An Interview with Brad Cardoza and John Sullivan By Eric Cressey

Walk into any gym and you'll encounter some really big guys. Heck, you might even find a few who can move some reasonably impressive weight on the bench. Rarely, you'll see people who actually deadlifts. And, once in a millennium, you might encounter someone who smokes a crisp 400-lb. butt-to-heels squat that brings a tear to your eye. I can guarantee you, however, that you've probably never encountered someone who can do what Brad Cardoza and John Sullivan do regularly in their training. That's not to say, however, that you should simply discount what these guys have to offer; chances are that some Strongman training methods could take your performance and physique to all new levels. You'll probably learn a few new ways to frighten the old ladies in your gym, too! EC: Tell me about yourselves to set the stage, fellas. Please omit anything related to your criminal records, favorite colors, and Sully's weird rash. BC: I've pretty much run the gamut in terms of participation in strength sports. I lifted in high school and threw the discus (some school and conference records), then went on to have a successful career at Division III UMASS-Dartmouth, where I was ranked #1 in the country in the hammer throw and held the UMASS-Dartmouth school record in the 35# weight throw. As a result, UMASS-Amherst offered me a D-I athletic scholarship, so I gladly accepted the opportunity to be involved with a program that had good coaching and a solid strength and conditioning program. I wound up going to D-I Nationals and still hold the UMASS school record in the hammer throw. I got away from competing for a few years after college, as I was busy trying to start a career www.pinnaclestrengthandfitness.com as a personal trainer in Boston. While working at Boston Sports Clubs for two years, I met quite a few people, most notably Sully. It took a little while, but he finally convinced me to give Strongman a try. Needless to say, I'm very happy he did; it has become the most important part of my life these days. This is one thing people have a hard time understanding about me: when I am involved in a sport that I love, it comes before everything else in my life besides loved ones. At UMASS, track came before classes, and now strongman comes before work, sometimes even my health. This attitude has lead to a lot of improvement, as I earned my pro card in the International Federation of Strength Athletes (IFSA); had some success in powerlifting during 2003 (575 squat, 375 bench, and 650 deadlift without much specific preparation); and received sponsorship from AtLarge Nutrition www.atlargenutrition.com and APT Pro Wrist Wraps www.prowristwraps.com. Then again, my approach has led to some frustration at times as well; I'm now dealing with my third major injury in only two months (a record for me); this time I'm going to need surgery (Editor's Note: at publication time, Brad has not only had the surgery, he's back in the gym already!).

JS: When I originally started becoming more focused on strength sports, I was interested in powerlifting. I began to learn more and more about the Westside system of powerlifting, and began to use their methods in my training. In 2002, I met the owners of Total Performance Sports in Everett, Mass., who were running the Mass. State Strongman Championships. They convinced me to come down to their place and give it a try. I did, and loved it. I wasn't sure I was going to enter the contest, but after about a month of training there, they basically said, "you're entered". I was kind of nervous, but in retrospect it was the best decision that was ever made for me. I won my division, and I was hooked after that. Later that same year I started working for Art McDermott, training clients at Highland Strength & Fitness in Andover, MA. I have trained there for all of my subsequent Strongman competitions. My last competition was NASS Nationals, where I placed 5th in the 200 lb. class. I've also been involved in Olympic lifting of late. EC: Those answers once again reaffirm my belief that lifting heavy stuff is more addictive than any drug – even Viagra on a trip to the Playboy mansion. Anyway, what does a typical week of training look like to you? BC: When I am healthy and preparing for a competition, my typical week would look something like this:

Monday - Max effort overhead pressing day (maybe a little thick bar bench or something to keep the bodybuilder in me happy!) Tuesday - Max effort leg day. This would include squat and deadlift variations as well as my single leg support stuff (my favorite) Wednesday or Thursday - There are usually two event days per week when preparing for a competition. This would usually be one of them; the other falls on Saturday. Usually, you are training for 5-6 events, so I prefer to do three of them on Wednesday/Thursday and three of them on Saturday. Friday - Upper body pull day. This includes all of my back work as well as any direct arm or grip stuff that I might need. Saturday - Event day #2

I should also mention that I usually mix in some Olympic movement at least once a week. Sometimes, I'll do it on a day off, or possibly just throw it in wherever I feel it fits best. JS: A typical training week is a little tough, since the nature of the events in a Strongman contest can vary so widely. That said, here is a template similar to the one I used to prepare for the 2004 X-Treme Strongman Showdown, where I placed second. Keep in mind that this template reflects my personal strengths and weaknesses, and may not necessarily be optimal for someone else.

