We welcome free agent MLB pitcher Trevor Rosenthal to the latest podcast. We talk about transitioning from shortstop to pitching, and then from starting to relieving. He discusses why some pitchers thrive with being challenged at young ages while others struggle, and highlights some key components of his pre-game preparation. We also touch on lessons learned from Tommy John and Thoracic Outlet Syndrome surgeries, as well as key competencies of the best coaches he's had.

A special thanks to this show's sponsor, AG1. Head to https://www.DrinkAG1.com/cressey and you'll receive a free 10-pack of Athletic Greens travel packets with your first order.

You can follow Trevor on Twitter at @TrevRosenthal.

Sponsor Reminder

This episode is brought to you by AG1. AG1 is your daily foundational nutrition; it has 75 whole-food sourced ingredients designed to support your body’s foundational nutrition needs across five critical areas of health: 1) energy, 2) immunity, 3) gut health, 4) hormonal support, and 5) healthy aging. It is the new and future way of getting a multivitamin, and a whole lot more. Head to www.DrinkAG1.com/cressey and claim my special offer today – 10 FREE travel packs – with your first purchase. I use AG1 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!

We're excited to welcome Arizona Diamondbacks relief pitcher Scott McGough to the latest podcast. Scott starts by speaking to his multi-sport, cold-weather upbringing and how it impacted his longer-term development. He also discusses lessons learned during Tommy John Surgery rehabilitation, pitching in Japan, and refining his pitching and training approach as his career progressed. Scott is one of the absolute best people I know in the game of baseball, and this conversation will help you to appreciate why.

A special thanks to this show's sponsor, AG1 by Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 10-pack of Athletic Greens travel packets with your first order.

You can follow Scott on Twitter at @Scooter_McGough.

Sponsor Reminder

This episode is brought to you by AG1 by Athletic Greens. AG1 is your daily foundational nutrition; it has 75 whole-food sourced ingredients designed to support your body’s foundational nutrition needs across five critical areas of health: 1) energy, 2) immunity, 3) gut health, 4) hormonal support, and 5) healthy aging. It is the new and future way of getting a multivitamin, and a whole lot more. Head to www.AthleticGreens.com/cressey and claim my special offer today – 10 FREE travel packs – with your first purchase. I use AG1 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!

It's time for another listener Q&A, so I cover three questions from our audience in this week's podcast on the following topics:

1. Do you have any tentative guidelines for working with post-op Tommy John patients who are trying to maintain a training effect during their rehab?
2. What do you think when you hear that a MRI is “clean?”
3. Why do shoulder surgeries in throwers have such a lower success rate than elbow surgeries?

A special thanks to this show’s sponsor, AG1 (formerly Athletic Greens). Head to http://www.athleticgreens.com/cressey and you’ll receive a free 10-pack of travel packets with your first 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!

We welcome Miami Marlins starting pitcher Braxton Garrett to the latest podcast. Braxton shares insights on how his mechanics and pitching approach has evolved, and how adversity has shaped his ability to compete at the Major League level.

A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 10-pack of Athletic Greens travel packets with your first order.

You can follow Braxton on Instagram at @BraxGarrett and Twitter at @BraxGarrett.

Sponsor Reminder

This episode is brought to you by Athletic Greens. It’s a NSF-certified 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 - 10 FREE travel packs - 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!

It's time for another listener Q&A, so I cover three questions from our audience in this week's podcast:

1. Tommy John surgery rates have skyrocketed over the past decade across all levels of basebalI. I know you’ve supported some of the highest profile athletes through their rehabs at CSP during this time, so I’m curious as to whether there have been any evolutions in your thought process on how you view or manage them?
2. What’s your approach to an athlete that has a Hip ER/IR total motion difference of greater than 10 degrees?
3. The more I learn, the more stressful I find programming for athletes. Any tips for this?

A special thanks to this show’s sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you’ll receive a free 10-pack of Athletic Greens travel packets with your first 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 – 10 FREE travel packs – 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!

We welcome St. Louis Cardinals pitcher Packy Naughton to this week’s podcast. I've known Packy since early in his teenage years and seen his development as a high school, college, and professional pitcher. In this conversation, he shares some great insights on the Tommy John rehab process, and what young players can do to take ownership of their careers.

A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 10-pack of Athletic Greens travel packets with your first order.

You can follow Packy on Instagram at @Packy_Naughton.

Sponsor Reminder

This episode is brought to you by Athletic Greens. It’s a NSF-certified 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 - 10 FREE travel packs - 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!

For this week's podcast, I'm flying solo as I tackle three questions from listeners:

1. Why do some pitchers come back to throw harder after Tommy John surgery?
2. What are some of the bigger mistakes you see athletes make with long toss?
3. What's your opinion of pitchers doing direct strengthening work for the forearm, wrist, and hand?

A special thanks to this show’s sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you’ll receive a free 10-pack of Athletic Greens travel packets with your first 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 – 10 FREE travel packs – 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!

About ten years ago, I was in the operating room to observe my first Tommy John surgery. Much like my time in gross anatomy class during my undergraduate studies, it was an invaluable experience that helped me to appreciate human structure (and, in turn, movement) in a way that anatomy textbooks couldn't offer.

