Home Posts tagged "Athlete Training Programs" (Page 3)

The Hips in Baseball Hitting

In just the past few days, I've had two separate conversations with some really knowledgeable CP "dads" who also happen to have a ton of experience with coaching youth baseball players, particularly hitters.  In both conversations, a (paraphrased) line that stood out was "improving as a hitter in the teenage years is largely about learning to use the hips."

In contrast, have the same hitting conversation with just about any professional baseball player, and he'll tell you "I hit with my hands."

So who is right?  Do professional players not use their hips?  Or, do kids not use their hands?

Actually, both parties are right.  You don't get to professional baseball in the first place if you don't use your hips well when hitting.  And, you don't succeed (and stick around) in professional baseball unless you use your hands efficiently and have remarkable hand-eye coordination.  It's just multiple levels of natural selection that set the best apart - and they may sometimes forgot about the early stages of progress.

Need proof?  Watch a little league batting practice session, and then go to a big-league game to watch their batting practice.  The young players all pull the ball on every pitch, whereas the big-leaguers usually spray the ball all over the field, moving from the opposite field to the pull side.  They do this with their hands and wrists, all the while taking the hips for granted.

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Think about this: how many more TFCC (wrist) injuries and hamate (hand) fractures do we see in professionals when compared to teenagers?  There are a lot more - because this area gets used a ton more.  Kids, on the other hand, get stress fractures if they misuse their hips.  It's no surprise, given the crazy rotational velocities and ranges of motion we see in hitters (outlined in my old articles, Oblique Strains and Rotational Power and Oblique Strains in Baseball: A 2011 Update).

What is a surprise, though, is that nobody has caught on to the ramifications of what this means for the youth baseball player who is learning to hit.

If a kid wanted to be a NASCAR driver, would we start him with a few 200mph laps at the Speedway amongst dozens of other drivers?  Of course not.

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Why, then, do we have kids playing 180-200 games per year between school teams, AAU, fall ball, and even winter ball?  Where is the opportunity to learn how to hit in a controlled environment (closed loop), as opposed to trying to learn how to hit in live situations off of kids with no control (open loop).  Don't get me wrong; many programs do a tremendous job with instruction and really do build outstanding technical hitters - but as much as I hate to say it, the occupation of "hitting coach" seems to be a dying profession.  Why?

1. Schools are starting to put batting cages on campus for year-round hitting, and some kids don't appreciate that they need to learn to hit.

2. Some people see more money in AAU programs than individual instruction.  If a hitting lesson is personal training, running a team practice is semi-private training: more money in less time (and it's usually cheaper for the players).  This strategy can work if it's executed properly with sufficient coaching on-hand and the right demographic in mind; I have seen some AAU programs that are run with outstanding organization and excellent individual instruction at crucial parts of the year.

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What is the right demographic?  I can't say for sure - but I can tell you that we need to be really careful in dealing with kids in the 11-17 year-old range.  They're learning to use their hips in an incredibly technically precise motion while their bodies are changing rapidly thanks to growth spurts and the fact that they spend 20 hours a day on their cans, thanks to sleeping, sitting at school desks, and playing around on Facebook and Instant Messenger.  We're giving more physically demanding challenges to less physically prepared (and, many times, less motivated) kids.

Kids need good hitting instruction early.  They also need targeted mobility work, foam rolling, and appropriate resistance training.

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Floor Press vs. Pin Press vs. Board Press

Q: I would like to know what the main differences are between floor presses and pin presses in the power rack, obviously with the same range of movement. Usually, in talking about injury at the shoulders, the advice is to drop full range of motion in the bench press in favor of floor press; does the pin press in the power rack - starting around middle point - accomplish the same thing? In a strength program for a healthy individuals, do these two similar movements have same utility? A: My experience with the pin press is that it is not as effective as a floor press or board press because the lifter isn't in a good position to appropriately "set" the scapular stabilizers to lock the shoulder blades down and back.  As a result, the lifter tends to shrug up - which allows the shoulder blades to anteriorly tilt - which can exacerbate the shoulder impingement that may already be occurring. Moreover, I believe that it is important to have a lifter lower the bar, as opposed to starting from a dead-stop.  This way, we not only teach eccentric control of the muscles acting at the shoulder girdle, but we also train the movement by learning the appropriate bar path.  Considering the number of individuals who take the bar too high on the chest and let the elbows flare out when benching, I think it's important to use movements like board presses and floor presses in lieu of the pin press.  Otherwise, we won't get rid of clowns like this.

