In continuing with our “Best of 2012″ theme to wrap up the year, today, I’ve got the top EricCressey.com videos of the year.
1. Four Must-Try Mobility Drills - This video was part of an article I had published at Schwarzenegger.com. You can check it out here.
2. Cleaning Up Your Chin-up Technique - It's one of the most popular exercises on the planet, but its technique is commonly butchered. Learn how to avoid the most common mistakes.
3. 8 Ways to Screw Up a Row - Rowing exercises are tremendously valuable for correcting bad posture and preventing injury, but only if they're performed correctly.
4. My Mock/Impromptu Powerlifting Meet - After being away from competitions for a while, I decided to stage my own "mock" powerlifting meet just to see where my progress stood. I wound up totaling elite (1435 at a body weight of 180.6) in about two hours.
5. Cressey Performance Facility Tour - We moved to a new space within our building back in August, and this was the tour I gave just prior to the doors opening.
Those were my top five videos of the year, but there were definitely plenty more you may have missed. Luckily, you can check them out on my YouTube Channel.
I’ll be back tomorrow with another “Best of 2011″ feature.
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A few years ago, I read What the Dog Saw, a collection of short stories from popular author Malcolm Gladwell.
In one particular short story, Gladwell introduces the concept of "risk homeostasis." Essentially, risk homeostasis refers to the fact that modifications that are designed to make things safer often eventually have a break-even effect on safety because of adaptations to those modifications. In other words, something that should protect us doesn't because new compensatory factors make things more dangerous.
As an example, Gladwell observers that taxi drivers who are given anti-lock brakes actually wind up with higher incidences of traffic violations and accidents. Presumably, this occurs because the drivers feel they can drive faster and more aggressively because of this added "protection."
In another case, a study showed that adding childproof lids to medicine bottles actually increased the likelihood that children would die from accidental overdose of consuming drugs not meant for them. The added “safety” leads to adults being less cautious with where they hide bottles of pills.
While watching an absolutely atrocious YouTube video with some of the worst box squat technique in history the other day, my thoughts flashed back to this concept of risk homeostasis from when I read Gladwell's work. There are actually some remarkable parallels in the world of strength and conditioning.
1. Wearing a belt.
When a lifter throws on a belt, he assumes that it will make an exercise safer for him. While the research isn't really in agreement with this assertion, we'll roll with this assumption.
In real life, most lifters throw on a belt because it helps them handle additional weights - and at these weights, their form usually deteriorates rapidly, and does so under additional compressive loading.
2. Popping anti-inflammatories and getting cortisone shots.
When a doctor gives you a cortisone shot or recommends oral anti-inflammatories, it's because he believes you have some level of inflammation, whether it's a bursitis, tenosynovitis, or other issue. This short course of anti-inflammatories will reduce that inflammation.
You rarely see these issues in isolation, though; they're usually accompanied by degenerative changes (e.g., tendinosis) or structural changes (e.g., bone spurs) that could also be causing your symptoms. Unfortunately, your anti-inflammatories don't know that; they just know they're supposed to kill off all your pain. They make you asymptomatic, but not necessarily "healthy."
Many individuals get a cortisone shot or take a few days of NSAIDs and assume they can just go right back to training hard with no restrictions because their pain is gone. A few weeks or months later (when the cortisone shot wears off), they're back in pain (and usually it's worse than before) because they've done nothing to address the underlying causes of the problem in the first place. They shut off the inflammation and pain, but kept the degeneration, structural changes, and stupid.
The anti-inflammatory intervention is supposed to be part of a treatment plan to make folks healthier, but actually gives them a false sense of security, which in turn makes an injury or condition worse.
3. Lifting alongside an "experienced" coach who has done stupid s**t for decades, but has never been hurt.
It's not uncommon to feel a sense of security when you train with a coach with tons of time "under the bar" himself. His training background - and reportedly clean injury history - gives you peace of mind and you buy into his system. And, you continue lifting heavier and heavier in poor form because he's proof that it works, right?
Unfortunately, he's a sample size of one.
His experience should make training safer, but instead, it just leads you to take more poorly calculated risks with your training.
As an example, I did this while goofing around a few years back, but I'd never let one of my athletes try it. There are enough ugly box jump videos out there on YouTube to appreciate that a lot of coaches don't have the same kind of self-restraint.
