Home Posts tagged "Lat Strain"

Elite Baseball Development Podcast with Richard Bleier

We're excited to welcome Baltimore Orioles relief pitcher Richard Bleier to the podcast for Episode #11. A special thanks goes out to this show's sponsor, Pedestal Footwear. Head to http://www.PedestalFootwear.com and enter the coupon code EC20 and you'll receive a 20% off on your order.

Show Outline

  • How Richard’s complacency in high school limited his growth as a ballplayer and how his experience at Florida Gulf Coast provided the discipline he needed to arrive at purposeful development
  • How Richard remained patient and persevered through an extensive minor league career
  • What transformed Richard from a career minor leaguer to one of best statistical pitchers to ever toe a big league rubber
  • Why Richard moved away from relying so heavily on his fastball and how mixing his pitches to include more changeups allowed him to become a more consistent and effective pitcher
  • How commanding the inner half of the plate revolutionized the way Richard attacks hitters and how this led to the development of his cutter
  • How Richard extracts value from analytical information on hitters while still playing to his strengths to create a plan that inspires confidence against the best hitters in baseball
  • Why Richard considers himself the most unlikely big leaguer of all time
  • What characteristics in coaches have helped and hindered Richard’s development throughout his career
  • How Richard’s parents have proven to be his most supportive (and embarrassing) fans as he reflects on the best moments of his minor league career
  • How Richard strained his lat in 2018 and how he worked diligently and intelligently to rehab from this injury successfully

You can follow Richard on Instagram at @RichardBleier.

Sponsor Reminder

This episode is brought to you by Pedestal Footwear. As featured in Men's Health, Women's Health, Hufffington Post, and MSNBC - and trusted by the top strength coaches in the world - Pedestal Footwear is on a mission to get athletes out of traditional sneakers and into Pedestals to help mitigate injury and improve performance. They're durable enough to handle all of your training needs; I LOVE them for deadlifting because they keep me in contact with the ground and have a patented grip design for added traction. They're made in the USA and can fit in your pocket. Pedestal also offers cool customization and wholesale options. If you head to www.PedestalFootwear.com and enter the coupon code EC20 at checkout, you'll get 20% off on your order.

Podcast Feedback

If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.

And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.

Thank you for your continued support!

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Strength and Conditioning Stuff You Should Read: 4/20/19

I hope you had a great week. In case you're looking for some recommended reading while you're sipping coffee this weekend, here's a good collection:

Overcoming the "Best Coach on Staff" Problem - This might be my favorite blog post that my business partner, Pete Dupuis, has ever written. This is a problem that just about every gym faces as they experience growth.

5 Simple Hacks You Can Use in the Gym Today- Here's a collection of programming and coaching strategies from Mike Robertson that you can immediately apply in the gym.

5 Reasons for the Increase in Lat Strains in Baseball -It's early in the season, but we've already seen several noteworthy lat (and teres major) injuries in professional baseball. Here are some reasons why.

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5 Reasons for the Increase in Lat Strains in Baseball Pitchers

There have been some noteworthy lat strains in MLB this year, and this trend isn't showing any signs of letting up. Here are a few reasons why they're occurring at such an alarming rate.

1. Better Diagnosis

Any time a diagnosis becomes more "accepted," doctors know to look for it more immediately. In 2011, Jake Peavy was the first player to actually tear the lat off the humerus and have surgery on it, but now we're actually seeing 1-2 of these each year in guys who come to Cressey Sports Performance for consultations (on top of guys who have lower grade lat strains). In the past, a lot of doctors would mistake lat strains for rotator cuff injuries or biceps tendon issues (because the lat attaches on the front of the humerus). Sometimes, lat injuries would be missed on MRIs because the attachment is far enough down the humerus that a regular shoulder MRI wouldn't cut wide enough. In short, better identification and subsequent diagnosis are always a big reason why a class of injuries "surges."

2. Harder Throwers

Lat recruitment during acceleration is substantially higher in high level throws than it is in amateur pitchers. In particular, as lot of elastic energy is put into lat during the lay-back phase of throwing while it works as an anterior stabilizer of the shoulder as it prepares to unleash that energy into powerful internal rotation and horizontal adduction.

