Often, I'll get inquiries that go something like this:
What do you think of yoga?
How do you feel about Pilates?
I have a friend who liked MAT. Do you think it's legit?
These are always challenging questions to answer because there are actually a number of variables you have to consider. To illustrate my point, let's try for some parallels in different industries. What do you think of real estate attorneys? Accountants? Veterinarians? Plumbers? General contractors?
As you can probably infer, there's going to be a high amount of variability in the delivery of each method, so you have to ask the following questions:
1. Is the method actually legit?
Sometimes, entire methodologies are based on bad science or bad people manipulating science for their own financial gain. A good example of this would be the thousands of different kinds of "cleanses" marketed in the nutrition/supplement industry.
2. Is the practitioner actually educated (and, where appropriate, licensed) in the method?
This is something that is near and dear to me. Each week, we get emails from young baseball players and their parents who say they train with a "Cressey guy" or someone "Eric has mentored." Then, they tell me that coach's name and I've never heard of him, and he's never even purchased one of my products or attended our actual baseball mentorship. Instead, he saw me give a one-hour talk in 2009. In describing himself, however, he positions himself on par with one of our interns who spent 3-5 months side-by-side with me six days per week. That's a markedly different level of education in our method.
As a good rule of thumb, think of the telephone game. The further away from the founder of a method, the more watered down the product becomes. As an example, Ron Hruska created the Postural Restoration Institute, and it's mostly disseminated through courses he's designed and by instructors he's trained himself. If an attendee then returns and teaches his/her staff the principles, then they teach their clients, and then the clients share their favorite positional breathing drill with a friend after a few adult beverages at a cocktail party, is it really representative of how impactful PRI can really be?
3. Does the practitioner actually have attention to detail?
Having just built a brand new Cressey Sports Performance facility, this is fresh on my mind. Not all contractors are created equal. Two can look at the exact same finished product and one person says it's beautiful, and the other says it's terrible work. No matter how great the method might be, if someone is lazy, it won't be positioned in a great light.
4. Does the practitioner understand how to "pivot" within a philosophy?
The back-to-wall shoulder flexion exercise is a central piece of our philosophy at Cressey Sports Performance. We think it's imperative to get the arms overhead without compensation at adjacent joints. Give this a video a watch to learn how we'd coach it under the three most common challenges one will typically encounter:
As you can see, these modifications rely on being able to do some basic, quick evaluations on the fly. If you don't have the ability to perform them, the client will likely just wind up banging on the front of the shoulder.
This is where a lot of group exercise methodologies can fall short. They don't understand how to pivot when someone can't perform a drill, so they wind up plowing through a bony block or exacerbating an existing movement fault.
5. Has the practitioner evolved with the methodology?
I tweeted this several years ago, but it still holds true:
If you look at your programs from 5 years ago and don't do a facepalm, you probably need to reconsider your continuing education approach.
If you look at CSP years ago versus now, it's easy to see how much we've evolved. What you would have learned in a single day of observation at the facility in 2010 is a lot different than what you'd learn on a 2020 visit. This might refer to the methodologies represented, coaching approaches, or equipment utilized.
6. Does the practitioner utilize one methodology exclusively?
As the hackneyed expression goes, "If you're a carpenter who only has a hammer, everything looks like a nail." For example, I'm very leery of chiropractors who only do adjustments when there are undoubtedly many other associated therapeutic interventions that could further help their patients. I'll always refer to multi-dimensional providers over one-trick ponies.
Pulling It All Together
As you can see, five of my six qualifications had nothing to do with the method, but rather the practitioner carrying out that method. That, my friends, is why I always refer to PEOPLE and not just methods. And, it's why you should always try to find good people - regardless of the methodologies they utilize - to help you get to your goals.
It's also why continuing education is so important: we need to understand the principles that govern how successful people can be within various methodologies. If you're looking to learn more about some of those principles and how I apply them to evaluation, programming, and coaching at the shoulder, be sure to check out my popular resource, Sturdy Shoulder Solutions.
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In this installment of Random Thoughts on Sports Performance Training, I want to hone in on shoulder stuff because, well, that's what I talk about a lot!
