I'm writing this blog on Tuesday night, as I'm pretty sure that my mind will be a bit hazy after the insulin-induced coma that follows my Thanksgiving feast.
1. While I've had a week-long argument with my new website set-up, I have to say that one of the cool features I now have is a really detailed analytic panel to look at hits, referring sites, and the keywords people used in their searches to find my site. Believe it or not, 6.8% of my readers can't spell my last name correctly in a web search. So, just to be clear, it's "CRESSEY," not "CRESSY." The extra "E" stands for excellence, in case anyone was wondering. Stop laughing.
2. I work with two pro ballplayers who were drafted out of Harvard, and the other day, we got to talking about how I had finally gotten DVR on my TV (mostly for my girlfriend, to be honest). They started talking about how it'd be nice to be able to fast-forward through the commercials, and I commented on how that parallels what I do with educational DVDs. You see, I just push fast-forward and listen to things in about half the time it would take to hear the entire thing. I still comprehend everything - kind of like this guy:
They were kind of floored that I could do that - although I'm really not sure why. I'd be willing to bet that there were a lot of students at Harvard who are a lot more cyborg-ish than I am.
3. For the record, this strategy comes in handy when listening to presenters with Midwestern and Southern accents. I employed it with great success when viewing the 2008 Indianapolis Performance Enhancement Seminar DVD Series, as that Robertson character is one........sloooooooowwwww......talker.
Kidding aside, this was a fantastic seminar; I'd highly recommend you pick up a copy. I actually reviewed it in detail in a previous blog entitled The Best Thing I've Seen All Year.
4. Eric Chessen has a new blog about Autism Fitness. Definitely check it out at www.Autism-Health.com if that's your cup of tea. Eric's at the head of his field in this regard.
5. I'm going to be writing a new article for T-Nation this weekend. And, while I have some ideas on what I am going to write, I'm always open to suggestions. If you have one, please post it as a comment on this blog and I'll see what I can do.
6. HERE is an interesting new study I just read that talks about performance decrements with subtle sleep deprivation. These results seem to suggest that if you're going to miss hours of sleep, it is better to do so by going to bed later than it is to do so by rising earlier. We always teach our athletes that one hour of sleep before midnight is worth two after midnight, so these results would seemingly fly in the face of our recommendations. However, these recommendations assume no sleep deprivation. In other words, I'd rather have an athlete sleep 11pm-7am than I would have him sleep 2am-10am.
Just a quick one this week in light of the holiday. Have a great weekend!
This past weekend, I attended a great seminar here in Boston with Dr. William Brady. In fact, it was among the best I've seen. I was the only non-chiropractor/manual therapist in attendance, but walked away from the seminar with some tremendously valuable insights that'll help me with each and every one of my clients moving forward.
The first lesson of the day is that those of you who have an opportunity to see Dr. Brady speak should absolutely, positively check him out: Integrated Diagnosis. Diagnostically, he's among the best I've ever seen - and that includes his ability to teach others.
The second lesson of the day revolves around an important concept Dr. Brady extended - and my take on how you can modify this message to accommodate your role as a coach, trainer, or fitness enthusiast/athlete. There is a reason that almost any doctor or physical therapist gets results - and it resolves around understanding where symptom threshold occurs. To illustrate this, let's examine a shoulder problem purely from a soft tissue perspective.
Dr. Brady talked about how you have building blocks to threshold. Let's say that after an accurate physical examination, this particular shoulder problem (supraspinatus tendinosis, for example) presents with soft tissue restrictions at the infraspinatus, teres minor, subscapularis, inferior capsule, and pec minor. So, symptom threshold (the dotted line) might look like this relative to baseline (straight line):
Pec Minor
- - - - - - - - - - -
Inferior Capsule
Subscapularis
Teres Minor
Infraspinatus
BASELINE - NO SYMPTOMS
So, imagine a therapist who just addresses pec minor. He gets that patient below threshold, but doesn't necessarily "fix" him; he might be back in with the same problem weeks later. This is confounded by the fact that "overuse" is actually one of the building blocks, too. So, even if you leave all the soft tissue restrictions alone, simply resting will get someone below threshold - even if the therapist has done ZERO to address the underlying problems.