Sprinters who run fast pull hamstrings more often. Basketball players who jump high increase their risk of Achilles ruptures. It shouldn't be a surprise that harder throwers have a higher incidence of lat strains.

3. Inappropriate Strength Training

With each passing day, weight training gets more and more "accepted" in baseball populations, and I absolutely love it. Unfortunately, that means a lot of inferior programs get implemented, and nothing is more inferior in a baseball strength and conditioning setting than programs that are way too lat dominant. If you're doing pull-ups, bench presses, heavy deadlifts, farmer's walks, walking dumbbell lunges - and then coaching all your rows and arm care exercises to be very lat dominant, you're really just exacerbating all the negative adaptations we see in throwers. If you look around your weight room and see a ton of guys with limited shoulder flexion, that should be a red flag.

4. Poorly Executed Arm Care Programs

Lats are sneaky, as they'll find a way to creep into a lot of arm care exercises. You'll see people "tug down" (extension/adduct) the humerus (upper arm) during external rotation exercises using the lat when it should be relaxing to allow the arm to externally rotate.

You'll see hands creeping toward the midline (shoulder internal rotation) during wall slide variations - when the lat should be relaxing to allow "clean" overhead motion to take place.

You'll see individuals lock the scapula down into depression during prone trap raises instead of allowing it to posterior tilt.

And, in the most commonly butchered exercise by every lat strain pitcher I've ever seen, you'll see the humerus tugged down during the prone horizontal abduction (when it should be at 90 degrees).

These examples should help to demonstrate that we've had a lot of success bringing lat strain injuries back to full function not only because of our quality manual therapy, but also because we know how to prescribe and meticulously coach the exercises that are so important for these individuals to master.

5. Weighted Balls

Weighted ball programs increase external rotation quickly (particularly in hypermobile throwers) and the lat - as one of the anterior stabilizers of the shoulder - is one structure that takes on the brunt of the load. When external rotation increases quickly and high speeds are involved, the lat at lay-back is analogous to the Achilles tendon of a basketball player that lands on a heavy dorsiflexed ankle; it just can't "give" any more. If you're a visual learner (and don't have a weak stomach), check out the 1:40 mark in this video to see what crazy eccentric stress at the end-range of a joint can do.

Now, imagine he's an untrained 14-year-old working at these speeds and you put a 100-pound weight vest on him; do you think it'll turn out well?

Weighted balls are awesome - when they're integrated at the right times, at the right loads, in the right dosages, with the right athletes who have earned the right to use them.

Closing Thoughts

If you look at these five contributing factors - and exclude the one (better diagnosis) that's actually a good thing - you'll realize that we have three that are completely in our control. Coach exercises correctly, prescribe strength and conditioning exercises appropriately, and integrate weighted baseball work the right way. If we do these three things correctly - and make sure to take care of tissue quality and length in our throwers - I firmly believe we can completely prevent lat strains, and that's been verified by our experience at Cressey Sports Performance.

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Strength and Conditioning Stuff You Should Read: 7/6/18

I hope you all had a great holiday week. Here's some recommended reading and listening from around the 'net over the past week:

The Best Team Wins - This was an awesome recommendation from my buddy Josh Bonhothal. Adrian Gostick and Chester Elton provide some outstanding strategies for both sports team settings and businesses alike. The section on Baby Boomers vs. Generation Xers vs. Millenials was particularly fascinating.

Matej Hocevar on the Physical Preparation Podcast - Matej is an absolutely awesome guy with a wealth of information to share, and this podcast is an excellent example. He was also an amazing host to my wife and me when we visited Slovenia a few years ago.

7 Ways to Increase Your Training Density - I reincarnated this post from the archives earlier in the week and it was a hit, so I wanted to give it a mention here as well.

