With my last post, I kicked off the "Best of 2015" 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. Avoid this Common Wall Slide Mistake - I'm a huge fan of wall slides for teaching good scapular upward rotation. Check out this video to see if you're making a common mistake on this front:
2. Steer Clear of this "Shoulder Health" Exercise - Continuing with the shoulder theme, here's a drill I don't particularly like. The good news is that I propose a suitable alternative.
3. Serratus Anterior Activation: Reach, Round, and Rotate - This video covers some of our common coaching cues for a different variation of wall slides than featured in video #1.
4. 3 Back to Wall Shoulder Flexion Cues - This drill is both a great training exercise and an assessment. With the right cueing, you can clean the pattern up pretty quickly, in most cases.
5. Exercise of the Week: Split-Stance Anti-Rotation Medicine Ball Scoop Toss - This is one of my favorite medicine ball exercises for early on in training progressions.
I'll be back soon with the top guest posts of 2015!
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I've spoken at length about how much I love the bench t-spine mobilization. Candidly, it's far more than an upper back mobility exercise - but you only can get the myriad of benefits it offers if you coach this drill correctly and prevent all the common compensations that can occur. Check out today's video for more details:
If you're looking for more information on these classic "extension posture" exercise technique compensations, I would encourage you to check out my presentation, Understanding and Coaching the Anterior Core.
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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:
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It's been 15 years since Mike Robertson and I introduced our Magnificent Mobility DVD set. This popular DVD set certainly helped a lot of people, but as with all aspects of the incredibly dynamic strength and conditioning and rehabilitation fields, we've learned a lot about mobility over the past decade. In other words, there are a lot of things I do differently with my training programs these days. I mean, seriously, I looked like I was 12 years old in this video.
Very simply, mobility is one's ability to reach a desired position or posture. Because many folks erroneously confused it with flexibility (range of motion at a specific joint), the industry as a whole trended toward labeling all mobility issues as true shortness of tissues that crossed the joint(s) in question. As the years have progressed, though, we've smartened up to realize that folks may struggle to get to specific positions because of joint structure (e.g., femoroacetabular impingement), insufficient stiffness at adjacent joints (e.g., poor core control "presenting" as bad hip mobility), density (rather than just length) of the aforementioned tissues that cross the joint, and a host of other factors. To be more succinct, mobility is dependent on much, much more than just tissue length!
1. Soft tissue work is important, even if we don’t know exactly why.
I'm honestly entertained when I hear someone insist that foam rolling is the devil, and we should never do it. People feel and move better after they do it, and it always seems to improve the quality of mobility initiatives that take place subsequently.
I certainly don't think it's truly mechanically breaking down scar tissue, but it's absolutely transiently reducing stiffness in the targeted tissues via one or more of a number of other mechanisms. Just because we can't explain them in complete certainty doesn't mean that "good" isn't being done.
2. Breathing can reduce bad stiffness and establish good stiffness.
This point could also be called, "The yoga folks have been right about breathing for a long time."
It's not uncommon to incorporate positional breathing drills that will transiently improve both flexibility and mobility. To me, that's an indicator that we're both reducing bad stiffness and establishing good stiffness. As an example, take all fours breathing in a flexed position:
I've utilized this with athletes and seen supine shoulder flexion range of motion increase by 10-15 degrees in a matter of 15-20 seconds without actually stretching the shoulder anywhere near its end-range. Additionally, scapular upward rotation (which takes place against gravity) usually improves a bit, presumably because of both the increased recruitment of serratus anterior (which helps preserve the convex/concave relationship of the rib cage and scapula) and reduced downward pull of the lats. Again, this is very much a theory, but it's consistently being tested with great results in our training each day. And, it's much easier than doing loads of manual therapy and time-consuming static stretching (although there are still places for both of those initiatives).
3. Not everyone conforms to the joint-by-joint approach.
The joint-by-joint approach was first introduced by Gray Cook and developed further by Mike Boyle. The concept is very sound: the body is a system of joints/segments that alternate in the need for mobility or stability. For instance, the ankles need mobility, the knees need stability, the hips need mobility, the lumbar spine needs stability, the thoracic spine needs mobility, the scapula needs stability, etc. This all makes a ton of sense, especially in the general population that is more predictable.
