Q: I've read a lot from you, Robertson, and Hartman about including push-up variations in strength training programs is really important for shoulder health. Unfortunately, whenever I do them, I have pain in my bum shoulder. Any ideas what to do?
A: Well, obviously, there are two things we need to rule out:
1. You may simply have a really irritated shoulder, which (in most cases) means that any sort of approximation or protraction movement could get it angrier, even if it is a closed-chain movement like the push-up that is normally pretty shoulder-friendly. Likewise, if you have a significant acromioclavicular joint injury, the extension range-of-motion at the bottom of a push-up could exacerbate your symptoms. So, obviously, the first step is to rule out if something is structurally wrong with your shoulder, and if so, if the push-up even belongs in your strength training program.
2. Your technique might just be atrocious. If the elbows are flared out, hips are sagging, and/or you're in a forward head posture, simply changing your technique may very well alleviate those symptoms. In a good push-up, the elbows should be tucked to a 45-degree angle to the body, with the hips, torso, neck, and head in a straight line. The muscles of the upper back should essentially "pull" you down into the bottom position:
Once you've ruled out those two issues and still have some annoying issues, there is one more thing you can try: simply elevate the feet. Looking to the research, Lear and Gross found that performing push-ups with the feet elevated significantly increased activation of the serratus anterior (SA).
If we can get more SA recruitment and less pectoralis minor contribution, it keeps us out of a position of scapular anterior tilt, which mechanically decreases the subacromial space through which the rotator cuff tendons pass. In the picture below, think of the area just below the word "acromion" being smaller, and then picture what would happen to the tendons that pass through that region; they get impinged. Serratus anterior (along with lower trapezius) can help prevent that.
That said, I've seen quite a few folks with persistent shoulder pain with bench pressing variations (barbell and DBs) and regular push-ups who were able to do the feet-elevated versions completely pain free in their strength training programs. Obviously, begin with just body weight and see how it goes, but over time, you can start to add resistance and use the single-leg version.
Another day, another happy Maximum Strength customer!
"Hey Eric,
Just wrapped up your Maximum Strength program and I was definitely more than pleased with the results. I know it's a little weird that I switched up the box height on the box squat. I switched because the pre-MS box squat was the first time I ever performed the box squat. Here are my numbers:
Starting Numbers
Body Fat: 16%
Weight: 178 at 5'9
Bench: 215
Box Squat (24 inch box): 315
Deadlift: 330
3 RM Chin: BW+35
Broadjump: 87 in.
Ending Numbers
Body Fat: 10%
Weight: 170
Bench: 240
Box Squat (12 inch box): 325
Conventional Deadlift: 403
3RM Chin: BW+50
Broadjump: 96 in.
Thanks Eric!
Mike Coval"
The nicest thing about baseball season is, obviously, the fact that I get to watch a ton of baseball and see their off-season dedication pay off on the field. Another nice perk, though, is that I get about six weeks to gather my thoughts, spend a little extra time on writing/consulting, and just tie up loose ends on little projects here and there.
One such project from last week - which clearly wasn't so little - was cleaning my desk at Cressey Performance. As you can see in the picture below (numerically labeled for the sake of explanation below), it was something that really needed to get done.
1. Water Bottle...likely from 2003.
2. One of my old business cards - and it's serving an important purpose: covering up the strawberry protein powder stain on #3.
3. Stained picture of my fiancee Anna and I. For the record, she spilled it, and it was her shake - but this relationship isn't about blame, is it, honey?
4. That's a world record deadlift certificate. I'm pretty sure it was a 567.5 deadlift at a body weight of 163 in my last meet as a junior back in 2005. However, I've received so many awards for my devastatingly good looks since then that it's all a blur (kidding, folks; they were all for my charming wit and personality).
5. Fiancee's watch. I've been engaged two weeks and she's already all up in my business!
6. Packing tape - to keep my mouth shut after my comment on #5.
7. Laptop, and I need a new one. Suggestions? I'm too big of a wuss to make the leap to a Mac.
8. Ball signed by all of my in-person pro baseball players from this past off-season. I get hounded all the time for my autograph, so I thought I'd turn the tables on someone.
9. DVD of my presentation from Ron Wolforth's Ultimate Pitching Coaches Bootcamp in December. This set is fantastic, and it would be worth checking out.
