Home Posts tagged "High Performance Training" (Page 8)

Three Years of Cressey Performance: The Right Reasons and the Right Way

Though a somewhat "normal" day at the gym, yesterday marked Cressey Performance's three-year anniversary. While my business partner's blog post yesterday did an excellent job of doling out "thank yous" to a lot of the important people who have been so involved in our success - from clients to parents, coaches, interns, and significant others - I wanted to add my own two cents on the matter today.  More than anything, I really wanted to highlight a sentence that illustrates what makes me the most proud about where CP has been, where it is, and where it's going.

We've done this for the right reasons, and we've done it the right way.

newcp21 I read a business development blog post by Chris McCombs the other day where he wrote something that really hit home for me.  When he was talking about how he decides to accept or reject a new project/opportunity, here is one of his guidelines: "Only Take on Projects That Are In Line With My Current Values and Fulfill Me Beyond Just The Money - A project must fulfill me in some way BESIDE just money...too many people spend their life JUST chasing a buck; to me, that's no way to live.  For me, the money must be there, but it should fulfill me personally, be fun, help a lot of people, and build and be in line with my current brand and brand equity." Back in 2007, I had a tough decision to make.  My online consulting business had really taken off, and the Maximum Strength book deal was in the works.  My other products - Magnificent Mobility, The Ultimate Off-Season Training Manual, and Building the Efficient Athlete - were selling well and getting great reviews, and I'd just had a study published in the Journal of Strength and Conditioning Research.  This website was growing exponentially in popularity, and I had just wrapped up my first year on the Perform Better tour - so lots of doors were opening for me on the seminar front to present all over the world - and I could have stayed home and just written all day, every day. I was getting really crunched for time, as I was already training clients 8-13 hours per day, seven days per week, as my in-person clientele had rapidly grown. My phone rang off the hook for about three weeks after Lincoln-Sudbury won a baseball state championship after I'd trained several of their guys, and one of my athletes was named state player of the year.  And, after being featured on the front page of the Boston Globe with a nipple so hard I could cut diamonds, I was in demand as a t-shirt model (okay, not really - but it made for an awesome blog post, The School of Hard Nipples).

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I was exhausted and stressed - but absolutely, positively, "living the dream" that I'd always wanted. To make matters a bit more interesting, I had just started dating a great girl (now my fiancee) who I really had a good feeling was "the one" after about three months.  The work days, however, were insanely long and I was worried that I'd screw up a good thing by not spending enough time with her. Every business development coach out there would have seen a "simple" answer to all my problems: stop training people in person.  Just write, consult, make DVDs, and give seminars.  It would have cut my hours by 80% and still allowed me to earn a pretty good living - and enjoy plenty of free time.  There was a huge problem with that, though; as Chris wrote, it wouldn't "fulfill me personally, be fun, help a lot of people, and build and be in line with my current brand and brand equity."  I like doing evaluations, writing programs, coaching, sweating, training with my guys, cranking up the music, helping people get to where they want to be, collaborating with and learning from other professionals, and watching my athletes compete - whether it's at some high school field or at Fenway Park.  Giving that up wasn't an option; I guess I'd have just been a crappy business coaching client, as I would have been stubborn as an ass on giving that up.

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Fortunately for me, Pete Dupuis, my roommate from my freshman year of college, had just finished his MBA and was in the midst of a job search.  And, during that MBA, he'd started to train with me and packed on a ton of strength and muscle mass - making him realize and truly appreciate the value in what I was doing (especially since he was and is a goalie in a very competitive soccer league).  Pete had also met and become friends with a ton of my clients - and taken a genuine interest in my baseball focus, as a lifelong Red Sox fan.  Almost daily, Pete would encourage me to do my own thing and let him handle all the business stuff for me. Simultaneously, Tony Gentilcore was ready for a change of scenery on the work front.  Having been Tony's roommate and training partner for almost two years at that point, I knew he was a genuinely great guy, that he'd read everything on my bookshelf, and that he could coach his butt off and "walk the walk."  He, too, had met a lot of my clients - so there was continuity from the get-go. So, on July 13, 2007, Cressey Performance was born.  Here is what we started with.

