 Ways to Differentiate Yourself as a Personal Trainer - Here's a must-read for the up-and-coming fitness professionals in the crowd.

I'll be back soon with another "Best of 2015" feature. Up next, the top videos of the year!

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Random Thoughts on Sports Performance Training – Installment 11

Earlier this week, the Major League Baseball Draft took place, and when all was said and done, 27 Cressey Sports Performance athletes had been selected. To that end, I thought it was a good time to type up this month's Random Thoughts on Sports Performance Training installment, as the draft has been what's on my mind. Point #1 is a lead-in to the points that follow.

1. I actually posted this on my Facebook page and was surprised at how many "likes" it got, so I'm sharing it here - especially since I think it'll serve as a jumping off point with respect to culture.

The biggest compliment a client can pay to CSP is when a parent trusts us to train their son/daughter during the teenage years when they're young and impressionable and need good role models to model positive behaviors.

The second biggest compliment a client can pay to us is when a professional athlete trusts us with his/her career.

The annual MLB Draft is the time of year when these two compliments coincide, and we get to see how point #1 can lead to point #2 as dreams come true. Congratulations to the 27 CSP athletes drafted over the past three days; thank you very much for having us along for the ride.

It's always awesome to see guys we've trained through their high school years transition to professional athletes. These scenarios not only provide lessons on long-term athletic development, but also the importance of creating a culture at the facility that makes training fun over the long haul.

2. I recently finished up the audiobook, Unmarketing, by Scott Stratten.

UnmarketingCover-232x300

One of the key messages Stratten drills home is that customers have to like you before they can get to know you, and they have to know you before they can trust you. Obviously, in the strength and conditioning field, our athletes/clients are our customers. This "like-know-trust" is an important message, because long-term athletic development - and certainly working with professional athletes (or those trying to become pro athletes) is all about trust. They need to trust that you're giving them the appropriate programming and cues they need for success.

He goes on to discuss how many businesses put the carriage in front of the horse on this point. They don't work to build a relationship with their customers before trying to monetize them. It's like asking someone to marry you in the middle of the first date. I immediately thought about how our business model has impacted our training model.

When a new athlete comes to CSP, they're individually assessed and we have a chance to spend anywhere from 20-60 minutes getting to know them. It's not only a chance to review injury history and go through a movement evaluation, but also an opportunity to build rapport by learning about goals, training history, and common interests. It also gives us a chance to subtly demonstrate our expertise and relate a plan of attack for how we can help. In short, an initial evaluation is about learning about so much more than just whether an athlete has sufficient hip internal rotation!

Eric-Cressey-Shoulder_OS___0-300x156

Conversely, think about what happens when an athlete walks into a facility where every athlete does the same program on the dry erase board, and there isn't an assessment to kick things off. In these scenarios, the trainers/coaches really haven't done anything to get to know the athletes, and they certainly haven't gotten these athletes to "like" them. The road to building trust has gotten started with a pretty messy detour - and it'll take a long time to build things up.

3. We really go out of our way to create context for our athletes when we're coaching. In other words, our coaching cues need to build on what an athlete already knows. A front squat is easier to learn when you've already done a goblet squat, and a rotational medicine ball shotput can build upon what an athlete knows from baseball hitting. However, I don't think people ever recognize the importance of creating context for success - and I'm a big believer that it's been a huge part of the results we've gotten.

Everyone knows that for years and years, the world dreamed of having someone run a sub-4-minute mile. Then, in 1954, Roger Bannister accomplished this great feat - and thereafter, it became very commonplace. Granted, the sports media somewhat unfairly sensationalized the "quest" for the 4-minute-mile, but the message is still very much the same: once you've seen someone accomplish something that appeared very daunting, you're more likely to be able to accomplish it yourself. The 27 CSP guys drafted this year have watched over 50 guys get drafted in the three years ahead of them - and, just as importantly, they've had a chance to rub elbows with them during training. Success leaves clues - and clues help to create context for more success.

