Both Cressey Sports Performance facilities are booming with baseball players coming back to start their offseason training, so it's the time of year when athletes are working hard to get their rotator cuff control back before they start up their offseason throwing programs. With that said, I've been thinking about some big principles on the rotator cuff readiness front.
1. In a broad sense, just above every rotator cuff exercise can be categorized in one of five ways:
a. Strength - this consists of manual resistance work and anything with cables at dumbbells; it needs to be loaded up and challenging.
b. Timing - this consists of drills like 90/90 holds and rhythmic stabilizations.
c. Endurance - this builds on what we see in Option A (some of the same exercises), but the resistance is a bit lower and it's done for higher reps or a longer time. The goal is less about strength and more about training the ability to hold the humeral head on the glenoid fossa for a lengthier period of time. I'd call it more important for a sport like swimming than for baseball or tennis athletes.
d. Irradiation - this can refer to just about any exercise, as your rotator cuff fires reflexively any time your arm moves. That said, certain exercises - bottoms-up kettlebell variations, for instance - are particularly useful for challenging this category of drills.
e. Patterning - these are just drills that take the humerus through its full range-of-motion. Of particular importance is end-range external rotation, which we train with drills like this:
2. I prefer near-daily exposures rather than exhaustive, less frequent programs.
If you look at our training programs, most of our pro guys are doing some kind of targeted training for the rotator cuff 5-6 days per week. Twice per week, we'll push more strength and irradiation work, and twice per week, we'll cover more timing drills. Just about every day, though, there will be some kind of patterning exercise so that we're reminding the cuff of what it's supposed to do.
This approach is a stark contrast to what you usually see in the baseball world, which is notorious for handing out the 2x/week arm care routines that take 45-60 minutes each. They're usually about 15 exercises for multiple sets, and leave an athlete hanging by the end of the session. I think this approach has more to do with the fact that it lines up with what's convenient for 2-3x/week physical therapy sessions than because it's truly optimal. I'm of the belief that you don't need (or want) to exhaust the cuff to get it to where it needs to be.
And, while we're at it, if the cuff is going to get abused on a daily basis with throwing, lifting, and activities of daily living, why not give it some more frequent exposure to build a little tissue resiliency?
3. Posterior deltoid shouldn't be lumped in with infraspinatus and teres minor.
Many times, the reason we have discomfort or the "wrong" feeling with drills is that athletes are paying close attention to the osteokinematics - gross movements of internal/external rotation, flexion/extension, adduction/abduction - of the joint in question, but not paying attention to the arthrokinematics of that same joint. In other words, the rolling, rocking, and gliding taking place needs to be controlled within a tight window to ensure ideal movement.
In shoulder external rotation variations, as we externally rotate the arm, the humeral head (ball) likes to glide forward on the glenoid fossa (socket). The glenohumeral ligaments (anterior shoulder capsule), rotator cuff, and biceps tendon are the only things that can hold it in the socket. In a throwing population, the capsule is usually a bit loose and the cuff is a bit weak, so the biceps tendon often has to pick up the slack - which is why some folks wind up feeling these in the front, thereby strengthening a bad pattern. There are also a bunch of nerves at the front of the shoulder that can get irritated.
Now, here's where things get a bit more complex. The infraspinatus and teres minor are both rotator cuff muscles that have attachments right on the humeral head, so they can control the arthrokinematics (posterior glide) during external rotation work. Conversely, the posterior deltoid (blue, in the image below) runs from the posterior aspect of the spine of the scapula to further down the arm on the deltoid tubercle. In other words, it completely bypasses control of the humeral head.
By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22835985
With this in mind, the posterior deltoid actually creates a gliding forward of the humeral head as it externally rotates and horizontally abducts the arm. For this reason, you need to make sure the arm doesn't come back (horizontal abduction) as it externally rotates during your arm care drills. This video should clarify things, if you're a visual learner:
Looking for more insights like these? Be sure to check out my new resource, Sturdy Shoulder Solutions.
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It's been pretty quiet here on the blog of late, as we've been really crazy with the CSP Fall Seminar, our Business Building Mentorship, loads of pro baseball guys starting up their offseason, and us moving the family down to Florida for the offseason. While there hasn't been a lot of time for new content, I do have some good recommendations from around the 'Net for you:
How to Build an Aerobic Base with Mobility Circuits - I wrote this blog three years ago, and it seemed like a good time to reincarnate it, as this is the time of year when we're incorporating these strategies with a lot of our MLB guys as they get back in action in the weight room.
EC on the Robby Row Show - If you're interested in baseball development, check out this podcast I did with Robby Rowland.