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Boatloads of renovations and equipment additions later, it wound up looking like this.

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Of course, we outgrew and demolished this space after about nine months and moved three miles east to a facility twice the size.  And, we've continued to grow right up to this day; June was our busiest month ever, and July should be busier.  We've got regular weekly clients who come from four states (MA, NH, CT, RI), and in the baseball off-season, I have college and pro guys who come from the likes of OH, AZ, CA, SC, NC, GA, FL, and VA.  And, we had 33 applicants for this summer's internships.

To be very candid, though, I don't consider myself a very good "businessman."  No offense to Pete or Tony, either, but I don't think they even come close to the textbook definition of the word, either.  We just try to be good dudes. "We've done this for the right reasons, and we've done it the right way."

We don't allocate a certain percentage of our monthly revenues to advertising.  In fact, we haven't spent a single penny on advertising - unless you count charitable donations to causes that are of significance to us.

We don't search high and low for new revenue streams to push on our clients.  In fact, if I get one more MonaVie sales pitch, I'm going to suplex whoever delivered it right off our loading dock.  Rather, we bust our butts to set clients up for success in any way possible - and trust that those efforts will lead to referrals and "allegiance" to Cressey Performance.  We ask what they want from us and modify our plans accordingly.  It's what led to us bringing in manual therapy, a pitching cage, and, of course, pitching coach/court jester Matt Blake's timeless antics.

Along those same lines, we don't measure our success based on revenue numbers; we measure it based on client results.  In three years of seeing LOADS of baseball players non-stop, we've only had three arm surgeries: one shoulder and two elbow.  All three were athletes who came to us with existing injuries, and in each case, we kept them afloat as long as we could and trained them through their entire rehabilitation.  I don't want to toot our own horn, but this is a remarkable statistic in a population where over 57% of pitchers suffer some form of shoulder injury during each competitive season - and that doesn't even include  elbows!  And, our statistics don't even count literally dozens of players who have come to us after a doctor has told them they needed surgery, but we've helped them avoid these procedures.  The college scholarships, draft picks, state titles, individual honors, and personal bests in the gym are all fantastic, but I'm most proud of saying that we've dedicated ourselves to keeping athletes healthy so that they can enjoy the sports they love.

The same goes for our non-competitive athlete clients.  The fat loss and strength gains they experience are awesome and quantifiable, but beyond that (and more qualitatively), I love knowing that they're training pain-free and are going to be able to enjoy exercise and reap the benefits of training for a long time.

We don't penny-pinch during our slowest times of the month (late March through mid-May - the high school baseball season).  We see it as an opportunity to do more staff continuing education, renovate the facilities, and get out to watch a lot of baseball and support our athletes.  And, we adjust our hours to open up on Sundays and stay later on weeknights during the baseball season to make it easier for athletes to get in-season training in whenever they can.  If a pitcher wants to come in and get his arm stretched out before or after an outing, he stops by and we do it for him - but don't charge him a penny for it.  It's about setting people up for success.

We don't try to just "factory line" as many clients through our facility as possible with everyone on the same program.  You might walk into CP and see 20 different clients on 20 different programs - because a 16-year old pitcher with crazy congenital laxity is going to have a markedly different set of needs than a 16-year-old linebacker with shoulder mobility so bad that he needs help putting a jacket on.  One program on one dry erase board for hundreds of athletes isn't training; it's babysitting.

Taking this a step further, we don't boot clients out after a certain amount of time.  Clients take as long as needed to complete the day's program. And, when they're done (or before they even begin), loads of our clients spend time hanging out in the office just shooting the breeze and enjoying the environment.  As an example, Toronto Blue Jays Organizational Pitcher of the Year Tim Collins spends a minimum of five hours a day at CP all off-season.

