Home Posts tagged "Rotator Cuff Rehab" (Page 5)

Random Friday Thoughts: 2/5/10

It's been a while since I've published a Random Friday Thoughts blog.  So, I guess you could say that this is some random randomness.  Enjoy. 1. Anyone who tells you that being a strength and conditioning coach is just about training doesn't realize that it goes far beyond that.  This off-season, we've helped our pro guys out everything from composing a best man's toast to tying a tie.  We've even come full-service to offer haircuts in the office.

2. Jacob Hiler recently interviewed me about vertical jump training; check it out HERE. 3. I got some great feedback on Assess and Correct via email the other day from Jon Hochberg: Just wanted to commend you on your latest product, Assess and Correct (kudos to Mike and Bill as well, of course).  As a purchaser of most all of your products, I found this to be your most mature - not necessarily in terms of content, but in terms of presentation and delivery.  Assess and Correct does not merely list corrective exercises, but outlines an integrated process that each athlete, regardless of level, can navigate through.  From the body photos at the beginning of the manual, to the exercise listings and the demonstrations on the video, the user has a complete road map in front of him that he can use for the rest of his career, especially since you grouped the progressions into sensible categories.  I think the manual in conjunction with the videos is the real key here.  I can read about what I need to do, and if I need a more clear demonstration, I can look it up in the video chapters and watch it for more clarification.  It's nice when someone else puts in the hard work and does the research for the rest of us, so that we have a clear picture of where to go next.

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Thanks to Jon for the feedback.  You can pick up your copy of Assess and Correct HERE. 4. My buddy Jim "Smitty" Smith at DieselCrew.com is doing a great fundraiser for Haiti relief efforts.  Check it out here. It's a great idea for a great cause. 5.  Another easy way to keep track of me is on Facebook, for those of you who have it.  Just consider yourself forewarned that if you post questions on my wall about why your shoulder hurts or ask "what's your biceps workout, bro?," I'll delete you as a friend faster than Tony Gentilcore can say "I love techno."  Life's not fair sometimes; sorry. 6. I don't know what this picture has to do with anything, but I thought that it was great.

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7. Quote of the week: "The higher up you get, the more hot air you encounter."  It rang true when one of my athletes this week informed me that - according to some local trainer (who I've never met, but apparently is a competitor of ours) - I was responsible for a nearby pitcher's elbow injury.  This was remarkable, considering I've never even met or talked with this pitcher, let alone assessed him, programmed for him, or trained him! I know we get a lot of industry up-and-comers reading this site, and perhaps the best career advice I can give you is to ignore what other people say.  Listen to your customers/clients/athletes, your staff, and your family; those are the opinions that matter.  If I spent hours each day arguing on internet forums with my critics, I'd be wasting time that could otherwise be spent with the former three groups: the ones that matter. 8. I'm keeping a diet log this week for the first time in about three years.  I've gotten so accustomed to just maintaining my weight without really thinking about it that I figured I actually ought to check and see just how many calories I'm taking in on a daily basis.  It definitely makes you think about what you eat a lot more! 9. Here's a great little piece about two Cressey Performance athletes - Billy Bereszniewicz and Adam Ravenelle (both of Lincoln-Sudbury) - who have committed to play Division 1 baseball. 10. Short one today, as I've got a bunch to do before the weekend. We've got a full schedule here at CP on Saturday, and then I'm back to my old stomping grounds at Gampel Pavilion at UCONN to watch the basketball team play Depaul.

Then, it's house/condo "shopping" on Sunday.  I'm getting all grown up before your very eyes...

Have a great weekend!

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Cressey Performance West?

I got a nice surprise in my email inbox from some of my athletes on the West Coast yesterday.  If you laughed at Posterized, you'll love this.

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From the Little Leagues to the Big Leagues? Nope.

