You can see that Beckett is just short of stride foot contact here - which means that he's at just about maximal hip external rotation on the lead leg...in open chain motion.  The femur is rotating on the acetabulum.

Meanwhile, he's riding out his trailing leg...in closed chain motion.  The acetabulum is rotating on the femur.

However, what is very interesting to me is that 9/10 cases were treated non-operatively; in other words, Tommy John surgery is much less prescribed in football quarterbacks than baseball pitchers - meaning that the quarterbacks respond better to conservative treatment. What's up with that?  They are the same injuries - and presumably the same rehabilitation programs. In my eyes, it's due to the sheer nature of the stress we see in a baseball pitch in comparison to a football throw.  As a quarterback, you can probably "get by" with a slightly insufficient UCL if you have adequate muscular strength, flexibility, and tissue quality.  While this is still the case in some baseball pitchers, the stresses on the passive structure (UCL) are still markedly higher on each throw, meaning that your chances of getting by conservatively are probably slightly poorer.

The AJC followed it up with a feature on Tim where my business partner, Pete Dupuis, was interviewed: Pitcher in Escobar Trade is 5-7 Fireballer.

Landers Rehabbing Repaired Shoulder

(yes, Keith is really almost as tall as I am, even though he's kneeling)

And, last, but certainly not least, the Daily New Tribue published this feature on CP athlete Travis Dean, who was drafted in the 14th round by the New York Yankees this year: Newton's Travis Dean Weighs Options as Yankees' Pitching Draftee.

Finally, here's a blog post from ESPN.com's Brendan Hall that features a boatload of CP studs who have had great summer showings: Tyler Beede, Adam Ravenelle, Carl Anderson, Barrett O'Neill, John Gorman, Jordan Cote, Ben Smith, Matt Luppi, AJ Zarozny, and David St. Lawrence.

Click here for more information on Cressey Performance's Elite Baseball Development Program.

Finally, I'd like to see pitchers lift more - because they simply don't do enough of it during the season.  With limited time between outings, it's important to get in the most important stuff first - and I just don't see swimming as "important" when compared to flexibility training, soft tissue work, the throwing program, and strength training.

We've done this for the right reasons, and we've done it the right way.

I read a business development blog post by Chris McCombs the other day where he wrote something that really hit home for me.  When he was talking about how he decides to accept or reject a new project/opportunity, here is one of his guidelines: "Only Take on Projects That Are In Line With My Current Values and Fulfill Me Beyond Just The Money - A project must fulfill me in some way BESIDE just money...too many people spend their life JUST chasing a buck; to me, that's no way to live.  For me, the money must be there, but it should fulfill me personally, be fun, help a lot of people, and build and be in line with my current brand and brand equity." Back in 2007, I had a tough decision to make.  My online consulting business had really taken off, and the Maximum Strength book deal was in the works.  My other products - Magnificent Mobility, The Ultimate Off-Season Training Manual, and Building the Efficient Athlete - were selling well and getting great reviews, and I'd just had a study published in the Journal of Strength and Conditioning Research.  This website was growing exponentially in popularity, and I had just wrapped up my first year on the Perform Better tour - so lots of doors were opening for me on the seminar front to present all over the world - and I could have stayed home and just written all day, every day. I was getting really crunched for time, as I was already training clients 8-13 hours per day, seven days per week, as my in-person clientele had rapidly grown. My phone rang off the hook for about three weeks after Lincoln-Sudbury won a baseball state championship after I'd trained several of their guys, and one of my athletes was named state player of the year.  And, after being featured on the front page of the Boston Globe with a nipple so hard I could cut diamonds, I was in demand as a t-shirt model (okay, not really - but it made for an awesome blog post, The School of Hard Nipples).

Boatloads of renovations and equipment additions later, it wound up looking like this.

Of course, we outgrew and demolished this space after about nine months and moved three miles east to a facility twice the size.  And, we've continued to grow right up to this day; June was our busiest month ever, and July should be busier.  We've got regular weekly clients who come from four states (MA, NH, CT, RI), and in the baseball off-season, I have college and pro guys who come from the likes of OH, AZ, CA, SC, NC, GA, FL, and VA.  And, we had 33 applicants for this summer's internships.