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That said, generally speaking, I prefer board presses first, followed by floor presses, and then (if at all) pin presses.  These, of course, come much later than push-up variations and (usually) dumbbell exercises.

For more information on the specific return-to-pressing progressions that we use with the athletes and clients we see with shoulder impingement, AC joint issues, and a host of other shoulder conditions, check out the Optimal Shoulder Performance DVD Set.

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The Importance of Strength and Conditioning for High School Baseball Players

Yesterday, the Division 1 North Baseball Semi-final here in MA between Lincoln-Sudbury (20-2) and Lawrence (20-2) got rained out - and postponed to today.  As many of you know, we deal with over 30 players from the LS high school baseball program, plus several in middle school and multiple graduates who are now playing college baseball. With no game, local reports were left looking for something about which to write, so an interview with Coach Kirk Fredericks took place - and one of the topics that was brought up was the effect of strength and conditioning on the program.  Here's an excerpt from the article: Meanwhile, L-S has been on recent offensive tear, which includes putting up 10 and 16 runs in its first two tournament contests, respectively. As a team, the Warriors have 25 home runs this season and 62 (14, 11, 12, 25) in their last four seasons. In Fredericks' first five seasons with the team, L-S combined for 19 (5, 1, 5, 2, 6) home runs. "In the last four years, we've been working with Eric Cressey, our personal trainer, and he's really made a difference," said Fredericks. "We've also played at the same fields and the kids have been dedicated to getting stronger. The numbers don't lie."

anderson I moved to Boston in 2006, so this is the fourth season I've gone through with the L-S guys - and while I knew power numbers had increased, I didn't realize that they had virtually quadrupled.  I did, however, get my first hint of what was happening when we saw seven pitchers hit 80mph on the radar gun on the first day of tryouts this year.  This is a pretty big deal for any high school, and certainly one in Massachusetts that has to compete with nasty winter weather and the draw of lacrosse, track, tennis, golf, and volleyball during the spring season.  It's also significant because the competition in the area has improved quite a bit; L-S actually faces many of the players from other schools that we train - and they've gone 85-10 since the start of the 2007 season (when they won the state championship). Needless to say, it was pretty cool to be able to put some numbers with the trend we'd been observing.  And, it serves as a great reminder that - contrary to what a lot of "old school" coaches will try to tell you - a strength and conditioning program is absolutely essential for high school baseball players to not only perform at a higher level, but stay healthy in the process.  In this four-year period, LS baseball has had only one arm surgery, and it was in early 2008 on a player who had been misdiagnosed on ulnar nerve issues since middle school.  He's now playing Division 1 baseball.  The guys understand that arm care is about more than just some foo-foo rotator cuff exercises. This is what happens when the players in a program dedicate themselves to something and are consistent with it over the course of several years. Please enter your email below to sign up for our FREE newsletter.

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The Fascial Knock on Distance Running for Pitchers

A while back, I had the privilege to experience Thomas Myers in seminar for the first time.  For those who aren't familiar with Myers, he is the author of Anatomy Trains and a pioneer in the world of bodywork and fascial research.

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There were a wide variety of attendees present, and Myers made dozens of interesting points - so the take-away message could easily have been different for everyone in attendance as they attempted to fit his perspective into their existing schemeta.