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Tim has sold girl scout cookies for the daughter of one of our clients, and he's been our back-up front desk guy when Pete is out of town.  Yesterday, he was back to visit on his all-star break - and he said hello to every client he saw - and remembered them by name.  If you're a 15-year-old up-and-coming baseball pitcher, how cool is it to get that kind of greeting when you walk into the office?  Well, at CP, kids get that greeting from 10-15 pro guys all the time.  And, if they're lucky, they might even get to throw on a bobsled helmet and join these pro guys in a rave to Miley Cyrus, apparently.

At least once a week, I get an email from an up-and-coming coach asking for advice about starting a facility.  When I get these emails, I now think about how Rachel Cosgrove recently mentioned that more than 80% of fitness coaches leave the industry within the first year. In most cases, this happens because these people never should have entered the fitness industry in the first place - because their intentions (money) were all wrong.  They usually leave under the assumption that they could never make a living training people, but in reality, these folks are going to have a hard time making a living in any occupation that requires genuinely caring about what you do and the people with whom you work, and being willing to hang your hat on the results you produce.

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As such, the first advice, in a general sense, is obvious: do it for the right reasons, and do it the right way.  Sure, making a living is essential, but only open a facility because it would fulfill you "personally, be fun, help a lot of people, and build and be in line" with who you are and what your values are - which together constitute your "brand." Making the move to start up this business was one of the most daunting decisions I have ever had to make, and all the efforts toward actually getting the business started were equally challenging.  However, in the end, it has been more rewarding both personally and professionally than I could have ever possibly imagined.

Thank you very much to all of you - clients/customers, parents, EricCressey.com readers, seminar attendees, and professional colleagues - for all your support over the past three years.  We couldn't have done it without you - and look forward to many more years of doing things for the right reasons and in the right way.

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Chad Waterbury on Why Some Fat Loss Plans Fail Miserably – and Why Body of Fire is a Better Approach

Today, we're fortunate to have an interview with Chad Waterbury. EC:  Chad, thanks for agreeing to this interview for the site.  It's hard to believe that EricCressey.com has been "live" since 2006, and this is the first time we've gotten you on-board for a feature.  Most of my readers are probably familiar with you already, but what have you been up to lately? CW: First off, I want to say that it's a pleasure to be here. You offer top-notch information to a wide variety of clients and that's why I'm happy to do this interview. This is one of the few websites that I read on a regular basis.

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Over the last few years, since moving to Los Angeles, I've gotten back to training more people one-on-one. In this town, it's all about fat loss. People want to get lean and ripped, like, yesterday. In LA, immediate gratification isn't fast enough. So I've spent time really honing my training and nutrition parameters to help people burn fat in record time. I've also been working with a lot of professional fighters. There's no greater challenge than developing a fighter because he needs to build elite levels of strength, endurance, and mobility at the same time. The cool part is that my work with fighters - and the parameters I use for burning fat - actually coalesce. Why? It's simple: the quickest way to get a leaner, stronger body is to train more like an athlete - especially a fighter. So my challenge was to create a system to get non-athletes to experience the same results that my athletes, such as Ralek Gracie, get when training with me personally.

EC: Gracie's rocking your "Body of FIRE" logo on his banner at the beginning of this clip; let's talk about that.  You've got a new fat loss e-book out (Body of F.I.R.E.).  Besides the obvious fact that a lot of people are...well...fat, what inspired you to write it? CW: Honestly, I was getting tired of hearing outrageous claims from trainers who've never transformed anyone. This industry is replete with self-proclaimed experts. Now, I'm certainly not against the idea of making money off your information, but when the sales pitch is exaggerated to the point of hysteria it becomes a little too much to stomach. It's funny because people often associate me with methods that are solely intended to build size and strength. In reality, I have more experience with training people for fat loss than anything else. So I took it upon myself to create a system that will transform people faster than they ever thought possible. That's why I created my new Body of F.I.R.E. program. In my experience, nothing transforms a person quicker than an effectively designed Full-body, Intense, Resistance Exercise program - hence the acronym.