Let's get to the new content:
1. The neck is the easiest place to start with cleaning up shoulder movement.
I've written a lot in the past about how our arm care programs work proximal to distal, meaning that we focus on the center of the body before the extremities. Usually, the right proximal changes yield immediate distal improvements both via reducing protective tension and reducing stiffness in the muscles we're trying to "overpower" to create good movement. Usually, though, when it comes to proximal changes, folks look at the thoracic spine and rib cage only. In reality, the cervical spine ought to take precedence over both of them - particularly because all the nerve of the upper extremity originate from the brachial plexus, which ranges from C5 to T1.
Fortunately, while it might be anatomically correct, coaching optimal positioning in the neck is actually very simple in the context of weight training and arm care drills: get it to neutral and keep it there. In 99% of cases, that means getting people out of upper cervical extension, which fires up the levator scapulae (which competes against all the scapular upward rotation we want). Here's a video that walks you through what you need to know:
The thoracic spine and rib cage are sexy right now, but the cervical spine is an older, reliable option for cleaning up movement quickly in just about everyone.
2. Whenever possible, get core control integrated in your arm care drills.
I often come across arm care protocols that literally have athletes laying on a table for 30 minutes worth of "exercise." This not only leads to a disengaged athlete, but also overlooks the fact that the entire kinetic chain needs to be synced up to keep a shoulder healthy. We'll often use predominantly table-based exercises in month 1 to make sure athletes are picking up the technique in a controlled environment, but in almost all scenarios, these table drills are actually "fillers" between sets of strength training exercises that have the athletes up and around in the gym.
More importantly, after that first month, I try to make sure that at least half of our arm care exercises are done separate from the table. Maybe we do our horizontal abductions in a side bridge position, or integrate more bottoms-up carries or bear crawls for serratus activation. Perhaps the prone trap raises take place on a stability ball, or we shift to a TRX Y instead. Or, we could move the athlete to half-kneeling, split-stance, or in a rear-foot elevated position for their 90/90 external rotation holds.
Regardless of what we choose, the buy-in from athletes is definitely better - and just as importantly, the resulting training effect has a more specific carryover to sporting success.
3. Yet another study reminds us that GIRD is a measurement and not an actual pathology.
Glenohumeral internal rotation deficit (GIRD) was all the rage in the baseball sports medicine community for decades. Unfortunately, what many practitioners fail to appreciate is that GIRD can be a completely normal finding as long as an individual's total motion is symmetrical between throwing and non-throwing shoulders. We expect to see less internal rotation and more external rotation in a throwing shoulder because of retroverion in the throwing shoulder; the arc is just shifted. Here's a glimpse at what it looks like:
Anyway, we are now at a point in time where more and more research on GIRD is out there, and it's pretty resounding: it doesn't predict injury as well as we once thought. And, more importantly, the opposite seems to be true: a loss of external rotation (usually from a combination of less retroversion and soft tissue limitations) equates to a greater injury risk. We need to get more of the "GIRD? So What?" literature into the hands of doctors who aren't familiar with the latest research, as many are still making "GIRD" diagnoses when they really are just range-of-motion measurements. I delve into this in great detail in the Sturdy Shoulder Solutions product, but figured another study reiterating the point can't hurt. This one - Relationship Between Glenohumeral Internal Rotation Deficit and Medial Elbow Torque in High School Baseball Pitchers - just found that GIRD wasn't associated with medial elbow torque in high school pitchers.
It's time to move on from GIRD!
4. If you're about to have shoulder surgery (or any surgery), get your Vitamin D checked.
For years, we've known that having an adequate Vitamin D status was important for a myriad of biologic functions. Perhaps the most well known among observations on this front was a 2015 study of NFL players that demonstrated that players with inadequate preseason Vitamin D levels were more likely to have suffered a lower extremity or core muscle injury. In fact, the likelihood of a hamstrings injury was 3.61 higher in those with inadequate vitamin D levels! As such, it's become a big area of focus in the nutrition and supplementation world for athletes.