While I enjoyed all 150 minutes of his presentations, the portion of Myers' talk that jumped out at me the most was his list of the eight means of improving "fascial fitness:"

1.       Use whole body movements

2.       Use long chain movements

3.       Use movements including a dynamic pre-stretch with proximal initiation

4.       Incorporate vector variation

5.       Use movements that incorporate elastic rebound - this consists of cylic motions of a certain speed (for instance, cycling wouldn't count)

6.       Create a rich proprioceptive environment

7.       Incorporate pauses/rest to optimize hydration status

8.       Be persistent, but gentle (prominent changes can take 18-24 months)

A big overriding them of Myers' lecture was that the role of the fascia - the entire extracellular matrix of the body - is remarkably overlooked when it comes to both posture and the development of pathology.  He remarked that he doesn't feel like we have 600+ muscles in the body; he feels like we have one muscle in 600+ fascial pockets because they are so interdependent.  And, in this fascia, we have nine times as many sensory receptors as we've got in muscles.

Think about what that means when someone has rotator cuff problems - and treatment only consists of ice, stim, NSAIDs, and some foo-foo rotator cuff exercises.  Or, worse yet, they just have a surgical intervention.  It overlooks a big piece of the puzzle - or, I should say, the entire puzzle.

For me, though, these eight factors got me to thinking again about just how atrocious distance running is for pitchers.  I have already ripped on it in the past with my article A New Model for Training Between Starts, but this presentation really turned on a light bulb over my head to rekindle the fire.  Let's examine these eight factors one-by-one:

1.       Use whole body movements - Distance running may involve require contribution from the entire body, but there is not a single joint in the body that goes through an appreciable range of motion.

2.       Use long chain movements - Pitching is a long chain movement.  Jumping is a long chain movement.  The only things that are "long" about distance running are the race distances and the length of the hip replacement rehabilitation process.

3.       Use movements including a dynamic pre-stretch with proximal initiation - This simply means that the muscles of the trunk and hips predominate in initiating the movement.  While the hips are certainly important in running, the fundamental issue is that there isn't a dynamic pre-stretch.  This would be a dynamic pre-stretch with proximal initiation:

4.       Incorporate vector variation - A vector is anything that has both force and direction.  Manual therapists vary the force they apply to tissues and the directions in which they apply them.  There are obviously vectors present in exercise as well.  Here are 30,000 or so people, and pretty much just one vector for hours: forward (to really simplify things):

Incorporating vector variation into programs is easy; it just takes more time and effort than just telling someone to "run poles."  Take 8-10 exercises from our Assess and Correct DVD set and you've got a perfect circuit ready to roll.

5.       Use movements that incorporate elastic rebound - Sorry, folks, but even though the stretch-shortening cycle is involved with jogging, its contribution diminishes markedly as duration of exercise increases.  And, frankly, I have a hard time justifying bored pitchers running laps as "elasticity."

6.       Create a rich proprioceptive environment - There is nothing proprioceptively rich about doing the same thing over and over again.  They call it pattern overload for a reason.  Pitchers get enough of that!

7.       Incorporate pauses/rest to optimize hydration status - Myers didn't seem to have specific recommendations to make regarding work: rest ratios that are optimal for improving fascial fitness, but I have to think that something more "sporadic" in nature - whether we are talking sprinting, agility work, weight training, or dynamic flexibility circuits - would be more appropriate than a continuous modality like jogging.  This is true not just because of duration, but because of the increased vector variation potential I outlined earlier.

8.       Be persistent, but gentle - This one really hit home for me.  Significant fascial changes take 18-24 months to really set in. I am convinced that the overwhelming majority of injuries I see in mature pitchers are largely the result of mismanagement - whether it's overuse, poor physical conditioning, or improper mechanics - at the youth levels.  Poor management takes time to reach the threshold needed to cause symptoms.  In other words, coaches who mismanage their players over the course of the few months or years they coach them may never actually appreciate the physical changes - positively or negatively - that are being set into action.

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Distance running might seem fine in the short-term.  Overweight kids might drop some body fat, and it might make the practice plan easier to just have 'em run.  Kids might not lose velocity, as they can compensate and throw harder with the upper extremity as their lower bodies get less and less powerful and flexible.

However, it's my firm belief that having pitchers run distances not only impedes long-term development, but also directly increases injury risk.  Folks just don't see it because they aren't looking far enough ahead.

