1. Sorry for the slower week here on the blog. In addition to trying to catch up from my three days in Houston, I had a few projects that needed to get sorted out this week. For starters, we had to finalize the agenda for my seminar in Vancouver in March.
And, the bigger task of late has been finishing up a chapter (on baseball testing and training) that I'm contributing to Dr. Craig Liebenson's newest book. Others contributing include Dr. Stuart McGill, Sue Falsone (Athletes Performance), Dr. Ben Kibler, Dr. Pavel Kolar, Ken Crenshaw (Arizona Diamondbacks), and Mike Boyle (among others). Needless to say, I'm lucky to be in such awesome company, and you'll definitely want to check it out once it's available. In the meantime, you might be interested in Liebenson's most popular work, Rehabilitation of the Spine: A Practitioner's Manual.
2. Mike Reinold and I are also working on getting our seminar, Testing, Treating, and Training the Shoulder: From Rehabilitation to High Performance, ready for production and sale. We're hoping it'll be ready by the first of the year, but only time will tell; editing takes time, and it's out of our hands now! Speaking of Mike, he just posted a blog outlining the recently revised pitch count rules. If you coach young players or one of your kids plays ball, definitely check it out HERE.
3. On the topic of little league, the clinic with Matt Blake and I at Cressey Performance on Tuesday night was pretty popular with local coaches. One of the things that Matt and I tried to stress is that kids almost never get hurt for JUST one reason. Usually, injuries are multifactorial, so you have to look at a host of different causes - from overuse, to physical limitations (weakness or immobility), to mechanical flaws in the pitching delivery.
The questions we received gave me some ideas for future posts, so keep an eye out for those in the not-so-distant future. Along those same lines, if there are specific baseball development questions you'd like covered, feel free to post some suggestions here as a reply to this blog.
4. I got the following question the other day, and thought it might make for a quick Q&A here:
Q: I am planning on training Westside style but I do not have access to bands and chains (or any other special equipment for that matter). What should I do to change up my dynamic effort days? Should I just use variations of the lifts (i.e. close grip vs regular grip bench, sumo vs conventional deadlifts)?
A: The whole idea that you absolutely have to have bands, chains, and specialized bars to learn from the Westside school of thought (which is constantly evolving anyway) couldn't be further from the truth. There are bits and pieces borrowed from Westside teachings in Maximum Strength, and you'll see that there is plenty of rotation among movements in the four-month program - and the assumption is that you don't have any of these goodies. Rotating among back squats and front squats (without a box, with a box, or from pins) and deadlifts will give you a great rotation of movements.
Regarding dynamic effort days, I don't think it's as important to rotate exercises on a regular basis, as this speed work is there to improve bar speed on that specific movement and help you groove the movement pattern itself. However, if you want to change it up, it's not too difficult.
In the lower body, simply go to a different deadlift or squat variation, or change the percentage at which you're working. In the upper body, you can change the grip width on the bench press, do some plyo push-ups, or even just throw the medicine ball around.
5. I'm going to see The Nutcracker tonight with my fiancee. In the words of Forrest Gump, "That's all I have to say about that."
6. I will, however, say that I'm a little bummed that Jim Breuer is in town tonight about ten minutes from where I live, and I'm not going to get to see him. Doh!
Q: Inspired by your articles on T-Nation, I've started to measure IR/ER/Total shoulder rotation deficits using a goniometer. I did have another question, however: you mentioned in an article that Hip Internal Rotation Deficit (HIRD) is a serious problem among baseball pitchers and hitters due to the asymmetrical front leg blocking in both mechanics. I absolutely agree, and I use corrective exercises and stretches to help alleviate these problems. However, I lack a good way to test for this; do you have any suggestions?
A: We check hip internal rotation in the seated position. Basically, you just have the individual sit up tall at the end of a table, and position the hips and knees at 90 degrees. Then, without allowing the hip to hike, you internally rotate the femur. This is one of the many assessments on our new DVD set, Assess and Correct, and it's featured on page 50 of the tag-along e-manual. Check it out:
For more information on how to correct the problem - and assess for other issues like this, check out www.AssessandCorrect.com.