Today marks another great blog Q&A from Matt Blake. Q: I was quite shocked to learn that only three pitchers have ever made it to the Big Leagues from the Little League World Series (LLWS). It makes perfect sense, as the mature kid at 12 generates more velocity than little Billy. Most parents assume that since he is more mature he can handle more stress when in actuality it just means his muscles are stretched out farther and are more susceptible to injury. More specifically, Tom House claimed that the stretched out muscles could be counteracted by dropping your center of gravity. Any input would be great! A: I think this speaks to a lot of problems with how the players got to Williamsport and the developmental path that carries into their teenage years. The main concerns with the 11-12 year olds that are competing in the LLWS is how skilled they are for such a young age. Typically, this means that they have had a tremendous amount of repetition at a young age, and have competed in a very large number of games over the course of the spring and summer to make it to Williamsport.

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Three issues that might speak to why only three pitchers have gone on to play professional ball include: Issue #1 - These players are not skeletally mature to handle the amount of stress placed on their bodies, so they will probably turn up with more overuse injuries in their teen years that have been accumulating due to the high demand from 9-12. Issue #2 - This could be a simple timing of maturation. A lot of the dominant players are taller, weigh more, throw harder and have probably entered certain stages of maturation quicker than their peers. This doesn't necessarily mean they'll be ahead of their peers at 13-15 or even 16-18; it just means that at the age (11-12) we happen to televise, they were more developed. There are at least six more years before this player can even think about playing professionally, so a lot of things can happen to level out the playing field. Issue #3 - There's a good chance the amount of repetition that these players have put in at an early age could lead to "burnout" down the road or a feeling of satisfaction and less of a demand to work hard, because everything came to the player so easily at a young age. This game will eat you up if you don't continue to get quality repetition over the long haul.

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At some point, an abundance of talent will be matched, whether it's in high school, college, or the minor leagues. This is where the intangible qualities separate players and hard work is required to keep your competitive edge. Needless to say, I'm still shocked that only three pitchers have made it from the LLWS. For me, this signifies a serious red flag in the way we are developing talent in the baseball industry if our best players at age 12 don't translate well to the upper levels. Have a question for Matt?  Drop him an email at mablak07@gmail.com. Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches used by Cressey Performance Pitchers after they Throw!
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A Sweet Free Fat Loss Report from John Romaniello

Just wanted to give you a quick heads-up on a free report John Romaniello just made available as a "prelude" to the launch of his new product Final Phase Fat Loss.  It's called "Why You've Stopped Losing Body Fat" and there are a few points in there that will interest even the most experienced folks in the crowd (and there's also some Romaniello humor, which I've come to appreciate as absolutely classic). I've also had a chance to review the final product that will be launched very soon, and I'd strongly encourage you to check it out when it becomes available.  John's a guy who walks the walk (as his picture below shows) and has helped a ton of people lean out over the years; he's got some great nutritional strategies and unique training ideas to share. You've got nothing to lose; this report's free.  So, check it out: Why You've Stopped Losing Body Fat.

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Clearing up the Rotator Cuff Controversy

The college coach of one of our current pro baseball players was asking me about the rotator cuff program he's doing with us now, and I figured I'd turn it into today's topic.  We take a bit of a different approach with it than you'll see with a lot of guys in the industry, and it's basically dictated by three assertions/assumptions: 1. The true function of the rotator cuff is to stabilize the humeral head on the glenoid (shoulder socket).  While external rotation is important for deceleration of the crazy internal rotation velocity seen with throwing, it's stabilization that we're really after. As you can see, the humeral head is too large to allow for great surface area contact with the glenoid.

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My feeling is that the bigger muscles - particularly scapular stabilizers, the core, and the lower half - will decelerate the crazy velocities we see as long as mechanics are effective and the deceleration arc is long enough.

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2. The shoulder internally rotates at over 7,000°/s during acceleration; that's the fastest motion in all of sports.  There's no way that the rotator cuff muscles alone with their small cross-sectional area can decelerate it.  And, to take it a step further, there isn't much that some rubber tubing is going to do to help the cause (aside from just promoting blood flow - although I'd rather get that in a more global sense with full-body flexibility circuits, as I discussed HERE).

