Home Posts tagged "Scapular Stability" (Page 3)

3 Tips for Improving Your Back to Wall Shoulder Flexion

I've often alluded to how important I think the back to wall shoulder flexion drill is as both an assessment and actual training exercise. Today, I've got three strategies for improving your performance of this exercise:

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Name
Email
Read more

10 Important Notes on Assessments

I'm a big believer in the importance of the "Assess, Don't Assume" mentality. However, it's crucial that assessments be approached the right way in order to deliver optimal results in strength and conditioning programs. Here are ten thoughts on the subject:

1. Assessments are an easy way to differentiate yourself.

With this era of semi-private training and bootcamps, there are still a lot of coaches and facilities out there that pay no attention whatsoever to pre-participation screenings. On one hand, it's a sad commentary on our industry, as one could argue that omitting assessments sets clients up for injuries. On the other hand, it creates an excellent opportunity for skilled coaches and trainers to differentiate themselves in a low-barrier-to-entry industry. If you're not assessing, you're just guessing! Make it a priority to start learning more about your clients/athletes.

2. Thorough assessments include both specific and general components.

In my eyes, every assessment can be categorized as either specific or general. Specific assessments may be anything from single-joint range-of-motion (ROM) assessments to the provocative tests physicians and rehabilitation specialists may use. They identify specific things like elbow extension ROM or whether a particular test elicits pain.

Conversely, general assessments look at global movements and evaluate multiple joints at the same time. Examples include overhead squats and push-ups.

The problem is that both kinds of assessments can fall short. As examples, you may see unstable young athletes who pass all ROM assessments (specific) with flying colors, but fold up like lawn chairs when they do an overhead lunge walk (general).

You may also see athletes with perfect overhead squats, but significantly limited knee flexion ROM that would make you concerned that they'd pull a quad (rectus femoris) while sprinting. These are just two examples, though; there are countless more we could cite.

3. You must always be willing to refer out.

You're better off being a great trainer/coach than you are trying to be an incredibly subpar physical therapist or physician. Even if you had a tremendous knowledge of provocative tests and rehabilitation techniques, as a trainer/coach, you don't have the same resources (e.g., diagnostic imaging equipment) these professionals have. Furthermore, diagnosing is outside your scope of practice, anyway.

I refer out every single week. It creates great opportunities for collaboration that will benefit our clients/athletes, and for our staff to learn from related professionals. If you see something on an assessment that raises a red flag, it's better to be safe than sorry.

4. Don't assess just for the sake of assessing; make it to the point.

My biggest assessment pet peeve is when the process takes too long. You can do an incredibly thorough evaluation in about 30 minutes, and most shouldn't even take that long. The only ones that would require more time would be those with extensive injury histories or other unique circumstances.

[bctt tweet="The sooner you're done assessing, the sooner you can get to training."]

5. Assess in the context of both injury history and functional demands.

As a follow-up to point #4, you never want to go into a movement assessment "blind" with respect to the person in front of you. Rather, it's best to first review a health history and have a discussion about training history, goals, athletic demands, and expectations. I find that it's best to perform an evaluation with a better knowledge of an individual's history than it is to look at movement and then work backward from it.

For example, if your pre-assessment discussion reveals that an individual was a baseball player growing up, you can expect to see more external rotation on his dominant shoulder. That might lead you to look more closely at whether he has adequate anterior shoulder stability, and whether his scapula upwardly rotates enough. It also might help to explain a low right shoulder.

RightER

Basically, you need to see the big picture; the "answers" are usually a combination of a bunch of tests, questions, and observations.

6. You have to emotionally separate yourself your personal biases when it comes to assessments.

Baseball players are the largest chunk of my clientele. As a result, I evaluate shoulders and elbows in a ton of detail.

Recently, we started training an NFL punter, though.

I did a thorough assessment with him, but let's just say that we didn't spend a ton of time worrying about verifying that he had perfect elbow ROM. Instead, we spent a lot more time looking at his core and lower extremity; otherwise, the assessment would have taken all day, and we'd acquire a lot of information that wouldn't have a significant impact on his programming.