I dislike the "take a month off" recommendation for athletes at season's end. Training shouldn't be an "all in" or "all out" decision; there are many levels of involvement, & the lowest tiers can be very impactful. Pick the lowest hanging fruit in the 1st month of the offseason.
If you've followed my writing for any length of time, you'll know that I'm a big fan of using medicine ball training for power development with our athletes. We have both rotational and overhead variations - and sometimes, we have drills that combine the two. Enter the knee-to-knee rollover medicine ball stomp.
Key Coaching Points:
1. Don't rush the back hip rotation; rather, sit into that hip for what seems like an uncomfortable long time. This allows hip-shoulder separation to occur.
2. Minimize lower back arching.
3. Be firm into the ground on the front leg. Some individuals will stiffen up on that front leg with more knee extension, while others will be slightly more flexed.
4. Perform 3-4 reps per side.
5. We utilize this exercise several months into the offseason after we've had a chance to optimize overhead and rotational medicine ball technique with less complex drills. Athletes have to earn this one.
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It's often been said that anything can be fixed with duct tape and WD-40. And, as a guy with extremely limited handyman skills, I really like this flowchart.
While this might seem like a dramatic oversimplification with respect the human body, I think there are actually some noteworthy parallels. To prove this, let's take a look at a study my buddy, Mike Reinold, co-authored back in 2008. While they looked at range of motion changes in professional pitchers after an outing, the findings of the study that I always keep coming back to have more to do with the absolute range of motion numbers in the data set (moreso than the changes). Take a look:
Looking at the mean shoulder total motion pre-throwing, MLB pitchers averaged about 191 degrees. However, when you look at the standard deviation of 14.6 degrees, you'll see that there were guys down around 175 degrees (very hypomobile or "tight"), and others up around 206 degrees (very hypermobile or "loose").
Speaking very generally, the tight guys need more WD-40 (range of motion work), and the loose guys need more duct tape (stability training). Now, here's what you make your mark as a coach: identify the exceptions to this rule.
For example, when you have an otherwise "tight" guy who comes back from a long season in with a significant range of motion increase at a joint, it could mean that he's developed instability (e.g., blown out a ligament). Or, maybe you see an otherwise "loose" guy who has lost a considerable amount of range of motion, it could mean that he's really hanging out in a bad pattern, developing musculotendinous shortness/stiffness that "overpowers" his ligamentous laxity. Or, he might be really out of alignment, or have developed a bony block.
Identifying outliers - exceptions to the rules - is a crucial part of evaluation success and subsequent programming. As I've often said, don't just focus on average.
Speaking of lessons to be learned in managing overhead throwing athletes, this will actually be a topic I expand upon at the upcoming fall seminar at Cressey Sports Performance - Massachusetts. We've got a great lineup, and the early bird registration deadline is this Fridya, September 21. You can learn more HERE.
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Each time I run a Q&A, I get questions along the lines of:
If you could only pick one hip mobility assessment, what would it be?
If you could only pick one exercise to build pitching velocity, what would it be?
If you could only pick one shoulder exercise to fix my shoulder pain, what would it be?
You know what's awesome? With respect to all of these questions - and many more - I've NEVER in my entire career had to choose just one.
There may be no such thing as a stupid question, but there are stupid lines of thinking - and this reductionist approach to solving health and human performance problems is a big issue in our industry. In my experience, we see far more chronic issues develop because individuals fail to see the synergy among many factors, as opposed to their inability to hone in on the most important one. I'll give you an example.
Earlier this year, we saw a pitcher with a cranky ulnar nerve. He'd had mixed results with anti-inflammatory medications.
As it turns out, he had a subluxating ulnar nerve, which would predispose him to this issue during a motion like pitching that involves repeated flexion/extension, especially when combined with valgus stress (which stretches the nerve).
He did some extensive manual therapy with my business partner, massage therapist Shane Rye, who treated everything from his neck down to his forearm. This alone gave him a ton of relief - and he even commented that he felt a lot better with respect to some shoulder and neck issues he'd had previously.
In his movement screen, we'd noticed a lot of glaring scapular control issues. At rest, he sat in considerable anterior tilt and depression. Upon initiation of overhead reaching, he pulled into retraction instead of initiating smooth upward rotation. Most of his "external rotation" was actually scapular retraction and lumbar extension. In short, he was getting a lot of motion in the wrong places during several upper extremity assessments - and when we went to watch his arm care exercises, they were reaffirming all these faulty patterns. As an example, he was pulling down with the lat on horizontal abduction work, going into forward head posture on a lot of lifts, and banging out push-ups that looked a lot like this.