4. Wearing elbow sleeves and knee wraps.
Elbow sleeves and knee wraps are incredibly common in the world of strength sports, and with good reason: they can really help with getting or keeping a joint warmed-up.
The only problem is that most lifters use them just so that they can power through the exact exercises that caused the joint aches in the first place.
As an example, a lot of lifters lack the upper back and shoulder mobility to use a narrow grip position on the barbell when back squatting, and the medial (inside of the) elbow takes a beating as a result. Rather than doing some shoulder mobility drills, they just throw on a band-aid in the form of an elbow sleeve.
5. Picking "joint-friendly" strength exercises.
There are lots of ways to deload a bit in the context of strength exercise selection. Maybe you do some single-leg work instead of squatting. Or, maybe you do some barbell supine bridges in place of deadlifting. These substitutions usually make a strength training program safer.
That is, of course, unless you do them with horrendous technique. Sadly, this isn't uncommon. You see people who meticulously prepare for squatting and deadlifting and heavily scrutinize their technique with video analysis, yet they'll blow through other exercises with terrible form. They expect exercise selection alone to make their strength training program safer, but compensate for this added safety by butchering technique.
Of course, these are only five examples of how risk homeostasis applies to strength and conditioning programs, and there are certainly thousands more. Where do you see good intentions go astray in your training? I'd love to hear your thoughts in the comment section below.
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In part 1 of this series, I touched on some of the mechanical factors one must consider in relation to increasing stride length in pitchers. Then, in part 2, I got discussed physical factors – hip mobility and lower-body strength/power – that govern how far you can stride. In wrapping up today with part 3, we’ll work our way up the kinetic chain to discuss three more physical factors that control stride length.
3. Rotary Stability – As I discussed in my recent article at T-Nation, What I Learned in 2011, hip mobility “sticks” better when you have adequate rotary stability, so we’ve been doing more of our core stability exercises in more “extreme” positions of hip mobility.
If you’re going to push the limits of hip abduction, internal, and external rotation range of motion, you need to be sure that you have adequate rotary stability to be stable in these positions in weight-bearing and not destroy the spine. Anybody can just get into these positions in slow speed, but not everyone can control the body precisely with a combination of isometric and eccentric muscle action at the high velocities we see with pitching.
Additionally, many of the big-time long stride guys rely heavily on controlling lumbar spine hyperextension as they ride the back hip down the mound. This is something you’ll see if you watch the deliveries of smaller, athletic guys like Tim Lincecum, Tim Collins, and Trevor Bauer. If they don’t maintain adequate anterior core function, they’ll wind up with extension-based back pain in no time.
4. Thoracic Mobility – Throwing and hitting (and really any rotational challenge like a hockey slapshot or tennis stroke) present a unique challenge to an athlete: the hips and shoulders are temporarily moving in opposite directions. This creates separation, which allows an athlete to store elastic energy and create velocity via the stretch-shortening cycle.
The first issue to consider is that not all separation is created equal. You can create separation with the hips and lower back – and jack up a lumbar spine over time. The goal is to having adequate thoracic spine mobility to ensure that this separation occurs higher up (and engages the upper extremity well).
The second issue is that the more you push the limits of hip mobility, the more you must push the limits of thoracic mobility. We’ve always heard “equal and opposite” when it comes to the throwing arm and glove arm, but the truth is that it probably apply to the lower half and thoracic spine as well. You simply don’t see guys with terrible thoracic mobility getting way down the mound, as that lack of thoracic mobility would cause them to leak forward with the upper body. I covered this in part 1, but the Cliff’s Notes version is that the head doesn’t stay behind the hips long enough, so throwers lose separation.
The third issue is that poor thoracic mobility will really interfere with getting an adequate scap load, so the arm speed will be slower. Throwing with a poorly positioned scapula is like trying to jump out of sand; you just don’t have a firm platform from which to create force.
A very basic thoracic spine mobility drill that would be a “safe” bet for most throwers would be the quadruped extension-rotation.
This drill doesn’t crank the shoulder into excessive external rotation, which may be a problem for the really “loose” arms in the crowd. Progressions for the really stiff pitchers would be the side-lying windmill and side-lying extension-rotation. I also like the yoga plex, a drill I learned from Nick Tumminello, as a means of syncing everything up with a longer stride.