This is one reason why a MRI might not tell you much at all about someone's problem. With this problem, the MRI would probably just say "supraspinatus tendinopathy" and recommend physical therapy and rest from painful activities. So, in the "full picture" - where soft tissue work is one of several components (assume they are equal contributors, for the sake of our argument) - the building blocks to threshold might look something like this:
Overuse
Rotator Cuff Weakness
Scapular Stability
Poor Glenohumeral (Ball-and-Socket) Range of Motion
- - - - - - - - - - - - - - - -
Soft Tissue Restrictions
Poor Thoracic Spine Mobility
Type 3 Acromion (non-modifiable, without surgery)
Poor Exercise Technique
Poor Cervical Spine Function
Opposite Hip/Ankle Restrictions (baseball pitchers are great examples)
Inappropriate Structural Balance in Programming (e.g., pressing more than pulling)
Faulty Breathing Patterns
BASELINE - NO SYMPTOMS
So, we've got 12 factors, and it's been my experience that conventional physical therapy only treats the first four - which would, in fact, bring a patient below symptom threshold. Put that patient back in the real-world with the other eight factors still present (seven of which are modifiable), and as soon as he gets back to bench pressing with terrible technique Monday, Wednesday, and Friday, he's going to be back in for more physical therapy sooner than later.
So, what do we do in an ideal scenario (not always possible with today's insurance plans)?
1. More time with patient education (exercise technique, programming strategies - or just outsource it to a qualified professional or good book/article or DVD).
2. Address Thoracic Mobility (Assess and Correct is a great resource for this)
3. When present, address Hip and Ankle Mobility
4. Retrain some breathing patterns with initial instructions home exercises
5. Provide some take-home neck drills and get people out of chronic forward head posture
All told, I think this could be as simple as 4-5 extra drills in each shoulder rehab program plus a brief sit-down conversation with each patient on exercise program modifications; it really is that simple. Unfortunately, it rarely happens - and that's when things become chronic.
So, fitness professionals and coaches need to step up as advocates for their clients and athletes, respectively, and fitness enthusiasts need to be relatively informed "consumers" to look out for themselves.
1. This is my first post on the new blog, so apologies in advance if:
a) the font style or color is out-of-whack
b) it comes up in Portuguese (meaning that you’d have no idea what I am saying, anyway)
c) your computer freezes up on account of the complete and utter awesomeness that you’re beholding with the new site
Kidding aside, it’s been a royal pain in the butt thus far and I’m just anxious to have it done so that I can just go back to writing.
2. Believe it or not, as some of you probably have noticed, I haven’t blogged for a full week.There was just a ton of stuff to get gone for the new site as well as loads of other projects on my plate.
Interestingly, though, it was by far my best week of training since the spring.I had a great front squatting session on Tuesday, and although Wednesday was supposed to be a day off, I got antsy later in the day.So, I did a little sprint work – and it felt great.So, I figured what the heck: I might as well test my vertical jump and broad jump.I wound up jumping a personal best of 34.7 inches and then tying a personal best on the broad jump with 114 inches.As a cooldown, I wrestled a grizzly bear and then did walking lunges in the parking lot with an intern over each shoulder.Those whippersnappers will learn!
Random digressions aside, it’s very clear that this blog is completely counterproductive for my strength, power, and physique goals.In fact, I’d say that is roughly on-par with distance running as a competing demand for my attention and physiological recuperation.I’m going to take one for the team and keep writing, though; winners persevere.
(and in case you folks didn’t pick up on it, that was a joke)
Essentially, this is a survey of all the available research on the topic, and here is what they determined: “Only one trial was found that investigated the efficacy of PUFAs and antioxidants on tendinopathies. The findings suggest that some (low level) evidence exists to support the supplementation in the management of tendinopathies. Any conclusions based on this one article should be reached with caution. Subsequently, there is a distinct and clear need for well-planned randomized controlled trials that aim to investigate the efficacy of supplements in the management of tendinopathies including those of the rotator cuff.”
Meanwhile, we spend BILLIONS on NSAIDs, cortisone shots, and surgeries.Don’t you just love the medical model?While these options are certainly warranted in some situations, we’re studying for the wrong test by ignoring the role of PUFAs and antioxidants in the treatment of tendinopathies.
Chances are that the NIH won’t soon fund anything to look at this, though, as they are too busy doing the 38,736th study in history on creatine.