Morever, the exercise selection in his strength and conditioning programs were contributing to these aberrant patterns. His program was very lat dominant, and he wasn't doing enough work above 90 degrees of shoulder elevation to drive better patterns of upward rotation with good scapular posterior tilt. And, if that wasn't enough, he was using blood flow restricted training on his upper arm regularly in hopes of optimizing recovery. In reality, the compression was probably "snagging" his nerve even more.
We made a bunch of changes - picking lots of very easy, low-hanging fruit - and he hasn't had issues with the nerve all season. I can't tell you exactly which ONE of these interventions had the biggest impact on him staying healthy - but the good news is that it doesn't matter. Success is a function of over a dozen assessments and several interventions from multiple people.
With that mind, quit looking for a quick, easy, reductionist answer. It's not about a single assessment, exercise, or coaching cue any more than it is about a magic pill. Rather, it's about how all the pieces fit together. If you look around at the best coaches and rehabilitation specialists in the industry today, they're usually very well rounded in terms of their knowledge base, skill sets, and referral network. As a result, they can appreciating multiple disciplines and provide comprehensive care to the athletes, clients, and patients they serve.
Looking for a diversified educational experience? Be sure to check out our 7th Annual Cressey Sports Performance Fall Seminar. It'll take place on October 14 at our Hudson, MA location. You can learn more HERE.
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A few weeks ago, we took our three-year-old twin daughters blueberry picking. They had an absolute blast - so you could say that they are very passionate about blueberry picking. In fact, they are quite certain that they are the best blueberry farmers on the planet today.
Here’s the thing, though: they really don’t know much about blueberries. And, they don’t even know what they don’t know.
Addison refused to take her sunglasses off, so she could barely tell the difference between the ripe ones and the ones that needed to stay on the branch for longer to ripen.
Lydia got so excited that she tripped over an irrigation hose.
In short, their passion left them nothing short of blind and disoriented with respect to the competencies it takes to become a successful blueberry farmer.
Sadly, this example is not much different than where many fitness professionals are at the start of their career. They're wildly passionate about fitness and really enjoy working out, so why not make it into a career?
Wikipedia defines the Dunning–Kruger effect as "a cognitive bias in which people of low ability have illusory superiority and mistakenly assess their cognitive ability as greater than it is."
In other words, you think you're going to be the varsity quarterback, but you're actually only skilled enough to be the carrying water bottles out to the JV squad. This is the harsh reality of most fitness businesses: they're often based too much on passion and not enough on specific career capital (which I previously wrote about here and here).
As a result, people who open gyms get surprised by a lot of things. Start-up costs are higher than anticipated. Generating leads is tougher than they'd expected. Managing growth proves challenging because they've never had to manage employees or pay attention to client retention strategies. They don't realize how complex managing finances is. There aren't enough hours in the day to get to everything they need to do when both working IN the business and ON the business. The list goes on and on.
And, I'd argue that these issues are even more prevalent in the fitness industry than in other entrepreneurial realms. There's a lower barrier to entry in the industry, significant initial start-up costs for gyms, and a service-oriented business model that presents unique challenges. In short, there are a lot of reasons why gyms either fail or really struggle to get by.
My Cressey Sports Performance business partner, Pete Dupuis, has a MBA and consults for various gym owners on a daily basis to help them avoid these common pitfalls. We've been at this for over 11 years and have two facilities still going strong, and a huge part of that success is the significant work we do behind the scenes to make sure we're a well-oiled machine and just just a "workout place" started because we were passionate.
With that in mind, last year, we offered our Business Building Mentorship for the first time. It sold out quickly and received outstanding feedback - so we've decided to offer it again. It'll take place October 15 at our Hudson, MA location (alongside our fall seminar). If you're interested in attending, you can learn more and register HERE.
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I hope you had a good weekend. We're back on our normal Monday schedule with this recommended reading collection after being a bit erratic over the past few weeks.
Divergent Thinking: Inside John O'Malley - This is a lengthy interview, but definitely worth the time. While the interview is with an accomplished cross country/track coach, the lessons are applicable across many disciplines. Thanks to former CSP intern Mike Boykin for sending this my way.
Transformer Bar Overview - I'm a big fan of the transformer Bar from Kabuki Strength, and this video outlines my thoughts (as well as those of Stuart McGill and Kelly Starrett) on why that's the case.
Top Tweet of the Week
Biggest regret I hear from college athletes? They should've started strength training sooner. Getting stronger is a game changer for performance AND the ability to acquire new skills. If you're 21 and just gaining strength you should have had when at age 16, you're way behind.
