Home Posts tagged "Shoulder Health"

What Do You Think of XYZ Method?

Often, I'll get inquiries that go something like this:

What do you think of yoga?

How do you feel about Pilates?

I have a friend who liked MAT. Do you think it's legit?

These are always challenging questions to answer because there are actually a number of variables you have to consider. To illustrate my point, let's try for some parallels in different industries. What do you think of real estate attorneys? Accountants? Veterinarians? Plumbers? General contractors?

As you can probably infer, there's going to be a high amount of variability in the delivery of each method, so you have to ask the following questions:

1. Is the method actually legit?

Sometimes, entire methodologies are based on bad science or bad people manipulating science for their own financial gain. A good example of this would be the thousands of different kinds of "cleanses" marketed in the nutrition/supplement industry.

2. Is the practitioner actually educated (and, where appropriate, licensed) in the method?

This is something that is near and dear to me. Each week, we get emails from young baseball players and their parents who say they train with a "Cressey guy" or someone "Eric has mentored." Then, they tell me that coach's name and I've never heard of him, and he's never even purchased one of my products or attended our actual baseball mentorship. Instead, he saw me give a one-hour talk in 2009. In describing himself, however, he positions himself on par with one of our interns who spent 3-5 months side-by-side with me six days per week. That's a markedly different level of education in our method.

As a good rule of thumb, think of the telephone game. The further away from the founder of a method, the more watered down the product becomes. As an example, Ron Hruska created the Postural Restoration Institute, and it's mostly disseminated through courses he's designed and by instructors he's trained himself. If an attendee then returns and teaches his/her staff the principles, then they teach their clients, and then the clients share their favorite positional breathing drill with a friend after a few adult beverages at a cocktail party, is it really representative of how impactful PRI can really be?

3. Does the practitioner actually have attention to detail?

Having just built a brand new Cressey Sports Performance facility, this is fresh on my mind. Not all contractors are created equal. Two can look at the exact same finished product and one person says it's beautiful, and the other says it's terrible work. No matter how great the method might be, if someone is lazy, it won't be positioned in a great light.

4. Does the practitioner understand how to "pivot" within a philosophy?

The back-to-wall shoulder flexion exercise is a central piece of our philosophy at Cressey Sports Performance. We think it's imperative to get the arms overhead without compensation at adjacent joints. Give this a video a watch to learn how we'd coach it under the three most common challenges one will typically encounter:

As you can see, these modifications rely on being able to do some basic, quick evaluations on the fly. If you don't have the ability to perform them, the client will likely just wind up banging on the front of the shoulder.

This is where a lot of group exercise methodologies can fall short. They don't understand how to pivot when someone can't perform a drill, so they wind up plowing through a bony block or exacerbating an existing movement fault.

5. Has the practitioner evolved with the methodology?

I tweeted this several years ago, but it still holds true:

 

If you look at CSP years ago versus now, it's easy to see how much we've evolved. What you would have learned in a single day of observation at the facility in 2010 is a lot different than what you'd learn on a 2020 visit. This might refer to the methodologies represented, coaching approaches, or equipment utilized.

6. Does the practitioner utilize one methodology exclusively?

As the hackneyed expression goes, "If you're a carpenter who only has a hammer, everything looks like a nail." For example, I'm very leery of chiropractors who only do adjustments when there are undoubtedly many other associated therapeutic interventions that could further help their patients. I'll always refer to multi-dimensional providers over one-trick ponies.

Pulling It All Together

As you can see, five of my six qualifications had nothing to do with the method, but rather the practitioner carrying out that method. That, my friends, is why I always refer to PEOPLE and not just methods. And, it's why you should always try to find good people - regardless of the methodologies they utilize - to help you get to your goals.

It's also why continuing education is so important: we need to understand the principles that govern how successful people can be within various methodologies. If you're looking to learn more about some of those principles and how I apply them to evaluation, programming, and coaching at the shoulder, be sure to check out my popular resource, Sturdy Shoulder Solutions. You can get $50 off through tonight at midnight at www.SturdyShoulders.com by entering coupon code podcast50.

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

Name
Email
Read more

Kansas City Seminar Announcement: August 22, 2020

I just wanted to give you a heads-up on one-day seminar with me in Kansas City Saturday, August 22, 2020. Important note: this is a reschedule of the event that was originally planned for April 18.

Cressey scapula

We’ll be spending the day geeking out on shoulders, as the event will cover Shoulder Assessment, Corrective Exercise, and Programming.  The event will be geared toward personal trainers, strength and conditioning professionals, rehabilitation specialists, and fitness enthusiasts alike.