10. Digital camera: quite possibly the most useful thing you can have kicking around if you are a strength coach. It's an awesome way to give athletes instant visual feedback, or to take videos of "team building."
11. Cell phone. Yes, I know it's white, but they were out of the black ones, and I needed a phone right away. I make up for it by being a text message rock star.
12. Keys, which are under something, meaning that I'll probably lose them when I go to leave for the night.
13. Desk: you'll notice it isn't a very nice one, and the reason is pretty simple. I'm a slob and don't really need anything better.
14. I-Pod, because I'm very 21st century-ish.
15. Waldo (of Where's Waldo? fame). Actually, it's an envelope I should have mailed to my brother a few days ago. Crap.
16. Royalty statement for Maximum Strength. Since we haven't earned any royalties, I guess you could just call it a piece of paper. Then again, reading these things is like perusing stereo instructions written in Chinese, so I'm assuming they'll always just be pieces of paper to me.
17. Sunglasses, because MC Hammer taught me that you're only cool if you wear sunglasses inside.
18. Two plaques I received for speaking at the Maine NSCA Symposium. One of them was the first annual Dr. Richard LaRue award. I definitely need to hang 'em up before I spill something on them.
19. This is a drawer filled with almonds, chewing gum, plastic forks, kryptonite, and Tony's manhood (he'll get it back when he stops listening to techno).
20. Basketball signed by the 2004-2005 UCONN women's basketball team. A lot of the girls on this year's national championship team were freshmen during my last year on campus. In hindsight, I never really got much stuff signed by the athletes with whom I worked, but this was one I actually got around to snagging.
21. This month's NSCA Journal, the focus of which was entirely baseball. Some of it was good (weighted balls meta-analysis), and some was absolutely atrocious (the take on pitchers distance running, to which I am ademantly opposed).
22. Free t-shirts, quite possibly the coolest perk of being a strength coach. Here, we've got shirts from the SF Giants (Steve Hammond), Nobles & Greenough (Ben Knott), and Stonehill College (Clark Leger). Thanks, guys!
23. Sticky note...as if a note could actually organize me!?!?!?
24. Journal article on glenoid dysplasia. I always try to have something right on-hand to read if I get a spare minute.
25. Business cards for local physical therapists with whom we work: it never hurts to have a great network.
26. Business cards for a local sports psychologist (all the CP staff members need to spend time with him to put up with my crap).
27. Dry erase board, also known as the center of my universe.
28. Health history for a client I had just evaluated. I use my notes to write his program.
29. Signed picture from USA Bobsled driver Bree Schaaf - and it reminds me that I have a bunch of other stuff like this that I need to hang up in my office!
30. Lincoln-Sudbury Baseball 2007 State Championship Plaque. Bring home another one this year, fellas!
31. Towel - originally brought to work for showering purposes, but it eventually got devoted to towel pull-ups full-time!
32. Boots that I should have taken home months ago when winter ended.
33. Warm-up pants that I always have on-hand in case I need to catch a bullpen. Putting catcher's gear on top of shorts is not comfortable.
34. My supplement stockpile. Chance favors the prepared mind, so I try not to ever get caught shorthanded on the calories front at work.
Fortunately, this is all pretty cleaned-up by now. I feel pretty out-of-sorts as a result, though!
1. First off, a little recognition for the Lincoln-Sudbury baseball team and coaching staff; LS baseball was was ranked #1 in Massachusetts by the Boston Herald this week. The guys ran their record to 10-0 with a 12-3 win yesterday. Just about every varsity player on the LS squad trains at Cressey Performance, and when you watch them get after it - whether it's the off-season or in-season - it's no surprise why these guys are doing special things. Here's are the starting RF, LF/RHP, 2B, and SS getting after it back in early March. You won't find a high school team in the country who trains harder or smarter than these guys.
Keep up the good work, fellas!
2. One of the first things I learned as a writer in the fitness industry was that it was best to avoid writing about religion and politics. Still, I'm going to just come right out and ask: why the hell do we need a photo of a presidential plane with two F-16 fighter jets over New York City, anyway? Are they trying to sell this sucker on EBay?