However, there are some glaring exceptions to this rule. You'll see folks with hypermobile hips, and excessively stiff lumbar spine segments. You'll observe thoracic spines that are so flat/extended that they shouldn't be mobilized, and shoulder blades that are so locked down that they demand more mobility training to achieve optimal function. Shoulders and elbows can really go either way.
The point is not that the joint-by-joint approach doesn't hold water; it's actually a tremendously useful paradigm I use on a daily basis. Rather, the point is that you can't "one-size-fits-all your mobility approaches." Everyone needs something slightly different, and every joint really needs a combination of mobility and stability.
4. A lot of people mistake laxity (or, worse yet, instability) for mobility.
Building on my last point, you'll find a lot of people who have so much congenital laxity that they don't need any stretching. Their mobility training is really a matter of attention to soft tissue quality and stability training.
The problem with these folks is that they can often "cheat the tests." For example, they might have unbelievably perfect overhead squats and shoulder mobility to the naked eye, but if you actually pair these tests up with stability-oriented screens, they may fall well short of what you'd deem "acceptable" movement.
Instability - or an acquired, excessive joint range of motion - is even more problematic. This is where folks will literally "blow out" their normal anatomy to acquire a desired range of motion. An example is the anterior shoulder capsule in throwers; they'll do whatever they can to get the arm back to help generate range-of-motion to support velocity production. Eventually, the shoulder can get so loose that the active restraints (rotator cuff and biceps tendon) can't effectively hold the ball on the socket, and pain occurs with throwing.
In consideration of both laxity and instability, just because you can get to a position does not mean that you're sufficiently stable in that position.
5. Building and maintaining mobility is like managing a bank account.
It goes without saying that it's easier to maintain mobility than it is to lose it and get it back. Everyone uses the analogy of babies and young children having freaky range of motion and perfect squat patterns, but losing them as time progresses. The assumption is that this occurs because they "make enough deposits:" targeted mobility work and a wide variety of activities throughout their days. Certainly, this is an issue, but I'd argue that it's because of excessive withdrawals, too.
Withdrawals could be sports participation where eccentric stress or direct trauma to tissue beats them down. It could be lifestyle factors like alcohol or tobacco use that negatively impact tissue quality. It could be pushing through faulty movement patterns until bone spurs result. What we take out is just as important as what we put in.
We all start with some money in the bank as children, but it's up to us to have more deposits than withdrawals in this mobility account over the course of the lifespan.
These are really just a few of many observations I've made over the years; there are countless more that could turn this article into an entire novel! With that said, if you're looking for both some governing principles on this front - and specific examples across the entire body - I'd recommend you check out Functional Stability Training.
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Today is Part 2 of a detailed series on the thoracic spine from Eric Schoenberg. If you missed it, be sure to check out Part 1. -EC
At this point, we need to quickly touch on the concept of “neutral.” This is certainly a hot topic in the physical therapy and strength and conditioning worlds, as it should be. For our purposes, we like to be clear that when someone is too flexed (i.e. fully slumped posture), our cue is to “extend back to neutral.” In addition, when someone is too extended, the cue would be to “flex back to neutral.” This holds true in all segments of the body and in all three planes of motion (e.g. pelvic tilt, genu valgus, etc.) The problem that we tend to see is we don’t grade our correction and “overcorrect.” This results in fixing one problem only to create a new one in the opposite direction.
In Malcolm Gladwell’s new book, David and Goliath, he refers to this as the “inverted U curve.” Its application here is that IF an athlete truly lacks T-spine mobility, then once we properly gain it, continued efforts to improve (rather than just maintain) this mobility will ultimately create a brand new problem (hypermobility). This needs to be considered when we write new programs and lends itself nicely to the importance of thorough evaluation and re-evaluations.
To quickly recap part 1, for the purpose of this series, a cue to “extend the T-spine” is really a case of moving out of excessive flexion and learning to control flexion throughout the throwing motion.