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Checks and Balances in the Shoulder of the Throwing Athlete

For today's guest post, I've collaborated with physical therapist Eric Schoenberg, one of my co-presenters at the Elite Baseball Mentorship. Enjoy! -EC

The #1 reason why a player or team does not succeed in baseball is injury. Today, there is a surplus of information, but at the same time a lack of basic understanding of how to keep a baseball player healthy. When in doubt, you can never go wrong by understanding and relying upon anatomy and quality human movement.

One key principle to understand in this regard is that there is a tremendous system of checks and balances working at the shoulder girdle to make sure that we control both the big movements (osteokinematics) and subtle joint movements (arthrokinematics) in a small window for health and performance. If we look to anatomy, we can appreciate a very important concept by looking at the attachment points for the deltoid, latissimus dorsi, and pectoralist major: your three biggest prime movers in the upper extremity. You'll notice that all three attach on the shaft of the humerus, not the humeral head. Take a look at their attachment sites on this anatomical chart, and then compare them to where the rotator cuff (supraspinatus, subscapularis, teres major, and teres minor) attach further up on the humeral head.

Source: http://howtorelief.com/humerus-anatomy-bony-landmarks-muscle-attachment/

You can appreciate that all these big muscles attach on the anterior (front) aspect of the humerus, which means that they have powerful pulls into internal rotation that have to be counteracted by fewer, smaller muscles that attach on the posterior (back) aspect of the shoulder.

Here are three specific implications of these anatomical observations that relate to how you manage your throwing athletes:

1. The Deltoid is strong/active enough!

The deltoid works in conjunction with the supraspinatus to form a “force couple.”

Source: www.MikeReinold.com

If the strength, recruitment, or timing of the deltoid is greater than the supraspinatus, then the result will be superior migration of the humeral head in the glenoid. This results in superior humeral head stress (chondral defect), undersurface rotator cuff tear, labral pathology, among other structural injuries to the glenohumeral joint.

Tip: Be sure that athletes feel rotator cuff strengthening exercises in the cuff and not the deltoid or biceps.

2. The lat is strong/active enough!

The lat (as it acts on the scapula) is opposed by the serratus anterior, lower trapezius, and upper trapezius to control scapular rotation. Increased relative stiffness of the lat results in excessive scapular depression and downward rotation at rest.

Additionally, if you have decreased activation or muscle performance of the scapular upward rotators and elevators with overhead motion, the outcome will be inferior migration of the glenoid on the humeral head.

This results in superior humeral head stress (chondral defect), undersurface rotator cuff tear, labral pathology, among other structural injuries to the glenohumeral joint.

Tip: Be sure that the athlete’s programs have a good balance of overhead reaching tasks done with proper mechanics and timing of the glenohumeral and scapulothoracic joints.

3. The pecs are strong/active enough!

Pectoralis major's impact on the anterior glenohumeral joint is opposed by the rotator cuff to prevent anterior humeral glide. Effectively, the pec and lats want to pull the ball forward on the socket as the arm goes through gross movements, and the rotator cuff works hard to prevent this gliding at the joint level.

Dominance of pec major over the rotator cuff muscles (namely subscapularis) will play a role in an athlete presenting with anterior humeral glide. We often hear the athlete report “tightness” in the front of the shoulder and their first option is to "stretch it."

This can lead to anterior shoulder pain and potential structural pathology including anterior joint laxity, biceps tendon pathology, and labral pathology – all common injuries in throwing athletes.

Tip: Rather than trying to decrease the “tightness” in the front of the shoulder by aggressively stretching—instead, focus on improving static alignment, proprioceptive awareness, and recruitment of the cuff. If you couple this with some self-massage work, this approach will yield far more favorable results.

In closing, the shoulder joint is happiest when alignment is optimal. Injury will occur if preferred alignment is altered. Examples of altered alignment at rest or with movement are the humeral head is riding too high in the socket, the socket is riding too low on the humeral head, or the humerus is gliding too far forward. The resultant stress to the active or passive restraints of the shoulder leads to injury and loss of playing time. Do yourself (and the players that you work with) a favor and master the basics to help improve success on the field.