To be very candid, though, I don't consider myself a very good "businessman."  No offense to Pete or Tony, either, but I don't think they even come close to the textbook definition of the word, either.  We just try to be good dudes. "We've done this for the right reasons, and we've done it the right way."

We don't allocate a certain percentage of our monthly revenues to advertising.  In fact, we haven't spent a single penny on advertising - unless you count charitable donations to causes that are of significance to us.

We don't search high and low for new revenue streams to push on our clients.  In fact, if I get one more MonaVie sales pitch, I'm going to suplex whoever delivered it right off our loading dock.  Rather, we bust our butts to set clients up for success in any way possible - and trust that those efforts will lead to referrals and "allegiance" to Cressey Performance.  We ask what they want from us and modify our plans accordingly.  It's what led to us bringing in manual therapy, a pitching cage, and, of course, pitching coach/court jester Matt Blake's timeless antics.

Along those same lines, we don't measure our success based on revenue numbers; we measure it based on client results.  In three years of seeing LOADS of baseball players non-stop, we've only had three arm surgeries: one shoulder and two elbow.  All three were athletes who came to us with existing injuries, and in each case, we kept them afloat as long as we could and trained them through their entire rehabilitation.  I don't want to toot our own horn, but this is a remarkable statistic in a population where over 57% of pitchers suffer some form of shoulder injury during each competitive season - and that doesn't even include  elbows!  And, our statistics don't even count literally dozens of players who have come to us after a doctor has told them they needed surgery, but we've helped them avoid these procedures.  The college scholarships, draft picks, state titles, individual honors, and personal bests in the gym are all fantastic, but I'm most proud of saying that we've dedicated ourselves to keeping athletes healthy so that they can enjoy the sports they love.

The same goes for our non-competitive athlete clients.  The fat loss and strength gains they experience are awesome and quantifiable, but beyond that (and more qualitatively), I love knowing that they're training pain-free and are going to be able to enjoy exercise and reap the benefits of training for a long time.

We don't penny-pinch during our slowest times of the month (late March through mid-May - the high school baseball season).  We see it as an opportunity to do more staff continuing education, renovate the facilities, and get out to watch a lot of baseball and support our athletes.  And, we adjust our hours to open up on Sundays and stay later on weeknights during the baseball season to make it easier for athletes to get in-season training in whenever they can.  If a pitcher wants to come in and get his arm stretched out before or after an outing, he stops by and we do it for him - but don't charge him a penny for it.  It's about setting people up for success.

We don't try to just "factory line" as many clients through our facility as possible with everyone on the same program.  You might walk into CP and see 20 different clients on 20 different programs - because a 16-year old pitcher with crazy congenital laxity is going to have a markedly different set of needs than a 16-year-old linebacker with shoulder mobility so bad that he needs help putting a jacket on.  One program on one dry erase board for hundreds of athletes isn't training; it's babysitting.

Taking this a step further, we don't boot clients out after a certain amount of time.  Clients take as long as needed to complete the day's program. And, when they're done (or before they even begin), loads of our clients spend time hanging out in the office just shooting the breeze and enjoying the environment.  As an example, Toronto Blue Jays Organizational Pitcher of the Year Tim Collins spends a minimum of five hours a day at CP all off-season.

Tim has sold girl scout cookies for the daughter of one of our clients, and he's been our back-up front desk guy when Pete is out of town.  Yesterday, he was back to visit on his all-star break - and he said hello to every client he saw - and remembered them by name.  If you're a 15-year-old up-and-coming baseball pitcher, how cool is it to get that kind of greeting when you walk into the office?  Well, at CP, kids get that greeting from 10-15 pro guys all the time.  And, if they're lucky, they might even get to throw on a bobsled helmet and join these pro guys in a rave to Miley Cyrus, apparently.

At least once a week, I get an email from an up-and-coming coach asking for advice about starting a facility.  When I get these emails, I now think about how Rachel Cosgrove recently mentioned that more than 80% of fitness coaches leave the industry within the first year. In most cases, this happens because these people never should have entered the fitness industry in the first place - because their intentions (money) were all wrong.  They usually leave under the assumption that they could never make a living training people, but in reality, these folks are going to have a hard time making a living in any occupation that requires genuinely caring about what you do and the people with whom you work, and being willing to hang your hat on the results you produce.