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As many of you know, Mike Reinold and I put on a seminar that was "everything shoulder" this past Sunday at Cressey Performance. The event sold out within 36 hours back when we first announced it in early October, and we had strength and conditioning and rehabilitation specialists come from the likes of Canada, Texas, and the Midwest on only a month's notice. Our goal was to keep the seminar more intimate to allow for more speaker-attendee interaction, Q&A, and easy viewing - as we also recorded the event on DVD.
While production won't be complete until December at the earliest, I thought I'd give my loyal readers a little taste of some of what was discussed on Sunday. Our primary goals were to introduce some current concepts in evaluation of both symptomatic and asymptomatic populations as well as ways to treat/train them during and after injury. Above all else, we wanted to show how rehabilitation specialists and strength and conditioning specialists could work hand-in-hand to improve outcomes - but that this successful interaction hinged on whether all parties involved were willing to commit to learning about how the shoulder functions.
You can call this my "Random Thoughts" for the week:
1.The side-lying external rotation (SLER) has the highest EMG of any rotator cuff exercise, and the adducted position is the safest position for most "testy" shoulders. So, if you have to pick one cuff exercise to get you a safety and a great return on investment, roll with the SLER:
2. Simply providing a small amount of "propping" to put the humerus in a slightly more abducted position actually increases EMG of the posterior rotator cuff muscles by 23%.
3. Shoulder evaluations rarely work completely independently of one another. For example, poor thoracic spine mobility directly impacts function of the scapula and, in turn, range of motion at the glenohumeral joint. So, rather than hanging your hat on 1-2 assessments, you need a barrage of assessments that cover glenohumeral range-of-motion, scapular stability/positioning, thoracic spine mobility, breathing patterns, and forward head posture. Then, once you've got all your information, you can look at each test as one piece in an individualized puzzle.
4. There are a ton of superior labrum anterior-posterior (SLAP) tests out there. It's because none of them are particularly great - but the better ones out there simulate the injury mechanism (e.g. pronated load and resisted supnation external rotation tests for overhead throwing athletes).
5. The true function of the cuff is - very simply - to center the humeral head within the glenoid fossa. So, rather than train it purely concentrically and eccentrically, we need to also work its isometric/stabilization function with rhythmic stabilization exercises. Here's a really entry level one we use quite a bit with our pitchers:
6. MRIs and x-rays can only tell you so much about a shoulder. For instance, 79% of professional baseball pitchers have "abnormal labrum" features. Likewise, a huge chunk of asymptomatic people in the general population are walking around with partial and even FULL thickness tears of the rotator cuff. It actually makes you wonder if abnormal is actually normal! The take-home message is that having adequate mobility, stability, and tissue quality in the torso and upper extremities matters more than anything else. You have to ASSESS, not assume!
7. We talk a lot about glenohumeral internal rotation deficit (GIRD) - and it certainly is important - but you have to appreciate that it's just one part of the total motion equation. Some internal rotation deficit is completely normal, and working to fix it may actually hurt some athletes. Look to total motion first, and then work backward to see whether IR, ER, or both need to be changed. It is better to be too tight than too loose!
8. If you have an athlete with good shoulders, thoracic spine, scapular stability, and tissue quality who has rehabbed and long-tossed pain-free, but has shoulder/elbow pain when he gets back on the mound, CHECK THE HIPS! Staying closed and flying open will be your two most common culprits, and this cannot be seen in a doctor's office or on an MRI.
9. Anytime you see an individual with a pronounced shrugging pattern as they try to reach overhead, it's wise to have them checked for a rotator cuff tear. The reason is that with a cuff tear, the deltoid's vertical action overpowers the cuff's compressive action. In a healthy shoulder, the supraspinatus "cancels out" this deltoid pull. Never, ever, ever, ever train through a shrugging pattern with overhead reaching!
10. External impingement and internal impingement are completely different "syndromes" that must be managed completely differently. Simply saying "impingement" is no longer acceptable with how far sports medicine has come! Both are generally multi-factorial issues that mandate a more specific diagnosis and comprehensive treatment/training plan. If you understand why/how they occur, you can understand how to train around them (and the same can be said about just about any shoulder condition).
UPDATE: The Optimal Shoulder Performance DVD set is now available! Check it out at www.ShoulderPerformance.com.