Monday: A) Heavy Pull/Good Morning (DL or DL variation once every 14-21 days) B) Harness Front Squat or Olympic Squat C1) Lunge Variation C2) Core Work Tuesday: A) Jerk Variation B1) T-Bar Row B2) Close grip Bench C) External Rotation Work Thursday: A) Power Clean B) Box Squat C) Core Work Saturday: Events

I don't do much overhead or grip work because I tend to do very well in those types of events. I focus on exercises that will bring up exercises like stones, which are a weakness for me.

EC: As sweet as training Strongman-style to prepare for Strongman competitions is, it stands to reason that the overwhelming majority of our readers have other goals. How can the ordinary fitness enthusiasts integrate Strongman training into their programs? Bodybuilders? Powerlifters? Other athletes? Regular weekend warriors? BC: What people have to realize is that Strongman training means nothing more than integrating explosive, compound movements into your workouts. I am actually quite impressed with how many guys at my gym have taken my advice and started doing a lot more squat and deadlift work. I even see guys attempting 1-leg reverse hypers, pull-throughs, etc. It all comes down to wanting to be athletic and strong - not just big or buff. I will admit that when I first arrived at UMASS and my coach told me that I wouldn’t be bench pressing again during my collegiate career, I was heartbroken! No more than two years later, when it was time for max day and everyone on the team was doing benches, squats, and cleans, I was no where to be found. I maxed on front squats, snatches, and behind the neck push presses! At this point, I was convinced that these were the lifts that were turning me into a successful hammer thrower, so "missing out" on the others was of absolutely no frustration. As far as strongman events are concerned, there are usually a limited number of things you can do at a traditional commercial gym. One the most beneficial and rewarding events is the farmer's walk. These were tough to do at the gym until I realized I had two of these guys at my disposal: Throw some tape in the middle of the handle to make it a little bit thicker, and it is probably the best farmer's simulation you will get without the real implements.

Besides farmer's, there aren’t too many events you can replicate in the gym, and this is when you have to use the imagination a little bit. Zercher holds (Conan's wheel), stiff leg pull-throughs (stones)…there are lots of things you can do that will be great for you and maybe even amp you up enough to try a competition sometime! Grip is the only other thing about which you ought to worry if you're thinking about competing. Sully covered that one pretty well in his article last month, though, didn't he? All that you have to remember is that most people's grips suck; I know mine did. The more heavy pulling you do on a weekly basis, the more rapidly your grip will improve. Certainly, it doesn’t hurt to add the grip-specific stuff as well. JS: I think certain athletes can benefit greatly from Strongman training. Strength athletes like powerlifters can expect greater hip, back, and abdominal stability, strength, and power from using Strongman equipment like the super yoke, stones, tries, kegs, and sandbags. Bodybuilders can fill the sandbags with chicken breasts to make sure they get their 1200 grams of protein a day, and use the kegs to stock up on posing oil! For combat athletes, I think it can also be extremely beneficial. Lifting oddly shaped, uneven objects will tax your body in a way you don't normally encounter in the weight room. On top of that, strongman medleys are an unbelievably effective conditioning method. Summarily, I've had great utilizing these methods with my football, hockey, wrestling, and baseball clients (just to name a few). EC: Any tips on improvising home versions of various Strongman implements? I've heard that the Strongmen are the closest thing to a freaky big and strong Bob Villa that one can imagine! BC: This depends! If you live with Art McDermott at Highland Strength and Fitness (www.highlandstrength.com), then yeah - just bring the stones into the driveway, pull out all the tires, and get to it after warming-up with a keg for height in the back yard! Most people don’t have these luxuries, so it really depends on what you have at your fingertips. If someone was really interested in training Strongman without spending any money, I would probably tell him to get the following Kegs – There are a lot of things you can do with a keg, and many of them you will see in competitions. First, it's ideal to get as many as you can so that you can have a variety of different weights. You will have to fill each keg with different stuff like water, sand, lead, and shot. Once you have all the kegs you can do the following:

1. Overhead presses- (strict, or clean and press) 2. Carries- (much like a Husafell stone) Try doing sprints while holding a 200 lb keg. 3. Loading – If you have platforms, you can load kegs just as you would load stones. A little bit more awkward, but it gets the job done. 4. Keg throw for height – This may be my favorite. It feels very similar to a snatch to me, and will build explosive power like you can only imagine!

Tires – Many people assume that tires are just for flipping, but different size tires can actually come in handy with:

1. Tire flip- Okay, so this one is pretty self-explanatory. This might be one of the most beneficial exercises I have ever done - inside the gym or training events.