In part 2 of this series, we will focus on the postural alignment and movement examination and its implications in developing an individualized exercise prescription for the athlete. As a quick side note, it is of particular importance to recognize that the body segments don’t work in isolation. This is a simple statement; however, when attempting to capture the role of a particular body segment or group of exercises, we are missing the big picture if we try to develop a concept without appreciating the kinetic chain.
In our opinion, the hallmark of an effective examination is the ability to properly identify the athlete’s unique postural alignment and movement tendencies. These exams must be done with the shirt off to appreciate the bony and soft tissue anatomy. With respect to the thoracic spine, we first identify whether that athlete is in flexion, neutral, or extension.
Here's an example of an athlete with a flattened T-spine, and shoulder blades that have no idea what to do!
Additionally, we need to appreciate the position of the scapula and its impact on the appearance of perceived thoracic flexion. An athlete that presents with scapular anterior tilt, abduction, and/or internal rotation can easily fool you into thinking that the athlete’s upper back is “rounded” or kyphotic. An athlete with a flat thoracic spine (hypokyphosis) will have a more prominent scapula due to lack of normal contour of the T-spine and ribcage. In extreme cases, we will see the following:
1. Hypokyphosis (lack of T-spine flexion)
2. Scheurmann's Disease (greater than 60 degrees, and structural)
On x-ray, these cases will show a change in the normal vertebral “wedging.” The intervention in this case is NOT to attempt to fix the mobility issue, but first determine if the issue is osseous/structural in nature. Just like any other joint (the hip immediately comes to mind), you can’t stretch bone and any attempt to do so will result in an unhappy athlete! These are extreme examples, but certainly something that warrants inclusion in this article.
However, more commonly in the physical therapy or strength and conditioning settings, we will see more “middle of the road” cases where there is too much or too little thoracic mobility. As you can see in the lateral view below, this athlete appears to be in excessive thoracic flexion, but it's really just anterior tilting of the scapulae.
However, in the posterior view, you'd be able to appreciate that the T-spine is relatively extended compared to accepted norms (40° flexion = normal curve).
Moving forward, static alignment does not tell the whole story, so don’t test it alone and don’t let it fool you. All too often, I hear people trying to prove a point about pitching mechanics or exercise technique and the only proof is a still photo. This practice needs to stop because it is impossible to capture the complexity of human movement and make a conclusive statement from a screen shot. This concept is why the combination of the postural exam and movement analysis is so critical.
Athletes don’t get injured when they are standing still. They get injured moving (incorrectly!). For that reason, watch your athlete’s move. The concepts of FMS or whatever collection of multi-joint movements you like to combine to form a “movement examination” are great tools to collect data on your athlete’s preferred movement patterns. However, it is also critical to watch the athlete perform the unique movements of their chosen sport.
In our case, we like to talk to our athlete’s about pitching and we certainly like to watch them throw. Asking questions like: “What do you struggle with mechanically” or “where do you break down when you get tired” gives us valuable insight into movement tendencies and injury risk. With respect to exercise, we observe closely to make sure we are achieving the desired result of the exercise. In addition, we ask our athletes where they feel a particular exercise to help determine activation patterns and sequencing (motor control).
In addition to watching our athletes throw/pitch, swing, and/or run, we employ simple movement tests such as standing bilateral shoulder flexion (and abduction) to gather critical information about movement quality, timing, and relative stiffness.
With respect to the video above, consider the excessive extension moment at the thoracic (and lumbar spine) due to increased relative flexibility resulting from poor anterior core stiffness. This video brings up a lot of questions in my mind:
Does this athlete need more mobility work into thoracic extension?
If he attempted these exercises, how can you be sure the motion will even come from the right place?
If an athlete is truly “lax” congenitally, then why would they lack mobility at the T-Spine and nowhere else?
Are you sure his lack of shoulder flexion is due to decreased thoracic mobility?
Or, is he too flexible in his spine and too readily pulls into extension due to the stiffness of his lats?
My point here is we need to consider the fact that improperly prescribed exercise will make the athlete worse than no exercise at all. So, if you’re not sure, don’t guess. Refer out or continue to re-assess until it becomes clear what the athlete needs.