However, I've honesty never heard of an orthopedic surgeon looking at it for those who either have chronic pain or are about to undergo a surgical intervention to treat a structural defect. We need to change that, though. A recently published study, Preoperative Vitamin D Deficiency Is Associated With Higher Postoperative Complications in Arthroscopic Rotator Cuff Repair, should help in that goal, though. Patients with pre-operative Vitamin D deficiency were 1.54 times more likely to require a revision surgery and 1.16 times more likely to require manipulation under anesthesia to overcome post-op stiffness.
Clearly, Vitamin D has a huge link to soft tissue health, so don't overlook it!
Wrap-up
I'm a shoulder nerd and could ramble on all day on this stuff, but instead, I'll direct you to check out Sturdy Shoulder Solutions if you'd like to dig in deeper. You can learn more at www.SturdyShoulders.com.
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We're excited to welcome St. Louis Cardinals Major League Hitting Coach Jeff Albert to this week's podcast. Jeff's one of the most innovative coaches in the game, and this interview features lessons for players, coaches, and parents alike. I should note that we had some audio difficulties on this call, but did our best to clean it up so that the great information wasn't wasted. Thanks for your patience and understanding in advance on that front!
How Jeff’s motivation to be the best player he could be and determination to answer the question "why" propelled him into a career of coaching
How Jeff’s graduate research put his foot in the door in professional baseball despite minimal professional playing experience
Where young coaches are falling short on making the most of their early coaching career and what these individuals should be doing to be able to capitalize on opportunities in pro sports
Where Jeff recommends young coaches look for more information on quality movement
What industries outside of baseball have been most influential on Jeff’s coaching career
What professionals outside of the world of professional baseball don't understand about the changing environment of the industry
What traits Jeff looks for when hiring new coaches
How Jeff approaches development in the hitting lifespan of a ball player
What the biggest limitations Jeff sees in youth and high school hitters are
How learning to optimize a hitter’s movement with as few words as possible has revolutionized the way Jeff coaches hitting
How establishing solid positions and learning to have a good swing path lay the foundation for future swings in young hitters
How the fundamentals of a swing do not change as a hitter matures, but clarifying a hitter’s approach, transforming one of their weaknesses, or building around one of their strength aids in taking them to the next level
Why being exposed to failure is important for developing great baseball players
Where Jeff sees baseball trending in the coming years and how hitters will be combating the transformations in the world of pitching
You can follow Jeff on Twitter at @JeffMAlbert and on Instagram at@JeffAlbert28. And, you can learn more about this November's SlugFest clinic at which we'll both be speaking at www.SlugFestConference.com.
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!
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The Major League Baseball regular season wrapped up yesterday - which means that the most exciting few weeks of the year at Cressey Sports Performance are upon us. Many pro guys roll back in for offseason training, and there's plenty of playoff baseball to watch every day.
To celebrate, I've put my resource, Sturdy Shoulder Solutions, on sale for $40 off through this upcoming Sunday (10/6) at midnight. This has been one of my most popular resources of all time, and it's particularly useful if you're planning to work with baseball players this offseason. Don't miss out on this great chance to pick it up at an excellent discount. Just head to www.SturdyShoulders.com and enter the coupon code OFFSEASON19 at checkout to get the discount.
This week's exercise of the week features a new spin on an old favorite of ours. By elevating the rear foot, you can get more weight shift into the front hip on split-stance low cable rows.
In both pitchers and hitters athletes, we're constantly seeking better ways to teach front hip pull-back - and this is an awesome exercise for feeling the involved musculature. If you want to see this in action, check out the 29-30 second mark in this video of Zach Greinke:
I was surprised at how heavy we've been able to go on this exercise, as I expected a big drop off in resistance utilized because of the balancing component that's involved. In athletes with some single-leg proficiency, though, the rear-foot elevated 1-arm low cable row is an awesome progression.
If you're looking to learn more about how we assess, program, and coach at the shoulder girdle, be sure to check out my popular resource, Sturdy Shoulder Solutions.