Note: be sure to read this shoulder mobility blog on why not all thoracic spine mobility drills are created equal for throwers!
5. Quick Arm – When I say that you have to have a quick arm to have a long stride, I really just mean that you need some upper body power to make things work. The longer the stride, the quicker your arm must be to catch up in time to create a downward plane and throw strikes.
You simply don’t see guys with long strides competing at high levels unless they have a quick arm that can catch up to the lower body.
When a guy’s arm isn’t quick enough to catch up to his lower half, you see him miss up and arm side.
This type of thrower would be better off shortening up his stride (at least temporarily) and spending more time on good throwing programs to increase arm speed.
This is one reason Justin Verlander is great. If you watch him, he’s not an insanely long stride. Rather, he’s shorter with it, and much stiffer on his landing leg to create an awesome downward plane. Plus, he actually does have a ridiculously quick arm and outstanding secondary stuff. A lot of pitching coaches would try to lengthen his stride – and while this might work, I don’t know about you, but I think overhauling a Cy Young winner’s mechanics is silly.
The “long stride, slow arm” issue is (in my experience) most common in young, lax players who have the joint range-of-motion and just enough stability to get a long stride, but don’t have adequate arm speed to catch up. This is really common in the 14-17 age ranges, and I think it’s one reason why so many of these kids respond incredibly favorably to long toss; it teaches their arms to go faster and keep up with their strides.
Conversely, as you start to deal with 18-year-olds and older (or kids who have grown quickly), you start to see that preparing everything below the arm is arguably more important than arm speed. You don’t pitch in college or professional baseball unless you have a reasonably quick arm, and getting more aggressive with the lower half to stride longer is often exactly what guys need to make the big velocity jump. Likewise, when guys don’t take care of the lower half, but continue on aggressive throwing programs, they often wind up with velocity drops, injuries, or control issues because they’ve lost the separation that made them successful.
Closing Thoughts
While a long stride can certainly be advantageous in the throwing motion, as I've shown in this series, forcing it when you don't have the right physical preparation or mechanical coaching in place can actually hurt an pitcher's performance and health. Remember that the best changes are subtle ones; in other words, you might increase a stride by six inches over the course of a year, not in a single session.
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The prone external rotation is a strength exercise for the posterior rotator cuff that we've added to our strength and conditioning programs over the past few months with good success. And, while the primary goal is to increase shoulder stability via improved rotator cuff function, the truth is that this drill also served as a motor control exercise to reeducate folks on what should be moving and when.
We use this drill a lot with guys who are in a dramatic anterior pelvic tilt, and start everything with the "gluteus tight, core braced" cues. Effectively, this means that you force the athlete to actually externally rotate the shoulder instead of simply arching through the lower back to get to the desired "finish" point. You'll be amazed to see how many athletes have significantly less "observable external rotation" when they are locked into neutral spine.
You also want to cue the athlete to keep the scapula (shoulder blade) on the rib cage, but he/she doesn't need to be aggressively pulled into scapular retraction in order to get there.
Once the scapula is set, I tell athletes to think about getting the ball to rotate in the socket without allowing the head of the humerus to slide down toward the table. This is a very important cue, as many athletes will allow excessive anterior migration of the humeral head during external rotation exercises; we want them to learn to keep the ball centered in the socket. If an athlete is really struggling with this, we may place a rolled up towel or half-roller underneath the anterior shoulder as feedback on where things should be.
Very rarely will we load this up, and in the rare instances we do, it wouldn't be for more than 2.5 -5 pounds. The shoulder is a joint with a broad range of movements that mandate a lot of dynamic stability, so we want to make sure things are working perfectly.
I'll generally include this movement in the warm-ups for sets of eight reps - or we may use it as a filler on a lower-body day between sets of more compound strength exercises. It can also serve as a great follow-up to shoulder mobility drill geared toward improving external rotation, as this is an avenue through which you can add stability to the range-of-motion you're creating.
Give it a shot in your strength and conditioning programs and then let me know how it goes in the comments section below!
Last Saturday night, the power went out at our house thanks to a rare October snowstorm in New England. Expecting it to come back on pretty quickly, I went to bed Saturday night assuming I’d wake up to a normal Sunday morning.