2. Tire throw for distance – If you have ever seen someone throw the discus, this one might make sense to you. Start with a tire from a smaller car, something like Sully’s Sentra. If you can throw your flipping tire, give me a call. This would mean that we need to bring you straight to the Olympic training center to start throwing the discus. 3. Drags – If you don’t have a sled, tie some tires together and drag those. This might be a pain, but it works, and dragging on grass will make it much tougher

Odd-shaped stones – Once again, not too many people have Atlas Stones or Husafell stones on hand, but if you have a quarry of any kind or even a cheap or generous mason in the area, you’re in luck. Your options with this implement include:

1. Loading – This is just like the Atlas stones you have seen; if you have a platform or even a keg onto which to load them, you’re all set. These may hurt and be a little bit more awkward than it real Atlas stones, but it does the job. 2. Throwing – Instead of throwing the stone like a discus, you would throw either for distance like a shot, or for height over a bar. 3. Carrying: Nothing beats a true Husafell stone carry. If you are lucky, you might be able to find a somewhat triangular piece of granite or something similar. As long as it sits in your arms comfortably, this could be on of the best free training implements of all.

You'll notice the similarities between the odd-shaped stone and keg exercises; this just underscores the importance of variety! Anything heavy on which you can get you hands – Last but not least comes everything else. You name it: blocks of wood; cars or trucks for pushing and pulling; sledgehammer swings; etc. If you are familiar with the events you will be able to pull it off. Just remember that it takes a very special (read: crazy!) person to be able to go out into the cold and be excited about running around holding onto kegs and rocks. Once you start seeing results from integrating workouts like this into your weekly routine, you will be hooked, I promise. Just have fun and if you feel like your isolating a muscle, stop immediately (just kidding). All that I ask is that you stop doing day purely for arms! EC: Whoa, Brad covered a lot. Say what you want, Sully, and then we'll make up the difference with a photo of you picking up a car. JS: Personally, I feel that for most of this stuff, you need to find the actual implements. As Brad mentioned, however, kegs, tires, and sandbag aren't too difficult to come by. You can also probably find a quarry or construction site and "borrow" some heavy stones. Or, you can just pick up cars.

EC: Okay, time to play the "glass is half empty" game. What are the downsides of competing as a Strongman? BC: My top four answers would have to be:

1. Injuries - I have had more injuries in the eighteen months than I have had in my entire life. There's been a hernia, broken foot, pulled hamstring, disk problems, and pec tear… and the list is still growing! 2. Convenience - I have to drive a total of three hours just to get proper equipment and training partners. 3. Getting beat – This is pretty much applicable to any sport, but I hate it when I don't win. 4. Nuisances in the Gym – Specifically, I'm referring to all of the attention that "strong guys " pay to you at the gym. Ever since I started competing and word got around, I constantly have guys lifting next to me and trying to show me up. At times, it gets ridiculous and I have to say something.

JS: It really tests your mettle, both mentally and physically. Plus, it's lots of fun to train and compete. There really is a great camaraderie in the sport. EC: Okay, now that you jerks have depressed our readers and killed the enthusiasm we'd built beforehand, let's finish on a positive note and highlight why being a Strongman competitor rules. That is, unless, of course, you'd like to club some baby seals, set a kitten on fire, or make fun of the handicapped. Got any good party tricks or cool stories? BC: How about another list?

1. Personal satisfaction - I have never been more excited with my accomplishments and training than I have been over the past 1.5 years. I am doing things that I thought (assumed) I would never be able to do. That keeps me going. 2. Being called one of the strongest small people in the country isn't half bad either. 3. The people – The individuals involved in Strongman competitions are some of the friendliest, most helpful people I have ever known. Ever since Sully introduced me to the sport, I am constantly amazed at how cool all of these people are. 4. When it comes down to it, I am just happy to have a successful career in the best sport in the world. People can try to argue this if they so choose, but I have never seen more talented athletes in my life. I am constantly amazed at some of the feats of strength and athleticism I see on a regular basis. 5. I wish I could say party tricks, but there's not much I can pull out my sleeve in that regard. Actually, I take that back. When I was in Vegas for Olympia this year, I spent a bunch of time doing overhead presses with a couple of girls in the hot tub. First they asked me to pose, so I figured I would go with the second option so that Sully wouldn't give me a hard time for acting like a bodybuilder. I guess that could be considered a party trick. I also like to throw things far at parties; I used to do this a lot in college, but not so much anymore. Usually, "things" consists of kegs, people, or whatever else is lying around.

JS: My family and friends automatically assume that I want to help them move, since I compete. Also, people look at the cuts and scars on your arms from doing stones and think you have some kind of weird rash. And, by far the worst, people ask, "Oh, you compete in bodybuilding?" Crushing full cans of soda and ripping phone books are always good times, too. EC: Way to try to explain that rash, Sully. Unfortunately, it isn't on your forearms… On that sickening note, it's time to wrap this up. Thanks very much for your time, guys, and best of luck.

EC:  People who enjoy gardening.  Next question?