7. Don't let hypermobile clients/athletes "cheat" assessments.

Just like you need to have both specific and general assessments, you also need to make sure to include both mobility and stability assessments. Hypermobile (loose-jointed) individuals are notorious for cheating assessments that are biased toward ROM. Comprehensive assessments need to also evaluate stability.

elbow10365821_744096285641478_6191697364410130329_n

In this vein, the Functional Movement Screen does a good job of looking at both sides of the equation. The shoulder mobility, overhead squat, and straight leg raise tests are general assessments largely biased toward mobility, but the trunk stability push-up, hurdle step, rotary stability, and in-line lunge screens are all predominately stability challenges.

To learn more about how hypermobile folks can "cheat" assessments, check out my article, 15 Static Stretching Mistakes.

8. Have some feel; don't make new clients (or any clients) uncomfortable.

If a man is overweight and uncomfortable with his body, it's probably not a great idea to have him take his shirt off for a scapular screen. If a woman is seriously deconditioned, it's probably not a good idea to put her through a lunge assessment that she'll fail miserably. And, it's an even worse idea to do these things in front of a crowded gym.

           Remember that the first day is as much about
           building rapport and starting a friendship as it
            is about evaluating how an individual moves.

As has been said in the past, "They have to know how much you care before they care how much you know."

9. Don't forget to highlight what individuals do well, too.

In How to Win Friends and Influence People, Dale Carnegie wrote, “It is always easier to listen to unpleasant things after we have heard some praise of our good points.” This point applies to fitness and movement assessments, too. Think about it: would you like to be criticized non-stop for 30 minutes? Probably not.

By contrast, if someone highlighted what you did well while also covering some important growth areas for you, wouldn't these suggestions be more well received? Absolutely.

Again, your goal is to establish a great relationship, not just analyze movement.

10. Remember that training is a never-ending assessment.

Every exercise is an assessment. Each time your clients and athletes move, they're providing you with information. The more you pay attention, the better you'll be able to individualize their programs and coaching cues moving forward.

If you're looking for more information on the assessment side of things, I'd encourage you to check out our Functional Stability Training series. These resources go into great detail on evaluating the lower body, upper body, and core.

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Name
Email
Read more

Avoid this Common Wall Slide Mistake

Those of you who have followed my work for any length of time surely know that I'm a big fan of including wall slide variations to improve scapular (shoulder blade) control. To get the benefits of these drills, though, it's important to use the right technique. Here's one mistake we commonly see, especially in really "tight" athletes who have a lot of stiffness in their lats to overcome:

Apologies for the contribution from Cressey Sports Performance mascot Tank Cressey at the 1:05 mark! This guy thought it'd be a good idea to bark hello to the UPS guy in the middle of my video.

TankTrapBar

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Name
Email
Read more

The Best of 2014: Strength and Conditioning Videos

With my last post, I kicked off the "Best of 2014" series with my top articles of the year. Today, we'll highlight the top five videos of the year. These videos only include instructional videos, not quick exercise demonstrations.

1. Thoracic Mobility and Back Squatting - Upper back positioning is a key factor in squat technique, but not everyone starts in the same position. Check out the video to learn more:

2. Serratus Wall Slide Variations - Serratus anterior is an incredibly important muscle for shoulder health and function. Here are two exercises we use in our serratus anterior activation progression.

3. Do You Really Have Poor Ankle Mobility? - It's been my experience that ankle flexibility restrictions are really "overdiagnosed," and in reality, people just don't know how to shut off their plantarflexors (calves) as part of a heavily extended posture. I elaborate in this video:

4. Are You Packing the Shoulder Correctly? - It's important to be able to pack the shoulder, but in many cases, folks don't know exactly what is or should be going on functionally. This webinar should clarify.

5. Limited Shoulder Flexion in Pitchers - We often hear that shoulder dysfunction relates to elbow pain in throwers, but very rarely do we hear the "why" behind this link. In this video, I elaborate:

I'll be back soon with the top guest posts of 2014!

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Name
Email
Read more

Bear Crawls vs. Crab Walks

Yesterday, I posted on Twitter that I was a big fan of bear crawls because they get you great serratus anterior recruitment, more scapular upward rotation, improved anterior core function, tri-planar stability, and some awesome reciprocal arm/leg activity. They're one of my favorite warm-up and end-of-workout low-level core activation drills.