Textbooks typically present a very "neat" anatomy where muscles, tendons, ligaments, bones, and nerves are predictably positioned. You can imagine my surprise, then, when the surgeon made the initial incision along the medial elbow and it yielded a bunch of "stuff" in the way. The fascia, the intermuscular septum, the ulnar nerve, and a host of other unrecognizable structures make you realize that a) every anatomy course or textbook you've ever undertaken hasn't done justice to what's really going on at the elbow (or anywhere else in the body, for that matter), b) it takes a lot of practice to become a great surgeon, and c) you shouldn't let just anyone cut you open for surgery.

Now, let's fast-forward to the post-operative timeline. After the repair is complete and the patient is stitched up, the elbow is splinted at 90 degrees of flexion for a week. Following that week, the arm is put in a hinged brace that gradually allows more motion over the course of weeks 2-6. After six weeks, the brace goes away. In short, it's quite a bit of time with the elbow in a limited range-of-motion situation as a means of protecting the repair.

Not surprisingly, some patients have a lot of trouble getting back their motion - both from the graft gradually stretching out and the musculotendinous structures regaining their length. We'd be crazy to think that the aforementioned fascia structures aren't implicated in the challenges of regaining ROM, though. And, if they've got a role in limiting ROM, they've certainly got a role in the associated stiffness (and, sometimes, pain) that post-operative patients feel. Here's where a variety of manual therapy interventions - ranging from dry needling to instrument-assisted work - have yielded outstanding results. While some folks like to scream and shout in opposition to this fact, it's hard to refute that manual therapy has endured the test of time to the tune of thousands of years.

Massage has been around for 4,300+ years, yet there are still people out there who deny the value of manual therapy? pic.twitter.com/uMUSPpPpJK

— Eric Cressey (@EricCressey) May 24, 2016

Only recently have there been technology advancements that allow us to better understand the role of the fascia system with respect to pain and performance (Bill Parisi spoke to this on our podcast a while back; listen here). In a seminar not too long ago, my friend Sue Falsone highlighted some great evidence on the "decompression" that takes place in this regard with a cupping intervention.

Now, let's take a step back and think about the big picture of diagnostic imaging. When we have chronic pain that alters movement patterns, we have adaptive changes of the fascial system. While the diagnostic imaging - MRI, CT scans, x-rays - might pick up on the structural defect, it might overlook the compensatory changes to the fascial system (much of which overlays the actual injury) that can't be appreciated by these types of scans. 

When we look at chronic shoulder pain, is the problem only the rotator cuff tear? Or is that problem magnified by the fascia limitations that arise from years of avoiding various ranges of motion (including at adjacent joints) that would normally be accessible?

I've written extensively about having both a Medical and Movement Diagnosis. The truth is that the discussion of the fascia system is probably a happy medium between the two. We may think too much about the injury the diagnostic imaging identifies and too little about the overlying and surrounding tissues. At the other end of the spectrum, we may be too quick to define a movement limitation as joint, musculotendinous, ligamentous, or motor control without first considering the role the fascial system is playing.

What's the most important lesson here? Professionals from all walks of sports medicine need to work together to thoroughly evaluate injuries and movement competencies in order to design the best performance and rehabilitation programs. And, we need to remain openminded to new technology that may make it easier for us to take an even more accurate and individualized approach to each case.

In this vein, I'd highly recommend checking out my new Thoracic Outlet Syndrome course, as this challenging diagnosis is a great example of how a condition often can slip past common diagnostic imaging.

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We're excited to welcome Colorado Rockies relief pitcher AJ Ramos to the latest podcast. As an athlete who has come back from both a Tommy John and a shoulder surgery, AJ has many insights to share on the rehab process to contribute to our sports medicine series.

A special thanks to this show's sponsor, Marc Pro. Head to www.MarcPro.com and enter the coupon code CRESSEY at checkout to receive an exclusive discount on your order.

You can follow AJ on Twitter at @TheAJRamos and Instagram at @TheAJRamos.

Sponsor Reminder

This episode is brought to you by Marc Pro, a cutting-edge EMS device that uses patented technology to create non-fatiguing muscle activation. Muscle activation with Marc Pro facilitates each stage of the body’s natural recovery process- similar to active recovery, but without the extra effort and muscle fatigue. Athletes can use it for as long as they need to ensure a more full and quick recovery in between training or games. With its portability and ease of use, players can use Marc Pro while traveling between games or while relaxing at home. Players and trainers from every MLB team - including over 200 pro pitchers - use Marc Pro. Put Marc Pro to the test for yourself and use promo code CRESSEY at checkout at www.MarcPro.com for an exclusive discount on your order.

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!

We're excited to welcome Oakland A's starting pitcher Jesus Luzardo to this week's podcast. He talks about his quick ascent to the big leagues, things he learned during Tommy John rehab, sacrifices needed to compete at the highest level, and the things he's working on to keep improving.

A special thanks to this show's sponsor, Athletic Greens. Head to http://www.athleticgreens.com/cressey and you'll receive a free 10-pack of Athletic Greens travel packets with your first order.

You can follow Jesus on Twitter at @Baby_Jesus9 and Instagram at @Baby_Jesus9.

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!