More important than blood flow is getting range of motion (ROM) back (particularly elbow extension and shoulder internal rotation) after a pitching outing.  In my experience, losses in ROM get guys injured faster than weakness, in my experience.  I've seen quite a few people come to me who have healthy shoulders, but test poorly on classic rotator cuff strength measures.  Why?  Perhaps they are very strong in their scapular stabilizers, core, and lower half and have become efficient enough to handle more of the deceleration demands in areas other than the rotator cuff.  Or, they may just be lucky; rotator cuff strength is still important!

3. We've mocked on the conventional bodybuilding community for training muscles and not movements: chest day, quads day - you get the picture.  Meanwhile, the baseball community is devoting five days a week to training muscles with cross-sectional areas smaller than any of these!

I've had multiple discussions with Mike Reinold that reaffirm this indirectly; he emphasizes that one should never train the rotator cuff to failure, as that's not how it works in the real world.  Our job is to enhance not just its strength, but also its proprioception and rate of force development.  If we chronically abuse it with training on top of the crazy demands of throwing, we never really know how strong the rotator cuff actually is. It makes you wonder how many guys in the baseball world actually have exhausted and chronically overtrained rotator cuff muscles as opposed to weak rotator cuff muscles!

With these three assertions in mind, most of our guys in the off-season will have four days of rotator cuff work spread out over two "types" of training.  Days 1 and 3 (say, Monday and Thursday) would be more rhythmic stabilization drills similar to this (although the options are really only limited by your imagination):

The other two days are more classic rotator cuff work that prioritizes external rotation and horizontal abduction (we never do empty cans).  I do a lot of work with cables here, plus a lot in the side-lying position (EMG activity for the cuff is highest here).

We'll also do a lot of manual resistance external rotation stuff, as it kind of "blends" conventional cuff work with rhythmic stabilizations due to the unstable load. Here's one option:

Later in the off-season, we'll throw in some one-arm medicine ball deceleration catches and external rotation tosses to the wall to get the thoracic spine and hips ready for the full-body demands of throwing.

Keep in mind that - as I noted - rotator cuff exercises are just one piece of the puzzle.  These are one component of a larger overall plan that addresses not only scapular stability, but also total body strength and mobility, soft tissue quality, medicine ball work, movement training, and the actual throwing program.

For more information (actually a LOT more information), check out the DVD set, Optimal Shoulder Performance: From Rehabilitation to High Performance from Mike Reinold and I.

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When Should Kids Learn Curveballs?

Today, we've got the first in a series of Q&A contributions from Matt Blake. Q: What do you think of Ron Johnson's presentation at the ABCA convention where he stated that curveballs are okay for youths to throw and that they do not cause any structural damage beyond what a fastball does? Rather, it was the frequency the curveball was thrown that was the indicator. A: I was at Ron Johnson's presentation and have had the chance to read much of the research that has been presented on this topic. I do generally agree that curveballs are not inherently more dangerous than fastballs, but I think the idea of curveballs sends a conflicting message at the youth levels.

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Fundamentally, I'd like to believe that this game is centered around the pitcher being able to locate a fastball to the center of the plate 100 out of 100 times. Obviously, this is an idealistic perspective, but above average fastball command should be the trademark of an advanced youth player, not the fact that he can spin a baseball with his hand in a supinated position so that he can fool unsuspecting 11 year olds. We don't teach hitters to focus on curveballs at this age, so why should we teach pitchers to throw them? Squaring up the fastball over the middle of the plate is step one for both hitters and pitchers. In order to put a player in the best chance to succeed down the road, I think a pitcher should be able to repeat his fastball mechanics and create a certain amount of hand-speed, before he is taught to craft his pitching skills. This is generally considered to be a throwing mechanics versus pitching skills debate and would prioritize mechanical knowledge and the sequencing of the body's rotations.