Instead, I woke up and it was 49 degrees in my house. And, that wound up being par for the course through Tuesday at about 4pm. No hot showers, no refrigeration, no coffee in the morning: it makes you realize how much you take some things for granted.
It’s not all that different than what you’ll hear from injured and sick athletes. We always just believe that we’re going to be healthy – and it’s that assumption that leads us to put too much weight on the bar and lift with poor technique, have the extra beer, go to bed an hour later, or make any of a number of other small, but crucial decisions that interfere with our short- and long-term health, and the continuity in our workout "routines."
I wish I’d foam rolled even when I wasn’t in pain.
I wish I’d eaten my vegetables even though I was just trying to shovel in as much calories as I could in my quest to get strong and gain muscle.
These are all things I've heard from injured people. Hindsight is always 20/20.
Some of these decisions are made out of negligence, but often, they’re made simply because folks don’t know about the right choices. I mean, do you think this guy would really continue doing this if he thought it was good for his body?
Nobody is immune to ignorance; we’ve all “been there, done that.”
Almost a decade ago, I had no idea how much soft tissue work, high volumes of horizontal pulling, and thoracic spine mobility drills could do to help my shoulder. It’s why I stumbled through fails attempts at physical therapy with that shoulder back in 2000-2003, only to accidentally discover how to fix it with my own training in time to cancel my shoulder surgery.
Back in that same time period, nobody ever told me how eating more vegetables would help take down the acidity of my diet, or that Vitamin D status impacted tissue quality and a host of other biological functions. I never knew most fish oil products you could buy are woefully underdosed and of poor quality. Now, I crush Vitamin D, fish oil, and Athletic Greens on top of a healthy diet that’s as much about nutrient quality as it is about caloric content and timing.
In short, I didn’t know everything then, and while I know a lot more now, I still don’t claim to have all the answers. Nobody has all of them. So what do you do to avoid taking important things for granted?
Get around people who have “been there, done that.” Ask questions. Follow workout routines they’ve followed, and consult resources they’ve consulted. I touched on this in my webinars last week.
I also discussed this topic in a blog about strength and conditioning program design a while back. The best way to avoid making mistakes and taking things for granted is to be open-minded and learn from other people.
With that in mind, let’s use this post as a starting point. What mistakes have you made when it comes to taking things for granted? And, what lessons have you learned? Post your comments below.
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This marks Part 2 of my write-up on Muscle Imbalances Revealed - Upper Body, a product that really impressed me. In my first post, I highlighted some of Dean Somerset's great contributions to the project, and today, I thought I'd bring to light seven more great corrective exercise lessons from another excellent presenter on this resource.
Dr. Jeff Cubos is an Alberta-based chiropractor with an outstanding skill set that not only encompasses his clinical work, but also an excellent ability to relate how what he does in the clinic applies to those in the strength and conditioning field. This "dual proficiency" was readily apparent in his presentations, too.
Here were a few highlights:
1. From an alignment standpoint, you can envision the core like a house - where the diaphragm is the ceiling, and the pelvic floor is the floor. Just like with the house, too, the ceiling and floor should be parallel. Having an anterior pelvic tilt and rib flair dramatically alters this:
2. Good training to address this issue isn't just about stretching hip flexors and activating glutes, though; it's about retraining breathing, "owning" one's breathing in various positions, and progressing that respiratory function (and, in turn, rib positioning) into more comprehensive strength exercises.
3. Jeff does the best job I've seen of discussing breathing drill progression - and how to sync them up with progressive strength training programs. Just as importantly, though, he does a great job discussing the role of the diaphragm, utilizing an excellent video to show exactly how it works (as you watch it, be sure to check out how the right diaphragm attachment point is more prominent on the spine). I've mentioned many times in the past in the blog about how we utilize breathing drills, and folks always want to know what they are. Unfortunately, you can't really just describe a breathing drill; you need to show it and add specific cues. Jeff does exactly that. Here's a good excerpt on the assessment side of things, too:
4. Dr. Cubos also discusses bits and pieces of both the Dynamic Neuromuscular Stability (DNS) and Postural Restoration Institute (PRI) philosophies. Having been to seminars for both disciplines, I can tell you that Jeff does a great job of presenting this valuable, but sometimes confusing information in as user-friendly a format as one possibly can. It's a cursory overview, but enough to give you an introduction to these philosophies to find out if they're right for you.