For some reason, though, every time you mention bear crawls, someone asks about crab walks. Candidly, I don't think so highly of crab walks. In fact, I have never used them - and that's why I didn't have a video on hand of them. As such, this demonstration took place on my kitchen floor at 11:15PM:

photo-82

Keeping this position in mind, here are a few reasons that I don't like crab walks:

1. Bear crawls drive more scapular upward rotation by putting the lats and scapular downward rotators on slack as the athlete reaches overhead. With a crab walk, the arms aren't just at the sides; they are actually behind the sides. The lats are as short as they can possibly be - especially if the athlete is allowed to slip into lumbar extension (an arched lower back posture). Most folks lack scapular upward rotation regardless of whether they sit at a computer all day or throw a baseball for a living; we don't need exercises that feed into that problem even more. Additionally, the scapula is generally anteriorly tilted unless it's an experienced athlete with great body awareness. Anterior tilt is an issue we work to combat in just about every population - athlete and non-athlete alike.

2. Crab walks are brutal on the anterior shoulder. For the same reasons I outlined in my article, Are Dips Safe and Effective?, I dislike crab walks. As the humerus (upper arm) is "hyperextended" behind the body, the head of the humerus (ball) glides forward relative to the glenoid fossa (shoulder socket). This puts a lot of stress on the anterior capsule, biceps tendon, and nerve structures that pass along the front of the shoulder. And, it makes the rotator cuff work overtime from a mechanically disadvantageous position.

IMG_8597

3. You don't walk around like a crab in any sport that comes to mind! Seriously, this is the position you're in when you got steamrolled by a running back, or you tripped over yourself! While I get the school of thought that says it's good to be somewhat prepared for just about every potentially injurious situation you'll encounter, we've got a limited amount of training time to deliver exercises that give athletes the most bang for their buck. And, even in young athlete populations, there are literally thousands of other movements we can use with kids to create a rich proprioceptive environment with safe movements they'll actually be able to utilize on a regular basis in life. And, the bear crawl is one of these movements.

Can a lot of athletes "get away" with doing crab walks? Absolutely! However, we never know what kind of long-term structural changes are going to be in place - and we can certainly never truly appreciate what kind of missed development is in play from not including more effective exercises.

To learn more about some of our approaches to assessing and improving upper body function, be sure to check out Functional Stability Training of the Upper Body.

fstupper

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Name
Email
Read more

Exercise(s) of the Week: Serratus Wall Slides

Serratus anterior is a really important muscle - and it works hand-in-hand with proper function of your thoracic spine (upper back). Check out these two drills we utilize to get it doing its job:

For more shoulder-friendly training drills like this, check out our new resource, Functional Stability Training of the Upper Body.

fstupper

Read more

5 Great Analogies for Training Baseball Players

In their outstanding book, Made to Stick, authors Chip and Dan Heath emphasize that a new idea will always be more readily accepted if it is incorporated into an individual’s existing schema. In an example I've used before here at EricCressey.com, if I give you the letters TICDGFASOH and then ask you to list all the letters I included to me 20 minutes later without writing them down, most of you won’t be able to accomplish the task correctly.

made_to_stick_heath1

However, if I reordered those letters as CATDOGFISH, you’d accomplish the task easily. You know the words DOG, CAT, and FISH – so it would fit into your existing schema. I work to apply this same logic to how I educate my baseball players. With that in mind, here are five analogies I like to use as part of the long-term baseball development process.

1. Arm care is just like making bank deposits and withdrawals.

To me, every action you make with your arm either takes you closer to or further away from arm health.  Every time you do your arm care drills, get in a strength training session, do some soft tissue work, or get your arm stretched out (when appropriate), you're making a deposit in your bank account. Each time you make a throw - especially off a mound - you're making a withdrawal. If withdrawals exceed deposits over the course of a year, you're likely going to go bankrupt (get injured).

2. Bad scapular positioning or scapulohumeral rhythm is like starting behind the starting line - or you're backpedaling when the starting gun fires.