Another simple movement test that we will have the athlete perform is standing thoracic flexion and extension. Here we will assess the timing (quality), location, and amount of available range of motion that the athlete is working with.
It is also good practice to watch an athlete perform an exercise prior to putting it in his program.
This athlete (also pictured above) demonstrates faulty movement by not getting out of extension at the top of his pushup prior to initiating the “pike” portion of the yoga push up. When corrected, in the video below, he did a better job of getting his T-spine in position to allow his scapula to have a better platform to upwardly rotate and elevate as his hands moved overhead. This was not a mobility issue; this was a patterning or motor control problem.
I should mention that in a full examination, we would consider movement testing of thoracic rotation and sidebending, ventilation, rib cage alignment, quadruped position/movement, etc. But, for the purposes of this series, we again are choosing to focus primarily on the sagittal plane. Pay attention to the way in which the athlete returns from flexion to get a good idea of his/her recruitment strategies.
In conclusion, the combination of static posture, movement testing, and unique athletic movement allows us to create a well-rounded profile of the athlete’s strengths and weaknesses. Be sure that your examination a) identifies areas of limitation that need to be addressed and b) determines the reason why the athlete has these impairments.
In the third and final part of this series, we will discuss the concepts of relative flexibility and motor control as it relates to the topic of thoracic spine extension.
Also, if you’re interested in more information like this, we would love to see you at one of our Elite Baseball Mentorships, with the next one taking place in June. Click here to learn more.
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2. Warm-ups for Sparing the Shoulders - This came as part of a post for Schwarzenegger.com.
3. Supine Alternating Shoulder Flexion on Doubled Tennis Ball - This upper back mobility/soft tissue drill was a big hit!
4. Fine-Tuning the Band Pullapart - This is a very popular exercise for shoulder health, but it's commonly performed incorrectly. Try these modifications!
5. Standing External Rotation Hold to Wall - This is an awesome warm-up that requires no equipment. We use it a lot with our throwers when they're on the field and don't have access to a table to do prone exercises.
As you can see, 2013 was the "Year of the Shoulder" at EricCressey.com! I'll be back soon with the top guest posts of 2013.
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A while back, I posted the following on my Facebook page:
"Fill in the Blank: ________ is the exercise that gives me the most trouble in the gym."
I've received 132 replies. Of that 132, 21 were people trying to be funny on the internet, so they're thrown out the window - which leaves us with 111 replies. Not surprisingly, more respondents highlighted trouble with an overhead movement - snatch, military press, overhead squat, etc. - than any other category of strength exercise. In fact, it was one-third of people (37/111). In a distant second place was squat variations, which comprised 19% of responses (21/111).
Digging a bit deeper, the most common "subcategory" of this overhead movements trend was the snatch, with 12 people saying that it was the exercise that gave them the most trouble. It shouldn't come as any surprise that the most high velocity movement in this category would be the most commonly cited, but what should surprise you is the sheer volume of people who are woefully unprepared to train overhead who try to fit a round peg in a square hole in this regard.
If you can't get your arms overhead correctly at rest, do you really think you'll be able to do it when you're in panic mode just trying to catch a barbell you've launched over your head? Heck no! You're going to hyperextend your lower back and slip into forward head posture. And, chances are that you'll have already set up with an ultra wide grip to ensure that you can catch the bar with as little shoulder mobility as possible.
Before we proceed, let's cover this classic presentation in more detail. Here's a video I originally filmed for Wil Fleming.
(Side note: if you're trying to learn to Olympic lift, definitely check out Wil's fantastic DVD on the topic: Complete Olympic Lifting.)
The people who struggle learn the snatch - or really perform any overhead lift - are generally adults. Why? Because they've lost a fundamental movement pattern - overhead reaching - that everyone should have! Barring some developmental disorder, everyone has the ability to get the arms overhead when they are kids, whether it's to reach for the cookie jar or to climb on the jungle gym at the playground.