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However, I didn't want to make a program that was only for advanced athletes, so I took a lot of time tweaking the parameters so anyone can get incredible results on the program. EC: Along those same lines, where are most people falling short on the fat loss front?  Why isn't the status quo getting the job done? CW: This is easy to answer. The first reason why people don't lose fat, and keep it off, is because they don't know how to eat to stimulate their metabolism. Most diets shut down fat burning and make people feel miserable. The second reason is due to their training program. It's imperative to stimulate as many muscle fibers as possible with full-body workouts while keeping the rest periods to a minimum in order to generate a large cardiovascular response. The third component is with their progression plan, or lack thereof. The only way to make your body lose fat week after week is to make it to do work without burning out your nervous system. Building athleticism is a key to making this work. Finally, tissue health is probably the most underrated and unappreciated aspect of body transformation. There are simple steps you can take to keep your joints healthy, and this is essential to sticking with a program. There are a lot of crazy programs out there that quickly impose an insane amount of stress on the joints. If you get injured, your fat loss endeavor immediately comes to a screeching halt. EC: Let's talk about the program itself.  What's unique about it that sets it apart from other fat loss methods that may fall short? CW: Quickly transforming your body starts with the right diet. You'll never lose fat unless your nutrition program focuses on foods that are high in nutrients but low in calories. It's all about food quality. You can eat an entire bag of potato chips because they contain no real nutrients. Therefore, your brain never gets the memo that your body is satisfied. However, you'd never be able to finish the same amount of calories from, say, blueberries or broccoli because your brain quickly gets the signal that your body is getting the nutrients it needs to support your metabolism. Bottom line: the only way to see your abs is to get your diet in order first. The second component is with your training program. As I mentioned, it's essential to train in a way that induces the largest metabolic cost that exercise can create. Tabata's research taught us that we need to think less about the metabolic changes that are occurring during a workout and focus more on what's happening after you leave the gym. An hour jog only burns calories while you're doing it, plus it's very hard on your hips, knees, and ankles. High intensity cardio, on the other hand, will stimulate your metabolism to keep burning calories long after you stop training - if you know how to do it right. Instead of running on a treadmill, focus on full-body circuits such as split jacks, jumping jacks, and burpees that are performed for multiple rounds with minimal rest.

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With regard to weight training, it's important to do three things. First, for every other workout, lift loads that are heavy enough to recruit all of your muscle fibers. Most people lose size and strength on a fat loss plan because they focus on light, high-rep weight training exercises that are performed to failure. This is a travesty because it's not optimal for maximum muscle fiber recruitment. Focus on weights that are between a 6-12 repetition maximum, and accelerate all of your lifts. This ensures that you're recruiting all of your muscle fibers with every rep. As the saying goes: if you don't use it, you lose it. A full-body circuit comprised of an upper body push, an upper body pull, a lower body exercise, and a core exercise is outstanding for creating a huge metabolic cost when the rest periods are kept to a minimum. From there, I have my clients perform "cardio strength" exercises. These are exercises that don't require as much load as a strength circuit, but they can still recruit all of your muscle fibers when performed correctly. For example, I like to pair up the kettlebell swing with a push-up for descending reps. You'll start with, say, 13 reps of the swing and then you'll drop to the floor and knock out 13 push-ups. Then you'll jump back to your feet and do 12 swings followed by 12 push-ups. Next it's 11 swings followed by 11 push-ups. You'll continue with this sequence until you reach one rep for each exercise. When you perform each exercise at top speed, and when you keep rest to a minimum, it's awesome for burning fat while boosting athleticism.