Agenda

9:00AM-9:30AM – Inefficiency vs. Pathology (Lecture)
9:30AM-10:15AM – Understanding Common Shoulder Injuries and Conditions (Lecture)
10:15AM-10:30AM – Break
10:30AM-12:30PM – Upper Extremity Assessment (Lab)
12:30PM-1:30PM – Lunch
1:30PM-3:30PM – Upper Extremity Mobility/Activation/Strength Drills (Lab)
3:30PM-3:45PM – Break
3:45PM-4:45PM – Upper Extremity Strength and Conditioning Programming: What Really Is Appropriate? (Lecture)
4:45PM-5:00PM – Q&A to Wrap Up

Location

Elite Sports Mall
2115 East Kansas City Road
Olathe, KS

Continuing Education Credits

This event has  been approved for 0.7 CEUs (7 contact hours) through the National Strength and Conditioning Association.

Cost: $149.99 Early Bird (through July 22), $199 Regular (after July 22)

Click here to register using our 100% secure server!

Note: we'll be capping the number of participants to ensure that there is a lot of presenter/attendee interaction - particularly during the hands-on workshop portion - so be sure to register early, as previous offerings of this evan have sold out well in advance of the early-bird registration deadline.

Looking forward to seeing you there!

Questions? Please email ec@ericcressey.com.

Read more

Subscapularis 101

The subscapularis is the largest of the four rotator cuff muscles, but it might also be the most misunderstood. With that in mind, I thought I'd use today's video as a chance to bring you up to speed on it:

This video is an excerpt from my popular Sturdy Shoulder Solutions resource. For more information, head to www.SturdyShoulders.com.

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

Name
Email
Read more

St. Louis Seminar Announcement: June 2, 2019

I just wanted to give you a heads-up on one-day seminar with me in St. Louis on Sunday, June 2, 2019.

Cressey scapula

We’ll be spending the day geeking out on shoulders, as the event will cover Shoulder Assessment, Corrective Exercise, and Programming.  The event will be geared toward personal trainers, strength and conditioning professionals, rehabilitation specialists, and fitness enthusiasts alike.

Agenda

9:00AM-9:30AM – Inefficiency vs. Pathology (Lecture)
9:30AM-10:15AM – Understanding Common Shoulder Injuries and Conditions (Lecture)
10:15AM-10:30AM – Break
10:30AM-12:30PM – Upper Extremity Assessment (Lab)
12:30PM-1:30PM – Lunch
1:30PM-3:30PM – Upper Extremity Mobility/Activation/Strength Drills (Lab)
3:30PM-3:45PM – Break
3:45PM-4:45PM – Upper Extremity Strength and Conditioning Programming: What Really Is Appropriate? (Lecture)
4:45PM-5:00PM – Q&A to Wrap Up

Location

Output Performance
1429 Strassner Dr.
St Louis, MO 63144

Continuing Education Credits

This event is approved for 0.7 CEUs through the National Strength and Conditioning Association (NSCA).

Cost: $199.99

Click here to register using our 100% secure server!

Note: we'll be capping the number of participants to ensure that there is a lot of presenter/attendee interaction - particularly during the hands-on workshop portion - so be sure to register early, as previous offerings of this evan have sold out well in advance of the early-bird registration deadline.

Looking forward to seeing you there!

Questions? Please email ec@ericcressey.com.

Read more

3 Random Thoughts on Rotator Cuff Readiness

Both Cressey Sports Performance facilities are booming with baseball players coming back to start their offseason training, so it's the time of year when athletes are working hard to get their rotator cuff control back before they start up their offseason throwing programs. With that said, I've been thinking about some big principles on the rotator cuff readiness front.

1. In a broad sense, just about every rotator cuff exercise can be categorized in one of five ways:

a. Strength - this consists of manual resistance work and anything with cables at dumbbells; it needs to be loaded up and challenging.

b. Timing - this consists of drills like 90/90 holds and rhythmic stabilizations.

c. Endurance - this builds on what we see in Option A (some of the same exercises), but the resistance is a bit lower and it's done for higher reps or a longer time. The goal is less about strength and more about training the ability to hold the humeral head on the glenoid fossa for a lengthier period of time. I'd call it more important for a sport like swimming than for baseball or tennis athletes.

d. Irradiation - this can refer to just about any exercise, as your rotator cuff fires reflexively any time your arm moves. That said, certain exercises - bottoms-up kettlebell variations, for instance - are particularly useful for challenging this category of drills.

e. Patterning - these are just drills that take the humerus through its full range-of-motion. Of particular importance is end-range external rotation, which we train with drills like this:

2. I prefer near-daily exposures rather than exhaustive, less frequent programs.

If you look at our training programs, most of our pro guys are doing some kind of targeted training for the rotator cuff 5-6 days per week. Twice per week, we'll push more strength and irradiation work, and twice per week, we'll cover more timing drills. Just about every day, though, there will be some kind of patterning exercise so that we're reminding the cuff of what it's supposed to do.