4. A good cartoon, in light of the week ahead:
5. Speaking of turducken, is anyone looking forward to listening to John Madden on Thanksgiving as much as I am? I mean, this is quite possibly the greatest broadcasting spectacle in football history, as Madden will be bouncing off the walls try to slip in as many Brett Favre references as possible - even if Favre and the Jets don't play until the following Sunday.
And, Frank Caliendo as Madden is awesome. They played this on the airplane on the ride back from Georgia a few weeks ago and everyone on board was laughing hysterically.
6. Another interesting study that ought to make you think:
Basically, the researchers found that college baseball players and swimmers were 3.23 and 2.95 times more likely (respectively) than their non-athlete counterparts to have disk degeneration.And, there was a clear association between disk degeneration and lower back pain.
Now, here is something to consider…I would be willing to bet that if you took these athletes and actually trained their “cores” the right way, they would be better off long-term than the nonathletes – in spite of the amount of disc degeneration that’s present already.I feel very strongly that multidirectional lumbar stability goes a long way in overcoming any structural flaws – from vertebral fractures (spondylolysis) to disc issues; there are a lot of structurally jacked up backs out there that are completely asymptomatic.
To me, it’s the folks who do nothing that are most at-risk of debilitating back pain long-term.When s**t hits the fan for them, they are playing behind the 8-ball, as they’re older and completely untrained.So, they are starting from scratch when it’s the hardest to start from scratch.Food for thought.
In the meantime, pick up a copy of Combat Core and save yourself.It’s the best “core training” program out there.
7. That last thought was pretty heavy with techy stuff, huh?Did it blow your mind?You know, kind of like it blew your mind when David Hasselhoff talked to that car – and the car actually talked back?
Yeah, that was crazy.
Anyway, that's all for this week. Did you miss me?
It's Halloween, and as you're reading this, I'm down in Georgia for baseball stuff. Because I'm actually writing this on Tuesday night, it's hard to get in the mood and be spooky, but I'll do my best.
1. I'll be doing a LOT of baseball seminars over the next few months: November 8-9 (NY), December 14-16 (TX), January 30 (MA), and February 14 (MA). For more information, check out my schedule page.
2. I actually think the Fat Tax is a good idea. While we're at it, can we institute an a**hole tax for guys who curl in the squat rack? My girlfriend was lifting at a gym down in Southern CT this week, and she told me a guy took up a squat rack all morning to do three curl variations - and then proceeded to set up two bars in the rack to do dips. The good news for him, though, is that the Horse's A** trophy he receives partially offsets the tax.
3. When dealing with athletes post-ACL reconstruction, it's obviously important to get range-of-motion back quickly. However, the direction of that ROM can actually tell you quite a bit about what is going on. When someone is struggling to get knee extension, the problems are usually do to scarring. Flexion problems, on the other hand, are usually related to graft tensioning issues. In other words, when there is loss of flexion, it is usually surgical. When there is loss of extension, it is usually rehabilitative. When there is a loss of both flexion and extension, the problem is - you guessed it - Richard Simmons.
Yes, he's spooked, spooky, and stupid. I don't want your trick or your treat, Richard; I just want you to put some pants on and get a haircut.
4. Scientists recently confirmed a virgin birth in a shark. Apparently, the baby shark (called a pup, for reasons I can't explain) carried no male genetic material. Immediately upon its birth, the shark started bitching about how it didn't want to get too bulky.
Scientists fear for the pup's survival, as it refuses to swim fast enough to catch its prey because it doesn't want to get out of the "fat burning zone."
5. I went into quite a bit of detail on why I dislike the term "shoulder impingement" in my newsletter this week. Check it out HERE.
Just five this week, as I've got lots to do. Have a great weekend!
We are publishing this on Thursday night again, as I am going to be up early tomorrow to train, do an evaluation on a pro baseball pitcher who is in town from South Carolina, and then hit the road to get to Stamford, CT in time to speak on a roundtable at Ryan Lee’s Bootcamp. I’m looking forward to a great weekend and catching up with plenty of friends in the industry – including Mike Roussell and Alwyn Cosgrove, which leads me to…
1. For those who missed it, it isn’t too late to get the EricCressey.com subscriber-only discount on Warp Speed Fat Loss. Check out this week's newsletter for more details – or just head over to pick up a discounted copy through the following link (coupon code is embedded already):
Warp Speed Fat Loss
2. Still overpriced and lame.
3. Alan Aragon had a great article published at T-Nation yesterday. Definitely check it out:
A Musclehead’s Guide to Alcohol
4. Anyone who can find me a good study that shows that you can isolate the vastus medialis effectively gets a gold star. If you want to save yourself a few days of frustrating Pubmed searching, you’ll give up now, because you aren’t going to find it.