Kidding, of course.  I would say that this book targets the typical lifter who goes to the internet to find information to take his/her training to the next level.  There are a lot of people in the T-Nation, etc. crowd who have done a good job to get from untrained, to beginner, to intermediate – but don’t necessarily have the tools to take it to the advanced level.  Maximum Strength provides that opportunity – and addresses mobility/activation, nutrition, motivation, programming strategies – basically a lot of the things you need to know to be successful not just for the 16-week program I outline, but also the years of lifting that follow it.  Thus far, the feedback has been fantastic.

MR: Could you give readers an idea of how much goes into the publication process? EC: Matt first approached me with the idea in the fall of 2006, and we created a proposal (I think it was 14 pages, plus a sample chapter).  Our literary agent took it to some publishing companies, and we eventually agreed on a contract with one (DaCapo) in January of 2007.  Matt and I wrote the book over the next six months and submitted in mid-June.  Over the summer, I dedicated seven Sundays to the photo shoot (harder than it sounds – especially when you wear the wrong color/type of clothing, as I did in the first two sessions).

We spent the fall going through proofs, cover designs, copy-editing, and sending out advanced copies.  I’m pretty sure that it was complete in February – and production started in time for a late April/early May release.  So, all told, it was about an 18-month process.

So, I’ve now self-published and dealt with a publisher.  Both have perks and drawbacks, so I’ve got plenty to consider as I take on future projects.

MR:  You also recently released an e-book called The Art of the Deload.  What prompted you to write a manual all about taking time off training?

EC: I honestly don’t know that many people understand what it feels like to remove fatigue and display fitness.  Heck, I never did before I got into competitive powerlifting.  Going into my first powerlifting meet, I had never deadlifted more than 484 in training.  I had to hold myself back like crazy the last three weeks before the meet to avoid doing anything stupid – and it was hard because that amount of deloading was unfamiliar to me.

I went out and pulled 510 on a fourth attempt at a body weight of 161 for a Connecticut state record in that meet.  Strategic deloading has been a big part of my programming ever since. The thing is, not all trainees are the same.  Experienced lifters need to deload differently than beginners and intermediates.  Lifters with a previous history of injury need to deload differently than those who are completely healthy.  Competitive lifters need to deload differently than those who are just lifting to enhance quality of life and look good.  This e-book has something for all of them.

MR:  Without giving away the farm, what are some of the different scenarios you outline?  I know that I talk to people and they think of a deload week as one of two things:

1 – No strength training whatsoever; maybe some cross training.

2 – The typical 60% volume approach with a slight reduction in intensity.

EC:  For the record, I don’t agree with #1 that you just outlined at all, and I think that in most cases, people who drop volume by 40% need to maintain or actually increase intensity.  How’s that for barbecuing some sacred cows?  Anyway, I also cover:

• • how to deload to make sure old injuries don’t resurface
  • how to know when to drop intensity instead of volume
  • how to effectively incorporate a testing day at the end of a deload week
  • why beginners don’t need to deload
  • what active rest means to me
  • how to deload on reactive training (particularly important for guys like me who have crazy supinated feet)

Plus, there is some nuts and bolts about how to individualize deload frequency.

MR:  Any new projects or things in the works we should know about?

EC: Next week, we’re moving everything – equipment, turf, flooring, computers, stereo – in Cressey Performance three miles east.  We also have to demolish the walls at our old place when we leave – and I have to admit that I’m really looking forward to that part!  All in all, though, with the new book out, and the new facility up and running (and summer training underway), I won’t have anything too exciting on tap until at least the fall.  My presentation at the Perform Better Summit in Providence at the end of May will be my last seminar for a while – unless we decide to do something at CP to celebrate the new location this summer.

MR:  Okay, time for the final question, and you know I ask everyone this!  You’ve been doing this for a while now – what mistakes have you made in the past, and what have you since done to correct that mistake?

EC:  My biggest mistake was caring what stupid people thought of me.  Let me explain.

For whatever reason, the strength and conditioning and fitness industry is very polarized.  I suspect it has something to do with the fact that physique and performance enhancement tends to put people on pedestals; many people think that looking good and being stronger or more athletic will make life so much better.  When was the last time that a forward-thinking accountant or surveyor got the attention some strength coaches get?

Because of the puzzling nature of this industry, people get irritated more.  I think Mike Boyle said it best when he noted that many people don’t know the difference between “disagree” and “dislike.”  That said, there are some people that disagree with my methodology and hate my guts.  Because I put myself out there by writing articles/books, making DVDs, and speaking at seminars, it is hard to avoid it getting back to me.