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The third essential component of body transformation comes from an effective progression plan. Many people stop getting results on a fat loss program after a few weeks because their parameters are stagnant. You must force your body to do more work over time. You don't need to keep adding weight to your lifts. Instead, focus on adding a rep or set, or increase your work interval, or shorten your rest periods by five seconds with each workout. This ensures that your metabolism is constantly being challenged. In my new program, I use a combination of these progression methods in each phase. EC: The thing I noticed right away is the dedicated focus to staying healthy with good soft tissue work and a focus on mobility and athletic movement.  It seems like a lot of fat loss programs out there are all about just making people move a ton to tire them out and burn calories - but there is rarely (if ever) a focus on the quality of movement.  Inevitably, exercise technique goes down the crapper and many folks wind up injured (in addition to being raging a**holes from caloric deprivation).  Can you speak a bit to how you attacked this aspect of the program? CW: You're right, Eric, getting the most out of your workouts comes from quality of movement. And getting the most out of your movements comes from having healthy joints that are in balance. Just like high quality foods are essential to boosting your metabolism, so are the exercises. I spent a lot of time developing the exercise guide in this resource by including big, high-resolution pictures along with many tips and technique guidelines to ensure that everyone is doing each exercise perfectly. Furthermore, each workout starts with a few mobility exercises. Most people are stiffest in their ankles, hips, T-spine, and shoulders so it's important to mobilize those areas before you start training. The good news is that it doesn't take long - just a few minutes when you know what to do. And each workout ends with a few, key stretches for the same areas. This is great insurance to keep you on track. A program is only as good as the corrective exercises it contains to keep you from throwing your joints out of whack.

EC: Let's talk nutrition.  What can readers expect on that front in Body of Fire? CW: The nutrition program is as effective as it is user-friendly. The first step, as I mentioned, comes from replacing low-quality foods in your current eating plan with nutrient-dense, low-calories foods. The second step is to control insulin and add in certain, key nutrients that research has shown to have the greatest impact on increasing your metabolism. You must eat frequently, every 3-4 hours, and most people know that. But what might surprise people is that front loading your calories, where breakfast is your highest calorie meal and dinner is the lowest, is a simple way to supercharge your metabolism and burn fat. The third component comes from your workout nutrition. If you take branched-chain amino acids in the right amounts, before and after training, along with a specific post-workout feeding you'll accelerate fat burning, recovery, and performance. The nutrition plan, when paired with the workouts I outline in the program, produce incredible results. My client, Jon, lost over 40 pounds of fat on the program. Since he's an athlete, he couldn't afford to lose any size and strength. As you can see from the before and after pictures, he created what many guys might consider to be the ultimate body. I'll concede that he shaved, tanned, and lost his shoes, but I think the rest speaks for itself.

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EC: Not too shabby at all! Thanks a lot for taking the time to answer my questions, Chad.  Where can readers find out more about the new product? CW: Just head over to BodyofFire.com and check it out while the introductory price is still in effect. This program is unlike anything I've written about in any of my books or articles. I've never spent as much time on a project as I have on the this system. No stone has been left unturned.
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Stuff You Should Read: 7/12/10

Here's this week's list of recommended reading from the EricCressey.com archives: The Proactive Patient - This is still, in my eyes, one of the best articles I've ever written. The 315 Deadlift Fiasco - This article, on the other hand, pissed a few people off.  There were good lessons to be learned, though. Why I Don't Like the 5x5 Workout - While the classic 5x5 set and rep scheme certainly has its place in some strength training programs, it definitely has its limitations. Please enter your email below to sign up for our FREE newsletter.
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What Could a One-Time Consultation at Cressey Performance do for You?