I've discussed the importance of scapular positioning and scapulohumeral rhythmic for throwers in the past - especially in our new resource, Functional Stability Training of the Upper Body. Here's a video to bring you up to speed:

In this video, I talk about "ball and socket congruency." In other words, the ball can't ride up, and the socket can't stay too low. I like to refer to neutral scapular resting position as the starting line. If you sit in too much downward rotation, you're effectively setting up behind the starting line. In the photo below, the black line is where the medial border of his scapula should be at rest, and the red line is where it actually is.

ScapularDownwardRotation

Other folks may actually start in the correct position, but begin what should be upward rotation with an aberrant movement - such as a "yank" toward the midline (rhomboid dominance) or into scapular depression (lat dominance). These are the exact opposites of what you want to occur - which is upward rotation, or running toward the finish line.

3. Doing arm care drills with a faulty core recruitment pattern is like shooting a cannon from a canoe.

I always talk about how the spine and rib cage "deliver" the shoulder blade. You can do all the arm care drills in the world, but if you don't know how to keep a stable core in place, you'll never really put your shoulder girdle (or elbow, for that matter) in an ideal position to throw - and you certainly won't effectively transfer force from your lower body. Here's what a lot of athletes look like with their overhead reaching pattern:

Instead of getting good shoulder flexion and scapular upward rotation, they just go into lumbar (lower back) extension. When you see an aberrant movement pattern like this, you realize that it's no surprise that some of the same underlying movement inefficiencies can contribute to upper extremity, core, and lower extremity injuries alike. It's really just a matter of where an athlete breaks down first.

4. Committing to a college really early is like proposing to the first girl you ever date - and then letting her "shop around" for other dudes while you stay faithful.

This observation has less to do with the actual training process, but more to do with long-term management of an athlete. Why in the world does a freshman in high school need to be verbally committing to a college - especially when he can't sign on the dotted line to officially commit until his senior year? If there's one thing I've learned in life, it's that we always look back on what we did 2-3 years earlier and laugh, as we realize how misdirected we were. I do it at age 33, and you can just imagine how much faster an impressionable teenage athlete can acquire new views on the world.

It's fine to take your time and see what's out there - and any coach that pressures a freshman or sophomore to commit so young is probably not a person for whom you'd like to play. And, 99% of the time, that offer is still going to be on the table 6-18 months down the road in spite of the false deadlines they throw on you.

Finally, as an "in the know" friend reminded me the other day, don't forget that even if you verbally commit to a school, they're still out there trying to "date" other athletes. If they can find someone who they think is a better prospect than you are, they'll drop you like yesterday's newspaper. The ethical coaches don't do this, but it is nonetheless still a sad part of college sports. With that in mind, it's okay to go on "dates" with different schools and take your time in finding the one that's right for you.

Side note: if you're looking to be a more informed consumer with respect to the college recruiting process, give this a read: 25 Questions to Ask During the College Recruiting Process.

5. Stretching a loose shoulder is like picking a scab; it feels good for a bit, but only makes things uglier over the long haul.

There are a lot of hypermobile (lose-jointed) pitchers out there. It's often a big part of what makes them successful, but it comes at a cost: increased injury risk, if they don't stay on top of their stability training.

 elbow10365821_744096285641478_6191697364410130329_n

What they often lose sight of, though, is the fact that it's just as important to avoid creating instability as it is to train for stability. In other words, continually stretching a hypermobile joint is likely even worse than just leaving out your strength work. The former reduces passive stability, whereas the latter just doesn't improve active stability.

The problem is that a lot of loose-jointed players feel "tight" - and it's usually because they lay down trigger points to make up for their lack of stability. The stretching feels good in the short term, but the trigger point comes back stronger and stronger each time - until you're eventually dealing with a torn anterior (shoulder) capsule or ulnar collateral ligament. Eventually, reducing the passive stability leads to a pathology - just like picking that scab eventually leads to an infection or scar.

Want to learn more about whether or not you're hypermobile? Check out my article, Assessments You Might Be Overlooking: Installment 1.