5. Someone asked what I thought the best substitute for front squats would be in the Maximum Strength program if one didn’t have access to a power rack. I’d probably go with walking dumbbell lunges – mostly because it’d be funny to see someone do clusters with lunges!
For the record, that was a joke, folks; lunge clusters would be stupid.
6. Some researchers say that we all would die of heart disease eventually if we “outlasted” everything else. I, on the other hand, would likely die from the monotony and pure frustration of trying to explain to baseball players and coaches why distance running is stupid. To tack a few years onto my life, please do me a favor; if you are a baseball player or coach, you need to read these two articles – and then forward them on to everyone you know who also plays or coaches.
Part 1Part 2
7. Someone asked me the other day if I thought all problems were related to anterior pelvic tilt. While it’s a big problem in athletes, I would not attribute any of the following problems to anterior pelvic tilt: gonorrhea, shingles, global warming, diarrhea, traffic jams, or that annoying cashier at Trader Joe’s who always insists on commenting on how I’m buying a lot of eggs. I do hope that bastard’s hip flexors are tight, though; he rubs me the wrong way. Michelle would probably kill him for a stupid comment like that.
8. I’ll be introducing a new product next week. While many of you might be disappointed that it won’t be the 2009 Mike Robertson Pin-up Calendar (March is the Funky Knee Surgery Scar Month; it drives the ladies wild), I’m sure you’ll be delighted with the content. This is absolutely, positively, a must-read for all personal trainers and strength and conditioning coaches. And, I suspect that a lot of you everyday gym-goers will like the content as well. If you aren’t already signed up for my free newsletter, sign up using the opt-in feature to the top-right of your screen (Name and Email Address) and you’ll be among the first to know.
Have a great weekend, folks!
We see a lot of baseball players, so a lot of these guys come to use with elbow problems. In most cases, the doctors they’ve seen have said, flat-out, “NO LIFTING WEIGHTS.” This drives me nuts for a variety of reasons:
1. They’ve still got two good legs, one good arm, and a bunch of core musculature that needs to be strong and functional.
2. This recommendation implicitly means “Stay away from personal trainers and strength coaches.” It’s probably due to the fact that there are a lot of bonehead personal trainers out there who could do more harm than good, but the truth is that these services comprise more than just lifting weights. We do a lot of mobility and activation work and self-myofascial release on the foam roller.
Collectively, #1 and #2 demonstrate that this blanket recommendation includes an insanely ignorant omission, as the majority of elbow problems can be attributed to mobility and strength deficits at the shoulder. You can train a shoulder a thousand different ways without even involving elbow motion – let alone challenging it sufficiently to cause a problem. In fact, I'd estimate that you could prevent 90% of elbow problems in baseball guys if we simply taught all of them how to sleeper stretch in their early teenage years:
I'd strongly encourage you to check out this article I wrote, where I go over the common mistakes folks make when performing the sleeper stretch.
3. This recommendation flat-out ignores the specific nature of the overwhelming majority of elbow problems in throwing athletes. Let me elaborate..
In my estimation, 95% of baseball players with elbow pain couldn’t elicit their pain in a weight room if they wanted to; seriously! The reason is that this elbow pain is typically mechanical in nature; that is, it’s only aggravated by specific activities (in their case, throwing).
Believe it or not, I have had guys do everything from pull-ups, to dumbbell bench presses, to rows, to push-ups, to grip work just days out from elbow surgery. It isn’t true in every case, but it’s definitely the majority. And, they can all get diesel in the lower body during this time period.
Some great related reading for you:
Inefficiency vs. PathologyLay Back to Throw GasSign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches
used by Cressey Performance Pitchers after they Throw!
Q: A trainer at my gym was telling me that the best way for a bodybuilding competitor to perform lateral raises was to execute them in or slightly behind the frontal plane and in the "empty-can" hand position (he said this is good for long-term shoulder health since he claimed it would strengthen the supraspinatus) while leaning slightly forward.
Do you think this recommendation is conducive to long-term shoulder health, or would it lead to excessive wear and tear and potentially create impingement problems? Or is it a case of this being perfectly acceptable for some populations and a nightmare for others? If it is the latter, who can perform them this way and who should avoid them?