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Draft Day Results

It was a fun day at Cressey Performance yesterday with the MLB draft taking place.  Just wanted to send out a quick congratulations to four Cressey Performance athletes who were selected yesterday: Ryan O'Rourke (13th Round - Twins), Chris McKenzie (13th Round - Nationals), Travis Dean (14th Round - Yankees), and Ryan Rodebaugh (15th Round - Rangers).  Nice work, fellas; lots of hard work rewarded! Noticeably absent from the draft, however, was CP Matt Blake.  We caught up with him during what amounted to a rough day in his professional career:

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How to M.O.L.D. Young Athletes for Success

Today's guest blog comes from Brian Grasso, the director of the International Youth Conditioning Association. The Slow Cook Way to Young Athlete Training The long-term approach to youth fitness and sport training is an essential ingredient and critical component of understanding how to work with clients in this very sensitive demographic.  Fitness Professionals must learn to appreciate that with young clients, the goal is not to 'lose weight', 'increase speed' or 'gain strength' - it is to enhance skill.  Increases in all biomotors (strength, speed, flexibility and cardiorespiratory) will be secondary benefits that occur naturally and as a result of quality, skill-based training systems. A few weeks ago, I spoke with legendary strength coach, Joe Kenn, about this very issue. Coach Kenn is as qualified, respected and 'in-the-trenches' smart as they come.  He's served for more than 20 years as a premier strength coach in U.S.-based Colleges and has worked with a litany of past and current stars from a variety of sports.

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During our conversation, he offered this advice to parents, coaches and fitness professionals when working with young athletes: "Cook 'Em Slow" Although a rather funny way of saying it, Coach Kenn's point cannot be ignored.  Training young athletes isn't about focusing on making them better right now - as I've mentioned, the biomotors will increase naturally when proper skill-based teaching is applied - what's critical is to not char them in the process of making them better.  Don't 'fry them' on a high temperature.  Don't "barbeque'"them until they're crispy.  Don't try to "grill" them to a golden brown.  Instead, think of training young athletes as heaping them in a crock pot with a bunch of other savory ingredients and then setting the temperature on low. Let the flavors meld and the ingredients come together in their time.  By the end, you'll have a mouth-watering dish that contains flavors and layers of "yummy" that you can't get through any of the "quick cook" methods. What Do Young Athletes Really Need Sometimes, it's beneficial to be given sample programs of what to do with young athletes in certain situations.  Other times, it's better to understand a philosophy of training.  I have found in my career, that appreciating the concept of what to do with young athletes is tremendously more important than the former. Sample programs allow you to see a system and implement it, but without necessarily understanding why it's been created that way.  It's akin to being given a fish versus being taught how to fish.  One allows you to be satiated for a day or week, while the other allows you to keep yourself satiated indefinitely.

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With young athletes, knowing the "why" behind the "what" is terribly important.  Moreover, understanding the universal laws of development that govern all human growth - and how they are applied to programming for young athletes - will allow you to create specific programs that are compatible with your given situation. When working with young athletes the acronym "M.O.L.D." provides a perfect backdrop for understanding what, specifically, are the musts of training this particular demographic. Movement is Critical for Young Athletes "M" stands for one of the most important tenants governing young athlete training - Movement Must Dominate. Although this seems like an absolute 'no-brain' reality, I am constantly amazed how many times it is breached within the fitness and sport training world with respect to young athletes.  Kids and teenagers don't belong sitting on strength training machines producing force.  And they certainly have no business performing 'cardio' on static pieces of machinery, either. This is true for so many reasons. Just watch a young person in their natural environment.  They move.  Constantly.  This desire to play, run, skip, hop, throw things and climb is not a product of "ants-in-the-pants" or any other form of contemporary "illness" as defined by modern society (ADD for example).  The neurology of human growth and development shows that during the young periods of life, the CNS is in constant "gathering" mode.