Sorry, everyone, for being a bit MIA of late. I'll use today's post as a quick catch-up on what's been going on, and what is on tap for EricCressey.com in the months to come.
Last week, I flew out to Phoenix on Tuesday to attend a seminar with Dr. Pavel Kolar. With the exception of just a few of us, everyone in attendance was a strength and conditioniong coach, athletic trainer, or physical therapist with a major league organization. For those who aren't familiar with Kolar, he is somewhat of a "rehabilitation rockstar" in the Czech Republic, with "clients" that include Jaromir Jagr, Roger Federer, Petr Korda, countless world-class track and field athletes, multiple Czech Olympic teams, and the president of the Czech Republic himself. Needless to say, he's a really smart dude; otherwise, people all around the world wouldn't be paying to hear him give seminars in Czech (yes, the majority of the seminar was through a translator).
All of us in attendance are probably still trying to wrap our heads around his ideas, but Kolar presented a very interesting perspective on dynamic neuromuscular stabilization (DNS) based on developmental kinesiology. The "Cliff's Notes" version is that the central nervous system and muscular system it governs are immature at birth, and must go through a very specific adaptation process to achieve anatomical maturation. In rehabilitation down the road, examining this sequence of events during the first few years of life - from rolling over, to crawling, to standing up, to walking - can help us to understand how we must re-educate the nervous system to optimize function in those with aberrant patterns.
According to Kolar, one can have altered stabilization patterns for any of three reasons: 1) abnormal early development, 2) abnormal training methodology, and 3) trauma. Sounds simple, right?
Unfortunately, it's not that easy. Sequencing of patterns - from the feet all the way up to the head (and including things like diaphramatic breathing and optimal tongue positioning) - is what's important...NOT recruitment of specific muscles.
So, while EMG of the vastus medialis, posterior rotator cuff, lower trapezius, transversus abdominus, and loads of other muscles that's important, it's how all those muscles work together that's important.
All in all, it was an awesome seminar that really tested those in attendance. A pessimist would have walked away from it saying that it was too complex and that it couldn't be applied right away. The optimist (and I'd include myself in this camp) left realizing that there were a lot of things I'm anxious to research and integrate in one's programming to get our clients back to their "roots" of rolling and moving from ground-based to upright movements (think sprint-start from the ground and Turkish Get-ups).
We're also looking a ton more at breathing patterns in all our athletes - especially after spending a few days in AZ with my buddy Neil Rampe, a great manual therapist with the Arizona Diamondbacks. Most people don't realize that the diaphram is both a respiratory and postural muscle, so if you're not using it properly, it'll interfere with both oxygenation and muscular activity.
Fun stuff. Just trying to get better...
As you're reading this, I'm either watching a seminar in Arizona, or flying back from the trip. Luckily, I prepared this list of recommended reading for the week in advance:
Is the Seated 90/90 Stretch Safe? - This great Q&A with Bill Hartman emerged following a question from a reader after we released Assess and Correct. It's definitely worth a read.
The Best Exercise You're Not Doing - This was an excellent piece from Matthew Hertilus last week at T-Muscle. We use the Turkish Get-up quite a bit with our athletes, and this article does a fantastic job of teaching the lift - complete with video tutorials.
Returning to Deadlifting after a Back Injury - This newsletter from a while back was a popular one. If you've got poor deadlifting technique or you've had an injury performing the lift in the past, it's definitely worth a read.
Q: I recently purchased Show and Go and noticed that you include barbell rollouts in the weight training program. I did this exercise at the end of an aerobics class and was told by the fitness instructor not to do it, as it was a dangerous exercise. Given it's in your book, I gather you deem it a safe exercise. What is your opinion on this exercise? Do you know why some people say it's a dangerous exercise?
A: As with just about everything, the devil is in the details. For many individuals, this is a fantastic exercise. For others, it may be too advanced. And, for another group of folks, it just isn't good because it gets absolutely butchered technique-wise. Let's attack this piece by piece with a rationale for its inclusion/exclusion, and then some training options and coaching cues:
(yes, I know I said "A" and then "2." Gotta love live TV!)