This one came at a price-tag of $328,835 to taxpayers - and that doesn't even include the wasted wages on the thousands of citizens who fled their places of employment. Whether you are a Republican or Democrat, this has got to make you want to go elwell on someone (inside joke, but I'm sure the rest of you catch my drift).
2. I've written previously on the tremendous benefits of increasing one's dosage of Vitamin D through supplementation. In particular, it seems to have a great effect on chronic musculoskeletal issues, particularly in darker skinned individuals in Northern climates. Well, add one more benefit to the list.
According to British researchers, daily supplementation with Vitamin D cut prostate specific antigen levels by more than 50% in some patients with prostate cancer. This marker is used as an indicator of the severity of prostate cancer.
3. I just got an email with some awesome feedback:
"I just finished your Maximum Strength program and had great success! Here are the stats:
Pre Max Strength
Bench Press = 300
Squat = 350
Deadlift = 425
3 Rep Pullup = Bodyweight + 15 lbs
Post Max Strength
Bench Press = 335
Squat = 385
Deadlift = 440
3 Rep Pullup = Bodyweight + 55 lbs
My weight stayed the same at 195 lbs at 5'10". Thanks for a great program!!!
-James Wigington"
Click here to pick up a copy of Maximum Strength!
4. Someone asked me the other day, "when a person presents with little or no level of asymmetry, is it safe to say that no pain = no problem in this case?"
My answer would be that it is definitely not safe to say that. While asymmetry is often a good predictor of injury, it doesn't tell us everything about an individual's current state. A lot of folks have bilateral strength/stability/flexibility deficits, and it's just a matter of where they wind up breaking down first.
5. Movement of the Week: The Spin Kick (pants optional)...
I figured I'd start up a mini-series of sorts here where I discuss some of the little changes you can make to programs to get big results.
Many intermediate lifters get stuck in a middle ground with respect to heavy loading in their quest to build strength. Obviously, they know that, as a general rule of thumb, they need to use some heavier loading at least once a week in the 1-5 rep range to build strength. And, a lot of them (at least those who have read my stuff and other articles at T-Nation and EliteFTS) know that dynamic work - in this case, speed squats, deadlifts, and bench presses - is a great way to train bar speed and rate of force development - all while improving technique with submaximal weights.
So, here you have two separate training sessions out of the week: one for maximal loading, and the other for speed. That said, a lot of these intermediates also are still new enough to the iron game that they can handle a bit more loading in the 85-100% range.
With that in mind, I'll often plug in heavy "work-ups" following speed work. So, a lifter might do eight sets of two reps on the bench press, and then work up to a heavy set of 1-3 reps after those eight sets. This not only serves as a way to add in some extra volume in the traditional strength rep-ranges, but also allows a lifter to build in some testing to the program and continuosly monitor progress.
I'll typically only do this 1-2 times a month, and as a general rule of thumb, it will come in a higher volume week that follows a lower volume week. So, in my high-medium-very high-low set-up, it would take place during weeks 1 and/or 3.
For more strength building strategies like this at a great price, check out Maximum Strength.
I got this email over the weekend from a recent finisher of the Maximum Strength Program:
"Eric,
Here are my results on the Maximum Strength program.
Packing Day
Standing Broad Jump: 80 inches
Bench Press: 225 lbs
Box Squat: 295 lbs
Deadlift: 385 lbs
------------------------
905 lbs total for the big 3
3-Rep Max Chins: BW (230) +10 lbs total of 240 lbs
------------------------------------------
Moving Day
Standing Broad Jump: 90.25 inches (+10.25 inches)
Bench Press: 275 lbs (+50 lbs)
Box Squat: 365 lbs (+70 lbs)
Deadlift: 405 lbs (+20 lbs)
-------------------------------------------
1045 lbs total for the big 3 (+140 lbs)
3-rep Max Chins:BW (220) +35 lbs total of 255 lbs (+15 lbs)
"Thoughts on the program:
"This is the first program I have ever completed from start to finish in the few years that I have been lifting. I always got burned out or got training A.D.D. and did something else. Not with yours.
"This program was incredible. Not only did it feel great to do a specifically designed program, but it felt great to see my progress as I was doing the program. The gym I worked out in didn't have a power rack-only a squat rack- so I had to do some McGuyver rigging for rack pulls and pin presses. I wasn't able to do the Anderson Front squats and had to go light on the floor presses, but all in all, I was able to stick with the program 100%.