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As young people, we are learning.  Our bodies, governed by our CNS, are wired to explore movements, environments and situations.  Kids don't mean to 'get into things' - they are being instructed to by an ever-changing, always-learning CNS that is requiring continual input.  Not only should this reality be honored and respected, it MUST be enhanced within the training systems of young athletes. If your training program for young athletes involves moving and producing force through an unregulated and free manner, then you are most assuredly on the right track.  Run, jump, throw, kick, hop, skip...that kind of stuff. Young Athletes.... The Key is Communication The second letter in our acronym, "O," stands for simply this - Open to Communication Variances. The "Lombardi-style" coaching system doesn't work.  You can't just bark orders and think that every young athlete you train is going to be listening.  With coaching, one-size DOES NOT fit all.  Just like physical ability, size, relative strength and potential, the way a young athlete needs to be communicated with is specific to that child or teen. Now, I'm no fool.  I've spent nearly 15 years in the trenches and know full well that when you have a group of kids (say 20 six-year-olds) getting to know them well enough and being able to provide individual attention to them is challenging to say the least.  But that doesn't mean individualized communication isn't possible.  It just takes a system.

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Over my years working with kids, I have found that every one of the young athletes I've trained fits somewhere into the following category: 1.       High Motivation/High Skill 2.       High Motivation/Low Skill 3.       Low Motivation/High Skill 4.       Low Motivation/Low Skill A brief overview of the template that shows how to communicate with each of these young athletes is as follows: 1.       Delegate - Look to get this young athlete involved in the training and planning process.  Have them lead warm-ups for the group.  Have them create the warm-up within the boundaries of your system.  If they are older, have them help you co-coach your younger groups.  Keeping this young athlete engaged is a critical part of keeping them excited about the training process and provide a perfect communication scenario. 2.       Guide - This young athlete doesn't require more motivation - they need to enhance their skill.  Rather than trying to incite them positively (because they're already incited!) slow them down and guide them through the process of skill increase slowly.  Breakdown complex exercises into specific stages and teach them in a whole-part-whole method.  Communication will be automatically improved.

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3.       Inspire - This young athlete is great at everything, but lacks the necessary motivation to produce consistent effort (likely due to pressure from other coaches or their parents).  Don't "ride" them or even ask them to work harder - they will tune you out quicker than you can say TRX!  Instead, talk with them about what inspires them.  What gets them excited?  We all have a switch on the inside that can turn on when the situation is a quality and inspiring one for us.  Find where there switch is and help them turn it on. 4.       Direct - Don't put this young athlete on the spot - even in a positive manner.  They crave autonomy and the ability to just "blend in."  So give it to them.  Provide instructions for the group at large and then quietly be sure that they know what is expected of them in the up-coming exercise or drill.  Once they realize that your communication with them will be non-threatening, they will deem your training environment a "safe" one and start to open up.  That's where the fun will start! How Do Young Athletes Learn? "L" brings us to learning.  Just like with "O," we must understand that young athletes learn in different ways and at varying speeds. Quick and easy rule of thumb - Explain what the exercise is.  Demonstrate it.  Explain it again.  And then ask them to explain it to you. This equates to a "Tell, Show, Tell, Converse" method of teaching and dramatically accelerates the learning process.  It also provides a divergent way of instruction so that all the young athletes in your group can learn in the manner that best suits them.

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Young Athletes.... Why Training is WRONG Sounds funny doesn't it? Don't train young athletes. But it brings us back full circle to where we started.... "Cook 'Em Slow." The most important thing you have to remember is that your job is not to make young athletes better - it's to enhance their skill.  When quality skill exists, it can be build upon to introduce and produce even more skill over time. And just a quick word to those who may be concerned... If a coach or parent asks you if their young athlete will get faster or stronger with your "slow cook" method of training, your answer is YES!!! Just because we aren't focusing on enhancing the biomotors doesn't mean they won't improve.  As I've mentioned already, kids get faster, stronger and more flexible automatically with skill-based training.  Human growth and development as seen to that for us. So that's it.  An easy philosophy that covers what you need to know about training young athletes. No more excuses.... The training effects and increases will come.  Just be sure to keep the temperature gage locked on "low!" Brian Grasso has trained more than 15,000 young athletes worldwide over the past decade.  He is the Founder and CEO of the International Youth Conditioning Association - the #1 certification for Youth Fitness and Youth Sports Performance.  For more information, visit www.IYCA.org. Please enter your email below to sign up for our FREE newsletter.
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The Lucky 13: Cressey’s Top Reading Recommendations

A few months ago, I gave a two-day seminar to just over 80 fitness professionals and strength and conditioning coaches.  Even with a seminar this long, I can never cover everything I'd like to cover - and it's generally because much of what I'd like to address relies on some prerequisite knowledge that the attendees may not possess.