You can progress this exercise a bit more by either elevating the knees slightly or going to a band-resisted ab wheel rollout. Just a heads-up: in this video, the athlete should have stopped a bit shorter in the top position to avoid the subtle lumbar rounding that took place; it's a good demonstration of technique that's good, but not quite perfect:
To learn more comparable exercises and see how they fit into a comprehensive weight training program, check out Show and Go: High Performance Training to Look, Feel, and Move Better.
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1.Just a quick heads-up: today is the last day you can get the new Functional Strength Coach 3 DVD set from Mike Boyle with all the sweet bonuses he's offered as an introductory special. Definitely check it out (here).
2. There's some great new research out in the Journal of Strength and Conditioning Research that compares front and back squats with respect to stress on the knees. Not surprisingly, you actually see higher compressive forces and knee extensor moments with the back squat - which would imply that the front squat is a safer option for most folks. This actually isn't a huge surprise to me, as we've integrated front squatting well in advance of back squatting in returning folks with lower extremity issues to "normal training." However, there is a bit more.
You see, we'll have people do a box squat variation before going to a front squat. There is more of a sitting back motion, and a bit less knee flexion, so more of the stress it put back on the posterior chain (glutes, hamstrings) than the quads. It not only takes the stress off the knees, but also allows folks to maintain a great training effect while they're on the mend. And, in reality, it probably helps to address some of their inefficiencies, as a good chunk of folks with knee issues tend to have weak posterior chains and be very quad-dominant. While the majority of these individuals' training focuses on deadlifting variations and single-leg work, when the time comes to squat, we'll first use a front box squat:
From there, we'd go to a back-loaded box squat variation (giant cambered bar, safety squat bar, or straight bar), and then on to regular ol' front squats. (FYI, I covered front vs. back squats from a different perspective HERE)
3. When it comes to shoulder health, one thing folks miss out on all the time is the important role of the subscapularis, one of the four muscles of the rotator cuff. This is a huge mistake if you want healthy shoulders. Why? As the picture below shows, this sucker has a big cross-sectional area (CSA). In fact, according to Bassett et al., its CSA is the second largest (behind only the deltoid) of any muscle crossing the glenohumeral joint.
As an interesting little tag-along to that fact, I recall reading that research has demonstrated that subscapularis cross-sectional area was the only factor that predicted powerlifting performance. While the primary focus of the subscapularis is dynamic stabilization of the humeral head (and, more specifically, creating anterior stability with its posterior pull), it also assists in internally rotating the humerus, so it's lumped in as a "bad guy" with the other internal rotators: pectoralis major, latissimus dorsi, anterior deltoid, and teres major.
In reality, in most folks, some subscapularis activation work during the warm-up should be done in conjunction with lengthening drills for the other internal rotators and posterior rotator cuff in order to establish a good shoulder groove before training. We go into great detail in Assess and Correct with two of our progressions, but to get the ball rolling, try putting your hand behind your back (as if handcuffed) and then lifting off without extending your elbow or flexing your wrist.
If this isn't happening easily (both getting the arm back there and lifting off), you need to get to work!
4. Speaking of Assess and Correct, the feedback thus far has been fantastic - and folks haven't even received the DVDs yet! Here's a little sample from some of the emails I've received:
"I ordered a copy last night and have been looking over the e-manual this morning and I’ve got to say, it looks awesome! Can’t wait to put it to use."
"I got it yesterday. It's awesome and the DVDs haven't even arrived yet!"
Needless to say, the DVDs alone will be 100% worth the deal, but the in-depth bonuses take things to the next level. Remember that the one-week only introductory price of $97 expires on Sunday at midnight, so pick up your copy ASAP!
Have a great weekend!
EC
PS - I'm looking for a good trainer/S&C coach in the State College, PA area. If you are located there or know someone good nearby, please email me ASAP at ec@ericcressey.com. Thanks!
PPS - I'm doing the Fitcast with Kevin Larrabee this morning. I'll get the link posted as soon as it's available.
Today's a really exciting day for Mike Robertson, Bill Hartman, and I - and hopefully for you, too!
You see, after months of planning, filming, and editing, our new product, Assess and Correct, is now available at www.AssessAndCorrect.com. And, for the first week ONLY, we're making the product available for $30 off what will be the normal retail price.