"I missed about a week total of workouts due to a couple serious, family emergencies, but I didn't use that as an excuse to fall off the wagon. I pushed through and loved my results.
"Thanks for such a great program, and I look forward to the sequel.
"David"
5o pounds added to a bench press in 16 weeks? Not too shabby!
Q: I recently came across an article by Nick Tumminello on tests for dynamic abdominal strength, and the primary focus was sit-ups and reverse crunches. Given your regard for training the core as an anti-rotator/resistor of lumbar hyperextension, do you have any thoughts on these testing protocols?
A: First off, Nick is a brilliant guy with some awesome ideas. For those who aren't familiar with him, check out his website, PerformanceU.net.
Moving on to your question, it is interesting that you would ask about this, as Bill Hartman and I had a good email exchange last week where we were talking about just how "functional" most tests are. And, more specifically, we were calling into question just how much particular assessments carry over to the real world of injury prevention and performance enhancement.
A study from Stanton et al. in 2004 is a great example of the divide between testing proficiency and performance. As I noted in my e-book, The Truth About Unstable Surface Training, researchers found that six weeks of stability ball training improved core stability in young athletes - as it was measured (in a manner consistent with the training itself). In other words, this is like saying that bench press training will make you better at bench pressing. Well, duh! The more important question, though, is whether or not that bench press performance will carry over to athletic performance.
And, this is where the intervention in the Stanton et al. study fell short. While their measure of "core stability" improved, it did not effect favorable changes in running economy or running posture, or modify EMG activity of the abdominal or erector spinae muscles. In other words, it didn't carry over.
A comparable result was seen in a study from Tse et al. in 2005. After eight weeks of stability ball training in collegiate rowers, while "core stability" (as they tested it) improved, the experimental (core training) group showed no performance improvements over those who did ZERO core training during this time. And, researcher tested several measures: "vertical jump, broad jump, shuttle run, 40-m sprint, overhead medicine ball throw, 2,000-m maximal rowing ergometer test."
So, with respect to your question, I think the question is: do those sit-up and reverse crunch progressions matter for an athlete who spends his/her life in the standing position? Wouldn't they have more predictive value with respect to performance in a mixed martial arts population that spends a significant amount of time in the supine position in competitive situations? Interestingly, Nick has extensive experience with mixed martial artists, and that is probably why he's seen such strong predictive value from those tests.
Additionally, these issues are worthy of consideration in an athletic population where fatigue is a big issue. Does an assessment in a rested state necessarily carry over to a situation where movements may change under fatigue? Bill wrote a great blog on this topic HERE.
Food for thought; never take anything at face value. As with almost everything you'll encounter in the world of fitness, the answer is "maybe" or "it depends." You have to know how to assess and program accordingly.
Maximum Strength Feedback
I just got the following feedback on the Maximum Strength program from a trainer who recently completed it:
"Body Weight 202--> 207
Bench 305--> 335
Broad Jump 99" --> 104"
Back Squat 315 --> 355
Deadlift 335 --> 370
Chin Ups 202+60=262 --> 207+90 = 297
I had two big 'uh-huh' moments when going through this program. (You have been preaching these forever, but it did not truly hit me until the third phase of the program)
1) Improving my ankle and hip mobility was the key to improving my squat and deadlift numbers.
2) Increasing my pulling power was the key to improving my bench press.
As a trainer, I had too much pride to ever follow anyone else's program. I am glad I finally decided to check my ego and follow your program."
Pick up your copy of Maximum StrengthHERE.
New Blog ContentIt's the Most Wonderful Time of the YearStatic Posture Assessment Mistakes: Part 2Pitchers vs. Quarterbacks vs. SwimmersRandom Friday Thoughts
All the Best,
EC
Here's your weekly Maximum Strength success story:
"Hey Eric,
"Just finished the Maximum Strength program and it was awesome! I played college volleyball and and after letting myself get out of shape, I started weight training about 2 years ago. Obviously playing volleyball you could probably guess I have bad knees. Bedsides the typical tendinitis and jumpers knee, I also had a lateral release done on each knee. I never really squatted since I thought it was bad for my knee's, but one of the guys at the gym who is involved in powerlifting got me squatting. Then I found your book and everything in it seemed to line up with the way I was thinking about working out, and I can tell you my knee's feel better now than they ever have in my life.