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With that in mind, at the attendees' request, I sent a follow up email to all of them with a list of some of the best resources - books/manuals and DVDs - that I've encountered along my journey of self-education. Please keep in mind that this is not an exhaustive list, by any means, but it does cover what I'd consider requisite reading to get a good foundation in a lot of the concepts I covered last weekend. 1.  Any anatomy text will do, but I prefer texts that speak more to functional anatomy.  Netter's Atlas of Human Anatomy is very good, and I know of many physical therapists in the US who keep a copy of this book on hand for patient education.  Kinetic Anatomy is also a solid text that speaks to functional anatomy, and I believe the newer version comes with a tag-along DVD.  Lastly, our Building the Efficient Athlete DVD set was created in part to educate folks on the functional anatomy side of things that they may miss during a conventional college curriculum.  I know of several facilities in the US that use it extensively for staff training. 2. Anything from Stuart McGill - While there are several schools of thought with respect to low back function and rehabilitation (and I'd encourage you to check out each of them), McGill is the one that resonates with me the most.  You can find a lot of his research on Pubmed, but he also has several books (and a DVD) available that I'd highly recommend.  For those of you who are interested in some science and some applied, go with Ultimate Back Fitness and Performance.

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For those of you who are a bit geekier and want to learn a lot more about the clinical side of things, check out Low Back Disorders.  If you are going to train clients or athletes, you need to understand back pain. 3. Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann is probably the book that has influenced me more than any other in my career.  It's worth every penny.

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4. For shoulder stuff, I think that The Athlete's Shoulder is a great resource.  It is written by physical therapists and surgeons, though, so it can get very clinical at times.  Those of you who are more interested in actual practical applications would be more interested in our new Optimal Shoulder Performance DVD set, which is the video of a seminar I did with Mike Reinold, who is actually one of the co-authors of The Athlete's Shoulder.  If you enter the coupon code "reinold200osp" today only at checkout HERE, you can get the DVD set with free shipping today as part of Mike's "sale week" to celebrate his 200th post.

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5. Muscles: Testing and Function with Posture and Pain - This is a newer version of Kendall's classic text, and it's an incredibly detailed resource that you'll find yourself referring back to time and time again.  Several of the screens we use in our everyday assessments with clients and athletes were influenced in part or entirely by Kendall's text. 6. Gray Cook's work is fantastic.  If you want quick, practical tips, check out Secrets of the Hip and Knee and Secrets of the Shoulder.  Both DVDs give you some tips that you can immediately put into practice. 7. Anatomy Trains by Thomas Myers is an excellent read to get you thinking more and more about the role of the fascial system.  I saw Thomas speak this past weekend in Providence, and he was absolutely fantastic - so excellent, in fact, that I'll probably write up a blog with some quick notes from his lecture.  And, I'll be reading this for the third time this week, too!

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8. Bulletproof Knees - Mike Robertson wrote this manual and I can honestly say that I haven't seen a better product on the market with respect to information that can be quickly applied to clients with knee pain - both in terms of understanding it and correcting it.

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9. Mike Boyle has some excellent products - including all the Functional Strength Coach DVDs (#3 was the most recent).  You can always find some good reading at StrengthCoach.com.  I believe they still have the 14 days for $1 trial period, and as part of that, you get his Designing Resistance Training Programs and Facilities book for free. 10. Anatomy of Breathing - I think it's valuable to appreciate the muscles involved in respiration and start to put them into your functional anatomy framework as soon as possible.  This book is a very quick read, but you'll get that foundational knowledge and start to think about how all this stuff lines up.