4. On the whole, at young ages (younger than 16), I think the notion of "Sports-Specific Training" is actually pretty silly. We can all agree that good movement is good movement, regardless of whether a young athlete plays soccer, football, lacrosse, or basketball. Overhead throwing athletes, though, are - at least in my opinion - a very important exception to the rule.

In all these other sports, we can adequately prepare for the most common injury mechanisms with well coached general training exercises in our strength and conditioning program. However, how many weight room exercises do you see that help an athlete build stability in this position?

layback

If you have an athlete that goes through this kind of lay back - whether it's with baseball/softball, swimming, tennis, or any other overhead sports - you need to train them to build stability in this position.

5. In all, there were 1,215 players drafted earlier this week over the 40 rounds. That's astronomically higher than any other professional sport - and in no other sport do you more quickly go from being a big fish in small pond to being the small fish in a big pond. As of right now, only two of the 41 first round (plus supplemental round) picks in last year's draft have made it to the big leagues. Conversely, if you're a first rounder in the NFL or NBA, you're in "the show" right away pretty close to 100% of the time.

In other words, there is a lot of time for things to go wrong for draft picks while in minor league baseball. Injury rates are at all-time highs, players may get into trouble, and others might just discover that they don't have the talents necessary to compete at the highest level. Scouting baseball players is an imperfect "science" - and, sadly, 90% (or more) of these 1,215 players won't "make it."

For this reason (and many others), I heavily emphasize to our staff and athletes that our #1 job is actually to educate our minor league guys on how to be advocates for themselves and understand what is unique about how they move. If we can give them the best training and nutrition insights possible - and teach them how to practically apply them throughout a long season - they stand much better chance of making it to the big leagues. Strength and conditioning coaches may not be able to impact talent (at least not directly), but we can impact one's ability to display it consistently. In fact, this is what the wall of our assessment room looks like:

durability-300x300-2

6. I've talked in the past about how all our arm care programs work proximal to distal. In other words, we focus on core control, rib positioning, and thoracic spine mobility, then move to scapular control, then to the glenohumeral (ball and socket) joint, and then down to the elbow. It's because there is somewhat of a "downstream" effect. Improving thoracic rotation can improve shoulder internal rotation. Getting an athlete out of a heavily extended core posture can get the latissimus dorsi to calm down, which takes stress off the elbow. Taking care of scapular control might even relieve nerve impingement that's causing symptoms into the hand. The possibilities for this "downstream" effect are really endless.

Conversely, though, there isn't an "upstream" effect. Nobody's thoracic spine mobility improves if you do some soft tissue work and stretching to get some elbow extension and supination back. Improving rotator cuff strength won't get rid of lower back pain.

This is why I think improving anterior core control in baseball players can be such an unbelievable game changer. We know that improving function in the sagittal plane is generally easier than improving it in the frontal or transverse planes, and the anterior core is really responsible for resisting lumbar extension.

APT

Additionally, the core is the furthest "upstream" option to impacting function. So, if you're a believer in the concept of minimum effective dose (and I am), your goal should be to work on the easiest, most impactful stuff first. Anterior core is that option in a baseball population.

In fact, it's so important that I did an entire 47-minute presentation on the topic. If you haven't checked out Understanding and Coaching the Anterior Core yet, I'd encourage you to do so.

AnteriorCore

Congratulations again to all this year's MLB draft picks! Have a great weekend, everyone.

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10 Important Notes on Assessments

I'm a big believer in the importance of the "Assess, Don't Assume" mentality. However, it's crucial that assessments be approached the right way in order to deliver optimal results in strength and conditioning programs. Here are ten thoughts on the subject:

1. Assessments are an easy way to differentiate yourself.

With this era of semi-private training and bootcamps, there are still a lot of coaches and facilities out there that pay no attention whatsoever to pre-participation screenings. On one hand, it's a sad commentary on our industry, as one could argue that omitting assessments sets clients up for injuries. On the other hand, it creates an excellent opportunity for skilled coaches and trainers to differentiate themselves in a low-barrier-to-entry industry. If you're not assessing, you're just guessing! Make it a priority to start learning more about your clients/athletes.

