One of the most common issues we see in both athletes and our general population clients is a lack of ankle mobility - and more specifically, dorsiflexion range-of-motion.
For just about everything in life - from sprinting, to lunging, to squatting - we need a certain amount of dorsiflexion (think of how far the knees can go over the toes, or the positive shin angle one can create without lifting the heel). If we don't have it, we have to compensate.
One of the most common things we see in people with a lack of dorsiflexion ROM is an "out-toeing," as this opens up the ankle and allows for them to get to where they need to be - even if it isn't the most biomechanically correct way to do so.
This out-toeing may also be caused by hip internal rotation deficit (HIRD), so it's important to assess both. Check out this previous video blog for more information on how to assess for HIRD.
In a more "uncompensated" scenario, an athlete with poor ankle mobility may push through the toe instead of the heel - creating a quad-dominant propulsion in a scenario that should have signification contribution from the posterior chain musculature. In the pictures below, you'll see that Josh Beckett requires a considerable amount of dorsiflexion range-of-motion to get the job done (push-off without the heel leaving the ground).
This lack of ankle mobility may also negatively affect knee function. Research has shown that a lack of ankle mobility can increase rotational torque at the knee. This falls right in line with the joint-by-joint school of thought with respect to training; if you lock up a joint that should be mobile, the body will look elsewhere to create that range-of-motion.
This definitely applies to what happens to the lumbar spine during squatting in a person with an ankle (or hip) mobility deficit. If someone can't get sufficient dorsiflexion (or hip flexion and internal rotation), he'll look to the lumbar spine to get that range of motion by rounding (lumbar flexion). We know that combining lumbar flexion with compressive loading is a big-time no-no, so it's important to realize that folks with considerable ankle mobility restrictions may need to modify or eliminate squatting altogether.
Take, for example, Olympic lifters who wear traditional Olympic lifting shoes with big heel lifts. This artificially created ankle mobility allows them to squat deeper. While I'm not a huge fan of this footwear for regular folks for squatting, used sparingly, it's not a big deal.
Other individuals may be better served with hip dominant squat variations (e.g., box squats) that allow them to sit back and not squat quite as deep while they work to improve that ankle mobility and get closer to squatting deeper (with more dorsiflexion). With these individuals, we supplement the more hip dominant squatting with extra single-leg work and plenty of deadlift variations.
The take-home message is that ankle mobility has some far-reaching implications, and it's important to be able to assess it to determine if it's the factor that's limiting someone's safe and efficient movement.
For more information on how to evaluate and address ankle mobility, check out Assess and Correct.
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Note from EC: Great content from Matt Blake today. If you want to read more of Matt's stuff, enter his name in the search box to the right of your screen, and you'll get some of his previous writing here.
Since the Christmas pre-sale is over on the 95 MPH arm, I figured I would follow up with some more insight into the way we are working with a wide range of pitchers here at Cressey Performance.
To give you perspective, recent throwing sessions in the CP cage have included anything from minor leaguers working through controlled flat-ground drills and some simulated long-toss, to high-school guys working on velocity drills or throwing bullpens getting ready for college winter camps (for better or worse). We've also had a handful of players come to us following injuries as they try to build their arms back up from essentially scratch. With the wide variety of development and training that needs to take place as a result of these different situations, a strong need emerges for an effective communication style with your athlete.
For me, this is tremendously important if I expect to push a player in a sport that will have 57% of their population suffer some form of shoulder injury during a playing season (1). It seems a little absurd to think that more than half the athletes in this population will get hurt in a given season, but it's not that crazy when you consider the fact that we're asking the shoulder to internally rotate at velocities greater than 7,000 degrees/second and the elbow to extend at 2,000+ degrees/s during the throwing motion. If that's not bad enough, at maximum external rotation the torque placed on the elbow is equivalent to 40lbs pulling down on the hand. When all of this is considered, it becomes clear how serious it is to actually ask an athlete to perform 80-100 repetitions of a skill at near human capacity.