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11. 2008 Indianapolis Performance Enhancement DVD set - This is a product that has largely flown under the radar because it was overshadowed by several other products that were launched around the same time.  However, the short vs. stiff discussion that Bill Hartman presented as part of it is well worth the cost of the entire DVD set. 12. Clinical Applications of Neuromuscular Techniques (Part 1 and 2) - These books read like stereo instructions, but they are insanely thorough.  I recommend them to anyone who is really dorky like I am.  They will definitely help you to collaborate with manual therapists and physiotherapists a lot more effectively. 13. Assess and Correct - Shameless self-promotion here, but I'm extremely proud of this product.  It's a DVD set and four accompanying manuals that cover 27 assessments and 78 corrective exercises we use with our clients and athletes.  If I had to recommend one of our products to a trainer, this would be it.  Stuart McGill have us some extremely flattering reviews on Assess and Correct as part of his new DVD.

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I should note that the countless journal articles I've read over the years are noticeably absent from this list, but you can easily access the abstracts of those pieces at www.pubmed.com if you search by whatever keyword relates to your area of interest.  I find myself using it daily, and I'll generally follow up on these abstracts by getting the full-text articles.  Also, in addition to the few resources I note below, you can find a more extensive collection of recommended readings on my resources page. This includes a collection of links to free blogs that I read daily.  Many of my blog readers don't know that, in addition to this blog, I have a free newsletter where readers get exclusive content and early notice on things - so you'll definitely want to sign up HERE if you haven't already. It's also been a matter of interacting with as many smart folks as possible, just making (and documenting) observations with our clients/athletes, and going to seminars.  This list should get you started, though!
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Random Friday Thoughts: 6/4/10

1. I'm headed to Providence first thing tomorrow to speak at the Perform Better Summit.  If you're in attendance, be sure to introduce yourself and say hello; it's always great to meet my readers. 2. It's the time of year where all the all-star and league MVP awards are handed out around here as playoffs are just getting underway. Here's a great article about one Cressey Performance athlete, Carl Anderson of Lincoln-Sudbury, who won the Dual County League MVP as he set school records for homeruns and RBIs: Diamond Natural, If a Bit Rough 3. Likewise, another CP athlete, Jeff Bercume in the Oakland A's organization, just got a little love: Bercume's Game Going North.

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4. HERE is some recent research to support the use of accommodating resistance in the form of bands in resistance training.  Many of us in the powerlifting community have anecdotally been able to verify its efficacy, but it's nice to see some research out there that confirms what a lot of folks have insisted for quite some time. It's important to interpret this research with caution, though.  Using bands on top of free weight resistance is fantastic, but it can really beat up your joints if you use it for too long without taking a break.  I always found that the added eccentric stress really beat up my shoulders and elbows on the bench press if I used bench presses against bands in my training cycles for more than three weeks without a break from them.

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5. Researchers from the University of Nebraska report that energy expenditure in untrained college students is the same on ellipticals and treadmills when working at a self-selected intensity.  An unnamed researcher from the Cressey School of Hard Knocks reports that working at a "self-selected intensity" on these modalities requires about as much effort and coordination as watching NASCAR.

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Call me crazy, but I think most college-age folks would be better off hitting things with sledgehammers as exercise; it's just way more badass.

6. Here's another solid testimonial we just received on Optimal Shoulder Performance: "Eric and Mike did a great job of taking complex information and making it easy to understand for the viewer.  I really liked the collaboration between the clinical side of things, and the training side.  I now have a much better understanding of how to effectively assess the shoulder.  More importantly, I am now better equipped to take that information and improve the training strategies and techniques for my clients." -Danny McLarty, CSCS Click here to pick up a copy of Optimal Shoulder Performance for yourself.