A: I disagree wholeheartedly. The empty can is a provocative test; it's what we do when we want to see just how angry an injured supraspinatus is.
If you want to keep the supraspinatus healthy, you don't need to make a dedicated effort to strengthen it. You need to strengthen the muscles that position the scapula so that there is more clearance through which that tendon can pass under the acromion process. These would include lower trapezius and serratus anterior. Strengthening the muscles of the rotator cuff will help to depress the humeral head as well.
There is also a definite role for thoracic spine mobility (as I wrote about in a previous newsletter) in this situation, as it helps dictate the positioning of the scapulae.
Sign-up Today for our FREE Baseball Newsletter and Receive a Copy of the Exact Stretches
used by Cressey Performance Pitchers after they Throw!
1. As you probably know, I haven't been updating here quite as frequently of late, but fortunately, it's with good reason. The summer's winding down, so we've been getting our fall schedule all squared away with the high school guys - plus some local college guys at programs that don't have organized S&C programs. Additionally, all of our minor leaguers are in the final few days of their seasons right now, so coordinating with them and a few agents has been a priority right now. Fortunately, though, there are also some exciting things in store for this blog...
2. Basically, we're going to be combining EricCressey.com with EricCressey.Blogspot.com. So, my blog will be available directly from EricCressey.com. In the process, we have to transfer a ton of content - but the good news is that the finished product will look a lot more professional and organized when all is said and done. In the meantime, thanks for your patience as we make this switch.
3. I was chatting yesterday with Doug Carroll, a great hitting coach with whom we work. Doug played professional baseball to a very high level in both the Mariners and Devil Rays organizations. We both agreed that one thing you’ll notice in the majority of high level athletes is that they really don’t give a crap what anyone outside their family thinks of them. I think that if more people approached their lifting with this mindset, we’ve have a lot more people who were really big and strong. Interestingly, this closely parallels my approach to internet forums - and, thus far, ignoring what the haters say has been a great decision.
4. Never forget that you don’t have to leave the gym exhausted for the session to be considered productive. Take a 300-pound lineman and have him run five miles; he’ll be completely exhausted by the end of the session. He’ll also be slower, more likely to get injured, and definitely more likely to want to kick your teeth in.
5. Something you might not know: there are estrogen receptors on the anterior cruciate ligament (ACL) that – along with several other factors – make females more susceptible to ACL ruptures. The cyclical nature of estrogen and progesterone markedly influences ACL strength via fibroblast activity – so at certain times of the month, the ACL is more likely to tear. The ACL may also be predisposed to dramatic mood swings that make everything your fault, fellas.
6. I had a new article published yesterday, in case you missed it: 5 More Common Technique Mistakes.
7. I got two separate bills from Comcast in the past two days for a total of over $314. Do you think they read my blog, or is their billing system simply as hopelessly inadequate as their customer service?
8. Someone asked me yesterday, "Are single-leg leg press a good unilateral leg exercise? I hate lunges." Sorry, dude; single-leg leg presses don't count for anything.
9. I'm working on a detailed write-up on my views on running for pitchers right now. I think it'll open a lot of eyes - if I ever get time to finish it! I also have a new e-book in the works that I think will open a lot of eyes.
10. Have a great holiday weekend, everyone.
It was a hectic day, and I just (finally) got internet access at our new place, so I'm going to be brief and use today for a few quick notes:
1. Congratulations to Cressey Performance athletes Derek Lowe (Lincoln-Sudbury) and John McKenna (Algonquin). Derek verbally committed to the William & Mary baseball program, and John did the same for the University of Massachusetts. Congratulations, guys; we're proud of you!
2. I just got an email from Patrick Gagnon about the second annual Vinkofest, which will take place in Montreal September 27-28. I spoke at the event last year, and Pat did a great job organizing it. While I won't be in attendance this year, I'd definitely encourage any of you who can make it to get out and check this event out. They have some great speakers, including John Berardi, Christian Thibaudeau, and Dave Barr. For more information, check out MuscleDriveThru.com.
Cressey Performance athlete and Weston High pitcher Sahil Bloom committed late last week to Stanford. Here's a great article from the Boston Globe on his signing and training with us.
Weston High pitcher buffing up his body as well as his scores
Congratulations, Sahil!