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

Name
Email
Read more

Common Arm Care Mistakes: Installment 3

In continuing with our series on common errors I see throwers make in their arm care programs, today, I want to focus on how we coach pulling motions in these populations.  Check out this video to learn more:

Throwers need to learn how to move the scapula on the rib cage in order to get to a good position of upward rotation to throw.  If you just pin everything down with the lats, you interfere with that upward rotation potential.  The scapula needs to be stable, but it also needs to be mobile enough to move freely on the rib cage.

Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!

Name
Email
Read more

Assessments You Might Be Overlooking: Installment 3

It's time for another installment of my series on things you might overlook when assessing a new client or athlete.  Here are three more things to which you should pay attention:
 
1. Shoulder Flexion Range of Motion - This is a valuable test to use in conjunction with a back-to-wall shoulder flexion test. If you can't effectively perform a back to wall shoulder flexion as in the video featured here, then we need to ask "why not?"

 
It might happen because you lack good stiffness in various places - anterior core, lower trapezius, upper trapezius, and serratus anterior, to name a few.  Or, it might be because you're unable to overpower bad stiffness or shortness. Maybe you lack thoracic extension, are too rhomboid dominant, or simply can't get full shoulder flexion range of motion.  To check for this last one, you'll want to put the individual in supine with the back flat and knees and hips flexed.  They should be able to get the arms all the way down to the table - so this would be no good.
 
shouderflexion
 
Shoulder flexion can be limited by a lot of things: short/stiff lats, teres major, long head of the triceps, and inferior capsule.  Regardless of what limits it, though, you can't just take someone with this limited a ROM and plug them into overhead pressing. You're just waiting to chew up a rotator cuff, biceps tendon, labrum, or all of the above.
 
As a little bonus, this is my favorite drill for improving shoulder flexion ROM:
 

 
2. Scapular Upward (or Downward) Rotation - It goes without saying that scapular control - or the ability to position the shoulder blades appropriately - is absolutely essential to safe and effective upper extremity movement.  In order for that to occur, though, the shoulder blades have to start in the right position.  With respect to scapular rotation, "neutral" posture has the shoulder blades sitting at 5 degrees of upward rotation at rest. In the picture below, the black line represents where he should be in terms of upward rotation, but instead, you'll see that he sits in about 20-25 degrees of downward rotation (for the record, there are a number of other things wrong with this posture, so this is only a start!).
 
ScapularDownwardRotation
 
The problem with starting in this much downward rotation (or any downward rotation, at all) is that it's like beginning a race from 20 yards behind the starting line.  When the arm starts to move up, the shoulder blade needs to rotate up to maintain the ball and socket congruency.  If it starts too low, it can't possibly be expected to catch up - so the ball will ride up relative to the socket, regardless of how strong the rotator cuff is to try to prevent that superior migration.  You'll wind up seeing irritation of the rotator cuff, biceps tendon, labrum, or bursa if it's left unchecked.
 
Step 1 is to simply educate people on where the scapula actually should sit, and step 2 is to work on training from that correct new starting position.

3. Constant stretching - I always take note of when I see a client who seems to be stretching "nervously" when they're just standing or sitting around.  You'll often see people cranking on their shoulders, cracking their necks, touching their toes, or any of a number of things that make them "feel better.
 
The problem is that these people are often stretching out protective tension - or stiffness that's there because they lack stability elsewhere.  This is often the case with those with significant joint hypermobility.  They're already unstable, but the stretching is like picking a scab; it gives them temporary relief from the tightness, but only makes things worse in the long run.  It might be hamstrings tightness in someone with crazy anterior pelvic tilt, biceps tightness in those with anterior shoulder instability, or any of a number of other presentations throughout the body.  Unquestionably, though, the most common one is neck stretching in those with poor scapular control.
 
There is no one solution for everyone's problem, but I would encourage you to always ask, "Why is this tight?"  And, don't even think about stretching until you know the answer.
 
I'll be back soon with more commonly overlooked assessments.  In the meantime, if you're looking for an additional resource on this front, I'd encourage you to check out Assess and Correct: Breaking Barriers to Unlock Performance and Functional Stability Training of the Upper Body
 
 fstupper

Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!

Name
Email
Read more
Page 1 2 3
LEARN HOW TO DEADLIFT
  • Avoid the most common deadlifting mistakes
  • 9 - minute instructional video
  • 3 part follow up series