Once you understand the implications of what you are requesting your player to do, the ability to effectively communicate in a manner that gains quality feedback from your pitcher becomes essential. With the tremendous amount of stress being placed on the body and no objective way to know how a particular player's arm or body feels during practice or competition, we need to have open lines of communication to make sure each and every piece is monitored for stress.
Obviously the easiest way to gather information is to verbally ask players how they are feeling, or have them rate their fatigue on a 1-10 scale with 1 being, "My arm feels like gold", and 10 being, "I think I just tore something". The only problem with this is that every player will have a slightly different pain threshold and one person's "3" may be another person's "6." So, if you are going to use this scale, it is important to stay on top of it and ask the player on a regular basis to calibrate the stress and watch how it slides one way or the other as they get loose or as the discomfort begins to build.
The other problem with the verbal scale is that you have to account for each player's personality and level of competitiveness. Some players will run themselves through a wall and not think twice about the damage they could be doing. These players will under-report their pain levels in an attempt to continue throwing. With players like this, you need to resort to other means of monitoring pain levels. This is where understanding a player's natural temperament is important. By knowing how a player normally acts, picking up subtle behavioral cues can play a large part in identifying underlying pain.
These subtle behaviors can include anything from the way they make eye contact, their facial expressions and head talk, body gestures, postural changes, etc... For example, if they grimace after throwing, shake out their arm after throws, or cross their arms when they're standing still, then you are probably looking at some tenderness building somewhere in the arm. Mechanically, you can watch the elbow/arm slot begin to drop as they throw, the torso might become more upright, and the ball to begin to stay up in the zone more often. Velocity changes may or may not occur as well. As you begin to see one or more of these traits, it's important to make sure you open the dialogue with the player to make them verbalize how the arm feels.
Identifying these traits and gaining trust from your pitcher to speak honestly with you about his arm's health is the foundation for developing them to their ceiling. Once you understand how much a player can be pushed while maintaining a healthy volume or amplitude, driving the development with this same mindset becomes just as critical.
One of the problems that I believe stands in the way of a lot of players/athletes in their personal development tends to be their inability to relate to new information that you are trying to give them. It's not that they weren't listening or the fact that what you gave them was right or wrong, but more that it didn't fit neatly with what they had previously learned. Different personalities, different backgrounds, different learning styles, can't all be expected to work off the same lesson plan.
Each piece of the development needs to be looked at dynamically to see how the information is registering for the player. Two of the main things I work hard to identify early in the process are:
1) what style of learning does the player prefer?
2) where are they in their development?
Once you have the answers to these questions, you can begin to provide the necessary information in the right form for the player, so they understand why they would want to apply it and, more importantly, how they apply the new information.
By using multiple avenues to find out what the player is looking to learn or needs to learn, you can optimize the use of certain tools to flush out higher levels of performance. One of the main tools we use here is slow-motion video analysis. I find this to be very effective in getting everyone on the same page regarding what is actually happening during these highly complex movements. From there, we'll agree on a plan of action going forward that might use lead-up drills, velocity drills, weighted baseballs, medicine balls, etc. All of these pieces help to teach something, whether it be rate of force development, knowledge of the kinetic chain, or simply a consistent rhythm and tempo in the delivery.
Obviously, the examples I'm using here are baseball related, but this can be just as easily applied to strength and conditioning, as well as other skill-specific sports. It really just comes down to the proper application of each drill or exercise with targeted work that fits the developmental needs of the athlete. If player and coach are effectively communicating, the learning loop can certainly be shortened and the sky is the limit for your athletes' development. With that said, I hope everyone enjoys the holidays and the rest of 2009, and I certainly look forward to continuing this ongoing conversation with you guys in 2010.
References
1. Ouelette, H et al. Spectrum of Shoulder injuries in the baseball pitcher. Skeletal Radiol. 2007 Oct 3.
2. Fleisig, GS. The Biomechanics of Baseball Pitching. Spring 2008 Southeast ACSM Conference.
Matt Blake can be reached at mablak07@gmail.com.
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used by Cressey Performance Pitchers after they Throw!
I get asked relatively frequently whether we use weighted baseballs with our pitchers, and if so, how they are incorporated. I figured it'd be worth a post to outline my thoughts. To answer these questions:
Do you use weighted baseballs?