Think about it: the overwhelming majority of teenagers can learn to Olympic lift in a matter of a few weeks or months. And, it's been discussed time and time again how Eastern European kids would practice Olympic lifting patterns with broomsticks to maintain these crucial movement patterns to prepare for the day when they'd load them up. They understood this very important lesson:
[bctt tweet="It's much easier to maintain mobility than it is to lose it and try to get it back."]
This isn't just because tissues can become fundamentally short and degenerative. And, it's not just because resting posture becomes more aberrant or individuals accumulate more wear and tear. It has a lot to do with the plasticity of the human brain. Just like it's a lot easier to train a puppy than it is to teach an old dog new tricks, it's much easier to shape the neuromuscular patterning of a developing child or teenager than it is to change the more concrete patterns of an adult with poor movement quality - especially when that adult insists on trying to learn the pattern with 65 pounds or more on the barbell (rather than just a broomstick) - and after years of sitting at a computer.
Really, we're just reaping what we've sowed over the past 15-20 years. The new generation of adults spent more time on Instant Messenger than on the basketball court. Fewer kids than ever did manual labor in their teenage years. It became cooler to get an iPhone than a bike for your birthday. And, society pared back on physical education classes and recess time. While this was happening, kids got more specialized on the sports front, meaning they were exposed to even less variety in movements when they actually did get exercise. Our health has obviously suffered, but so has our movement quality.
Before I get off on too much of a tangent, though, let's circle back to the back-to-wall shoulder flexion test from the video I posted earlier. If you failed it miserably, don’t worry! The "good" thing about struggling to get overhead correctly is that you know that there are a number of different things that could be limiting your ability to get there:
Limited shoulder flexion (short/stiff lats, long head of triceps, teres major, inferior capsule)
Lack of scapular upward rotation (weakness of lower traps, upper traps, and/or serratus anterior; and dominance of levator scapula, rhomboids, and pec minor)
Poor thoracic spine extension
Lack of anterior core stiffness
With all these potential problems, chances are that improving each just a little bit will yield big results, especially since they interact with each other on a number of fronts. For instance, if you reduce stiffness in your lats, your anterior core won't have to work quite as hard to overpower that stiffness, so its relative stiffness improves.
Below, you’ll find six videos of exercises you’ll want to incorporate in your warm-ups daily to gradually build up your range-of-motion and overhead stability. Be sure to perform them in this order:
(Note: perform the rest of your foam rolling series, too - and make sure to spend some extra time on the lats and pecs.)
2. Bench T-Spine Mobilizations: 8 reps
3. Side-Lying Windmills: 8 reps/side
4. Dead Bugs: 8 reps/side
5. Back to Wall Shoulder Flexion (it's a test and a training exercise): 8 reps
6. Wall Slides with Upward Rotation and Lift-off: 8 reps
Do these drills each day during your warm-ups and - if schedule allows - another time during the day. You'll find that it'll be much easier to get overhead in a matter of days and weeks. In the meantime, gradually build toward your ultimate goal with some regressions in your strength training program. You can use a landmine press instead of a true overhead press, and cleans or high pulls in place of snatches. Eventually, once your body is ready to tackle these more complex movements, you'll find that learning them will be much easier.
Looking for more great self-assessment and mobility tips like these – as part of a comprehensive strength and conditioning program? Check out my resource, The High Performance Handbook, which features versatile strength and conditioning programs you can modify to suit your needs.
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It's been a while since we covered some strength training coaching cues that you'll want to have in your back pocket, so here's installment 7.
1. Follow your hand with your eyes.
It goes without saying the improving thoracic (upper back) mobility needs to be a big priority for many athletes. However, individuals can lose out on the benefit of thoracic mobility drills can be performed incorrectly if one only moves through the shoulder and not the upper back. Greg Robins covers that problem in this video, in fact:
To help ensure optimal technique, I encourage athletes, "Follow you hands with your eyes." It always seems to "right the ship" with respect to movement of the humerus.
2. Ease the bar out.
One of the biggest mistakes I see both lifters and spotters make is just picking UP the bar and handing it out from the pins on the bench press. This causes a lifter to lose his upper back tightness and start the lift from an unstable platform. Plus, the bar is more likely to drift excessively toward the hips, as opposed to staying right in the path the lifter prefers.
