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Written on June 30, 2010 at 7:42 am, by Eric Cressey
It’s a question I get asked quite a bit. In fact, I was asked this very question three times this past weekend at the Perform Better Summit in Chicago. As a little background, here’s a glimpse into the different things my work entails:
1. Cressey Performance responsibilities - Generally, this is 5-8 hours of coaching per day (six days a week), plus another hour of programming. There is also a lot of time on the phone and answering emails in there, as I am the president. The days would be a lot shorter and simpler if I was just coaching and programming.
2. Online Consulting – I have a small group of online consulting clients on completely individualized programs all around the world.
3. Writing – This might include blogs, newsletters, or new projects (and some website work, although I outsource more of this).
4. Tech Support for Products - I don’t have to worry about much of this, but it’s an email or two a day.
5. Seminars – I travel 1-2 weekends per month to give seminars. Between creating the content, traveling to the seminar location, and actually delivering the talk, they are a big time investment.
6. Continuing Education - While this is listed as the sixth role, it’s actually something that belongs at the top of the priorities list. I spend a lot of time reading, watching DVDs/webinars, and just talking to coaches, therapists, and doctors to get better at what I do.
For most fitness professionals, life is really as simple at #1 and #6. Things change if you decide that you want to be someone whose goal is to be an industry leader and add to the body of knowledge, and develop additional revenue streams.
What is noticeably absent from this list, but a new challenge I face, is the fact that I become a homeowner this spring. With everything that needs to be done when you buy a house, it would have been very easy to get sidetracked mowing lawns, painting walls/ceilings, etc. – but I didn’t miss a beat. Why not?
First, we bought a house that was built in 2009 – so there wasn’t a whole lot of fixing-up that needed to be done. Still, though, it was still pretty “bare bones.”
Second, and more importantly, I outsourced as much as I possibly could. I was joking with my dad last weekend that he taught me everything I need to know about tools: “Hand them to someone else.” I don’t have a carpenter’s mindset, a green thumb, or whatever else one needs to have a pristine lawn and flawless house.
We hired a landscaper. We hired an irrigation company to set up automatic sprinklers. We hired painters for several rooms on the interior. And, we hired a window treatments company to get our blinds up. Honestly, the primary thing that my fiancee and I did was the furniture shopping – and we only did that in person because we thought it would be something fun we could do together. We’ve also been planning a wedding, so home-owner issues are definitely the first to get outsourced!
The point is that I outsourced the stuff that was not in line with my expertise so that I could use that time to leverage my strengths. At one of my old apartments, I remember trying to put up vertical blinds. It took me four hours to do one window, it came out uneven, and I wound up damaging the wall so badly that it knocked a few hundred bucks off my security deposit when I moved out a year later. How’s that for a productive use of time?
This time around, we paid a small fortune to have it done professionally, and the two guys installed blinds in eleven rooms in all in under 90 minutes this morning. They came out looking great – and the best part was that I wrote two programs and a blog and answered several emails during that time period.
So, my new answer to the “How do you find time for everything?” question is going to be: “I only find time for things at which I’m good. Someone else does the other stuff.”
Think Bill Gates mows his own lawn?
Will Lebron James use TurboTax next April 15?
Does Donald Trump mop the floors at any of the 500 or so buildings he owns?
While I only borrowed bits and pieces from The 4-Hour Workweek, this was the most valuable takeaway for me: leveraging your strengths is a lot more important than bringing up your weaknesses. And, as I look back at my most productive periods in this industry, they have all come when I had no distractions and was just in “tunnel vision” mode on something that allowed me to leverage my strengths.
Written on June 29, 2010 at 8:00 am, by Eric Cressey
Q: What do you think of Bodyblades and how – if at all- should they be incorporated into a pitcher’s routine?
A: As many of you know, I’m a fan of integrating rhythmic stabilization drills that train the true function of the rotator cuff: maintaining the humeral head in the glenoid fossa. I wrote about it in some depth HERE, and Mike Reinold and I spent quite a bit of time on it in our Optimal Shoulder Performance DVD set.
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.
Written on June 28, 2010 at 7:28 am, by Eric Cressey
I just got back from Chicago yesterday, and am playing a bit of catch-up, so I don’t have time to write much today. However, as I was tinkering with a formatting issue on the site last night, I realized that I now have almost four years worth of archives – and that many readers haven’t seen a lot of that older work of mine. So, I think I’ll be using my reading recommendations for the next few weeks as a way of bringing older (but still applicable) material back to the forefront.