This approach is a stark contrast to what you usually see in the baseball world, which is notorious for handing out the 2x/week arm care routines that take 45-60 minutes each. They're usually about 15 exercises for multiple sets, and leave an athlete hanging by the end of the session. I think this approach has more to do with the fact that it lines up with what's convenient for 2-3x/week physical therapy sessions than because it's truly optimal. I'm of the belief that you don't need (or want) to exhaust the cuff to get it to where it needs to be.

And, while we're at it, if the cuff is going to get abused on a daily basis with throwing, lifting, and activities of daily living, why not give it some more frequent exposure to build a little tissue resiliency?

3. Posterior deltoid shouldn't be lumped in with infraspinatus and teres minor.

Many times, the reason we have discomfort or the "wrong" feeling with drills is that athletes are paying close attention to the osteokinematics - gross movements of internal/external rotation, flexion/extension, adduction/abduction - of the joint in question, but not paying attention to the arthrokinematics of that same joint. In other words, the rolling, rocking, and gliding taking place needs to be controlled within a tight window to ensure ideal movement.

In shoulder external rotation variations, as we externally rotate the arm, the humeral head (ball) likes to glide forward on the glenoid fossa (socket). The glenohumeral ligaments (anterior shoulder capsule), rotator cuff, and biceps tendon are the only things that can hold it in the socket. In a throwing population, the capsule is usually a bit loose and the cuff is a bit weak, so the biceps tendon often has to pick up the slack - which is why some folks wind up feeling these in the front, thereby strengthening a bad pattern. There are also a bunch of nerves at the front of the shoulder that can get irritated.

Now, here's where things get a bit more complex. The infraspinatus and teres minor are both rotator cuff muscles that have attachments right on the humeral head, so they can control the arthrokinematics (posterior glide) during external rotation work. Conversely, the posterior deltoid (blue, in the image below) runs from the posterior aspect of the spine of the scapula to further down the arm on the deltoid tubercle. In other words, it completely bypasses control of the humeral head.


By Anatomography - en:Anatomography (setting page of this image), CC BY-SA 2.1 jp, https://commons.wikimedia.org/w/index.php?curid=22835985

With this in mind, the posterior deltoid actually creates a gliding forward of the humeral head as it externally rotates and horizontally abducts the arm. For this reason, you need to make sure the arm doesn't come back (horizontal abduction) as it externally rotates during your arm care drills. This video should clarify things, if you're a visual learner:

Looking for more insights like these? Be sure to check out my new resource, Sturdy Shoulder Solutions.

 

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

Case Study: Shutting Down Scapular Depression

I just posted this little "challenge" on Instagram. What do you see? 

I see some of the lowest shoulders in history. This is a well-muscled guy who looks like his upper traps are non-existent because he sits in such significant scapular depression. Take note of the angle of his clavicles; normally, they should have an upslode from the sternoclavicular joint to the acromioclavicular joint, but in this case, they're actually downsloped. Wherever the scapula goes, the collarbone follows. In this presentation, expect to see tissue density in lats, subclavius, and scalenes (among other areas).

The most interesting discussion point, though, is what to do about that upper trap tightness. That tightness is protective tension: his body doing anything it possibly can to avoid dropping any lower into scapular depression. The upper traps are working to elevate the scapula against gravity all the time. If you give him a bunch of massage and stretching, it's like picking a scab; he'll feel better for 15 minutes, and then in rougher shape over the long haul. You never want to stretch out protective tension.

He'd had previous bouts of unsuccessful physical therapy, and while I had the benefit of hindsight here, it was clear that the unifying theme of these approaches was an emphasis on the one-size-fits-all "pull the shoulder blades down" cue that gets thrown around all too much and usually leaves this presentation in a tough spot while helping a lot of senior citizen rotator cuff pain cases. You can't one-size-fits-all cues because everyone moves differently.