With that in mind, another Greg Robins video complements this tip well; check it out:
3. Get the chest to the floor before the chin.
Push-up variations are an incredibly valuable inclusion in just about any strength training program, but unfortunately, the technique goes downhill quite frequently, particularly under conditions of fatigue. Everyone knows that we need to monitor core positioning so as to avoid excessive lumbar hyperextension (lower back arching). However, what a lot of people may not realize is that this "sag" is only one potential extension-bias fault.
You see, people who are in extension will find all the ways they can to shift away from a neutral posture and toward a more extended posture. Take, for example, this shoulder flexion video. The individual doesn't just go into lumbar extension and a heavy rib flare to get his arms up overhead; rather, he also goes into a forward head posture.
I liken this to patching up a hole in a leaky roof - only to find a leak starting up somewhere else. It's important that we patch them all! With that said, with push-up variations, you can either cue "make a double chin" or tell folks that the chest should make it to the floor before the chin. As long as you've already controlled for excessive arching of the lower back, the cue will be spot-on.
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Those of you who have followed along with my "Exercise of the Week" series probably can tell by now that I'm a fan of "big bang for your buck" exercises. This isn't just limited to multi-joint strength exercises like deadlifts, bench presses, lunges, squats, overhead presses, chin-ups, and rows, though. Rather, it can also apply to mobility exercises because - let's face it - single-joint warm-ups are boring and take too long. Here's one mobility warm-up drill we'll use to improve thoracic mobility and pec length while opening up the hips. Simultaneously, you're training the anterior core to resist excessive lumbar extension (arching at the lower back).
For the throwers out there reading this post, be sure to avoid really cranking those elbows back; chances are you already have plenty of range-of-motion. Just focus more on resisting the excessive arching of the lumbar spine.
It's been a while since I published a new installment in my "Coaching Cues" series, so here are three new ones you can put into action.
1. "Imagine I have a rope around your waist and pull it back."
It goes without saying that teaching a proper hip hinge is essential to get the correct posterior weight shift we need for good deadlifting and squatting patterns. Unfortunately, it can sometimes be much easier said than done, as lifters with poor kinesthetic awareness and body control might not even know what it feels like. Take, for instance, this example from my 15 Static Stretching Mistakes article; he has so much congenital laxity (loose joints) that he can perform an "extreme" toe touch without any posterior weight shift.
Just because he can do it doesn't mean that he should do it, though. Just saying "sit back" or "hips back" doesn't always correct this, though. I've spoken about the "touch your butt to an imaginary wall behind you" external focus cue here, but I also like the idea of telling folks to pretend like I'm tugging them backward with a rope, as this fits the correction into a scenario with which they're familiar.
2. "Ribs down, scaps up."
We work with a lot of athletes who have a heavily extended posture, and their overhead movements often look like this:
Essentially, they will substitute lumbar extension (arched lower back) in place of keeping a stable core so that the scapula (and, in turn, humerus) can move appropriately with respect to the rib cage. Most of these athletes lack scapular upward rotation, so we need to help them to get the scapula moving a bit while keeping the ribs down. Here's a great exercise for which this cue would be appropriate:
In other words, you can use this cue with your core stability exercises and shoulder mobility drills in this population. Keep in mind, though, that this cue probably won't be appropriate for folks who sit at desks all day and are really kyphotic.
3. "Push yourself away from the bar."
One of the biggest bench press technique problems you'll see is that folks lose their "tightness" at the top of the rep by protracting the shoulder blades too much. This sets you up for problems - both in terms of shoulder health and strength - on sets with more than one rep.
With that in mind, one of the easiest ways to coach folks out of this bench press technique problem is to think about pushing themselves away from the bar, as opposed to pushing the bar away from them. It gets them into the "ground yourself" frame of mind and ensures that the upper back is a stable platform from which to press. It's not uncommon at all to see larger than normal dropoffs from 1-rep max loads to what you see on multiple-rep sets, and I firmly believe it's because a lot of lifters lose their tightness on the subsequent reps. So, if you find that you can bench 315 for one rep, but only 265 for three reps, this cue could very well be a solution for you.
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