Early on in my career, I let this stuff get to me.  The negativity weighed on me and I actually lost sleep at night for what some keyboard warrior said about me on an internet forum.  Fortunately, I quickly recognized the unfavorable impact taking criticism to heart was having on me.  I had five or six guys on the internet who didn’t like me even though they’d never met me and disagreed with an article I wrote.  It’s not something I needed to be losing sleep over.

So, I got that negativity out of my life and focused on what I’m doing right.  I’m a better coach, much more positive, and far more productive.  I’m helping people and not arguing with them.  Instead of defending myself or worrying, I’m continuing to contribute to the body of knowledge.  If I was as bad as these 5-6 people (or however many there are) seem to think, why are athletes practically kicking the door down to Cressey Performance to train?  And, why would a traditionally strength-training-unmotivated population (baseball athletes) not only be appreciating the benefits of what we do, but thoroughly enjoying the process as much as the destination?

So, my advice to those out there would be to get rid of the negativity in your lives.  We’ve all worked with people who just punch the clock, criticize those around them, and don’t really care.  Stay away from these people and focus on what’s right in the world around you.  It’ll make you a better lifter, coach, and person. As I type this newsletter up, I realized that I've trained athletes on each of the past 24 days - and the two days prior to that were spent attending a Perform Better Summit.  So, I guess you could say that I can't remember when my last true day off was.  But, you know what?  I'm not nearly as tired as I would have been if I had stayed up all night worrying about what somebody said about me on the internet.

Where are most people missing the boat with regards to training overhead throwing athletes?

You’ve got unilateral dominance and handedness patterns, too; when was the last time you saw someone throw the first inning right-handed and then toss the second inning as a southpaw?  We know that asymmetry is a big predictor of injury.

And, to be more blunt, there is absolutely nothing even remotely healthy about throwing a baseball.  Do a MRI of a pitcher’s shoulder and you’re going to find labral fraying: big deal!  That’s just what happens when you go through 7,500°/second of internal rotation during acceleration – or the equivalent of 20 full revolutions per second!  Some guys are symptomatic and some aren’t; it’s the other “stuff” that’s going on that dictates whether they’re hurting or playing pain-free.

MR: So what’s this “other stuff” of which you’re speaking?

Now, there is some debate over whether the loss of internal rotation in experienced throwers is due to posterior capsule tightness.  Burkhart and Morgan insisted that there was posterior capsule tightness involved via what they called the “peel-back” mechanism, which causes the humeral head to translate posteriorly and superiorly during the late cocking phase.  They picked up on these posterior capsule contracture issues during surgeries of a large number of pitchers with type II SLAP lesions.

•Overhead lifting (not chin-ups, though)

•Straight-bar benching

•One-Arm Medicine Ball Work

•Upright rows

•Front/Side raises (especially empty can – why anyone would do a provocative test as a training measure is beyond me)

•Olympic lifts aside from high pulls

•Back squats

Likewise, comparing an overhead-throwing athlete to a non-overhead-throwing athlete is apples and oranges again.  Throwing shoulders have more humeral and glenoid retroversion, an adaptation that many believe occurs when pre-pubescent athletes throw when the proximal humeral epiphysis (growth plate) isn’t closed yet.  This retroversion gives rise to a greater arc of total rotation range-of-motion.  Wilk et al termed this the “total motion concept” (internal rotation + external rotation ROM) and noted that the total arc is equal on the throwing and non-throwing shoulders – yet the composition (IR vs. ER) is different in overhead athletes, who have more less internal rotation in their throwing shoulders.

Some might ask if I feel that it limits development of the athlete on the whole.  If you’re dealing with a little leaguer, feel free to do some overhead stuff with him; I love one-arm DB push presses with our younger kids.  However, with our 16+ athletes, my glass-is-half-full mentality is that we're avoiding any unnecessary risk because the reward is trivial at best compared to what you can do with effective non-overhead programming.  Like I said, every baseball pitcher you see will have fraying in their labrum - and that means less mechanical stability.

•Push-up variations: chain, band-resisted, blast strap

•Multi-purpose bar benching (neutral grip benching bar)

•DB bench pressing variations

•Every row and chin-up you can imagine (excluding upright rows)

•Loads of thick handle/grip training

•Med ball throws

•Specialty squat bars: giant cambered bar, safety squat bar

•Front Squats

In terms of “a,” I’ve found that we need to spend more time ironing out asymmetries early on in the off-season with pitchers, as they simply don’t move as much as position players.  Additionally, with the amount of moronic distance running (can you tell I’m not a fan?) that many pitchers do, we spend a lot of time trying to get back a solid base of strength, power, and reactive ability upon which to build some pitching-specific endurance.