As such, the first advice, in a general sense, is obvious: do it for the right reasons, and do it the right way.  Sure, making a living is essential, but only open a facility because it would fulfill you "personally, be fun, help a lot of people, and build and be in line" with who you are and what your values are - which together constitute your "brand." Making the move to start up this business was one of the most daunting decisions I have ever had to make, and all the efforts toward actually getting the business started were equally challenging.  However, in the end, it has been more rewarding both personally and professionally than I could have ever possibly imagined.

Thank you very much to all of you - clients/customers, parents, EricCressey.com readers, seminar attendees, and professional colleagues - for all your support over the past three years.  We couldn't have done it without you - and look forward to many more years of doing things for the right reasons and in the right way.

4.  Chalk: Chalk up well.  Chalk the inside of your palm and fingers as well as the thumb and the back of the fingers. 5.  Thumb: Wrap your thumb up over your index finger, middle finger, or both, depending on what is comfortable.  This contact will secure your grip and it is also why you want to chalk on the back of your fingers.  If they are wet, your thumb will slip and that is no good. 6.  Heels and Glutes: Push the heels into the ground when you pull the handles up, just like you would a narrow stance deadlift.   When you near lockout, fire the glutes instead of the lower back.  You'll last longer this way and be able to do more sets. 7.  Short Choppy Steps: Take short, choppy steps when walking, especially the first few.  This allows you to conserve energy and stay balanced during your stride.  Once you pick up momentum, you can take longer strides, but it is almost always easier to maintain control with short choppy steps. Farmer's Walks are great for building Grip Strength, and that is something that is important for all sports, as well as many other lifts in the gym. Interested in learning more about Jedd's unique grip training ideas?  Check out his new e-book, Ultimate Forearm Training for Baseball.

Of course, if you compare the perturbations to stability that the Bodyblade provides, it appears to simulate some of what you'd get with a rhythmic stabilization drill.  So, it's probably a good alternative to a pitcher who doesn't have a training partner, therapist, or coach who can provide those destabilizing torques.  Shirts, apparently, are optional.

That said, to me, using a Bodyblade is a more closed-loop (predictable) drill, whereas manual rhythmic stabilizations are more open-loop (unpredictable).  So, it goes without saying that the benefits of "surprise" stabilization probably extend a lot further - and they don't cost a penny.  Moreover, I've heard claims about the Bodyblade being an effective way to build muscle, which (outside an untrained population) just isn't going to happen.  There are also much better ways to train the core.

For more information, check out the Optimal Shoulder Performance DVD set.

In the same grain as Monday's post on lower back pain, today, I thought I'd highlight some of the common findings in diagnostic imaging of the shoulder, as these findings are just as alarming.

Do you train loads of overhead throwing athletes (especially pitchers) like I do?  Miniaci et al. found that 79% of asymptomatic professional pitchers (28/40) had "abnormal labrum" features and noted that "magnetic resonance imaging of the shoulder in asymptomatic high performance throwing athletes reveals abnormalities that may encompass a spectrum of 'nonclinical' findings."  Yes, you can have a torn labrum and not be in pain (it depends on the kind of labral tear you have; for more information, check out Mike Reinold's great series on SLAP lesions, starting with Part 1).

This isn't just limited to baseball players, either; you'll see it in handball, swimming, track and field throwers, and tennis as well.  And, it isn't just limited to the labrum.  Connor et al. found that eight of 20 (40%) dominant shoulders in asymptomatic tennis/baseball players had evidence of partial or full-thickness cuff tears on MRI. Five of the 20 also had evidence of Bennett's lesions.

The general population may be even worse, particularly as folks age. Sher et al. took MRIs of 96 asymptomatic subjects, finding rotator cuff tears in 34% of cases, and 54% of those older than 60 - so if you're dealing with older adult fitness, you have to assume they're present in more than half your clients!

Also, in another Miniaci et al. study, MRIs of 30 asymptomatic shoulders under age 50 demonstrated "no completely 'normal' rotator cuffs."  People's MRIs are such train wrecks that we don't even know what "normal" is anymore!