How to Progress Back to Deadlifting after a Back Injury – Here’s a step-by-step progression we’ve used quite a bit with excellent success.
Bench Pressing with the Feet Up? – Not a good idea. Here’s why.
Lifestyle Checklists – Here’s a quick strategy for getting people adherent to training and nutrition practices.
Written on June 25, 2010 at 9:09 am, by Eric Cressey
I hope everyone had a good week. I’m writing this blog in a bit of a hurry, as I need to pack this morning before heading to Cressey Performance and then directly to the airport to fly out to Chicago.
1. Why Chicago? Well, in case you’ve been living under a rock and haven’t heard, this weekend is the second Perform Better Summit of the year. I’ll be giving two talks on Saturday. If you’re up in the air on which one to attend, I’d recommend my second one (lecture, not hands on). With the room design (no concrete walls), we won’t be able to do much true medicine ball training so that the hands-on can parallel my lecture topic. I’ll be talking about shoulder assessment and corrective exercise with a little medicine ball flavor in my hands-on instead. There are a ton of videos in the presentation, though, so you’ll be able to get the next best thing.
While I enjoy presenting at seminars, I don’t like to travel at all; sitting in airports and on planes is just not my thing. However, when it’s Perform Better, the hassle of traveling just doesn’t seem to be present – because I know how awesome the “light at the end of the tunnel” is. As a presenter, I don’t always get to check out as many of the other talks as I’d like because I’m tied up with speaking and answering questions, but I do get to experience a lot of interaction with audience members and other speakers between lectures, at breakfast/lunch/dinner, and on the town. These, for me, are really as valuable as the presentations themselves. Audience members ask some excellent questions that can drive blog content, and I’ve also added some valuable people from around the country to my network this way. Chatting with presenters is great as well, because they always have some new project or business strategy that they’re working on that can get my mind working. Chicago is also great because I can catch up with my buddy, Josh Bonhotal, who is a strength and conditioning coach for the Chicago Bulls.
All that said, I have to say that it is kind of nice to see my schedule as empty for the rest of the summer. With the new house, wedding planning, and our busiest month at Cressey Performance at-hand, it’ll be nice to focus my efforts here both personally and professionally. I try to keep the summers reasonably free so that we can take weekend trips up to Maine to visit my parents a few times a month. Additionally, with a few of our minor league guys on the cusp of call-ups to the big leagues, I want to make sure that I can hop on a plane at a moment’s notice to be there to support them and share in the excitement wherever they wind up making those MLB debuts.
Anyway, if you’re in attendance in Chicago, please be sure to introduce yourself.
2.Those of you who can’t make it would probably like this article as the next best thing: Medicine Ball Madness.
3. Oh, I should say that it looks like my second presentation coincides with the U.S. vs. Ghana World Cup game. Skip me, if you have to; I’d probably skip me, if I was in your shoes.
Check out this great article from Ryan Andrews at Precision Nutrition: Cattle Feedlot: Behind the Scenes.
4. Many of you might recall how much I abhor Comcast. Well, I’m happy to report that we officially kicked them to the curb about two weeks ago by making the switch to Verizon for our internet and cable – and I have to say that it was an awesome decision. The price, service, speed, and product offering don’t just beat Comcast; they beat it like a red-headed rented mule. If you’re thinking about making the switch, I highly recommend it.
Incidentally, I had to chuckle when I saw that MSN Money had released its list of the 2010 Customer Service Hall of Shame, and Comcast was in third place. Meanwhile, Sprint – which I had dropped for my cell phone service after seven years (also to go with Verizon) was listed as #4. I guess you could say that I was getting rid of the dead wood around here last month!
Written on June 24, 2010 at 7:00 am, by Eric Cressey
Okay, this subject line was undoubtedly the worst of all time, but I promise that the information that follows will be worth reading.
A lot of you were probably hoping that you were out of the woods after I told you how bad your lower backs and shoulders look on diagnostic imaging such as MRIs. I’m sorry to say that these “normal” structural disasters also apply to the knees.
A 2010 review from Flanigan et al. looked at studies that collectively examined the (1,862) knees of 931 athletes (40% of whom were professional athletes) using MRI and arthroscopy. They found that 36% of these knees had full-thickness chondral defects, but 14% of these subjects had no symptoms when diagnosed. The researchers concluded that “Over one-half of asymptomatic athletes have a full-thickness defect.”
