Home Posts tagged "Sports Medicine"

CSP Elite Baseball Development Podcast: “To Ice or Not to Ice?” with Gary Reinl

We're excited to welcome Gary Reinl, Director of National Accounts and Professional Athletic Teams for Marc Pro, to this week's podcast. Gary delves into one of the most controversial topics in sports medicine history: icing.

A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 20-pack of Athletic Greens travel packets with your first order.

Show Outline

  • How Gary become involved in the realm of sports medicine in 1973
  • How Gary became passionate about the science and practice of recovery
  • Where the belief in icing for recovery began, and how did it became so accepted in the sports medicine community
  • Where the RICE protocol (Rest, Ice, Compress, Elevate) originated
  • What the research says about the use of ice for recovery and the traditional RICE method
  • How Gary formulated his simple and organized system for healing damaged tissue away from the common belief in ice and the RICE protocol
  • Why tissue preservation, tissue regeneration, and angiogenesis are the primary goals when promoting recovery of damaged tissue
  • Why evacuating waste and clearing congestion is important for creating healthy tissue
  • What physiological mechanisms electrical stimulation takes advantage of to push waste out of damaged areas via the lymphatic system
  • How low intensity muscular contractions decongest damaged tissues, avoid the unnecessary killing of healthy tissue, restore circulation, and promote tissue regeneration
  • What benefits e-stim has beyond the recovery of damaged tissue
  • Why sports medicine professionals and the general population often confuse inflammation with degeneration
  • How can individuals maximize the effectiveness of Marc Pro and other e-stim units through pad placement and overall set-up during treatment
  • Where would Gary like to see the Marc Pro used more in the sports medicine world

You can follow Gary on Twitter at @TheAntiIceMan and email him at gary@marcpro.com. Be sure to check out his book, Iced!, and take advantage of the great offer on Marc Pro for podcast listeners by heading to www.MarcPro.com and entering the coupon code CRESSEY at checkout to receive 10% off on your order.

Sponsor Reminder

This episode is brought to you by Athletic Greens. It’s an all-in-one superfood supplement with 75 whole-food sourced ingredients designed to support your body’s nutrition needs across 5 critical areas of health: 1) energy, 2) immunity, 3) gut health, 4) hormonal support, and 5) healthy aging. Head to www.AthleticGreens.com/cressey and claim my special offer today - 20 FREE travel packs (valued at $79) - with your first purchase. I use this product daily myself and highly recommend it to our athletes as well. I'd encourage you to give it a shot, too - especially with this great offer.

Podcast Feedback

If you like what you hear, we'd be thrilled if you'd consider subscribing to the podcast and leaving us an iTunes review. You can do so HERE.

And, we welcome your suggestions for future guests and questions. Just email elitebaseballpodcast@gmail.com.

Thank you for your continued support!

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

Name
Email
Read more

Movement vs. Medical Diagnoses

Recently, during my weekly Instagram Q&A, I received this question:

"Have you ever dealt with valgus extension overload syndrome and how?"

My initial response was, "Absolutely - and with every single overhead throwing athlete I've ever encountered."

You see, "valgus extension overload" simply described the two most common injury mechanisms in throwers. Your elbow can get hurt at lay-back (max shoulder external rotation) or full elbow extension. This terminology doesn't describe a specific tissue pathology, nor an underlying movement competency that is insufficient and therefore allowing an individual to become symptomatic. To me, it's a completely incomplete "diagnosis." Let's dig deeper.

You have medical diagnoses and movement diagnoses. Both are important.

A medical diagnosis might be a rotator cuff tear, MCL sprain, or tibial fracture. These deviations speak directly to the damaged tissue and relate the severity of this structural change.

A movement diagnosis (popularized by physical therapist Shirley Sahrmann) might be scapular downward rotation syndrome, femoral anterior glide syndrome, or lumbar extension-rotation syndrome. These diagnoses speak to the deviation from normal movement that’s observed.

At times, both types of diagnoses are bastardized.