At Cressey Performance, we regularly have visitors in town for One-Time Consultations.  Ronell Smith came to us in December of 2009 and was kind enough to share the following feedback regarding his experience. "The term genius is thrown around far too loosely in every field. But to say that Eric Cressey and Tony Gentilcore are geniuses of the strength training and performance enhancement game is an understatement. I'm proof that their programming and philosophy are magical. "Before discovering Eric and CP, I was a 30-something desk jockey whose main concern was being lean while developing bigger arms and a solid chest. High reps and medium weights, however, were getting me nowhere. But after spending an entire weekend reading Eric's articles on tmuscle.com, I saw the light with his philosophy: Get strong first, and all of my other goals will fall into place. "It made perfect sense. I knew then that Eric was the guy I wanted to design my program. "The two days I spent at CP forever opened my eyes. I learned to stop working out and start training, realized what true intensity meant, and the staff helped me shore up (more like overhaul) the technique on all of my major lifts. "I arrived at CP a 6'5", 204-pound weakling with a ton of structural issues; I left  knowledgeable and confident that I could reach my goals, thanks in part to Eric's "focus on what people can do, not what they can't do" approach. "In the few short months since that initial visit, I've been blown away by the progress that Eric's programming has provided. My deadlift and squat are up over 100 pounds, my max-rep pull-ups have gone from zero to eight and my bench is up 33 percent. (See? Magic!) "Most important, however, my posture is no longer Neanderthalish, I'm stronger, faster and leaner than I've ever been, and trainers ask me who designs my workout. Not to mention, I feel healthier overall and have the added mobility and stability as proof. "Before CP, I've never considered being an online client. But these guys are prompt in answering my questions-and there are many - consistent in providing feedback, including positive reinforcement, and are incredibly easy to work with and fun. "I've spent hundreds of hours reading various coaches' training philosophies and programming - and have even tried several well-known programs over the last year - but none gave me the results that Eric's has provided. "When friends ask how happy I am with my 'personal trainer,' I say two things: (a) What Eric and Tony do is more "life changing" than training and (b) CP is the only facility on earth that I would trust to create my programming."
Ronell Smith Orlando, FL Click here for more information on one-time consultations at Cressey Performance.
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Stuff You Should Read: 7/6/10

In continuing with last week's trend of "reincarnating" good stuff from the EricCressey.com archives, here is some old, but once-again-new flavor for you. Who Needs Percentages? - This blog discusses why I don't think that using a ton of percentages in your training is a good idea - even if it does have its place here and there. The Art of the Deload - In the percentages blog, I referenced my e-book, The Art of the Deload.  As I think about it, this resource really flew under the radar.  Not to toot my own horn, but I think that at just $12.99, it's a tremendous value that just about everyone would be wise to read.  Effectively, it gives you the information you need to modify programs to fit your needs based on a number of factors (age, training history, etc.).

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The Great Eight Reasons for Basketball Mobility Training - Here's a little background on the difference between mobility and stability, plus a rationale for the inclusion of both in this remarkably underserved (and sometimes uninterested!) population.
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Stuff You Should Read: 6/28/10

I just got back from Chicago yesterday, and am playing a bit of catch-up, so I don't have time to write much today.  However, as I was tinkering with a formatting issue on the site last night, I realized that I now have almost four years worth of archives - and that many readers haven't seen a lot of that older work of mine.  So, I think I'll be using my reading recommendations for the next few weeks as a way of bringing older (but still applicable) material back to the forefront. How to Progress Back to Deadlifting after a Back Injury - Here's a step-by-step progression we've used quite a bit with excellent success. Bench Pressing with the Feet Up? - Not a good idea.  Here's why. Lifestyle Checklists - Here's a quick strategy for getting people adherent to training and nutrition practices. Please enter your email below to sign up for our FREE newsletter.
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Random Friday Thoughts: Chicago, Cattle, Comcast, and Customer Service

I hope everyone had a good week.  I'm writing this blog in a bit of a hurry, as I need to pack this morning before heading to Cressey Performance and then directly to the airport to fly out to Chicago. 1. Why Chicago?  Well, in case you've been living under a rock and haven't heard, this weekend is the second Perform Better Summit of the year.  I'll be giving two talks on Saturday. If you're up in the air on which one to attend, I'd recommend my second one (lecture, not hands on).  With the room design (no concrete walls), we won't be able to do much true medicine ball training so that the hands-on can parallel my lecture topic.  I'll be talking about shoulder assessment and corrective exercise with a little medicine ball flavor in my hands-on instead. There are a ton of videos in the presentation, though, so you'll be able to get the next best thing.