Compiled by Eric Cressey

RB: I am 22 and played college baseball for three years: two at the Vincensses Junior College, and one at Division 1 University of Tennessee-Martin. I had to have stomach surgery during my junior season, at which point I decided to go back home to Indianapolis. I needed some thing to keep my competitive demeanor satisfied, so I checked out an Elite Fitness seminar and got totally hooked. I did some small local meets and then had to have stomach surgery again, which set me back 6 months with no training. I have been training very serious for the last year and a half but haven't been able to get to a meet recently because of my job and a recent injury. At a body weight of approximately 280-285 pounds, my best gym lifts are a 735x2 box squat, 505 bench press and 595 deadlift. Currently I am employed by the Franklin Boys and Girls Club and coach the Indianapolis Grizzlies College baseball team and go to school at IUPUI.

TD: I started powerlifting at the 1982 Pennsylvania Teenage State Championships, and competed approximately 12 times over six years ending in 1988. I started at 132, but after two years I moved up to 148 where I competed for 5 more years. My best ranking in the ADFPA/USAPL was Class 1. After chiropractic college, I continued lifting, but various injuries kept me from competing. In 1998, I began to learn ART, which helped to fix my injuries, and started training with Westside methods, which brought the excitement for lifting back. Last year, I did a deadlift meet and a push/pull. As of right now, I hope to be healthy enough to make a Class 1 or Master's classification later this year. My son, Tommy, Jr., is getting into the action, too, as you can see!

SC: I’m 22 years old, and compete in the 242 weight class as an “amateur” lifter. My best meet numbers are a 725 squat, 450 bench, 620 deadlift, and a 1795 total done in IPA meets. I’ve been a competitive athlete in various sports since age 8, but have only been competing in powerlifting meets since 2003 when my college baseball days came to an end. I’m lucky enough to train with a great group of lifters in Buffalo, NY; this group includes Paul Childress and Joe Dougherty, two of the top lifters in the world in their respective weight classes. We train using a conjugate system that is similar to Westside Barbell.

1. Not going into the meet fresh, and rested enough. Too many people overestimate their recuperative abilities, and don’t realize what it truly takes for supercompensation to take place, so they essentially wind up being overtrained leading into a meet. In my experience, this tends to occur moreso on the squat and deadlift than the bench. In my gym, we recommend lifters take their last heavy squat/bench/dead at least 2-3 weeks prior to meet day, minimum. Sometimes we will push this minimum to 3-4 weeks out from meet day for the deadlift depending on the lifter.

By: Eric Cressey

By: Eric Cressey

By: Eric Cressey

As you’ve probably already surmised by now, I’m always looking to meet new physical therapists who are effective at bridging the gap between healthy and injured athletes. The sad truth is that just as there aren’t many trainers/coaches who really understand musculoskeletal dysfunction and the resulting pathology, there aren’t many PTs who really understand what an athlete puts his/her body through on a daily basis. Let’s just say that I’m lucky to have found Mike Stare, and it’s just my luck that he’s right up the road from me here in Massachusetts. Mike is a brilliant PT and trainer from whom you can expect to hear a lot more in the months and years to come; we’re already brainstorming on some projects together. Here’s a small sample of the great information Mike has to offer; as I told Mike, I think it’s some of the best information we’ve had in any interview at EricCressey.com thus far.

EC: Hi Mike, thanks for taking the time to join us today. Before we get cracking with the interview, could you tell us a bit about who you are, where you’ve been, where you are, and where you’re going?

MS: I’m a Physical Therapist and a CSCS, practicing with Orthopaedics Plus in Beverly, MA, as well as Director of Spectrum Fitness Consulting, also in Beverly.

My early years as an oft injured and undersized athlete landed me in the orthopedists’ office far too often. After a serious neck injury from football, I found myself in Physical Therapy for several weeks. That experience really opened up my eyes and I decided that I wanted to pursue a career as a PT.

I studied kinesiology at the University of Illinois, and began working as a personal trainer for the division of campus recreation. I also worked with the spinal cord athletes there, and had an opportunity to travel to the 1996 Paralympic games to work with spinal cord injured athletes. I moved East to pursue a Masters of Science in Physical Therapy at Boston University. I continued to work as a personal trainer with the Boston Sports Clubs and obtained the CSCS while I was in grad school. I also had the opportunity to help develop and teach a training curriculum for the trainers at BSC.

After graduation, I worked in an outpatient rehab hospital where I saw the full spectrum of conditions. I treated a C5 quadriplegic who was more athletic the most people I know, a lady who had both legs amputated from her pelvis (best pair of arms on a 60 year old I ever saw and a heart of gold), bodybuilders with overuse injuries, chronic low back pain - you name it – I saw it. It was a phenomenal learning experience, but I knew that I needed to focus in order to hone my expertise. So I choose to concentrate on orthopedics, and jumped on board with Orthopaedics Plus.

