Call me a traditionalist, but I still love using prone (on the stomach) drills to teach good scapular (shoulder blade) control. However, we never teach these drills face-down on the floor. Check out today's video to learn why:
If you're looking for a detailed tutorial on how to perform this exercise off a table, give this a watch:
If you're looking to learn about how I assess, program, and coach at the shoulder, be sure to check out my resource, Sturdy Shoulder Solutions.
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It's time to bring back this coaching cues series to the forefront, as it's always been a popular one here at EricCressey.com. Here are three more cues I find myself using on a daily basis at Cressey Sports Performance:
1. "Chest before chin."
One of the biggest issues we see in folks with a lack of anterior core control and/or upper body strength is that they'll shoot into forward head posture as they descend to the bottom position of a push-up. Effectively, they're substituting head/neck movement for true scapular protraction and retraction. One cue that seems to clean the issue up quite well is the "chest before chin" recommendation - which means that the chest should arrive at the floor before the chin does.
You do, however, need to make sure that the individual doesn't confuse this with simply puffing the chest out, which would put them in more extended (arched back) posture at the lumbar spine.
2. "Get your scaps to your armpits."
A huge goal of upper body corrective exercise program is to teach individuals how to differentiate between scapulothoracic movement and glenohumeral movement. In layman's terms, this means understanding that it's important to know when the shoulder blade is moving on the rib cage, as opposed to the upper arm (ball) moving on the shoulder blade (socket). Especially during overhead reaching, what we typically see in athletes is insufficient scapulothoracic movement and excessive glenohumeral movement - particularly in those athletes with noteworthy joint hyper mobility. This is one reason why we incorporate a lot of wall slide variations in our warm-ups.
Since we are really looking to teach good upward rotation (as opposed to just elevation), I always try to cue a rotational component to the scapular movement as the arms go overhead. I've found that "get your scaps to your armpits" can really get the message across, especially when this verbal cue is combined with the kinesthetic cue of me guiding the shoulder blades around the rib cage. These modifications can really help to kick up serratus anterior recruitment, as this video shows:
3. "Start in your jump rope position."
When you're working with young athletes on jumping variations - whether they're broad jumps, box jumps, or some other variations - many of them will start with an excessively wide stance. Then, they'll "dip" to create eccentric preloading (stretch) and the knees almost always cave in. As I've said before, if the feet are too wide, the knees have no place to go but in. My feeling is that many young athletes "default" to this pattern because a wider base of support generally supports a more stable position for a weaker athlete. Unfortunately, this position doesn't put them in a great posture for producing force.
The best coaching cues are the ones that build upon those movements an individual already knows, and most kids have jumped rope in the past. If you use a wide stance when you jump rope, you trip over the rope. Instead, you have to stay with the feet in around hip-width, which is right where we want our jump variations to occur.
If you're looking for more coaching tutorials and exercise demonstrations, be sure to check out Elite Training Mentorship, which is updated each month with new content from Cressey Sports Performance staff members.
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It's been a while since I posted a new "Exercise of the Week" feature, but to atone for the wait, I've got a great one for you. I actually came up with this one myself while brainstorming a bit during my own warm-up a few weeks ago.
Serratus anterior is an incredibly important muscle for shoulder health, as it is really the big player in making sure there is a "rotation" component to scapular upward rotation (watch this video first if you need more information on that). Long story short, as you can tell from the picture below that depicts its positioning and line of pull, serratus anterior is hugely important for healthy shoulder function. This is particularly true in movement patterns involving reaching, whether it's out in front or overhead.
Loss of serratus anterior function is incredibly common in those with shoulder pathology, but we also see it really commonly in those who are pain-free but don't move well. To that end, we like to include specific serratus anterior targeted drills in our warm-ups and as low-key "fillers" between heavier compound lifts during our training sessions.
The research has demonstrated that serratus anterior recruitment is highest when you have more than 90 degrees of shoulder flexion, and this assertion really recognizes that this muscle does far more than just protract the shoulder blade; it is a key upward rotator. As such, we train it to assist that function:
Coaching Cues
1. Make sure the athlete is not in a heavily extended (arched lower back) posture, and don't allow forward head posture.
2. If range of motion allows, reach behind the back with the opposite hand to monitor the position of the inferomedial (inside/bottom) border of the scapula. It should stay "snug" to the rib cage, not wing off.
3. Think of "wrapping" the scapula to the armpit as the arm goes up. I'll usually manually guide the shoulder blade with my hands as I'm first instructing this. You can usually see if the movement is sufficient through an athlete's shirt.
4. Actively push the medicine ball into the wall the entire time. In addition to training the protraction function of serratus anterior, you'll also likely get some reflexive rotator cuff recruitment. This is a 4-pound med ball, but you can really work anywhere from one pound to six pounds.