Yes, with some of our pitchers. The asterisk that follows this statement is that they're only implemented with those who have built a decent foundation of strength and mastered the fundamental mechanics of throwing a regular (5oz) baseball. So, the athletes we have that may be utilizing weighted baseballs are some of our pro guys, college guys, and more advanced high school guys. It is NOT something I think coaches should just implement on a gross scale with unprepared 13-year-old kids.
But aren't weighted baseballs dangerous?
The first response that comes to mind is "Who decided a baseball should be 50z?" It's actually a very arbitrary number.
Quarterbacks throw 14-16oz footballs (140z is the dry weight; balls actually become heavier as they're used more). And, you could say that a lot of quarterbacks throw every day - and potentially even more than pitchers throw. Yet, they have far fewer elbow and shoulder problems than pitchers - and usually far less coaching on the mechanics of throwing than pitchers.
Granted, there are differences in the way that footballs are thrown, as compared to baseballs, but you have to consider that tripling the weight of the ball would increase arm stress, right? Wrong!
If you increase the weight of the implement, you slow down the arm action. In other words, you move further to the right on the absolute speed>>>>absolute strength continuum. In other words, weighted baseballs comprise a medium between traditional throwing drills (bullpens, long toss, flat ground drills) and what one encounters with medicine ball work and resistance training. If you slow down the arm action a bit, the deceleration demands drop - and it appears to be more arm-friendly.
How are weighted baseballs incorporated?
First, let me make two things abundantly clear:
1. You should never throw a weighted baseball off a mound (arm stress is higher when elevated) or with long-toss. We do all our weighted ball drills into a tarp/net from about 6-8 feet away.
2. You don't play catch with weighted baseballs. Someone will get hurt if you try. Throw the ball, then walk to pick it up.
We don't start throwing weighted baseballs until we've built guys up on their long tossing and the arm is 100% ready. In other words, weighted ball work starts up right around the time that bullpens start. As an example, most of our guys start throwing right after Thanksgiving, and pick up bullpens around January 10 after about 5-6 weeks of long-tossing and flat-ground drill work with the 5oz ball. The entire throwing program for them encompasses about 14 weeks (sometimes a bit longer or shorter, depending on the individual).
As an example, as I wrote previously, we used weighted balls with Oakland A's minor league prospect Shawn Haviland last off-season, and he made a nice velocity jump from 87-88 to 90-94 in a single off-season. Looking back at Shawn's program, his first session with weighted baseballs was January 11, and his last one was February 18th - so it wasn't something he was doing year-round or in-season.
We have, however, had scenarios where guys have used weighted baseballs to get ready for fall throwing appearances (for example, the World Wood Bat Tournament in Jupiter, FL every October). These guys push their winter throwing programs back because they accumulated mileage on their arms in the fall (one reason I don't love fall baseball, but it's part of the game as it's played nowadays).
When the time comes to implement the weighted baseball drills, they are either done as after long toss, after a bullpen, or as a stand-alone training session. They are never done before a bullpen, which comprises complete specificity with which you don't want to interfere.
All of our weighted baseball drills generally take place in the 7-11oz range. I do, however, know some very bright minds in the field who will go heavier.
We always bring the athlete back to the normal 5oz ball at the end of each set. So, it might be three throws at 7oz, three throws at 9oz, and then three throws at 5oz, then rest. Other coaches may build all the way up (five at 7oz, five at 9oz, and five at 11oz) and then work their way back down to 5oz at the end of the session. Personally, I prefer to keep the learning loop short and keep the athlete cognizant of the 5oz feel with repeated sets as opposed to one big one.
Matching the drill to the weight of the ball is absolutely imperative, too. As a general rule of thumb, I do not go above 8oz for any drill that has a considerable lay-back (as pictured below) component, as the stress on the elbow is already pretty high in this position.
We can go considerably heavier with drills that are more focused on what's happening out in front of the body, though.