I returned to graduate school part-time while working full time as a clinician to finish my Doctorate in Physical Therapy, and then completed a two-year fellowship in orthopaedic manual therapy. That was an invaluable experience; I learned from what I truly believe to be the greatest minds in Physical Therapy.

I had moved away from personal training while pursuing my post-graduate studies, and I really missed it. As a clinician, I grew frustrated with the fact that many of my patients were seeing me for injuries or conditions that could have been prevented if they had received the proper training or education. I thought I was going to lose my mind if I saw another 16-year-old girl with excessive genu valgum and the glute strength of a mosquito limping in after ACL reconstruction waiting to get back to her three soccer leagues.

I decided that I needed to provide a service that would not only help people recover from their injury, but also reduce their injury risk and enhance their performance and health. As a result, in partnership with Orthopaedics Plus, I formed Spectrum Fitness Consulting this past January. We focus on providing personal training services, as well as sports conditioning for young athletes. Our studio is located adjacent to the PT clinic, which facilitates me working as both a clinician and a trainer.

We are rapidly growing and have some excellent new programs coming soon. I’m looking forward to finding some quality trainers to help us grow, as well as expanding our reach throughout the North Shore region, developing more of a web presence, and hopefully perform some research in the near future For now, I’m trying to stay focused on getting things done right, keep my head from spinning off, and enjoy hanging out with my new baby and my wife as often as possible.

EC: The first chapter of your memoirs is now officially complete; congratulations! Moving on…you’ve done quite a bit of research on preventing elbow injuries in young pitchers; what have you got for us?

MS: Last fall I had the opportunity to mentor a Doctoral Student from BU. We found some great info about elbow and shoulder injuries in young baseball pitchers. Among some of the most notable findings:

· Injuries in young pitchers most often involve the growth plates, as opposed to the rotator cuff, labrum, or ligaments commonly seen in adults

· The growth plates are the weakest link in the joint complex in young pitchers.

· Growth plates in the elbow are open until about 16 and until 19-22 in the shoulder.

· Injury to the growth plate is very difficult to detect, except in severe cases. Thus, early and appropriate response to pain is critical.

· Pitch counts and pitch types are associated with risk of elbow and shoulder injury. Researchers from the American Sports Medicine Institute (ASMI) have given specific recommendations for pitch type and count based on their findings. For example, a sample of 476 9-14 year olds who threw curve balls had a 56% increased risk for shoulder pain and those who threw sliders had an 86% increased risk for elbow pain. A sample of 330 9-12 year olds showed increased incidence of elbow and shoulder injury occurred with:

1) Those who threw >75 pitches/game or 600/season

2) Pitched in multiple leagues

3) Experienced arm pain during the season

4) Pitched less than 300 pitches per season.

EC: Very interesting; we often hear about throwing too much as being a problem, but some kids were actually having problems from not throwing enough pitches and then going out to “turn it loose?” In other words, is that 300-600 pitches/season number precedent for a “golden pitch count rule?”

MS: No, I don’t consider it as a golden rule. Rather, it should provide a basis from which coaches, clinicians, and researchers can begin to establish the boundaries between what is too much stimulus for a developing arm, and what is not enough stimulus to facilitate enhanced motor skill and optimal conditioning.

The research from ASMI and others is merely revealing initial data about factors that correlate with shoulder and elbow injury, not cause the injuries. Pitch counts are a convenient way to quantify arm stress, but they are far from perfect. The research regarding this topic is still very new and continues to evolve. Pitch counts are just one of the many factors related to increased risk. I think focusing on a firm pitch count for the season may be a problem in that it relieves the coaches, parents, etc., of responsibility of considering other variables that may also indicate increased risk, essentially, providing a false sense of security.

It still isn’t clear why pitching less than 300/season was associated with risk of arm injuries. Perhaps those who threw less had less skill, and thus imposed greater stress upon their arms. Maybe they were less conditioned. Or perhaps, as you mentioned, they progressed their volume of throwing too quickly. The higher risk with throwing greater than 600 seems more obvious – perhaps it was just too much?

Regardless, I think the problem is not simply about too many pitches or too few pitches in games over the season. There seems to be a trend towards kids playing in less informal settings, and more often in competitive settings. This has some significant implications. Less informal play means less opportunity for honing the motor skill of throwing. Motor learning is best developed by practicing frequently, in small chunks of time, at initially lower intensities. This is what is typically done through informal play.

There is a big difference between how you throw in a competitive game situation versus while practicing or playing catch with friends. Thus, kids are in more frequent situations that place higher stresses on the arm, while spending less time improving their motor skills. Given this trend, I think it becomes clear why the incidence of arm injuries is one the rise.