Looking to learn more about our unique approach to assessing and managing throwing athletes? Check out the upcoming Elite Baseball Mentorship Upper Extremity Course on January 14-16, 2018. For more information, click here.  The early-bird registration discount ends tonight at midnight.

About the Co-Author

Eric Schoenberg (@PTMomentum) is a physical therapist and strength coach located in Milford, MA where he is co-owner of Momentum Physical Therapy. Eric is addicted to baseball and plays a part in the Elite Baseball Mentorship Seminars at Cressey Sports Performance. He can be reached at eric@momentumpt.com.
 

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How to Make the Most of Your Lat Stretches (Video)

I have a love/hate relationship with the lats. On one hand, you need strong lats for all sorts of athletic endeavors, from throwing to sprinting. On the other hand, if they're too overactive, a host of different injuries/conditions can result. With that in mind, preserving full latissimus dorsi length is important, and that's why we incorporate a lot of stretches on this front. It's important that those stretches are done correctly, though, and in today's video, I want to discuss one big mistake we commonly see in this regard.

Speaking of upper body work, if you're interested in learning more, be sure to check out my new resource, Sturdy Shoulder Solutions.

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Strength and Conditioning Stuff You Should Read: 5/22/17

I hope you all had a great weekend. I turned 36 on Saturday, and it was a pretty mellow, unremarkable birthday - which is exactly what I wanted! Here's a little recommended reading/listening/viewing for you to kick off the week:

Lat Injuries in Major League Baseball - Here's an article from Lindsay Berra on an injury on the rise in MLB. I chipped in some info on the function of the lats in throwing.  

EC on The Fit Clique Podcast - I hopped on Chris Doherty's podcast last week, and you can check it out on YouTube:

Business Bench Pressing with Pete Dupuis - Speaking of podcast, my business partner, Pete, shared some great business tips for fitness professionals on The Fitcast a few weeks ago.

How Harmful Are Processed Foods? - The Examine.com crew has been on a roll with great content lately; here's another example.

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Strength and Conditioning Stuff You Should Read: 5/3/17

After surviving last week's sale, I took a quick blog hiatus to get my feet underneath me. I'll have some new content posted later in the week, but in the meantime, here's with some recommended reading.

Pitching Injuries: Should Lat Strains Even Be Happening? - In light of Noah Syndergaard's lat injury this week, this article of mine from last year got a lot of traffic (and I received lots of emails and social media outreach). This one's a whopper, so have a cup of coffee ready to help get you through it.

The Hardest Topic to Write About: Program Design - My old friend Tony Gentilcore did an excellent job tackling a complex topic. I'd highly recommend you give this a thorough read to appreciate just how daunting a task it is to write about program design.

The Stop & Give Me 20 Podcast - I hopped on a 20-minute podcast interview with Anthony Renna a few weeks ago, and you can listen to it here. I really enjoyed it because it wasn't the same 10 questions that ever podcast interviewer seems to ask!

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The Best of 2016: Baseball Articles

With baseball athletes being the largest segment of the Cressey Sports Performance athletic clientele, it seems only fitting to devote a "Best of 2016" feature to the top baseball posts from last year. Check them out:

1. Preventing Baseball Injuries: Actions Speak Louder Than Words

This was my first post of 2016, and it turned out to be one of my most impactful. A cool follow-up note on this: one of the suggestions I had to reduce pitching injuries was to push the high school season back in warm weather states, and here in Florida, they actually moved it back two weeks for 2017. I doubt my writing had anything to do with it, but it's nice to see things moving in a positive direction. 

2. Should Lat Strains Even Be Happening?

The lat strain is becoming far more prevalent in higher levels of baseball as pitchers throw with more and more velocity. In this lengthy article, I discuss mechanisms of injury, diagnostic challenges, prevention strategies, and longer-term prognoses.

Latissimus_dorsi

3. 6 Saturday Shoulder Strategies

I wrote this as a "brain dump" in about 30 minutes on a Saturday morning, and it turned out to be a hit with the baseball audience.