It's not easy buying holiday gifts for me. I'm "that guy" who really can't think of anything that he really wants - or even needs. Call me simple, or call me stubborn (or a bit of both), but short of books, audiobooks, and DVDs within my field (all of which are continuing education write-offs that go directly to the Cressey Performance library), I'm generally really at a loss for what to write after "Dear Santa."
So, I thought I'd make my holiday wish list a bit non-traditional for the sake of this blog. Without further ado, here's my holiday blog wish list:
1. I'd like for the phrase "it's all you" to be permanently banished from gyms worldwide.
2. I'd like to see it get markedly more difficult to be in a position to train people for a living. In other words, I think that states ought to implement licensing requirements that - even if not very strict - would discourage folks from getting into the industry if they weren't fully committed to being good at their chosen craft.
Now, don't get me wrong; I would never discourage someone from making a career change to become a fitness professional. I know some excellent coaches/trainers who have done just this and been very successful - and helped a lot of people. These effective transitions, though, were made by people who invested the time, energy, and patience to do it the right way.
3. Similarly, I'd like for more people in the fitness industry to appreciate the process (human interaction) more than just the destination (making money). There's been a big push on the business side of things in this industry to help people run their business more efficiently, and I think the intentions are fantastic. However, I think it's important to not lose sight of the fact that training people should be fun; I'm a firm believer that if you love what you do, you'll never work a day in your life. If you aren't enjoying it and letting your enthusiasm show because all you can think about is getting to the four-hour work-week, then you're not doing everything you can to help your clients.
I know I can say that I am like a little kid on Christmas morning when it comes to helping out up-and-coming high school athletes with the college recruiting process, and I watch dozens of high school baseball games every spring. In addition to the great time I have working with all our pro and college guys at CP, I'm also following all of them during their seasons - because it really does matter to me how they do. While it may add value to your services in your clients' eyes, this extra stuff isn't "billable" (and never should be). It may extend your "work" week, but you don't perceive it because it's all part of a process that you enjoy, not just something you "get through" as quickly as possible so that you can do something else. Case in point: here's how I spent one Friday afternoon last spring after the facility had closed up for the day (this video followed a crazy circuit we'd designed for the guys, and the winners got the hoses):
So, if you find that you aren't having fun and taking an active interest in your clients' successes, then your job should be to rearrange things to either find your enthusiasm or put someone else in your place who can provide enthusiasm of their own. I guess the take-home point is that it doesn't take any extra time to simply care.
4. I'd like for Tony Gentilcore to misplace every techno CD he owns.
5. I'd like to see more rehabilitation specialists be proactive with soft tissue work. Please understand that it may not be indicated in every condition, but for me, knowing that a rehabilitation specialist is willing to use some elbow grease with a patient is a sign that he/she isn't just going through the motions.
6. I'd like to know why my business partner needs to wear a weight belt to answer the phone. Is it really that heavy?
7. Shameless (but justified) self-promotion alert: I'd like to see anyone who exercises purchase a copy of Assess and Correct. The overwhelming majority of people who come through our doors with a history of pain are not just people who have dysfunction. Rather, they're often people who have had dysfunction for a long time and accumulated exercise volume on top of it. Or, they've done therapy just enough to get asymptomatic, and then gone right back into their "normal routines" without addressing an underlying imbalance. That, to me, is why we made Assess and Correct.
It's a proactive approach in a more reactive fitness world. People wait for something to go wrong with the knee, back, shoulder, or something else. To me, it makes a lot more sense (both financially and in terms of the cost of one's time) to assess oneself and address what's wrong than it is to wait for symptoms to kick in - and then spend time in physical therapy. As hackneyed as the saying is, "An ounce of prevention is worth a pound of cure." Click HERE to check it out.
8. Along these same lines, I'd like to see people think more along the lines of "contraindicated people" than contraindicated exercises. Short of a few movements (e.g., upright rows, behind-the-neck pulldowns, empty cans), there aren't many exercises I'd completely "banish" from my training arsenal. Mike Boyle's "The Death of Squatting" interview kicked off a lot of interest on this front. I think that it's our job to fit the exercise program to the individual, and not the individual to the exercise - and as such, we don't need to worry about excluding certain exercises altogether.