5. Even if you aren't planning to delve deeply into these disciplines, Jeff covers a few specific cues that you can apply to breathing correctly on every exercise you do - especially if you (or your clients) are stuck in anterior pelvic tilt, lordosis, and an elevated ribs posture. For instance, Jeff uses the cue of performing a few diaphragmatic breaths at the point of greatest tension in a movement; this will enable an athlete to "own" that position more quickly. He uses the example of holding for a count of "one-one-thousand" at the top position of the quadruped extension-rotation:
6. I've got to great lengths in several previous blog posts to distinguish between tendinitis (inflammatory) and tendinosis (degenerative) - and Dr. Cubos did a good job of reaffirming things on that front (tendinosis is much more common than tendinitis). However, he took it even further with some excellent information on the "continuum" of tendinopathies. I've spoken about how we're all waiting to reach "threshold" (presentation of symptoms), but haven't paid a lot of attention to sub-clinical tendinopathies. Here's how Jeff portrayed the continuum:
Reactive Tendinopathy - This is acute overload (too much, too soon). Soft tissue treatments are beneficial, but not locally to the tissue in question. An example that immediately comes to my mind is a supraspinatus tendinosis; manual therapy to the pec minor, posterior rotator cuff, etc. would be very helpful, but working directly on the supraspinatus could exacerbate the problem significantly.
Tendon Dysrepair - Dr. Cubos referred to this as "a failed attempt at healing, and a disorganization of the connective tissue matrix." Immediately, I thought of someone with chronically crank hamstrings following a previous strain. Direct soft tissue work has much more immediate and profound benefits.
Degenerative Tendinopathy - This is the obnoxious, long-term tendinosis we've come to know - whether it's an Achilles tendon or common extensor tendon (Tennis Elbow). Here we have cell death, disorganization of the connective tissues, and less collagen. Unfortunately, full resolution isn't that common - but most people can respond over time to the right kind of rehabilitation programs.
7. Last, but certainly not least, Jeff introduces his audience to several common soft tissue treatment approaches, including Active Release Technique, Fascial Manipulation, Functional Range Release, and the various modalities of Instrument Assisted Soft Tissue Mobilization. In describing each, he outlines why some may be better for others in certain instances, as well as the differences between approaches. I think this is a "must-watch" for trainers to understand the skills of the manual therapists to whom they refer, and also up-and-coming rehabilitation specialists to decide which approaches they'll utilize in their professional careers.
All in all, Dr. Cubos was another new name (for me, at least) that I was glad to come across - and I'll definitely be following him more moving forward. And, in addition to Cubos and Somerset's contributions, there are a host of other great professionals who have contributed to the entire Muscle Imbalances Revealed - Upper series, which is currently on sale with a 60-day money back guarantee, too, so check it out here.
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Last summer, a college pitcher came up to Cressey Performance from the South to train for a month before his summer league got underway. He was seven months post-op on a shoulder surgery (Type 2 SLAP) and had been working his way back. Unfortunately, his arm was still bothering him a bit when he got up to see us.
After the first few days at CP, though, he told me that his arm felt as good as it’s felt in as long as he could remember. He’d been doing a comprehensive strength and conditioning program, but the “impact” stuff for him had been soft tissue work, some Postural Restoration Institute drills, an emphasis on thoracic mobility, and manual stretching into internal rotation, horizontal adduction, and shoulder flexion. From all the rehab, his cuff was strong and scapular stabilizers were functioning reasonably well – which led me to believe that his issues were largely due to tissue shortness and/or stiffness.
This realization made me immediately wonder what he’d been doing in the previous months for mobility work for his arm – so I asked. He then demonstrated the manual stretching series that every pitcher on his team went through every day on the table with their athletic trainer. Each stretch was done for 2x20s – and two of those stretches took him into extreme external rotation and horizontal abduction. I was pretty shocked.
Me: “You’re probably not the only guy on your team rehabbing right now, huh?”
Him: “No; there are actually too many to count.”
Me: “Elbows, too, I’m sure.”
Him: “Yep.”
Want to irritate a labrum, biceps tendon, or the undersurface of the rotator cuff? Stretch a thrower into extreme external rotation and simulate the peel-back mechanism. This also increases anterior capsular laxity and likely exacerbates the internal impingement mechanism over the long-term. To reiterate, this is a bad stretch!