4. Looking Closer at Pitching Injuries: An Interview with Jeff Passan

I interviewed Jeff Passan around the time of the launch of his popular book, The Arm, and we covered in more specific detail some of the areas he touched on in the book.

y648

5. Specificity, Delayed Transmutation, and Long-Term Baseball Development

This was actually a video blog more than an article, but it was still very popular - but didn't quite crack the top 5 videos of the year because it's more baseball specific.

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Random Thoughts on Sports Performance Training – Installment 24

With only a few days to spare, here is the November 2016 edition of randomness!

1. Don’t let bad movement become cemented joints.

As I presented in Functional Stability Training of the Upper Body, mobility can be restricted for a lot of reasons.

One thing I didn't note in this video is that if you have muscular, capsular, or alignment issues that persist for an extended period of time, you'll eventually develop changes to the joint (bony overgrowth). In a 2013 study, world-renowned hip specialist Marc Phillipon examined how the incidence of femoroacetabular impingment (FAI) - bony overgrowth at the hip - changed across various stages of youth hockey. At the PeeWee (10-12 years old) level, 37% had FAI and 48% had labral tears. These numbers went to 63% and 63% at the Bantam level (ages 13-15), and 93% and 93% at the Midget (ages 16-19) levels, respectively. The longer one played hockey, the messier the hip – and the greater the likelihood that the FAI would “chew up” the labrum.

fai
Source: Lavigne et al. 2004

It's imperative for strength and conditioning coaches to understand these issues. On evaluation, if an athlete already has changes to the joint, we need to create training programs to deliver a training effect while working around these issues. If you squat an entire team of football players even though you know 4-5 of them already have significant FAI and associated pathologies in their hips, you're probably going to be funding some hip surgeon's retirement. Work on deadlifting and single-leg work instead, though, and you'll probably kick the can down the road for those athletes.

Conversely, if your assessment reveals that an athlete is out of alignment and has some tissue density and core control issues that are preventing quality hip flexion and internal rotation, you need to design a program to get to work on those problems before they can develop bony blocks at the hip. As my buddy Mike Reinold often says, "Assess, don't guess." 

2. We might be seeing the end of the versatile strength and conditioning coach.

One thing I've noticed in the strength and conditioning field over the past decade is an increased tendency toward specialization among coaches. Over the years, there have some been really bright coaches - Al Vermeil, Mike Boyle, and Bob Alejo come to mind - who've had success across multiple sports at the highest levels. They were few and far between, but it was still something that was feasible if someone was educated and motivated enough. I think that's changing and this versatility will be obsolete very soon.

We're seeing a much bigger focus on analytics in all professional sports; the focus on minute details has never been greater. In college sports, we are seeing more "baseball only" and "hockey only" guys to build on the years of the football strength and conditioning coach typically not working with other teams. At every level, specialization among strength coaches (and rehabilitation specialists, for that matter) is increasing. As a result, if a coach tries to venture out into another sport at a high level, it takes longer to get up to speed. 

If a guy leaves basketball to go to baseball, he's got to learn about thoracic outlet syndrome, ulnar collateral ligament injuries, and lat strains; these just don't happen very often in hoops. He won't have to worry much about humeral retroversion in his programming for shooting guards, either - but it has a huge influence on how he manages functional mobility in pitchers.

 

Today is Day 12 of #30DaysOfArmCare. Thanks to #Tigers pitcher @adamrav12 for the assist! Key takeaways: 1. Retroversion is a common finding and throwing shoulders. It gives rise to greater lay-back at max external rotation. 2. The more passive range of motion you have, the more consistently you must work to maintain active stability of that ROM. ROM without stability is injury risk. 3. Perform your cuff work in the positions that matter - and keep in mind that individual differences in passive ROM may be present. 4. Don't stretch throwers into external rotation, especially if they already have this much lay-back! Follow #30DaysOfArmCare and @cresseysportsperformance for more tips to keep throwing arms healthy. #cspfamily #armcare #baseball #mlb

A video posted by Eric Cressey (@ericcressey) on

Likewise, just because I have a solid handle on managing shoulders in overhead athletes doesn't mean that I'm equipped to handle the metabolic demands that swimmers encounter.