Assess and Correct is the first resource that empowers you with not only a series of self-assessments to identify your own flexibility and stability limitations, but also exercise progressions to correct those inefficiencies. In the process, you'll take your athletic performance to all new levelsandprevent injuries from creeping up on you - whether you're a high-level athlete or someone who sits at a desk too much.
With 27 self-assessments and 78 corresponding exercises, you'll cover virtually everything you need to feel and perform well. And, you'll have plenty of variety to use for many years to come! And, while the DVDs alone are really comprehensive, the bonuses we've added to this really sweeten the deal. Included in this package are:
DVD #1:Your Comprehensive Guide to Self-Assessment
DVD #2:Your Individualized Corrective Exercise Progressions
Bonus #1:The Assess and Correct Assessment E-Manual, which is a guide to which you can refer to in conjunction with DVD #1.
Bonus #2:The Assess and Correct E-Manual, which includes written cues and photos for each recommended drill in DVD #2 so that you'll have a resource you can take to the gym with you.
Bonus #3: "The Great Eight Static Stretches" E-Manual, which shows you eight additional flexibility drills that we use on a regular basis in addition to the drills featured in the DVDs.
Bonus #4:The "Optimal Self Myofascial Release" E-Manual, which shows you the soft tissue methods and techniques we use with our clients and athletes.
Bonus #5: "Warm-ups for Every Body" E-Manual, which is a collection of two sample warm-up templates for 19 different sports/scenarios.
Again, this introductory offer will end next Sunday, November 1 at midnight EST. For now, though, I'd encourage you to head over to www.AssessAndCorrect.com to check out some of the sample videos from the DVDs - including the introduction in which we discuss our rationale for creating the product.
1. I got a question earlier this week about how I felt about swimming for pitchers. To be honest, I'm not a huge fan for pitchers. Swimmers actually have a lot of the same issues as pitchers in terms of adaptive changes in the shoulder: an acquired anterior scapular tilt, glenohumeral internal rotation deficit (GIRD), and generalized laxity. I guess when it really comes down to it, I'd rather have guys actually throwing if they are going to develop imbalances.
2. Last, but not least, Mike Boyle has a good video up in conjunction with the release of his new Functional Strength Coach 3 product. Check out The Death of Squatting.
3. Even if he never scores another goal in his life, this kid is a stud - quite possibly on par with the West Virginia Ninja from last week.
4. Tony Gentilcore just switched his blog over to a new site. If you guys want to be entertained and learn something in the process (infotainment), check out www. TonyGentilcore.com.
5. Speaking of Tony, the two of us tested 1RM deadlifts yesterday (yes, together; it's kind of like when women go to the bathroom together). This came after a month-long deadlift specialization program that kicked the crap out of us (let's just say it was 4x/week deadlifting for three weeks, then one week of rest). Tony pulled a personal-best 550 pounds; here's our boy in action:
6. As for me, well, there was no PR. In fact, I got sent down to the JV team. I got 700 about three inches off the floor, and that was it. A subsequent attempt at 675 went only slightly better in my fatigued state. And I put a crater in the middle of my hand when a callus ripped off.
7. If you're a strength and conditioning coach or personal trainer looking for work and are anywhere near (or willing to move to) just east of Philadelphia, please shoot me an email at ec@ericcressey.com. I have a friend who is looking for some good coaches to work with athletes at his facility in that area. It's a positive, learning environment - and he's a great dude.
8. And, last, but certainly not least: Assess and Correct will be up for sale on Monday! Newsletter subscribers will hear about the product first, so if you aren't subscribed already, head HERE to get signed up.
Here's this week's list of recommended reading:
When I Was Young - In this newsletter of mine from a while back, I discuss why I think young athletes are getting injured at such alarming rates nowadays. It draws quite a bit on my own experience as a young athlete "back in the day."
Dirty Nutrition, Volume 2 - This is the latest installment in Dr. Jonny Bowden's nutrition Q&A. The stuff on high-fructose alone is fantastic.
Lastly, Joel Marion's got some sweet new bonuses going on a big promo he's running at TransformationDomination.com. It's worth checking out; Joel knows transformations...