"I'm kicking myself for not doing all the energy workouts, but still stoked with the results. It's been about six weeks since I completed the program and I am already thinking of doing Maximum Strength again.
"Thanks for the great book and looking forward to the next one.
Me:
Male
36 (37 in April)
6"3
Packing Day:
Body weight: 216 (13.1% body fat)
Broad jump: 98 inches.
Box Squat: 365 lbs.
Bench Press: 255 lbs.
Deadlift: 365 lbs.
3 Rep Chin-up: 254 lbs.
Moving Day:
Body weight: 226 (14.1% body fat)
Broad jump: 110 inches.
Box Squat: 395 lbs. (just missed 405, didn't get the depth)
Bench Press: 275 lbs
Deadlift: 405
3 rep Chin-lup: 268 pounds
Larry Quinn"
Q: Recently, I've noticed that I've lost a lot of mobility/flexibility that means I can't squat with my hands close in and with a high bar like I used to, I now have to go low bar and hands almost at the collars. What stretches/mobility work would you recommend to remedy this problem? I don't think this situation's very good for my shoulder health.
A: It's a common problem, and while the solution is pretty simple, it takes a dedicated effort to regular flexibility and soft tissue work. And, you're right that it isn't very good for shoulder health; that low-bar position can really wreak havoc on the long head of the biceps.
For starters, it's important to address thoracic spine mobility. If you're rounded over at the upper back, it'll be impossible to get the bar in the right "rack" position - regardless of what's going on with the shoulder itself. The first thing I do with folks in these situations is check to make sure that they aren't doing any sit-ups or crunches, which shorten the rectus abdominus and depress the rib cage, causing a more "hunchback" posture.
After you've eliminated these exercises from their programming, you can get to work on their thoracic spine mobility with drills from Optimal Shoulder Performance; one example would be thoracic extensions on the foam roller.
As you work to regain that mobility, it's valuable to build stability within that newly acquired range-of-motion (ROM) with loads of horizontal pulling (rows) and deadlift variations.
With respect to the shoulder itself, it's important to regain lost external rotation ROM and scapular posterior tilt. As I recently wrote in "The Right Way to Stretch the Pecs," I prefer the 1-arm doorway pec stretch and supine pec minor stretches. You can find videos of both HERE - and you can expedite the process with regular foam rolling on the pecs.
In the interim, substitute front squats, overhead squats, single-leg exercises, and deadlift variations to maintain a training effect.
As you progress back to squatting, you can ease the stress on your shoulders by going with a pinky-less grip in the short-term.
That said, for many individuals, the back squat set-up may not be appropriate. These include overhead throwing athletes, those with flexion-based back pain (e.g., disc herniations), and individuals with posterior labral tears.
I'd estimate that only about 25% of Cressey Performance clients do a true back squat, but that's influenced considerably by the fact that we deal with a ton of baseball players, and I get a lot of shoulder corrective exercise cases. Instead, we do a lot of work with the giant cambered bar and safety squat bar, in addition to front squatting.
Hopefully, these recommendations get you headed in the right direction and back to squatting as soon as possible!
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1. Water Bottle...likely from 2003.
2. One of my old business cards - and it's serving an important purpose: covering up the strawberry protein powder stain on #3.
3. Stained picture of my fiancee Anna and I. For the record, she spilled it, and it was her shake - but this relationship isn't about blame, is it, honey?
4. That's a world record deadlift certificate. I'm pretty sure it was a 567.5 deadlift at a body weight of 163 in my last meet as a junior back in 2005. However, I've received so many awards for my devastatingly good looks since then that it's all a blur (kidding, folks; they were all for my charming wit and personality).
5. Fiancee's watch. I've been engaged two weeks and she's already all up in my business!
6. Packing tape - to keep my mouth shut after my comment on #5.
7. Laptop, and I need a new one. Suggestions? I'm too big of a wuss to make the leap to a Mac.
8. Ball signed by all of my in-person pro baseball players from this past off-season. I get hounded all the time for my autograph, so I thought I'd turn the tables on someone.
9. DVD of my presentation from 