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I first came across the "No Money" drill for scapular control and rotator cuff activation/strength back around 2008, and introduced it to a lot of people when I included it in my first book, Maximum Strength.
At the time, I was working heavily in the general population segment and hadn't gotten as entrenched in the baseball world as I am now. So, like a carpenter who only had a hammer, I started thinking everything was a nail - and logically applied the No Money Drill with all our baseball athletes.
The more time I spent around baseball players, though, the more I realized that the No Money Drill was actually feeding into the negative adaptations we saw in them: a loss of scapular upward rotation, lat stiffness, lumbar extension syndrome, etc. As a result, we've gotten away from the drill with most of our overhead athletes (depending on what we see in an evaluation). Check out this video to learn more:
If you're looking to learn more about how we assess, program, and coach at the shoulder girdle, be sure to check out my popular resource, Sturdy Shoulder Solutions.
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Not too long ago, I evaluated a baseball pitcher (left) and swimmer (right) back-to-back. It should serve as a reminder that not all overhead athletes are created equal - both in terms of the demands of their sports and the way they adapt to those demands.
The pitcher is a classic scapular depression example. Notice how “flat” the clavicle presentation is. He’s very lat dominant and struggles to get scapular elevation as part of upward rotation as the arms go overhead. He needs more upper trap activity.
Conversely, the swimmer is a scapular elevation presentation. Notice the significant upslope of the collarbone. He’s already so elevated that he struggles to get the rotational component of upward rotation. He needs more serratus anterior and lower trap, but less upper trap.
Three huge takeaways:
1. This is yet another reminder that you can’t just have a “rotator cuff program.” Both of these guys could present with the same pathology, but with completely different underlying movement diagnoses.
2. The same exercises might need to be coached differently for two different athletes
3. Whenever you see tightness, before you stretch it, ask why it’s there. With the pitcher in scapular depression, it’s a protective tension you don’t want to just stretch out. The swimmer could actually benefit.
The subscapularis is the largest of the four rotator cuff muscles, but it might also be the most misunderstood. With that in mind, I thought I'd use today's video as a chance to bring you up to speed on it:
This video is an excerpt from my popular Sturdy Shoulder Solutions resource, which is on sale for 25% right now. For more information, head to www.SturdyShoulders.com and enter coupon code MLB2024.
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It's time for this month's installment of my random thoughts on sports performance training. In light of my ongoing sale on my Sturdy Shoulder Solutions resource, I thought I'd focus this edition on the shoulder.
1. If you want a healthy shoulder, getting tobacco products out of your life is a good place to start.
The research is pretty clear: smoking is a bad idea (and an independent risk factor) if you're looking to stay healthy from a musculoskeletal standpoint, or have a good outcome in rehabilitation (whether conservative or post-surgical) . Here's an excerpt from a recent study with an excellent review of the literature:
"Cigarette smoking adversely affects a variety of musculoskeletal conditions and procedures, including spinal fusion, fracture healing, surgical wound healing, tendon injury and knee ligament reconstruction. More recently, smoking has been suggested to negatively impact rotator cuff tear pathogenesis and healing. Tobacco smoke contains nicotine, a potent vasoconstrictor that can reduce the blood supply to the already relatively avascular rotator cuff insertion. Furthermore, carbon monoxide in smoke reduces the oxygen tension levels available for cellular metabolism. The combination of these toxins may lead to the development of attritional rotator cuff tears with a decreased capacity for healing."
Many times, we're looking for the best exercise, rehabilitation protocol, soft tissue treatment, or volume amounts - but we really ought to be looking at lifestyle factors.
With a large baseball readership on this site, the logical next question: are these harmful effects also noted with smokeless tobacco (i.e., dip/chew)? The research is somewhat sparse, as it's harder to study a younger, active population than a bunch of middle-aged post-operative rotator cuff patients. However, it's hard to believe that the aforementioned carbon monoxide implications would cause 100% of the issues and that the nicotine would serve as just an innocent bystander. So if you're looking to check every box in your quest to stay healthy, it's not a bad idea to lay off the dip.
And, if healthy tendons aren't enough to convince you, do yourself a favor and read this article by Curt Schilling.