Want to make an acromioclavicular joint unhappy? Stretch a thrower into horizontal abduction like this (again, this is a BAD stretch that is pictured):
Want to irritate an ulnar nerve or contribute to the rupture of an ulnar collateral ligament? Make sure to apply direct pressure to the forearm during these dangerous stretches to create some valgus stress. This is a sure-fire way to make a bad stretch even worse:
These stretches are very rarely indicated in a healthy population – especially pitchers who already have a tendency toward increased external rotation. The shoulder is a delicate joint that can’t just be manhandled – and when you’re dealing with shoulders that are usually also pretty loose (both from congenital and acquired factors), you’re waiting for a problem when you include such stretches. In fact, I devoted an entire article to this: The Right Way to Stretch the Pecs.
Everyone thinks that shoulder external rotation and horizontal abduction alone account for the lay-back in the extreme cocking position.
In reality, though, this position is derived from a bunch of factors:
1. Shoulder External Rotation Range-of-Motion – and this is the kind of freaky external rotation you’ll commonly see thanks to retroversion and anterior laxity:
2. Scapular Retraction/Posterior Tilt
3. Thoracic Spine Extension/Rotation
4. Valgus Carrying Angle
So, how do you improve lay-back without risking damage to the shoulder and elbow?
1. Soft tissue work on Pec minor/major and subscapularis – Ideally, this would be performed by a qualified manual therapist – especially since you’re not going to be able to get to subscapularis yourself. However, you can use this technique to attack the pecs:
2. Exercises to improve scapular retraction/depression/posterior tilt – This could include any of a number of horizontal pulling exercises or specific lower trap/serratus anterior exercises like the forearm wall slide with band.
3. Incorporate specific thoracic spine mobility drills – In most pitchers, you want to be careful about including thoracic spine mobility drills that also encourage a lot of glenohumeral external rotation. However, when we assess a pitcher and find that he’s really lacking in this regard, there are two drills that we use with them. The first is the side-lying extension-rotation, which is a good entry level progression because the floor actually limits external rotation range-of-motion, and it’s easy to coach. I tell athletes that they should think of thoracic spine extension/rotation driving scapular retraction/depression, which in turn drives humeral external rotation (and flexion/horizontal abduction). Usually, simply putting your hands on the shoulder girdle and guiding them through the motion is the best teaching tool.
A progression on the side-lying extension-rotation is the side-lying windmill, which requires a bit more attention to detail to ensure that the range-of-motion comes from the right place. The goal is to think of moving exclusively from the thoracic spine with an appropriate scapular retraction/posterior tilt. In other words, the arm just comes along for the ride. The eyes (and head) should follow the hand wherever it goes.
Again, these are only exercises we use with certain players who we’ve deemed deficient in external rotation. If you’re a thrower, don’t simply add these to your routine without a valid assessment from someone who is qualified to make that estimation. You could actually make the argument that this would apply to some folks in the general population who have congenital laxity as well (especially females).
4. Throw!!!!! – Pitchers gain a considerable amount of glenohumeral external rotation over the course of a competitive season simply from throwing. Sometimes, the best solution is to simply be patient. I really like long toss above all else for these folks.
In closing, there are three important things I should note:
1. You don’t want to do anything to increase valgus laxity.
2. You’re much more likely to get hurt from being “too loose” than you are from being “too tight.” When it comes to stretching the throwing shoulder, “gentle” is the name of the game – and all mobility programs should be as individualized as possible.
3. Maintaining internal rotation is a lot more important than whatever is going on with external rotation. In fact, this piece could have just as easily been named "The Two Stretches Pitchers Shouldn't Do, Plus a Few That Only Some of Them Need."
As you can probably imagine, given that I deal with a ton of baseball players - and the fact that I've written about shoulder pain a ton over the past decade - a lot of people initially come to Cressey Performance because their shoulder hurts. It might be rotator cuff pain, AC joint irritation, or any of a host of other issues, but you'd be surprised at how many similarities there are among the ways that you address most of these issues.