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Understanding Elbow Pain – Part 6: Elbow Pain in Lifters

Today, I'm going to wrap up this six-part series entirely devoted to the elbow.  In case you missed the first five, check them out: Part 1: Functional Anatomy Part 2: Pathology Part 3: Throwing Injuries Part 4: Protecting Pitchers Part 5: The Truth About Tennis Elbow In this final installment, I'm going to discuss elbow issues as they pertain to a strength training population.  Even though some of the treatments for these injuries/conditioning may be very similar or even identical to what we see in a throwing population, I separate lifters because their problems are almost always soft tissue in nature.  While we may see stress fractures, ulnar nerve issues, and ulnar collateral ligament tears in throwers, we are virtually always dealing with problems with muscles and tendons in folks who are avid lifters.  What gives? Well, it's very simple: they grip stuff a lot more than normal folks, and also perform a ton of repetitive movements at the elbows and wrists.  This difference also makes you appreciate why we often see elbow issues in those who work on factory lines, performing the same task for hours on-end. Why is it that all these issues present at the elbow?  You see, many of the muscles involved in gripping originate at the superomedial aspect of the forearm, particularly on the medial epicondyle:

medialepicondyle

When these structures get overused, they shorten - and as we discussed in Part 1, the zones of convergence (where tendons bunch up and create friction with one another) are where we develop some nasty soft tissue adhesions.

However, this doesn't just happen from gripping.  Think about what happens when you put the bar in this position to back squat:

hammer-back-squat2

That bar wants to roll off his back, and while the majority of the weight is compressive loading, a good chunk of it becomes valgus stress that must be resisted by the flexors and pronators that attach at the medial aspect of the forearm/elbow. It's not a whole lot different than the stress we see here; we just trade off the velocity and extreme range of motion in the throwing motion for prolonged loading in the lifting example:

wagner2

As a general rule of thumb, the narrower the squatting grip, the more stress on the elbow.  Unfortunately, the wider the grip, the more shoulder problems we tend to see, as this position can chew up the biceps tendon.  The solution is to maintain as much specificity as possible with respect to one's chosen endeavor, but find breaks from the repetition of these squatting positions by plugging in options like front squats, giant cambered bar squats, and safety squat bar squats.

For these reasons, I also look at soft tissue work on the forearms - and particularly the medial aspect - as a form of preventative maintenance.  Regardless of the soft tissue modality you select, get some work done every few months and stay on top of your stretching in the area to maintain adequate length of these tissues.

We'll also see a fair amount of "underside" elbow pain in lifters, in most cases where the three heads of the triceps join up as a common tendon (another zone of convergence; does anyone see a pattern here?) to attach to the olecranon process.  The smaller anconeus - a weak elbow extensor - also comes in here.

Almost universally, the lifters who present with overuse injuries posteriorly are the ones who use loads of elbow-only extension movements like skullcrushers/nosebreakers/French presses/triceps extensions.  As a random aside to this, how can these movements have four different names, and not one of them begins with some Eastern European nationality?  "French" just doesn't get it done when we have Russian good mornings, Bulgarian split squats, Romanian Deadlifts.

lying_triceps_extension_5314_7

Anyway, we vilify leg extensions and leg curls as being non-functional and overly stressful at the knee.  The knee is the joint most similar to the elbow, yet it's much bigger than the elbow, yet nobody contraindicates 4-5 elbow extension-only exercises per week in many routines as being inappropriate - or even excessive.  If you want to build big legs, you squat, deadlift, and lunge.  If you want to build big triceps, you bench, do weighted push-ups, overhead press, and do dips.  The absolute load is higher, but the stress is shared over multiple joints.

In just about every instance, when you drop the direct elbow extension work from someone's program, their elbow issues resolve very quickly and they don't miss a beat with training.

So, as you probably inferred, it's very rarely a lack of strength that causes elbow pain in lifters.  Rather, it's generally poor tissue quality, a lack of flexibility, and overuse of a collection of muscles that have "congested" insertion points.  Simply changing the program around, getting some soft tissue work done, and following it up with some stretching can go a long way to both prevent and address these issues.  That said, there will be cases where elbow pain may originate further up at the cervical spine or shoulder or - as I learned from a reader in the comments section of Part 5 - from an abducted ulna.  So, there is definitely no one-size-fits-all approach.

That wraps up this series.  Hopefully, you've gained insights into some of what's rattling around inside my brain with respect to elbows.  Thanks for putting up with me for all six installments!

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