It's time for a new edition of my thoughts on the business of fitness. Before I get to it, just a friendly reminder that we're hosting our second-ever Cressey Sports Performance Business Building Mentorship on October 15. You can learn more HERE.
Now on to some business concepts...
1. It might take years for someone to become a customer.
Just a few weeks ago, I released my newest product, Sturdy Shoulder Solutions. One interesting thing about my newsletter/product management set-up is that I can tell how long someone has been a "prospect" before becoming a customer. Basically, I know the date they signed up for my newsletter, and then I can check that out to see what products they've purchased and when.
During this launch, I had multiple people purchase this resource as their first purchase with me after over 3,000 days on my list. Yes, that means they "window shopped" for over eight years prior to taking the plunge.
Very few people purchase on the first exposure to a marketing message. Or the second. Or the third. It actually takes load of opportunities for them to perceive your expertise, and usually over the course of an extended period of time. They need to know, like, and trust you - and some people take a long time to get to trusting you enough to initiate a transaction.
Be persistent, but patient. It's harder than ever to be seen and heard.
2. It's a very small world; watch your social media behavior.
I made this post on Twitter yesterday, and it got quite a bit of attention.
You know the pro athlete you’re heckling on Twitter? He’s probably pitched or been hot in the ‘pen 7 straight days. Something likely hurts. Good chance he had a red-eye flight & only slept 2hrs last night. May not have seen wife/kids for wks. So settle down & just watch the game.
Beyond the obvious moral issues of saying cruel things to pro athletes (or celebrities - or anyone else, for that matter), you should be cognizant of the fact that it can very quickly come back to bite you in the butt. Some of the agencies who represent these players may also represent others - athletes, actors, musicians, speakers, or coaches - who could be potential future clients for you. One of your followers could be an old friend or teammate of the athlete. It's an incredibly small world, so chasing a few retweets isn't worth sacrificing a relationship or potential client down the road.
3. Investments are different from expenses.
This is one of the most misunderstood accounting/economics concepts in all industries, and certainly in the fitness business.
An investment has the potential to appreciate in value. Maybe you spend money on a continuing education event, buy a DVD for some new training strategies, put money into a retirement account, or purchase some equipment that allows you to deliver a higher-quality product to your clients. Perhaps you hire a consultant to fine-tune your business, or decide to buy your building instead of continuing to pay rent. Additionally, from an accounting standpoint, investments are usually (but not always) tax deductible.
Expenses are like setting money on fire. They're the $5 you spend at Starbucks each morning, or the Porsche you bought on credit when you were making $20,000/year (is that even possible?). They don't appreciate, and there is a huge opportunity cost to these expenditures. Some are necessary and even tax deductible (e.g., rent), but they always need to be heavily scrutinized. Can that expense be reduced or somehow shifted into an investment?
Fitness businesses are notoriously bad at understanding the difference between the two, or understanding that one's financial situation may dictate what is and isn't acceptable. If you're grossing $5,000/month, paying $1,000/month to a cleaning service probably isn't a good expense; clean the gym yourself. Do you really need to buy seven different types of leg curl machines when you're already $300,000 in debt? And, why do you have payroll expenses when you've only got three clients?
Most businesses (and individuals, in their personal finances) would be wise to go through every cash expenditure and figure out how each one can be categorized. Growing gross revenue is always a priority, but many businesses can be even more profitable if they learn to appropriately trim the fat.
If you've found value in these insights, I think you might enjoy the upcoming Business Building Mentorship Pete Dupuis and I will be hosting on Monday, October 15th. It's a tax deductible expense if you're a fitness business owner, and we'd guarantee that the lessons learned will more than pay for the cost of attendance. Plus, registration in the mentorship includes free attendance at our fall seminar on October 14.
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We’re excited to announce that on Monday, October 15, we’ll be hosting our second CSP Business-Building Mentorship, a day of learning with Pete Dupuis and me. This event will take place at our Hudson, MA location the day after our annual fall seminar. Pete and I have spent nearly a decade crafting the operational systems and strategies that fuel CSP today, and we’re excited to pull back the curtain for fellow gym owners.
It is our intention to foster an environment conducive to learning and the exchanging of ideas, so we will be limiting participation to 25 individuals.