9. I'd like to see distance running for pitchers (or any baseball player) completely abolished. I've wrote about my opposition to it in A New Model for Training Between Starts: Part 1.
10. I'd like for this kid to get the record deal he deserves.
As you read this, I'm presenting at the Ultimate Pitching Coaches Bootcamp in Houston, TX. As such, it seems fitting to devote today's blog to some pitching content.
A question I get pretty often is what I think of light band work for pitchers the day after pitching. The truth is that I'm pretty apathetic about the use of bands, but I am adamant about the inclusion of post-throwing stretching to regain lost flexibility. Research from Reinold et al. demonstrated that pitchers lose both elbow extension and shoulder internal rotation range of motion (ROM) over the course of a competitive season, and it's no surprise, given the huge eccentric (deceleration) stress those arms encounter during the throwing motion. Anecdotally, my experience has been that they also lose hip internal rotation and knee flexion on the front leg. So, you don't just want to take care of shoulder range of motion; you also want to attend to hip ROM.
Here's the side-lying cross-body stretch, one of my favorite self-stretches for improving shoulder internal rotation. I tend to use it more than the sleeper stretch nowadays because it's generally a lot tougher to butcher the form. It's important to stabilize the scapula down and back before the cross-body pull. This should not be an aggressive stretch! If you are gentle but consistent with it, the ROM will come around in time.
You can find more ways to both identify and address shoulder and hip rotational imbalances in Assess & Correct.
So, flexibility is a must, but light band work may have a place as well. There's a lot of muscular damage, and some very light bloodflow work may assist in rotator cuff recovery, as it tends to have a poor blood supply. I go into more detail on how we train our pitchers after an outing in A New Model for Training Between Starts: Part 2.
For more information, check out Optimal Shoulder Performance.
This is another excellent guest post from Matt Blake.
Now that fall sports are beginning to wrap up and the winter training season is upon us, I thought it might be timely to contribute some more information for the youth baseball development community.
Recently, I have been running some pitching clinics on the weekends for the 9-12 year old age group - and it got me thinking a lot about the importance of proper development for the youth baseball player. This is especially true in what has been traditionally considered a "dead period" or off-season for baseball players in the Northeast.
For better or worse, I believe this mentality is beginning to change a lot, as the greater population is forcing players to become more and more specialized at earlier ages. This may not be true across the board, but there are definitely some undertones driving this movement, such as showcases during the December/January months, where players are expected to show up to a workout and light-up a radar gun in order to impress college coaches or scouts. This thought alone might send shivers down Eric's spine and will probably hold its own as a blog topic in the near future.
To give you an idea, one study published by Olsen et al (2006) at the American Sports Medicine Institute in Birmingham, AL actually documented that injured baseball players (requiring elbow or shoulder surgery) went to four times as many showcases as those who were in the healthy control group!
Now, I certainly can't say I think specialization at a young age is a healthy thing with regard to developing baseball players, as there are tremendous demands placed on the body in the act of throwing a baseball overhead. But at the same time, if players and parents decide that is what they would like to do and it is in the best interest of the kid, there needs to be a safe way to approach development during this time period for this population.
When I say this population, I'm speaking to the baseball population as a whole, but when I say a "safe approach," there obviously needs to be some clarification on the intended goals and ambitions of the particular player.
Some of the major concerns that I believe need to be addressed before engaging a player in a throwing session include:
-How much has this player thrown over the last day/week/month/year? Has he taken any breaks in his development to rest his arm for at least three weeks (at the very minimum)?
- Has he complained of arm pain during practice or competition during this period? If so, where was the pain? How often did it occur and to what degree?
These are just a few of the important signs and indicators that need to be tracked throughout the year, specialized winter training or not. The study referenced above by Olsen et al identifies a host of other variables found in the injured population and should be a must read for anyone who is working with amateur baseball players.
Now there are obviously a lot of different ways to look at this, so I'll try to explain what I think "proper development" means for players depending on their age range, and the level of performance they desire to reach.
This winter alone, I will be aiding the development of pitchers ranging from the professional and collegiate baseball players taking part in Eric's Elite Baseball Development Program all the way down to the 9-12 year old population, where players are trying to figure out how to throw a baseball in the right direction.