The problem is that pain can throw a wrench in your plans and limit you in your ability to get to exactly where someone needs to improve movement-wise. For instance, you might have someone who has a significant glenohumeral (ball-and-socket) internal rotation deficit, but it's hard to manually stretch them into internal rotation without further irritating a cranky AC joint. Or, someone with a partial thickness rotator cuff tear may be dramatically limited in shoulder flexion, but even shoulder flexion with assisted scapular posterior tilt and upward rotation exacerbates their symptoms. Very simply, you can't just pound round pegs into square holes when it comes to dealing with a delicate joint like the shoulder - and that applies to both asymptomatic and symptomatic shoulders.
To that end, there are three initiatives that I think are the absolute most important places to start in just about every case.
First, I'm a huge advocate of soft tissue work with a skilled manual therapist. In our office, we have a massage therapist and chiropractor who performs both Active Release and Graston. And, we make sure that any physical therapist to whom we refer clients uses manual therapy as an integral part of their treatment approach. Whether you're a regular exerciser or not, tissues can get dense, nasty, and fibrotic, and integrating some hands-on work on the pec minor, posterior rotator cuff, lats, scalenes, sternocleidomastoid, and several other areas can dramatically reduce an individual's symptoms and improve range-of-motion instantly - and that allows us to do more with a corrective exercise program.
Understandably, not everyone has access to a qualified manual therapist all the time, so you can always utilize self-myofascial release in the interim. Here, in a video from Show and Go: High Performance Training to Look, Feel, and Move Better, CP massage therapist Chris Howard goes over a quick and easy way to loosen up the pecs:
The second area where you really can't go wrong is incorporating thoracic spine mobilizations. The thoracic spine has direct interactions with the lumbar spine, rib cage, cervical spine, and scapulae; as a result, it has some very far-reaching effects. Unfortunately, most people are really stiff in this region - and that means they wind up with poor core and scapular stability, altered rib positioning (which impacts respiration), and cervical spine dysfunction. Fortunately, mobilizing this area can have some quick and profound benefits; I've seen shoulder internal rotation improve by as much as 20 degrees in a matter of 30 seconds simply by incorporating a basic thoracic spine mobility drill.
That said, not all thoracic spine mobility drills are created equal. Many of these drills require the glenohumeral joint to go into external rotation, abduction, and horizontal abduction in order to drive scapular posterior tilt/retraction and, in turn, thoracic spine extension and rotation. If you've got a cranky shoulder, this more extreme shoulder position usually isn't going to go over well. So, drills like the side-lying extension-rotation are likely out:
For most folks, a quadruped extension-rotation drill will be an appropriate regression:
And, if the hand position (behind the head) is still problematic for the shoulder, you can always simply put it on the opposite shoulder (in the above example, the right hand would be placed on the left shoulder) and keep the rest of the movement the same.
Last, but certainly not least, you can almost always work on forward head posture from the get-go with someone whose shoulder hurts. We start with standing chin tucks, and then progress to quadruped chin tucks.
Additionally, working on cervical rotation is extremely valuable, although teaching that is a bit beyond the scope of this post.
Keep in mind that these three broad initiatives are really just the tip of the iceberg when it comes to a comprehensive corrective exercise plan that would also include a focus on scapular stabilization and rotator cuff exercises, plus additional mobility drills. They are, however, safe entry-level strategies you can use with just about anyone to get the ball rolling without making a shoulder hurt worse in a strength and conditioning program.
For more information on what a comprehensive shoulder rehabilitation program and the concurrent strength and conditioning program should include, check out Optimal Shoulder Performance, a DVD set I co-created with Mike Reinold, the Head Athletic Trainer and Rehabilitation Coordinator of the Boston Red Sox.
The Optimal Shoulder Performance DVD is a phenomenal presentation of the variables surrounding shoulder health, function, and performance. It combines the most current research, real world application as well as the the instruction on how to implement its vast amount of material immediately. After just one viewing, I decided to employ some of the tactics and methods into our assessment and exercise protocols, and as a result, I feel that myself, my staff and my clients have benefited greatly.
Michael Ranfone BS, CSCS, LMT, ART
Owner, Ranfone Training Systems
In case you missed Part 1 of this series on In-Season Baseball Strength and Conditioning, you can check it out HERE.
Today, I'll be discussing how to attack in-season training for high school baseball players. I'll divide things up between position players (plus catchers) and pitchers.