Improving their conditioning and responding to the early warning signs of injury would substantially offset this higher risk. Combined with coaches focusing more on teaching the skill of throwing, while gradually increasing the volume and intensity of throwing, the incidence of arm injuries could be greatly reduced. Rather than just focusing on the pitch count, I suggest coaches and parents also simply rate velocity and control each inning, as well as observe any other signs of a change in mechanics or taking more time between pitches. This will be more effective than just quantifying pitch count.

EC: Great stuff – sorry to interrupt. What else have you got?

MS:

· Certain flaws in pitching mechanics will predispose the shoulder or elbow to greater stress. For example, excessive shoulder rotation at initial contact of the stride leg, and a more cross body horizontal arm follow-through leads to increased torque on the elbow.

· The humerus rotates up to 7000 degrees per second in from late cocking phase to acceleration phase, and the arm experiences a distraction force of up to 1.5 the athlete’s bodyweight during the deceleration phase

· Clinicians and surgeons are reporting a 5-6 fold increase in pitching related elbow and shoulder injuries in youth pitchers. I’ve seen too many kids devastated by realizing that their throwing careers are over at age 15, recovering from their second arm surgery. There’s too much information out there; we need to apply it.

EC: Agreed! So why aren’t more trainers and coaches putting this information into practice?

MS: Although we found some great info about kinematics, kinetics, and epidemiology, there was very little information about conditioning or training strategies. It was implied by almost every researcher, but never thoroughly discussed. That is were my “Young Guns” program comes in. Our program will be the only that I’m aware of that will emphasize not only the preventative strategies via pitch count, pitch type, and throwing mechanic alterations, but also implement specific conditioning strategies. As with so many other conditions, the ability to generate and translate force through out the entire kinetic chain, as well as efficiently decelerate, correlates with improved performance and reduced injury. I think this reasoning applies perfectly to throwing athletes, and they should be trained accordingly.

EC: Great stuff; I’m sure it’ll be fantastic. How about correcting injuries once they’re in place? Any rehab tips for those who already have bum elbows?

MS: The injured tissue must be identified first. This is especially important for young athletes, as growth plates are particularly vulnerable. Treating a growth plate injury will be much different than treating a lateral epicondylopathy. Seeing an orthopedist who specializes in elbows and shoulders – together with a PT with a manual therapy background – is your best bet.

Next, identify the cause of the problem. It’s always easier to investigate a crime closest to when it was committed. The irritating factors must be modified or avoided.

Look at the shoulder, thoracic spine, and hips for mobility deficits. Inadequate mobility at any of the joints along the kinetic chain can result in greater compensatory mobility demands upon the more vulnerable elbow joint, leading to excessive strain and ultimately injury.

If soft tissues of the elbow are involved, such as is the case with tendonopathy of the common extensor (lateral epicondylopathy) or common flexor (medial epicondylopathy) tendons, deep tissue massage is very effective. It doesn’t feel so good initially, but it works. Usually, you can do it yourself; just follow the tendons starting about ½ inch from the origin, and deeply massage with small amplitude parallel and perpendicular to the tendons.

Joint mobilization is also very effective at restoring normal mobility and promoting joint healing – but you’ll need a skilled therapist for that. For less acute injuries, very high repetition, low load exercise can be effective at improving tensile qualities and promoting healing.

The common practice of applying ice shouldn’t be overlooked. Ice massage is very easy and effective. Freeze water in a Dixie cup, peel back the edges, and rub the effected area for about 5-10 minutes.

EC: My favorite part is that you never recommended non-steroidal anti-inflammatory drugs (NSAIDs). We know we’re dealing with degenerative, not inflammatory conditions, so these interventions have little merit aside of pain relief, which is better accomplished with ice anyway. All those NSAIDs are just inhibiting the healing process and giving people a false sense of good health, leading them to throw the tissue back into the fire much too soon. Would you agree? (You’re not allowed to disagree, for the record; this is my newsletter!)

MS: I absolutely agree, and not just because I fear being chastised like your friend Hugo from a few newsletters ago! Soft tissue injuries have often been labeled as tendonitis, the –itis suffix inferring an inflammatory pathology. However, histological studies consistently fail to find markers indicative of inflammation with these conditions, leading to the increasing use of the appropriate term tendonopathy instead. This is more than a semantics issue. As you mention, taking an anti-inflammatory to treat something that does not have an inflammatory pathology may yield unnecessary risks and hinder healing. Recent research has demonstrated impaired bone healing in conjunction with NSAID usage. This is particularly important if bone pathology is suspected, as often is the case with young pitchers having a high incidence of growth plate injuries

EC: This has been fantastic stuff, Mike; thanks for taking the time. Where can our readers find out more about you?

MS: It’s my pleasure Eric, anytime. I can be reached at mike@spectrumfit.net, and your readers can learn more about Spectrum Fitness Consulting, the Young Guns program, and myself at www.spectrumfit.net.