While I enjoy presenting at seminars, I don't like to travel at all; sitting in airports and on planes is just not my thing.  However, when it's Perform Better, the hassle of traveling just doesn't seem to be present - because I know how awesome the "light at the end of the tunnel" is.   As a presenter, I don't always get to check out as many of the other talks as I'd like because I'm tied up with speaking and answering questions, but I do get to experience a lot of interaction with audience members and other speakers between lectures, at breakfast/lunch/dinner, and on the town.  These, for me, are really as valuable as the presentations themselves.  Audience members ask some excellent questions that can drive blog content, and I've also added some valuable people from around the country to my network this way.  Chatting with presenters is great as well, because they always have some new project or business strategy that they're working on that can get my mind working.  Chicago is also great because I can catch up with my buddy, Josh Bonhotal, who is a strength and conditioning coach for the Chicago Bulls.

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All that said, I have to say that it is kind of nice to see my schedule as empty for the rest of the summer.  With the new house, wedding planning, and our busiest month at Cressey Performance at-hand, it'll be nice to focus my efforts here both personally and professionally.  I try to keep the summers reasonably free so that we can take weekend trips up to Maine to visit my parents a few times a month.  Additionally, with a few of our minor league guys on the cusp of call-ups to the big leagues, I want to make sure that I can hop on a plane at a moment's notice to be there to support them and share in the excitement wherever they wind up making those MLB debuts. Anyway, if you're in attendance in Chicago, please be sure to introduce yourself. 2.Those of you who can't make it would probably like this article as the next best thing: Medicine Ball Madness. 3. Oh, I should say that it looks like my second presentation coincides with the U.S. vs. Ghana World Cup game.  Skip me, if you have to; I'd probably skip me, if I was in your shoes.

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Check out this great article from Ryan Andrews at Precision Nutrition: Cattle Feedlot: Behind the Scenes. 4. Many of you might recall how much I abhor Comcast.  Well, I'm happy to report that we officially kicked them to the curb about two weeks ago by making the switch to Verizon for our internet and cable - and I have to say that it was an awesome decision.  The price, service, speed, and product offering don't just beat Comcast; they beat it like a red-headed rented mule.  If you're thinking about making the switch, I highly recommend it. Incidentally, I had to chuckle when I saw that MSN Money had released its list of the 2010 Customer Service Hall of Shame, and Comcast was in third place.  Meanwhile, Sprint - which I had dropped for my cell phone service after seven years (also to go with Verizon) was listed as #4.  I guess you could say that I was getting rid of the dead wood around here last month! Please enter your email below to sign up for our FREE newsletter.
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Who “Kneeds” Normal Knees?

Okay, this subject line was undoubtedly the worst of all time, but I promise that the information that follows will be worth reading. A lot of you were probably hoping that you were out of the woods after I told you how bad your lower backs and shoulders look on diagnostic imaging such as MRIs.  I'm sorry to say that these "normal" structural disasters also apply to the knees. A 2010 review from Flanigan et al. looked at studies that collectively examined the (1,862) knees of 931 athletes (40% of whom were professional athletes) using MRI and arthroscopy.  They found that 36% of these knees had full-thickness chondral defects, but 14% of these subjects had no symptoms when diagnosed.  The researchers concluded that "Over one-half of asymptomatic athletes have a full-thickness defect."