Obviously, the pro players are extremely specialized and probably have been for awhile. A lot of their development has already occurred and their windows for adaptation are a lot smaller, so we're working more towards preparing them to handle the stress of a 140+ games than we are skill refinement.
On the other end of the spectrum, the 9-12 year olds one might be dealing with are incredibly raw and undeveloped with huge windows of adaptation ahead of them from pure maturation of their bodies to the development of their motor patterns. This time period is huge for kids to begin ironing out the proper motor patterns that they will use to refine their athletic skills in their teen years of development.
With this in mind, a substantial amount of throwing might not be in their best interest and maybe getting more athletic in general would be more beneficial in the long term. How can you expect a player to repeat his mechanics with any sense of consistency if he doesn't understand how his body even works? One way that I like to spend time with this type of player is to extend the warm-up and movement training portion of these clinics to really drive home the importance of being in good physical shape. We also use more group oriented video analysis sessions for the players and parents to point out what common mechanical faults look like in this age group, and what verbal cues the parent might be able to use to help correct when playing catch on their own.
I actually find this portion of the clinic to be the most beneficial for all involved, because when you think about it, you only get about 3 to 4 hours with these players in a clinic setting. In order to get the information to settle in for these players, it needs to be constantly reinforced as their mind and bodies continue to develop. This is where mom or dad need to be informed, because they are the ones who will do much of the reinforcing, whether or not they are qualified to teach their son to throw a baseball. The more information they can have at their disposal and the more teaching tools you can give them, the better off they will be at aiding their child's development in the backyard.
This is the main reason why Eric and I are holding a FREE clinic this coming Tuesday, Dec 8th at 7pm for parents and coaches in the area, who are interested in learning more about how to prepare and protect the amateur baseball player. We'll be discussing the current injury epidemic in youth baseball, how it stems from overuse in competition, and what some of the major developmental needs are for the youth baseball player. If you're interested in attending, please RSVP to CresseyPerformance@gmail.com. Hopefully we'll see some of you there!
Matt Blake can be reached at mablak07@gmail.com.
1. First off, I hope everyone had a great Thanksgiving. Before I get to the video footage from yesterday morning, I wanted to give you a couple of quick heads-ups on some seminars at which I'll be speaking in 2010 (just confirmed):
January 30, 2010: Mike Boyle Strength and Conditioning 4th Annual Winter Seminar - Winchester, MA
March 7-8, 2010: NSCA Personal Trainers Conference - Las Vegas, NV
May 8-10, 2010: Sports Medicine 2010: Advances in MRI and Orthopaedic Management - Boston, MA
Hope to see some of you at one or more of these events!
2. A big congratulations goes out to CP athlete CJ Retherford, who hit the game-winning HR in the championship of the Arizona Fall League (Video HERE). CJ will be out to Boston to train when January rolls around.
3. And, just when we thought the post-baseball-season celebration was over, we learned that CP athlete Tim Collins was named Toronto Blue Jays Organizational Pitcher of the Year. Congratulations, Tim!
4. John Berardi is running a great sale on Precision Nutrition through December 1. They're offering them the Precision Nutrition System - including Gourmet Nutrition Version 1 and an all-access membership to their private Member Zone - plus a one-year subscription to their Results Tracker program, and free shipping to the US and Canada for just $99.00. If you haven't checked it out - or you have a family member or friend who could use some help on the nutrition side of things - I'd strongly encourage you to check this out. It's the single-best nutrition resource available on the web today: Precision Nutrition
5. We'll have the pictures and videos from the CP Thanksgiving lift posted as soon as possible. A camera was lost and we're in the process of finding it!
6. In the meantime, here are some recommended readings from the past here at EricCressey.com that might interest you:
Hip Injuries in Baseball: My take on the huge increase in hip issues in MLB players.
Stagnancy vs. Stability: Even in a dynamic field like strength and conditioning, the status quo is sometimes still just fine.