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If a player has demonstrated above average command of his fastball to the center of the plate, then obviously, the next progression would begin to zone the plate off for him. Once he can dissect the lanes of the plate with a straight fastball, then maybe teach him a different grip on the fastball or even a changeup. Start by working the changeup down the middle, etc....This game is built on efficient pitching, so to skip steps at these early developmental levels or to place too great an emphasis on winning at this age would compromise the player's development. Obviously, all of this is just simply my opinion. When would I teach a breaking ball? I guess it would be when a player looks skeletally mature to repeat his delivery and can demonstrate effective use of his fastball/changeup combination. If these pieces are set as the foundation, introducing spin tilt and depth might follow. If a player at the age of 11 or 12 is capable of doing this because he has put the necessary repetition in, then I suppose you can't hold him back, but for some reason, I think people might be skipping steps 2 and 3 to get to 4, because 4 gets outs easier at age 12. Have a question for Matt?  Drop him an email at mablak07@gmail.com. Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches used by Cressey Performance Pitchers after they Throw!
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The Six Kinds of Seminar Attendees

On Sunday, we hosted Neil Rampe of the Arizona Diamondbacks for a Myokinematic Dysfunction seminar at Cressey Performance.  It was a great experience, and Neil did a very thorough job of highlighting the different schools of thought with respect to addressing movement impairments.  In particular, Neil spent a lot of time on two schools of thought: Dynamic Neuromuscular Stabilization (discussed in this post) and the Postural Restoration Institute. There was some advanced stuff being discussed, and we had a wide variety of professions and ability levels represented in the audience.  There were athletic trainers, strength and conditioning coaches, personal trainers, physical therapists, and chiropractors in attendance.  And, they ranged in age from 20 all the way up to 55 (or so).  After the seminar, I got to talking with Neil about how it's interesting to think what each person takes away from a seminar based on their age, occupation, and experience level.  It led to me coming up with the six kinds of seminar attendees: 1. The Experienced, Open-minded Attendee - This individual may have similar experience in similar fields as the presenter.  If he gets just 2-3 good tips over the course of the seminar, he's thrilled.  The more experienced you get, the more you appreciate the little things you can add (or subtract) to refine your approach. Example: Last year, I spent about 95% of Greg Rose's presentation at Perform Better in Long Beach nodding in agreement, as he and I both deal with a ton of rotational sport athletes (him with golf, and me with baseball).  He did, however, introduce one new thoracic spine mobility test that I absolutely love and use to this day.  I might have only picked up one thing, but it was a hugely valuable for me. 2.The Experienced, Close-minded Attendee - This individual may be very experienced in a similar realm as the presenter, but isn't openminded enough to realize that a professional on his level still might have things to offer to improve his approach.  These are usually the people who claim to be "old school" - which essentially applies that they only have experience doing the same thing for 25 years.  This is one kind of "there's nothing new here" person. 3. The Experienced Attendee from a Different Field - This individual might be excellent at what he does in a semi-related field, but completely new to the material presented at a seminar.  The challenge here is to learn what can be applied in that other realm. Think of a pitching or track coach attending a strength and conditioning seminar - or a S&C coach attending a pitching or physical therapy conference.

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4. The Intimidated, Lazy Beginner Attendee - There are times when a beginner attends a seminar and has little to no clue what's going on during the event and is completely intimidated by what he doesn't know.  And, as a result, the attendee claims that he will never need the information anyway.  These folks should either change their attitudes or pick a different industry, as they are the second kind of "there's nothing new here" person. 5. The Motivated Beginner Attendee - This attendee is identical to the intimidated beginner, but rather than getting insecure about his lack of knowledge on the subject, he uses it as motivation to study further and find a way to get to where he wants to be.  This may be an understanding of how to apply bits and pieces of what the presenter taught, or a desire to become an expert in the same topic the presenter covered.  You see this quite a bit in the fitness industry, as exercise enthusiasts who aren't in the industry will actually attend seminars just to learn about better training practices - just like I might tend a talk by an economist, for instance. 6. The Middle of the Road Attendee - This individual is somewhere between a beginner and an expert in the material being covered.  My experience has been that the "middle of the road" folks only attend seminars (at least the ones at which I've presented) if they genuinely care about getting better, not just for CEUs (the intimidated/lazy beginners do that).  I find that this is probably the biggest group of the six. Groups 5 and 6 are the ones who have loved our Building the Efficient Athlete seminar the most, as it either complemented their college anatomy and kinesiology curriculum nicely, or helped to take the place of it altogether (for those who didn't attend school).