5. The athlete should only feel this along the scapula near arm pit (reference the anatomy picture above for a frame of reference). There should be no anterior shoulder discomfort. If there is, it's a sign of one of two things:
a. Pectoralis minor taking over to protract with anterior scapular tilt
b. Excessive movement of the humerus (upper arm) without sufficient scapular movement
5. Don't force upward range of motion. The arm really shouldn't get above 140-150 degrees, and most people don't even need to go this far. Note that the medicine ball doesn't say in the hand the entire time; it rolls to the elbow. This is a great ROM "check" that tells you how far up you should go.
6. Control things down slowly; don't yank to the bottom.
7. For added benefit, you can add a full exhale at the top of each rep to help solidify the pattern.
I'll generally program this for sets of 6-8 reps on each side.
If you're looking for some more serratus anterior programming options and detailed coaching cues, check out this video:
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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.
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.
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.
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I just wanted to give you a heads-up on one-day seminar with me at Cressey Sports Performance in Jupiter, FL on Sunday, March 29, 2015.
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, 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 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
Cressey Sports Performance
880 Jupiter Park Drive
Suite 7
Jupiter, FL 33458
Continuing Education Credits
The event has previously been approved for 0.7 NSCA CEUs when I've presented it elsewhere, and we expect the same to be the case here in FL as soon as the paperwork goes through.
Cost:
Early Bird (before March 2) – $149.99
Regular (after March 2) - $199.99
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 the previous offering sold out well in advance of the early-bird registration deadline.
In this installment of "Exercise of the Week," I have a drill that combines a few of my all-time favorite shoulder health exercises into one comprehensive approach that gives you a lot of bang for your buck. Check it out:
Also, for more exercises and coaching cues like this, don't forget to check out our Mike Reinold and my new resource, Functional Stability Training of the Upper Body. It's on sale at a big introductory discount through the end of the week.
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I'm psyched to announce that Functional Stability Training of the Upper Body - the new product from Mike Reinold and me - is now available. This week only, you can get it at a great introductory discount HERE.
This product reflects our up-to-date approaches with respect to optimizing upper extremity function and preventing and rehabilitation injuries, and is available in both DVD and online-only formats. We're sure you'll enjoy it!
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In this installment of "Exercise of the Week," I want to introduce you to another great carrying variation you can use to accomplish a number of different objectives. The 1-arm Bottoms-up Kettlebell Waiter's Walk is one of my personal favorites, and we use it a lot with not only our baseball guys, but also many of our non-baseball clientele.
Those of you who have followed my "Exercise of the Week" series probably notice that this is a progression on a previous drill I introduced, the 1-arm Bottoms-up KB Carry. To bring you up to speed on the "why" behind this kettlebell exercise, here are a few reasons it's a great one:
1. It gets great reflexive rotator cuff activation in light of the bottoms-up position and the subtle perturbations to stability as the individual walks.
2. It teaches an athlete to fully upwardly rotate the scapula (shoulder blade) correctly, which helps us to build stability in an overhead position and solidify the mobility we have. This is wildly important for overhead throwing athletes, too, as they always lose upward rotation over the course of the competitive season.
3. It creates a challenge to both lateral/rotary and anterior core function. The individual has to work to prevent excessive lower back arching, as well as side bending. Being able to get these challenges while still working the shoulder girdle ensures that you get great functional carryover to the real world.
4. Without even knowing it, you're also getting a pretty good grip workout simply from holding the slightly thicker handle of the kettlebell.
In addition to the coaching cues I discuss in the video above, one "outcome" measure for which you'll want to look is the amount of scapular upward rotation present. You can do that by drawing a line along the medial (inside border) of the scapula, and then checking what angle it creates with a vertical line along the spine. Your goal is about 55-60 degrees of scapular upward rotation.
In a good overhead position, you shouldn't feel it at all in the top or front of your shoulder. If you do, though, it's a sign that you're probably either lacking scapular upward rotation or don't have sufficient cuff strength to do this correctly. I always tell athletes that they shouldn't "feel" this in one place; it should feel like the entire shoulder girdle is working synergistically to create good stabilization.
Also, a lot of people will ask if they need to "pack the shoulder down with the lat." Why you would want to turn your lat on to reach overhead is a puzzle to me, as it limits shoulder flexion and scapular upward rotation, draws the humerus into internal rotation (closes down the subacromial space), and pulls the spine into an extended position (excessive arching). What folks really should be doing is a subtly posterior tilting the scapula to free up space at the front of the shoulder, and facilitate upward rotation. It's a flawed movement if you're just cranking the entire shoulder girdle down. In short, we want lower traps, not lats.
If you're looking to learn more about how I incorporate many different carrying variations in my programming, I'd encourage you to check out my new resource, The High Performance Handbook.
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Dreaming of a Title - In light of the World Series run by the Red Sox, CP's Elite Baseball Development Program was featured, with interviews with several of our pro guys. Check out this video.
I just wanted to give you a heads-up on one-day seminar with me in Seattle on October 26, 2013. 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, rehabilitation specialists, and fitness enthusiasts alike.