7. Just got this little bit of feedback on Assess and Correct from Mark Young of markyoungtrainingsystems.com:
"As a strength coach myself, I have literally read thousands of studies, textbooks, and articles relating to assessment and correction. But when I heard that Mike, Eric, and Bill were going to be putting together a product on this very subject I wanted to be first in line to put my hard earned money on the table. I think this product is going to change how people prepare for performance and that owning it is a must for anyone who is absolutely serious about results."
Check it out for yourself: Assess and Correct.
Q: Inspired by your articles on T-Nation, I've started to measure IR/ER/Total shoulder rotation deficits using a goniometer. I did have another question, however: you mentioned in an article that Hip Internal Rotation Deficit (HIRD) is a serious problem among baseball pitchers and hitters due to the asymmetrical front leg blocking in both mechanics. I absolutely agree, and I use corrective exercises and stretches to help alleviate these problems. However, I lack a good way to test for this; do you have any suggestions?
A: We check hip internal rotation in the seated position. Basically, you just have the individual sit up tall at the end of a table, and position the hips and knees at 90 degrees. Then, without allowing the hip to hike, you internally rotate the femur. This is one of the many assessments on our new DVD set, Assess and Correct, and it's featured on page 50 of the tag-along e-manual. Check it out:
For more information on how to correct the problem - and assess for other issues like this, check out www.AssessandCorrect.com.
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1. Exciting week around here, as it's getting to be that time of the year when our high school ballplayers - both 2010 and 2011 - finalize some of their plans.
Last weekend, RHP Barrett O'Neill (2011) verbally committed to the University of Virginia on a baseball scholarship, and on Tuesday, RHP Travis Dean (2010) signed his letter of intent to pitch at Kennesaw St. University in Georgia. A few weeks earlier, RHP/3B Joe Napolitano (2011) had verbally committed to Boston College. These three comprise 3/8 of our current 90mph+ high school crew - and I suspect that the other five will be following soon!
Also this week, 2B Erik Watkins (2010) committed to Skidmore and CF Billy Bereszniewicz (2010) committed to Binghampton. Previously, catcher James Alfonso (2010) had accepted a scholarship to play at the University of Hartford. Plenty more to come soon, no doubt...
2. Speaking of Travis, here is something I love about him: he has INTENT on every single medicine ball throw he makes. It isn't just about "tossing" a ball to a wall and rotating your hips. It's about getting your entire body into the effort - to the point that you're trying to break the ball (or wall!) on every single drill.
Once we have taught our guys the technique for the drill, it's about getting after it. If you aren't training rotation aggressively, you might as well not do it at all.
3. I got a lot of great comments from readers on my A Few Days in Arizona on Monday; I'd encourage you to check it out.
4. One of the key points I made was that respiratory function was essential for ideal performance and posture, and I recognize that the concept might be completely foreign for a lot of my readers. To that end, I'd encourage you check out The Anatomy of Breathing.
It's a pretty quick read that gives you good insights into the anatomy of the respiratory system and common dysfunctions that occur. Once you start getting an appreciation for the muscles involved, you can start to see how poor diaphragmatic function can easily lead to overactivity of sternocleidomastoid, scalene, pec minor, intercostals - basically, a lot of muscles commonly implicated in upper extremity dysfunction. You can just stretch and massage those areas, but it's just like putting a bucket on the floor when the roof is leaking; it's better to just fix the roof (aberrant breathing patterns).
5. I also touched on breathing patterns a bit in my seminar this past weekend. Check out a few great reviews of the event:
6. Some interesting findings HERE that shows that there may be a strong link between childhood obesity and the development of multiple sclerosis later on in life. One hypothesis is that it may be linked to the low levels of Vitamin D that one sees in overweight kids, and another that it could be related to the fatty tissue itself. One more reason to take Vitamin D!
7. We're all headed to Providence tonight to watch CP client and pro boxer Danny O'Connor try to run his professional record to 10-0. I think we'll be setting a world record for the number of professional baseball players in attendance at a boxing match. Let's go, Danny!