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Think about this for yourself and start to consider where you fall in the context of these six categories.  And, more importantly, how does your "placement" in this scheme dictate the next 2-3 seminars you're going to attend?  Do you want to completely get outside your realm of expertise and see something entirely new, or do you want to hone in on your specialty and see if you can come up with a few new tricks to take you to the next level?  There isn't a correct answer on this, other than that you need to keep getting out to see others in action to get better! On a related note, I've got a busy spring of seminars booked, so if you haven't already, check out my schedule page for details.
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3 Corrective Exercise Mistakes Fitness Professionals Make

Thought you all might be interested in a recent interview I did for Rick Kaselj of ExerciseForInjuries.com: 3 Corrective Exercise Mistakes Fitness Professionals Make For more details on some of the concepts I discuss, I'd encourage you to check out Assess & Correct.

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Consistently applying the information on this DVD for a few minutes each day should help anyone remain limber and injury free for a long time. Not only does it show you what to do in terms of fixing your problems, but it also shows you how to assess where you're at in terms of muscle balance and flexibility, so you can see how you're improving or regressing in those areas over time and in what areas you might need more work. It definitely makes a great addition to anyone's training library. -Kelly Baggett
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Stuff You Should Read: 1/25/10

Recommended Reading for the Week: Personal Training Certifications: A Different Perspective - Pat Rigsby got the idea for this blog post from a conversation we had at dinner at a conference last weekend in Tampa, and it came out really well. Exercises You Should Be Doing: Slideboard Bodysaw - Tony Gentilcore wrote up a good blog post about an exercise we've been incorporating quite a bit more nowadays since we picked it up from Mike Boyle. Video included! On Question, Many Answers - One of our interns this semester brought this blog post from Dr. Mike Scott to my attention.  It's a collection of responses from various experts to the question, "Why are childhood overuse injuries becoming so prevalent in our society?"
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Guinea Pigs Needed!

Okay, gang; here's the scoop: I have a new project in the works. In fact, the entire program is already written, and a few lifters have already taken it for a test-drive with excellent results.  However, I need to get my sample size up to confirm that I'm really onto something here - and that's where you may be able to help. I need some guinea pigs to put this program to the test! Before I get 10,000 email applications, here are a few things that "qualify" you: 1.  You must be healthy - or at least very close to it!  Some aches and pain in the past aren't a big deal, but we aren't going to be taking on anyone who is currently dealing with any injuries. 2. You must be at least 18 years of age, with at least one year of resistance training experience. 3. You must have access to a reasonably well-equipped gym that is at least equivalent to a commercial gym set-up.  Those who train at home are welcome to apply only if they have access to a cable column at home. 4. You would ideally have purchased Assess & Correct already. 5. You need to be able to train for four uninterrupted months for a minimum of three times each week. 6. You must be willing to take before/after pictures plus some performance tests. 7. Both men and women are welcome to "apply." 8 You must have $199 to devote to this, because it is going to be a ton of work on our end to give you tech support for four months!  That's only about $50/month for full-on programming and tech support - which is markedly lower than my online consulting rates. If you're interested, please drop me an email at ec@ericcressey.com with your name, age, and a brief background on your training history.  I'll only be accepting 12 guinea pigs for this project, and all decisions will be made by February 1.  Those who are selected will be notified by February 1. You won't receive notification unless you're selected, so please don't take it personally if I don't reply to your email; I'm just trying to save myself some extra work! Thanks!
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