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Years earlier, Cook et al. screened 134 elite junior basketball players (268 total knees) for patellar tendinopathy.  At the time, only 19 (7%) of the 268 tendons presented with symptoms (pain) of tendinopathy.  Interestingly, though, under diagnosis with ultrasound, researchers actually found that 26% of all the tendons could be labeled tendinopathy based on the degenerative changes observed.  In other words, for every one that actually presents clinically with symptoms, more than three more go undiagnosed because people either haven't reached threshold, or they move well enough to keep symptoms at bay.  Or they are Kurt Rambis and can just look so awkward that nobody even pays attention to their knee sleeve.

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On the "move well enough" side of things, check out this study from Edwards et al.  They showed that these athletes with asymptomatic patellar tendinopathy actually land differently - both in terms of muscle recruitment and sequencing - than asymptomatic athletes without tendinopathy.  Fix that movement pattern neurally and strengthen the right muscles, and those issues never reach threshold.  Leave it alone, and they'll be presenting with knee pain sooner than later.  Mike Robertson does a great job of outlining ways to improve knee health via movement retraining in his Bulletproof Knees Manual.

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This is just the tip of the iceberg.  You'll see loads of chronic ACL and meniscus tears that folks never realize they have.  I could go on and on. The take-home messages?  Yet again, diagnostic imaging is just one piece of the puzzle, and how you move is far more important. Related Posts The Importance of Ankle Mobility Healthy Knees, Steady Progress
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Healthy Shoulders with Terrible MRIs?

In the same grain as Monday's post on lower back pain, today, I thought I'd highlight some of the common findings in diagnostic imaging of the shoulder, as these findings are just as alarming.

Do you train loads of overhead throwing athletes (especially pitchers) like I do?  Miniaci et al. found that 79% of asymptomatic professional pitchers (28/40) had "abnormal labrum" features and noted that "magnetic resonance imaging of the shoulder in asymptomatic high performance throwing athletes reveals abnormalities that may encompass a spectrum of 'nonclinical' findings."  Yes, you can have a torn labrum and not be in pain (it depends on the kind of labral tear you have; for more information, check out Mike Reinold's great series on SLAP lesions, starting with Part 1).

slap_lesion

This isn't just limited to baseball players, either; you'll see it in handball, swimming, track and field throwers, and tennis as well.  And, it isn't just limited to the labrum.  Connor et al. found that eight of 20 (40%) dominant shoulders in asymptomatic tennis/baseball players had evidence of partial or full-thickness cuff tears on MRI. Five of the 20 also had evidence of Bennett's lesions.

The general population may be even worse, particularly as folks age. Sher et al. took MRIs of 96 asymptomatic subjects, finding rotator cuff tears in 34% of cases, and 54% of those older than 60 - so if you're dealing with older adult fitness, you have to assume they're present in more than half your clients!

rtc-tear

Also, in another Miniaci et al. study, MRIs of 30 asymptomatic shoulders under age 50 demonstrated "no completely 'normal' rotator cuffs."  People's MRIs are such train wrecks that we don't even know what "normal" is anymore!

As is the case with back pain, these issues generally only become symptomatic when you don't move well - meaning you have insufficient strength, limited flexibility, or poor tissue quality.  For more information on how to screen for and prevent these issues from reaching threshold, check out Optimal Shoulder Performance from Mike Reinold and me.

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Stuff You Should Read: 6/22/10

Some recommended reading for the week: Ultimate Forearm Training for Baseball - Knowing I work with a lot of baseball guys, Jedd Johnson sent me a copy of his new e-book on forearm training the other day.  Just as I've come to expect from the Diesel Crew guys, I picked up some innovative new exercises that we're going to incorporate with our athletes moving forward.  It's definitely worth picking up. Perform Better-Providence Review - This is a lengthy (and a bit all over the place) blog from Charlie Weingroff, but the bulletpointed information for each presentation he attended is excellent. Strength Coaches Doing Heavy Lifting - This is a pretty cool ESPN article outlining how the role of the strength coach in the college setting has evolved, and what it means in some bigger D-1 football programs. Please enter your email below to sign up for our FREE newsletter.
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