Versatility is still important; a well-rounded professional will never go hungry. However, at the higher levels, I just see fewer and fewer professional teams and colleges valuing it highly when the quickest option is to seek out specialists in specific realms.

3. Create context not only to improve coaching, but also to improve adherence.

Recently, I saw a professional pitcher who noted that his team had commented on how limited his extension on each pitch was. For those who aren't familiar, in recent years, teams have started tracking the actual release point of various pitchers. Basically, if two pitchers both throw 95mph, but one releases the ball closer to the plate, the one with more extension is actually releasing the ball closer to the plate, so it "gets on" the hitter faster. All things considered, a higher extension is generally better. You can view it as part of the Statcast panel on each MLB pitchers' page; here's CSP athlete Steve Cishek's, as a frame of reference. Steve's extension is well above MLB average, so the perceived velocity of his pitches are over one mph higher than their actual velocity.

cishekextension2

Returning to the pitcher I evaluated recently, he commented that although his fastball velocity is among the best in the minor leagues and he has quite a bit of movement, he doesn't strike a lot of guys out. While there are a lot of reasons for this, one consideration has to be physical limitations that don't allow him to get extension out in front. In his case, on evaluation, we saw a pseudo military posture; his shoulder blades were tugged back into adduction, and he lacked the upward rotation to effectively "get out front."

adductedscap

Additionally, in the lower extremity, he had significant bilateral muscular/alignment limitations to hip internal rotation. If you don't have sufficient hip internal rotation on your back leg, you aren't going to ride your hip down the mound very far. If you don't have internal rotation on the front hip, you won't be able to accept force on the front leg, so you'll effectively cut off your deceleration arc, also shortening your extension out front. These are usually the guys who "miss" up-and-armside, or cut balls off in an attempt to correct the issue.

If I had just told him he needed to fix these for the sake of fixing them - or even just to prevent injury - it probably wouldn't hold much water. However, by relating these movement inefficiencies back to aspects of his delivery with which he struggles, the buy-in is a lot higher. Striking guys out is a lot "sexier" than avoiding injury or conforming to some range-of-motion norm. 

4. This is a great weekend to be an up-and-coming fitness professional or rehabilitation specialist on a limited budget.

Black Friday/Cyber Monday might be annoying if you're in stores and dealing with a bunch of crazy Moms who are fighting over the last Tickle-Me-Elmo, but in an online context, it's pretty darn awesome - especially if you're an aspiring coach looking to get your hands on some quality educational material.

I did my undergraduate education at a smaller Division 3 school in Southern Maine. We didn't have a varsity weight room where I could observe or volunteer, and there weren't tip top internship opportunities right down the road where I could've found opportunities like that. Looking back, I realize that one of the main reasons I got on the right path was that I was willing to search high and low for those learning opportunities. I spent hours reading T-Nation and hard copy books I'd bought, not to mention driving to whatever seminars I could find.

Nowadays, education is much, more more accessible. Instead of driving nine hours to Buffalo or dropping $1,000 on a plane right, hotel, rental car, and seminar registration, you can spend 10% of that amount and get an awesome education - and you can pick and choose what you want to learn. This weekend, you can do it super affordably, too.

Want a crash course in relative stiffness? Check out my presentations in Functional Stability Training: Optimizing Movement (on sale for 20% off with coupon code BF2016). 

Looking to patch up the holes in your college anatomy course by learning about functional anatomy instead? Pick up Building the Efficient Athlete from Mike Robertson and me (20% off this weekend; no coupon code needed).

Need some cutting-edge hip mobility strategies? Watch Dean Somerset's presentations in The Complete Shoulder and Hip Blueprint (on sale for $30 off through Monday).

Interested in taking a peek into the mind of a successful NFL strength and conditioning coach? Soak up Joe Kenn's knowledge in Elite Athletic Development (20% off this weekend; no coupon code needed).

It's an amazing age in strength and conditioning; short of actual hands-on coaching experience, all the information you need to be successful is at your fingertips in a digital medium - and this is the weekend to get it at the best price.

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