2. Thorough assessments include both specific and general components.

In my eyes, every assessment can be categorized as either specific or general. Specific assessments may be anything from single-joint range-of-motion (ROM) assessments to the provocative tests physicians and rehabilitation specialists may use. They identify specific things like elbow extension ROM or whether a particular test elicits pain.

Conversely, general assessments look at global movements and evaluate multiple joints at the same time. Examples include overhead squats and push-ups.

The problem is that both kinds of assessments can fall short. As examples, you may see unstable young athletes who pass all ROM assessments (specific) with flying colors, but fold up like lawn chairs when they do an overhead lunge walk (general).

You may also see athletes with perfect overhead squats, but significantly limited knee flexion ROM that would make you concerned that they'd pull a quad (rectus femoris) while sprinting. These are just two examples, though; there are countless more we could cite.

3. You must always be willing to refer out.

You're better off being a great trainer/coach than you are trying to be an incredibly subpar physical therapist or physician. Even if you had a tremendous knowledge of provocative tests and rehabilitation techniques, as a trainer/coach, you don't have the same resources (e.g., diagnostic imaging equipment) these professionals have. Furthermore, diagnosing is outside your scope of practice, anyway.

I refer out every single week. It creates great opportunities for collaboration that will benefit our clients/athletes, and for our staff to learn from related professionals. If you see something on an assessment that raises a red flag, it's better to be safe than sorry.

4. Don't assess just for the sake of assessing; make it to the point.

My biggest assessment pet peeve is when the process takes too long. You can do an incredibly thorough evaluation in about 30 minutes, and most shouldn't even take that long. The only ones that would require more time would be those with extensive injury histories or other unique circumstances.

[bctt tweet="The sooner you're done assessing, the sooner you can get to training."]

5. Assess in the context of both injury history and functional demands.

As a follow-up to point #4, you never want to go into a movement assessment "blind" with respect to the person in front of you. Rather, it's best to first review a health history and have a discussion about training history, goals, athletic demands, and expectations. I find that it's best to perform an evaluation with a better knowledge of an individual's history than it is to look at movement and then work backward from it.

For example, if your pre-assessment discussion reveals that an individual was a baseball player growing up, you can expect to see more external rotation on his dominant shoulder. That might lead you to look more closely at whether he has adequate anterior shoulder stability, and whether his scapula upwardly rotates enough. It also might help to explain a low right shoulder.

RightER

Basically, you need to see the big picture; the "answers" are usually a combination of a bunch of tests, questions, and observations.

6. You have to emotionally separate yourself your personal biases when it comes to assessments.

Baseball players are the largest chunk of my clientele. As a result, I evaluate shoulders and elbows in a ton of detail.

Recently, we started training an NFL punter, though.

I did a thorough assessment with him, but let's just say that we didn't spend a ton of time worrying about verifying that he had perfect elbow ROM. Instead, we spent a lot more time looking at his core and lower extremity; otherwise, the assessment would have taken all day, and we'd acquire a lot of information that wouldn't have a significant impact on his programming.

7. Don't let hypermobile clients/athletes "cheat" assessments.

Just like you need to have both specific and general assessments, you also need to make sure to include both mobility and stability assessments. Hypermobile (loose-jointed) individuals are notorious for cheating assessments that are biased toward ROM. Comprehensive assessments need to also evaluate stability.

elbow10365821_744096285641478_6191697364410130329_n

In this vein, the Functional Movement Screen does a good job of looking at both sides of the equation. The shoulder mobility, overhead squat, and straight leg raise tests are general assessments largely biased toward mobility, but the trunk stability push-up, hurdle step, rotary stability, and in-line lunge screens are all predominately stability challenges.

To learn more about how hypermobile folks can "cheat" assessments, check out my article, 15 Static Stretching Mistakes.

8. Have some feel; don't make new clients (or any clients) uncomfortable.

If a man is overweight and uncomfortable with his body, it's probably not a great idea to have him take his shirt off for a scapular screen. If a woman is seriously deconditioned, it's probably not a good idea to put her through a lunge assessment that she'll fail miserably. And, it's an even worse idea to do these things in front of a crowded gym.