As is the case with back pain, these issues generally only become symptomatic when you don't move well - meaning you have insufficient strength, limited flexibility, or poor tissue quality.  For more information on how to screen for and prevent these issues from reaching threshold, check out Optimal Shoulder Performance from Mike Reinold and me.

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Here, you've got supination of the forearm, external rotation of the shoulder, scapular retraction/posterior tilt, and thoracic spine extension/rotation occurring simultaneously on the "lay back" component.  And, the opposite occurs as the athlete returns to the starting position.  Again, to reiterate, this is NOT a drill that is appropriate for a large chunk of throwing shoulders who already have crazy external rotation; it's just one we use with specific cases of guys we discover need to gain it. With the broomstick dislocation, you're going to be throwing a lot of valgus stress on the elbow - and as I noted in my recent six-part series on elbow pain, pitchers already get enough of that.  To read a bit more, check out Part 3: Throwing Injuries.

In just the past few days, I've had two separate conversations with some really knowledgeable CP "dads" who also happen to have a ton of experience with coaching youth baseball players, particularly hitters.  In both conversations, a (paraphrased) line that stood out was "improving as a hitter in the teenage years is largely about learning to use the hips."

In contrast, have the same hitting conversation with just about any professional baseball player, and he'll tell you "I hit with my hands."

So who is right?  Do professional players not use their hips?  Or, do kids not use their hands?

Actually, both parties are right.  You don't get to professional baseball in the first place if you don't use your hips well when hitting.  And, you don't succeed (and stick around) in professional baseball unless you use your hands efficiently and have remarkable hand-eye coordination.  It's just multiple levels of natural selection that set the best apart - and they may sometimes forgot about the early stages of progress.

Need proof?  Watch a little league batting practice session, and then go to a big-league game to watch their batting practice.  The young players all pull the ball on every pitch, whereas the big-leaguers usually spray the ball all over the field, moving from the opposite field to the pull side.  They do this with their hands and wrists, all the while taking the hips for granted.

Think about this: how many more TFCC (wrist) injuries and hamate (hand) fractures do we see in professionals when compared to teenagers?  There are a lot more - because this area gets used a ton more.  Kids, on the other hand, get stress fractures if they misuse their hips.  It's no surprise, given the crazy rotational velocities and ranges of motion we see in hitters (outlined in my old articles, Oblique Strains and Rotational Power and Oblique Strains in Baseball: A 2011 Update).

What is a surprise, though, is that nobody has caught on to the ramifications of what this means for the youth baseball player who is learning to hit.

If a kid wanted to be a NASCAR driver, would we start him with a few 200mph laps at the Speedway amongst dozens of other drivers?  Of course not.

Why, then, do we have kids playing 180-200 games per year between school teams, AAU, fall ball, and even winter ball?  Where is the opportunity to learn how to hit in a controlled environment (closed loop), as opposed to trying to learn how to hit in live situations off of kids with no control (open loop).  Don't get me wrong; many programs do a tremendous job with instruction and really do build outstanding technical hitters - but as much as I hate to say it, the occupation of "hitting coach" seems to be a dying profession.  Why?

1. Schools are starting to put batting cages on campus for year-round hitting, and some kids don't appreciate that they need to learn to hit.

2. Some people see more money in AAU programs than individual instruction.  If a hitting lesson is personal training, running a team practice is semi-private training: more money in less time (and it's usually cheaper for the players).  This strategy can work if it's executed properly with sufficient coaching on-hand and the right demographic in mind; I have seen some AAU programs that are run with outstanding organization and excellent individual instruction at crucial parts of the year.

What is the right demographic?  I can't say for sure - but I can tell you that we need to be really careful in dealing with kids in the 11-17 year-old range.  They're learning to use their hips in an incredibly technically precise motion while their bodies are changing rapidly thanks to growth spurts and the fact that they spend 20 hours a day on their cans, thanks to sleeping, sitting at school desks, and playing around on Facebook and Instant Messenger.  We're giving more physically demanding challenges to less physically prepared (and, many times, less motivated) kids.

Kids need good hitting instruction early.  They also need targeted mobility work, foam rolling, and appropriate resistance training.

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