Here’s a look at our agenda for the day:
8:30am: Registration & Coffee
Morning Session – Lead Generation & Conversion
09:00am – 09:30am: Introduction: The Four Pillars of Fitness Business Success
09:30am – 10:30am: Lead Generation: Strategic Relationship Development, Identifying & Connecting with Opinion Leaders, Social Media Strategies
10:30am - 11:00am: Q&A
11:00am - 12:00pm: Lead Conversion: CSP Selling Strategy & Methodology
12:00pm - 01:00pm: Lunch (provided)
Afternoon Session – Business Operations & Long-Term Planning
We're very excited to announce that on Sunday, October 14, we’ll be hosting our seventh annual fall seminar at Cressey Sports Performance. As was the case with our extremely popular fall event over the past six years, this event will showcase the great staff we're fortunate to have as part of our team. Also like last year, we want to make this an affordable event for everyone and create a great forum for industry professionals and fitness enthusiasts alike to interact, exchange ideas, and learn. We're happy to have Perform Better as our official sponsor again this year as well.
Here are the presentation topics:
Guest Keynote Speaker: Pat Rigsby --The Future of Fitness Business: The Blueprint for Success in a Changing Market
In this presentation, you'll discover how you can position yourself to succeed now and in the future within the fast-evolving fitness industry. You'll learn what you must do to stand out from the competition, earn more and take advantage of your strengths to design a business that will thrive for the long-term. If you want to command higher rates, enjoy better retention and grow a business you enjoy, don't miss this session.
Eric Cressey -- The Overhead Athlete Evolution
Cressey Sports Performance opened in 2007 and quickly became known as a destination for baseball players from around the country looking to improve. This niche gave rise to specific expertise with this demographic. Interestingly, development of the overhead athlete has changed drastically during the past 11 years, and Eric will outline the new challenges we face and strategies that must be employed to keep arms healthy. While the presentation will focus on overhead athletes, the overwhelming majority of lessons will also be applicable to everyday fitness clients as well.
Pete Dupuis -- The Secrets of Our Industry's Top Performing Fitness Businesses
In this presentation, Pete will bring you inside the strategic mindset of some of our industry's most successful fitness business owners. He's interviewed a series of industry influencers and will share the most under appreciated components of their established and immensely profitable operations. Takeaways will include tips for upgrading branding strategy, fine-tuning employee development, maximizing the effectiveness of social media efforts, and more.
Kyle Driscoll -- Simplifying Coaching Cues for High Speed Movements
Kyle will discuss why training rotational power, especially via medicine ball work, is important for everybody. Coaching high speed movements can, however, be difficult to see - and even more difficult to coach. The higher speed the movement is, the more simple the cues needs to be.
Chris Howard -- Shoulder Pain: What Causes It and What Can We Do About It?
Nearly every fitness professional has encountered an athlete or client dealing with shoulder pain or discomfort. In this presentation, Chris will blend his experience of anatomy and muscular referred pain patterns with strength and conditioning and soft-tissue strategies to illustrate how he addresses clients experiencing shoulder pain. Whether you are new to strength and conditioning, or a seasoned veteran, you will see shoulder pain from a new perspective following this presentation.
John O'Neil -- Stress Application and The Principles of Load Management: What Every Coach Needs to Know
In this discussion, John will cover how he as a strength coach for training clients who have multiple variables that affect their ability to handle applied stress within a gym setting, including how to manage these principles in conjunction with a sport coach. This information will include both theoretical aspects of load management in addition to very specific examples used at Cressey Sports Performance.
Cole Russo -- Creating a System for Movement Progressions
Many strength and conditioning coaches have a collection of sprint and agility drills they like to utilize, but no organized framework of how to apply them. In this presentation, Cole will define a system for teaching your athletes movement. This presentation will include both a lecture on movement progressions, coaching tips, and crucial movement competencies; as well as a following practical/movement session.
**Bonus 3:00PM Saturday Hands-on Session**
Frank Duffy -- Neanderthal No More 2.0: Reviving a Classic
Whether you’re a high-level professional athlete or a desk jockey, at the end of the day, you’re a human being. In this hands-on presentation, Frank will outline the “big rocks” you should consider integrating on a daily basis and how to modify them to align with your own capabilities and goals.
Location:
Cressey Sports Performance
577 Main St.
Suite 310
Hudson, MA 01749
We’re really excited about this event, and would love to have you join us! However, space is limited and most seminars we’ve hosted in the past have sold out quickly, so don’t delay on signing up!
If you have additional questions, please direct them to cspmass@gmail.com. Looking forward to seeing you there!
PS - If you're looking for hotel information, The Extended Stay America in Marlborough, MA offers our clients a heavily discounted nightly rate of just under $65.00. Just mention "Cressey" during the booking process in order to secure the discount. Their booking phone number is 508-490-9911.