As many of you know, Mike Reinold and I put on a seminar that was "everything shoulder" this past Sunday at Cressey Performance. The event sold out within 36 hours back when we first announced it in early October, and we had strength and conditioning and rehabilitation specialists come from the likes of Canada, Texas, and the Midwest on only a month's notice. Our goal was to keep the seminar more intimate to allow for more speaker-attendee interaction, Q&A, and easy viewing - as we also recorded the event on DVD.
While production won't be complete until December at the earliest, I thought I'd give my loyal readers a little taste of some of what was discussed on Sunday. Our primary goals were to introduce some current concepts in evaluation of both symptomatic and asymptomatic populations as well as ways to treat/train them during and after injury. Above all else, we wanted to show how rehabilitation specialists and strength and conditioning specialists could work hand-in-hand to improve outcomes - but that this successful interaction hinged on whether all parties involved were willing to commit to learning about how the shoulder functions.
You can call this my "Random Thoughts" for the week:
1.The side-lying external rotation (SLER) has the highest EMG of any rotator cuff exercise, and the adducted position is the safest position for most "testy" shoulders. So, if you have to pick one cuff exercise to get you a safety and a great return on investment, roll with the SLER:
2. Simply providing a small amount of "propping" to put the humerus in a slightly more abducted position actually increases EMG of the posterior rotator cuff muscles by 23%.
3. Shoulder evaluations rarely work completely independently of one another. For example, poor thoracic spine mobility directly impacts function of the scapula and, in turn, range of motion at the glenohumeral joint. So, rather than hanging your hat on 1-2 assessments, you need a barrage of assessments that cover glenohumeral range-of-motion, scapular stability/positioning, thoracic spine mobility, breathing patterns, and forward head posture. Then, once you've got all your information, you can look at each test as one piece in an individualized puzzle.
4. There are a ton of superior labrum anterior-posterior (SLAP) tests out there. It's because none of them are particularly great - but the better ones out there simulate the injury mechanism (e.g. pronated load and resisted supnation external rotation tests for overhead throwing athletes).
5. The true function of the cuff is - very simply - to center the humeral head within the glenoid fossa. So, rather than train it purely concentrically and eccentrically, we need to also work its isometric/stabilization function with rhythmic stabilization exercises. Here's a really entry level one we use quite a bit with our pitchers:
6. MRIs and x-rays can only tell you so much about a shoulder. For instance, 79% of professional baseball pitchers have "abnormal labrum" features. Likewise, a huge chunk of asymptomatic people in the general population are walking around with partial and even FULL thickness tears of the rotator cuff. It actually makes you wonder if abnormal is actually normal! The take-home message is that having adequate mobility, stability, and tissue quality in the torso and upper extremities matters more than anything else. You have to ASSESS, not assume!
7. We talk a lot about glenohumeral internal rotation deficit (GIRD) - and it certainly is important - but you have to appreciate that it's just one part of the total motion equation. Some internal rotation deficit is completely normal, and working to fix it may actually hurt some athletes. Look to total motion first, and then work backward to see whether IR, ER, or both need to be changed. It is better to be too tight than too loose!
8. If you have an athlete with good shoulders, thoracic spine, scapular stability, and tissue quality who has rehabbed and long-tossed pain-free, but has shoulder/elbow pain when he gets back on the mound, CHECK THE HIPS! Staying closed and flying open will be your two most common culprits, and this cannot be seen in a doctor's office or on an MRI.
9. Anytime you see an individual with a pronounced shrugging pattern as they try to reach overhead, it's wise to have them checked for a rotator cuff tear. The reason is that with a cuff tear, the deltoid's vertical action overpowers the cuff's compressive action. In a healthy shoulder, the supraspinatus "cancels out" this deltoid pull. Never, ever, ever, ever train through a shrugging pattern with overhead reaching!
10. External impingement and internal impingement are completely different "syndromes" that must be managed completely differently. Simply saying "impingement" is no longer acceptable with how far sports medicine has come! Both are generally multi-factorial issues that mandate a more specific diagnosis and comprehensive treatment/training plan. If you understand why/how they occur, you can understand how to train around them (and the same can be said about just about any shoulder condition).
UPDATE: The Optimal Shoulder Performance DVD set is now available! Check it out at www.ShoulderPerformance.com.