2. The 1-arm, 1-leg landmine press isn't a mainstay in your training programs, but can be a perfect fit in a few circumstances.
This looks like kind of a wussy exercise, but I actually really like it in two circumstances.
a. It's awesome in a post-surgery period when you can't load like crazy, but still want folks to be challenged in their upper extremity progressions. The single-leg support creates a more unstable environment, which means that antagonist activity is higher and there is more work going to joint stability than actual movement. In other words, it makes pressing safer.
b. Once we get to the inseason period, it allows us to check two boxes with a single exercise: single-leg balance and upper body strength (plus serratus activation/scapular upward rotation).
I've written about it a lot in the past: core positioning has an incredibly important impact on shoulder function. Check out this study on how reducing anterior pelvic tilt increases lower trapezius activation during arm elevation and the return from the overhead position.
In my experience working with extension-rotation athletes (particularly baseball players), one of the biggest risk factors for shoulder injury is when the lower trapezius can't keep up with the latissimus dorsi. Just consider the attachment points of the lat in the picture below; as you can imagine, if you posteriorly tilt the pelvis, the lat is inhibited, making it easier for lower trap to get to work.
The lower trapezius is very important for providing posterior tilt (slight tipping back) of the scapula and assisting in upward rotation. These two functions are key for a pitcher to get the scapula in the correct position during the lay-back phase of throwing.
By contrast, the lat has more of a "gross" depression effect on the scapula; it pulls it down, but doesn't contribute to posterior tilting or upward rotation. This might help with an adult rotator cuff pain patient who has an aggressive scapular elevation (shrug) substitution pattern, but it's actually problematic for a thrower who is trying to get his scapula up and around the rib cage to make sure that the ball-on-socket congruency is "flush" when it really matters: the maximal external rotation position.
As such, you can say that the lat and lower trap "compete" for control of the scapula - and the lat has a big advantage because of its cross-sectional area and multiple attachment points. It's also much easier to train and strengthen - even if it's by accident. Upper body work in faulty core positioning (in this case, too much anterior pelvic tilt and the accompanying lumbar extension) shifts the balance to the lats.
We'll often hear throwers cued "down and back" during arm care drills. The intention - improving posterior tilt via lower trap activation - is admirable, but the outcome usually isn't what's desired. Unless athletes are actually put in a position of posterior tilt where they can actually feel the lower traps working, they don't get it. Instead, they pull further down into scapular depression, which feeds the lat-dominant strategy. This is why we teach almost all our throwers to differentiate between depression and posterior tilt early on in their training at Cressey Sports Performance.
If you're looking to learn more about how I assess, program, and coach at the shoulder, be sure to check out my popular resource, Sturdy Shoulder Solutions. Learn more at www.SturdyShoulders.com.
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To wrap up my “Best of 2018″ series, I’ll highlight the top product reviews I did at this site in the last year. Here they are:
1. Complete Youth Training - This was Mike Boyle's great new resource for those who work with young athletes. He touched on everything from the problems with early specialization to age-specific training stages. It's a good investment for parents and coaches alike. I loved how his perspective as a parent coalesced with his commentary as a strength and conditioning coach and business owner. 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 4, you can get $50 off on the resource. No coupon code is needed; just head HERE.
2. The Culture Code - This new book from Dan Coyle was one of my favorite reads of the year. Dan's become a friend over the years, so I was able to get him to do an interview here at EricCressey.com when the book was released:Coyle on Culture.
3. Bought In - Brett Bartholomew is an outstanding strength and conditioning coach who has taken a huge interest in the art of "getting through" to athletes. In this course, he outlines a lot of great strategies for building rapport with athletes. Brett authored a guest post for this site as well:5 Quick Tips to Enhance Coach-Athlete Communication.
Also in 2018, I released a product of my own that was a long time in the making: Sturdy Shoulder Solutions. This resource includes close to seven hours of webinars and lab sections on everything upper extremity.
We're back to the regular EricCressey.com content this week. Thanks for all your support in 2018! We've got some great stuff planned for 2019.
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