We modified his training to avoid anything with heavy weights tugging the shoulders down (no deadlifts, walking lunges, farmer's walks, etc.) and instead trained the lower body with lots of front squat and goblet set-ups, plus sled work, glute-ham raises, and barbell supine bridges/hip thrusts. We cut back on lat dominant upper body work and instead chose drills like push-up variations and landmine presses that drove scapular upward rotation (and even prioritized elevation, which is borderline heresy in some rehab circles). We got his arms overhead more often during the warm-ups and integrated some manual therapy in the areas I noted earlier. I even encouraged him to do less unsupported sitting at work, too, because his upper traps were competing against gravity all the time (yes, there are actually times that standing desks make things worse).

Today, two weeks to the day after the evaluation, he's feeling significantly better - and training hard. Posture is the interaction of structure and function, and if you can't identify aberrant postures, you're simply guessing with how someone is going to respond to a given exercise.

Interested in learning more about what I look for when evaluating the upper extremity - and how my findings drive our programming and coaching cues? Check out Sturdy Shoulder Solutions (which is on sale for $50 off through Sunday at midnight) at www.SturdyShoulders.com.

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

Name
Email
Read more

Building Mobility Efficiently: Modified Pigeon with 1-arm Child’s Pose

Here's another Sturdy Shoulder Solutions sale inspired post. The Modified Pigeon with 1-arm Child's Pose is another new drill we've busted out in our warm-ups to get a little more bang for our buck. It's particularly useful for pitchers, who need to get into their lead hip (adduction) while getting lat length, scapular upward rotation, and apical expansion on the throwing shoulder.

A few big coaching points:

1. You should feel a stretch in the outside of the front hip, but nothing in the knee (particularly the inner part). If you're feeling it in your knee, you've probably set up incorrectly.

2. Think of a stretch along the entire outside of the torso and arm: quadratus lumborum, lats, and long head of triceps, especially. If you pinch at the front/top of the shoulder, ease off it a bit.

3. Breath in through the nose and exhale fully through the mouth as if you're blowing out birthday candles (and hold for a count of three before inhaling again). You should feel your abs turn on as the shoulder stretch increases. Do five breaths.

You can learn more about how I assess, program, and coach at the shoulder girdle - and save $50 through Sunday at midnight - at www.SturdyShoulders.com.

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

Name
Email
Read more

Video: When Should You Train Shoulder Internal Rotation?

With this week's $50 off sale on Sturdy Shoulder Solutions, (using coupon code podcast5), let's cover a question I got a while back. A reader asked whether it was ever useful to train shoulder internal rotation. With the lats and pecs (both internal rotators) always getting blasted in a typical strength training program, is any specific work for internal rotation ever recommended? My response warranted a three-part video, which I've compiled into one here:

To learn more about how I assess, program, and coach at the shoulder girdle, check out Sturdy Shoulder Solutions. It's on sale for $50 off through Sunday at midnight. Just use coupon code podcast50 at checkout.

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

Name
Email
Read more

Exercise of the Week: Wall Slides with Upward Rotation and Lift-off to Swimmer Hover

With this week’s $50 off sale on Sturdy Shoulder Solutions, I wanted to introduce a new drill I’ve started using. The wall slide with upward rotation and lift-off to swimmers hover effectively blends two schools of thought: Shirley Sahrmann’s work and that of Functional Range Conditioning.

1. With the wall slide portion, we drive scapular upward rotation.

2. With the lift off portion, we get scapular posterior tilt and thoracic extension (as opposed to excessive arm-only motion).

3. With the swimmer hover, we lengthen the long head of the triceps and even drive a little bit more serratus anterior recruitment as the scapula rotated around the rib cage.

Get exposure to multiple philosophies and have an appreciation for functional anatomy, and the exercise selection possibilities are endless. Learn more at www.SturdyShoulders.com.

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

Name
Email
Read more

Why Rhomboids Probably Aren’t Your Best Friend

Today, I've got an excerpt from my new course, Sturdy Shoulder Solutions. I discuss the functional anatomy of the rhomboids, a commonly misunderstood muscle group with big implications.

For a lot more functional anatomy insights like these - as well as a comprehensive look at shoulder assessment, programming, and coaching - be sure to check out Sturdy Shoulder Solutions.

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
Page 1 2 3 104
LEARN HOW TO DEADLIFT
  • Avoid the most common deadlifting mistakes
  • 9 - minute instructional video
  • 3 part follow up series