On the medical side, examples would include “shoulder impingement,” “shin splints,” and “valgus-extension overload.” All of these flawed medical diagnoses speak to a region of the body, but not a specific structure.

On the movement side, examples would be vague things like “weak posterior chain,” “scapular dyskinesis,” or “poor stability.” They don’t speak to the specific movement competencies that need to be improved.

I'm all for simplifying things as much as possible. However, diagnosis is an area where oversimplifying is completely inappropriate. Diagnosis is what establishes the road map for the journey you're about to begin - so make sure to eliminate any guesswork in this regard, whether it's on the medical or movement side of things.

Looking to learn more about how we assess and correct movement inefficiencies - and relate them to the rehabilitation and prevention of common medical diagnoses? Be sure to check out the Functional Stability Training series from Mike Reinold and me. It's on sale for 25% off through this Tuesday at midnight. Just head to THIS LINK and enter coupon code allstar2019cressey to get the discount.

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

Name
Email
Read more

Is It Really Biceps “Tendonitis?”

One of my biggest pet peeves is when all anterior shoulder pain is given a "blanket diagnosis" of biceps tendonitis. With that in mind, today, I've got a webinar excerpt from my Sturdy Shoulder Solutions resource that delves into the topic in greater detail. Check it out:

For more information, check out www.SturdyShoulders.com. It's on sale for 30% off through Sunday night; just use the coupon code BASEBALL at checkout to get the discount.

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

Name
Email
Read more

Shoulder Health: Where Small Hinges Swing Big Doors

The shoulder girdle is a complex series of joints unified by subtle movements in perfect timing. If you need proof, just check out this slide from my new release, Sturdy Shoulder Solutions.

This study looked at the difference between the empty can and full can in terms of both muscular recruitment and actual movement in folks with symptomatic impingement vs. healthy controls. Not surprisingly, the empty can exercise hurt more. Just looking at this picture hurts my shoulder (and my shirt is wildly fitting).

To me, though, that's not the most significant takeaway from these study results. Rather, take a look at some of the numbers included in their findings: 1-3 degrees (joint movement) and 1-4% (muscular activation). These are subtle, subtle quantifiable differences between those in pain and those who are pain free - and most of them really can't be perceived "on the fly."

What does this mean for how you assess, program, and coach?

First, from an evaluation standpoint, we have to truly understand what quality movement should look and feel like. If you can't truly define "normal," then how can you ever truly appreciate "abnormal?"

Second, not all exercises are created equal (as we learned from the empty vs. full can discussion). 

Third, in coaching, we have to constantly solicit feedback from our athletes on where they feel exercises.

These are all key principles on which I focus in my new resource, Sturdy Shoulder Solutions - and it's on sale for $50 off through Sunday at midnight. You can learn more at www.SturdyShoulders.com.

 

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

Name
Email
Read more

“Sturdy Shoulder Solutions” is Now Available!

I'm super excited to announce the release of my new resource, Sturdy Shoulder Solutions, which will be on sale for $50 off through Sunday. This product has been years in the making, and it includes over six hours of cutting edge assessment, coaching, and programming strategies. You can learn more at the following link:

http://www.SturdyShoulders.com

Here's what you'll experience:

  • Simplifying Shoulder Health (Webinar)
  • How Posture Impacts Pain and Performance (Webinar)
  • Important Upper Extremity Functional Anatomy Considerations (Webinar)
  • The Proximal-to-Distal Principle (Webinar)
  • Nuances of the Neck (Webinar)
  • Rethinking the Thoracic Spine (Webinar)
  • Making Sense of Serratus Anterior (Webinar)
  • Is Upper Trapezius the Devil? (Lab)
  • The Myth of Normal Range of Motion (Lab)
  • Rethinking the Thoracic Spine (Lab)
  • Making Sense of Serratus Anterior (Lab)
  • Good Exercises Gone Bad (Lab)
  • The Myth of Balancing Pushes and Pulls (Lab)

It's a great fit for personal trainers, strength and conditioning coaches, sports coaches, and rehabilitation specialists. Additionally, many fitness enthusiasts will appreciate the focus on individualizing programming recommendations and technique coaching strategies.