           Remember that the first day is as much about
           building rapport and starting a friendship as it
            is about evaluating how an individual moves.

As has been said in the past, "They have to know how much you care before they care how much you know."

9. Don't forget to highlight what individuals do well, too.

In How to Win Friends and Influence People, Dale Carnegie wrote, “It is always easier to listen to unpleasant things after we have heard some praise of our good points.” This point applies to fitness and movement assessments, too. Think about it: would you like to be criticized non-stop for 30 minutes? Probably not.

By contrast, if someone highlighted what you did well while also covering some important growth areas for you, wouldn't these suggestions be more well received? Absolutely.

Again, your goal is to establish a great relationship, not just analyze movement.

10. Remember that training is a never-ending assessment.

Every exercise is an assessment. Each time your clients and athletes move, they're providing you with information. The more you pay attention, the better you'll be able to individualize their programs and coaching cues moving forward.

If you're looking for more information on the assessment side of things, I'd encourage you to check out our Functional Stability Training series. These resources go into great detail on evaluating the lower body, upper body, and core.

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The Overhead Lunge Walk: My Favorite “Catch-All” Assessment

We spend a good chunk of our lives standing on one-leg. Obviously, that means we need to train on one leg, but it's also important that fitness professionals and rehabilitation specialists assess folks when they're in single-leg stance, too. Enter the overhead lunge walk, which is likely my favorite assessment because of just how comprehensive it is.

Why is it so great? Let's examine it, working from the upper extremity to the lower extremity.

First, you can evaluate whether someone has full extension of the elbows. Just tell folks to "reach the fingers to the sky." In a baseball population, as an example, you can quickly pick up on an elbow flexion contracture, as it's quick and easy to make a comparison to the non-throwing side.

IMG_7810

Additionally, you can screen for congenital laxity, as a lot of hypermobile (loose jointed) folks will actually hyperextend the elbows during the overhead reach.

elbow10365821_744096285641478_6191697364410130329_n

At the shoulder girdle, you can evaluate whether an individual has full shoulder flexion range of motion:

IMG_7895

You can also tell whether the aforementioned hypermobile folks actually move excessively at the ball-and-socket joint of the shoulder, as they'll actually go too far into flexion instead of moving through the shoulder blades.

You can determine whether an individual has an excessively kyphotic, neutral, or extended thoracic spine. If they're kyphotic, they'll struggle to get overhead without compensation (arching the lower back or going into forward head posture). If they've got an excessively extended thoracic spine, they'll actually go too far with the overhead reach (hands will actually wind up behind the head if it's combined with a very "loose" shoulder).

You can tell whether an individual is able to fully upwardly rotate the shoulder blades in the overhead position.

You can tell whether someone preferentially goes into forward head posture as a compensation for limited shoulder flexion, poor anterior core control, or a lack of thoracic spine extension or scapular posterior tilt.

You can evaluate whether an individual has enough anterior core control to resist extension of the lumbar spine (lower back) during overhead reaching. This is a great test of relative stiffness of the rectus abdominus and external obliques relative to the latissimus dorsi.

You can evaluate whether an individual is in excessive anterior or posterior pelvic tilt from the side view.

Also from the side view, you can determine whether the athlete hyperextends the knees in the standing position.

With the lunge, you can see if an athlete is quad dominant - which is clearly evidenced if the stride is short and the knee drifts out past the toes of the front leg. You can also venture a guess as to whether he or she has full hip extension range of motion.

Also with the lunge, you can determine how much control the athlete has over the frontal and tranverse planes; does the knee cave in significantly?

You can make a reasonably good evaluation of foot and ankle function. Does the ankle collapse excessively into pronation? Or, does he stay in supination and "thud" down?

Does the athlete handle the deceleration component effectively, indicating solid eccentric strength in the lower extremity?

As you can see, this assessment can tell you a ton about someone's movement capabilities and provide you with useful information for improving your program design. Taking it a step further, though, it goes to show you that if you select the right "general" assessments, you can make your assessment process much more efficient.

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