Position Players/Catchers
With our position players and catchers, we typically opt for two full-body strength training sessions per week. Some players, however, will opt for shorter, more frequent training sessions. This may be the case for "gym rats" who feel better when they lift more often, or those who simply aren't getting much playing time and really want to continue developing.
These players get enough movement training just from taking ground balls and sprinting during warm-ups and practices, so there usually isn't any need to add extra movement training to their programs.
We also keep medicine ball volume down because they're already doing a lot of high volume rotation with their throwing and hitting. They'll do their foam rolling and mobility work daily, though.
Pitchers
High school pitchers are challenging to train because most are two-way players – meaning that they play a position in the field when they aren’t pitching. As a general rule of thumb, I encourage kids to avoid catching and playing SS/3B if they are going to pitch regularly, as the throwing volume really adds up. If a young athlete pitches fewer than three innings per week, though, we just train him like we would a position player, but try to make sure that at least one of these training sessions comes the day after throwing. I like this approach because it not only "consolidates" stress into a 24-hour block to allow for better recovery, but it also forces a kid to go through his mobility drills, soft tissue work, and manual stretching with us to "normalize" his range of motion after a throwing appearance.
If a pitcher throws more than three innings per week, it’s best to try to pin down one particular day of the week when he is a starter. If he starts on Friday, he’d want to lift Saturday and Monday or Tuesday. Moreover, if he strength trains on Monday, he’ll have the option of getting in another good brief, light session on Wednesday. Like the position players, our pitchers take part in daily foam rolling and mobility work.
Sample Schedule for a Position Player/Catcher with games on MoWeFr
Su: off completely
Mo: Game
Tu: Practice and Strength Training (shorter option)
We: Game
Th: Practice, but no strength training
Fr: Game
Sa: Practice, Strength Training (longer option)
I may deviate from this schedule and do a bit more (added Thursday strength training session) with a younger player who needs to develop (usually have fewer practices/games, anyway) or someone who is not getting all that much playing time.
Sample Schedule for a Pitcher with only one start per week (same as college pitchers on 7-day rotations)
Mo: Pitch
Tu: Strength Training (lower body emphasis, core, and light upper body)
We: Movement Training
Th: Low Volume Medicine Ball Work, Strength training (upper emphasis, plus low volume lower)
Fr: Movement Training
Sa: Very light Strength Training (mostly upper and core work)
Su: off completely
If this pitcher was playing the field on non-pitching days, we’d simply drop the movement training and eliminate either the Thursday or Saturday strength training session.
This obviously doesn’t include the throwing program component, which we find it a bit different for everyone. I will say, though, that most of our guys tend to long toss the furthest on Wed/Thu and throw their bullpen on Fri/Sat. They’d be playing catch on some of the other days, too, of course.
Tomorrow, I’ll be back with my approaches to in-season strength and conditioning for college baseball players.
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The other day, I received an email from a Show and Go customer who noticed that the scapular wall slide and the doorway slide were two similar, but not identical shoulder mobility drills included in the program. He asked if I could talk a bit more about the differences between the two - and when to use both.
First, let's have a look at the two exercises. Here's the scapular wall slide:
And, here's the doorway slide:
As the voice-over on the video above notes, the scapular wall slide is an acceptable fit for just about any workout routine. The only exceptions would be those who have upper extremity pain with overhead motions (rotator cuff tears, etc.).
However, we can utilize the doorway slide in certain folks to get to where we want to be a bit faster. More specifically, these folks are the ones who are REALLY immobile in their upper extremity and wouldn't even be able to get their arms back even close to the wall on the wall slides. So, in addition to not making them feel bad about their "tight shoulders", the doorway slide actually allows us to use the doorway as a stretching implement to get a gentle stretch across the anterior shoulder girdle (predominantly pec major and minor). There are three very important coaching points:
1. Don't let the head poke forward, as a forward head posture is simply a substitution for not retracting/depressing the scapulae or horizontally adducting the humerus.
2. Don't crank too aggressively on the shoulders; it should be a subtle stretch. And, it shouldn't be used with those (particularly overhead throwing athletes) who already have increased external rotation and, in turn, more anterior laxity.
3. Make sure to focus on pulling the shoulder blades down and back as the elbows are lowered. You shouldn't have movement of the humerus without movement of the scapula.