In particular, it’s a tremendous fit for anyone who has previously been exposed to our Optimal Shoulder Performance and Functional Stability Training products. Sturdy Shoulder Solutions serves as an up-to-date companion to the educational material covered in those previous offerings.

You'll get instant online access to this digital-only product after purchase. Just head to http://www.SturdyShoulders.com to pick it up.
 

Read more

Making Sense of Subclavius

If you’re looking for a really common trigger point in throwers, look no further than subclavius. It’s stuck right between the clavicle (collarbone) and first rib (highlighted in red here).

In normal posture, the clavicle should have a slight upslope. In many throwers who sit in scapular depression, downward rotation, and/or anterior tilt, the clavicle is pulled down even more, as the collarbone interacts with the shoulder blade at the acromioclavicular joint. Wherever the scapula goes, the collarbone goes.

Here’s the problem: with overhead motion, the clavicle actually needs to rotate up as well – and a short, dense, fibrotic subclavius will restrict that movement.

Making matters worse, the subclavius works with the often hypertonic scalenes to elevate the first rib – so this muscle gets smashed from the bottom while it’s already bunched up from the top. And don’t forget that there are important nerve and vascular structures that course between these two bones as well, so subclavius is an anatomical structure that can’t be ignored anytime a thoracic outlet syndrome diagnosis is considered.

From a referral standpoint, trigger points in subclavius can lead to symptoms in the anterior shoulder, biceps muscle belly, and lateral forearm all the way down to the thumb side of the hand. It’s also not uncommon to see the clavicular angle increase (upslope) after good manual therapy on subclavius in someone with a low shoulder.

In short, don’t overlook this muscle just because you’ve never heard of it or it’s really small. Taking care of it can be a game changer, whether it's with quality manual therapy, self-myofascial release on the Acumobility Ball, or a combination of the two.

Also, a friendly reminder that you get $40 off on my popular resource, Sturdy Shoulder Solutions, through this Sunday at midnight by entering the coupon code OFFSEASON19 at checkout at www.SturdyShoulders.com. I dig in deep on functional anatomy of the upper extremity on a number of fronts in this resource.

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

Name
Email
Read more

The Best of 2017: Product Reviews

To wrap up my “Best of 2017″ series, I’ll highlight the top product reviews I did at this site in the last year. Here they are:

1. Complete Sports Conditioning - This resource from Mike Boyle is top notch, and he does a great job of simplifying complex topics for up-and-coming strength and conditioning coaches. Since it was the most popular product I reviewed this year, I reached out to Mike to see if he'd be up for running a quick promo sale for my readers, and he kindly agreed. From now through January 3, you can get $100 off on the resource. No coupon code is needed; just head HERE.

2. American Sports Medicine Institute Injuries in Baseball Course - Mike Reinold compiled this great list of webinars from accomplished surgeons and rehabilitation specialists to create an excellent sports medicine resource for those in the baseball world.

3. L2 Fitness Summit Video Series - Dean Somerset and Dr. Mike Israetel released this video of a one-day seminar back in November, Dean offers a nice glimpse into some assessment components that go beyond typical movement screens, and Mike's presentation on hypertrophy mechanisms and strategies was insightful as well. These are some seemingly minimally-related topics, but they did a good job of pulling everything together.

Also in 2017, the Cressey Sports Performance team released CSP Innovations. This resource highlighted a collection of different topics from the CSP staff, so there's something for everyone at a price much cheaper than attending a seminar.

We're back to the regular EricCressey.com content this week. Thanks for all your support in 2017!

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

Name
Email
Read more

Not-So-Simple Sports Medicine Solutions

Last year, in her series on common injuries in professional baseball, MLB.com writer Lindsay Berra covered the topic of hamstrings strains, and even interviewed Cressey Sports Performance - Florida co-founder Shane Rye for the piece. You can give it a read here.

This article goes into some detail on why these injuries have been so prevalent and challenging in MLB over the years:

a) the nature of baseball (stand around for a while, then have to sprint full-bore without a re-warm-up)

b) poor strength and conditioning practices (e.g., lifting too much to the exclusion of actual sprinting and mobility work)

c) muscular imbalances (e.g., poor glute recruitment, quad/hamstrings imbalances, etc)

I'd also add previous injuries as a big risk factor. Many times, it's one player who is reinjuring the same old hamstrings injury to "inflate" league-wide numbers. 

For a while, the solution was to get the hamstrings stronger relative to the quads. Then the answer was to bring an underactive synergist (gluteus maximus) up to par. And, lately everyone has jumped on board the Nordic hamstrings curl bandwagon; they apparently not only help prevent hamstrings strains, but cure cancer, acne, and hemorrhoids - and will even make girls like you. I joke, but it's actually a perfect lead-in to the next point: sports medicine doesn't have a perfect answer to the hamstrings problem in baseball.

Luckily, as with everything in life, the internet has all the solutions. Monday Morning Quarterbacks abound, and all these doctors, rehabilitation specialists, and strength and conditioning professionals really could have just gotten the billion-dollar solution they needed on Twitter.

As an example, when I linked to the aforementioned article on Twitter, one reply was particularly entertaining: 

"Simple fix already seen especially in female soccer training. With the 'best' sports med docs in pro sports crazy it hasn't been corrected."

This response couldn't be further from the truth.

First, comparing males and females is an issue in itself. Females have far more joint laxity, so they're significantly less likely to have "tight" hamstrings (for a variety of reasons) that could potentially be injured. Moreover, male athletes are stronger and more powerful than females, so there are gender-specific differences in the actual forces experienced. The faster you are, the more likely you are to pull a hammy. This is also why we see far more hamstrings strains in baseball than we do in softball even if they're both equally "far behind" in prevention strategies.

Second, soccer and baseball couldn't be more different. Soccer is continuous play for 90 minutes, and as I recall, the average midfielder covers approximately seven miles per game. Baseball games might last four hours, and a player might not cover seven miles in an entire month - and all of it is done at a high percentage of maximum speed. They stand or sit around, and then are expected to sprint full-tilt without much warning. Improving work capacity in soccer players can definitely reduce the risk of injury late in matches, but won't do much in the baseball world because they never really get fatigued; rather, they stiffen up from doing nothing.

Third, the competitive calendar is different. If you look at the Major League Soccer schedule, most clubs play 6-7 matches in June. Major League Baseball teams play this many games each week - and do so with a much more challenging travel schedule. That crazy schedule pushes out a lot of training time, and makes optimizing recovery incredibly difficult.

Fourth - and this is a very subjective, anecdotal observation - baseball players are less likely to take good care of themselves off the field. Major leaguers are far more likely to go out and crush eight beers after a game than the 16-year-old female soccer player that's been positioned atop a pedestal of sports medicine excellence. They also don't test for recreational drugs in 40-man roster players in MLB. Don't you think the guy who went on a bender the night before a doubleheader is more likely to strain his hamstrings than Susie Soccer who still lives with her parents?

I could go on and on about the differences, but I don't think that the point needs to be illustrated any further. Every sport has different physiological, biomechanical, social, and psychological factors that need to be taken into account in the injury prevention battle. Most people on social media can't possibly even come close to fathoming all these different contributing factors.

Now, I'm all for borrowing training ideas from different facets of the sports medicine industry. I've learned a ton from coaches in everything from sprinting, to tennis, to track & field, to powerlifting. Nobody has the perfect solution for your sport-specific problem, though (even though social media might tell you otherwise). Still look to to learn from these other professionals, but critically evaluating everything you come across. 

Above all else, make sure that you're still working hard to get educated in your specific sporting discipline. As an example, it's one reason why I highly recommend the American Sports Medicine Institute (ASMI) Injuries in Baseball course. This resource brings together some of the most renowned surgeons, rehabilitation specialists, and strength and conditioning professionals in the baseball world each year. And, it's on sale for $150 off (50% off) this week only. If you work with overhead athletes in any capacity, I'd encourage you to look into it. You can check it out HERE.

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

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