Years earlier, Cook et al. screened 134 elite junior basketball players (268 total knees) for patellar tendinopathy. At the time, only 19 (7%) of the 268 tendons presented with symptoms (pain) of tendinopathy. Interestingly, though, under diagnosis with ultrasound, researchers actually found that 26% of all the tendons could be labeled tendinopathy based on the degenerative changes observed. In other words, for every one that actually presents clinically with symptoms, more than three more go undiagnosed because people either haven’t reached threshold, or they move well enough to keep symptoms at bay. Or they are Kurt Rambis and can just look so awkward that nobody even pays attention to their knee sleeve.
On the “move well enough” side of things, check out this study from Edwards et al. They showed that these athletes with asymptomatic patellar tendinopathy actually land differently – both in terms of muscle recruitment and sequencing – than asymptomatic athletes without tendinopathy. Fix that movement pattern neurally and strengthen the right muscles, and those issues never reach threshold. Leave it alone, and they’ll be presenting with knee pain sooner than later. Mike Robertson does a great job of outlining ways to improve knee health via movement retraining in his Bulletproof Knees Manual.
This is just the tip of the iceberg. You’ll see loads of chronic ACL and meniscus tears that folks never realize they have. I could go on and on. The take-home messages? Yet again, diagnostic imaging is just one piece of the puzzle, and how you move is far more important.
Written on June 23, 2010 at 6:00 am, by Eric Cressey
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 Mike Reinold and my Optimal Shoulder Performance DVD set.
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Written on June 22, 2010 at 5:41 am, by Eric Cressey
Some recommended reading for the week:
Ultimate Forearm Training for Baseball – Knowing I work with a lot of baseball guys, Jedd Johnson sent me a copy of his new e-book on forearm training the other day. Just as I’ve come to expect from the Diesel Crew guys, I picked up some innovative new exercises that we’re going to incorporate with our athletes moving forward. It’s definitely worth picking up.
Perform Better-Providence Review – This is a lengthy (and a bit all over the place) blog from Charlie Weingroff, but the bulletpointed information for each presentation he attended is excellent.
Strength Coaches Doing Heavy Lifting – This is a pretty cool ESPN article outlining how the role of the strength coach in the college setting has evolved, and what it means in some bigger D-1 football programs.
Written on June 21, 2010 at 7:43 am, by Eric Cressey
It’s widely known that approximately 80% of the population will suffer from lower back pain at some point during their lives. What isn’t widely known, however, is that even those who are asymptomatic are usually walking around with a host of nasty stuff going on with their spines. Don’t believe me?
A 1994 study in the New England Journal of Medicine found that in a study of MRIs of 98 asymptomatic individuals, 82% of those MRIs came back as positive for a disc bulge, protrusion, or extrusion at one level. And, 38% actually had these issues at more than one level. You can read the free full text HERE.
As the others discovered, it doesn’t stop with disc issues, either – and that’s where a great study from Soler and Calderon comes in. They looked at the incidence of spondylolysis (vertebral fractures) in elite Spanish athletes, and found that 8% of those they examined had them. Only about half of those diagnosed via imaging actually had back pain, though. The incidence was highest in track and field throwers, rowers, gymnasts, and weightlifters – and I’d expect that this figure is actually higher in the U.S., where we have more sports (hockey, baseball, lacrosse) involving violent extension and rotation, more contact sports, and more participation in weight training.
What does this mean for us? Well, as Chou et al. reported in The Lancet, “Lumbar imaging for low-back pain without indications of serious underlying conditions does not improve clinical outcomes. Therefore, clinicians should refrain from routine, immediate lumbar imaging in patients with acute or subacute low-back pain and without features suggesting a serious underlying condition.” That’s not the point of my article today, though; I’ll leave that stuff to the physicians to decide and rehabilitation specialists to interpret and treat.
As fitness professionals, strength coaches, and even just fitness enthusiasts and athletes, we need to assume that there is are probably a lot of structural abnormalities going on in the spines we encounter – including our own. The programs we write and follow need to be sound and take these issues into account, considering differences in age, gender, sport participation, and injury history. The technique we use needs to position us so that we can avoid causing them to reach threshold. And, we need to appreciate that there is a risk-reward balance to be “struck” with everything we do in training because nobody will ever be “perfectly prepared” for the demands to be placed on their bodies.
Rather than lay all my thoughts out here, I’m going to direct you to some previous writing of mine:
I’d also highly recommend Ultimate Back Fitness and Performance by Dr. Stuart McGill.
Written on June 18, 2010 at 7:32 am, by Eric Cressey
Q: I recently opened up my own place to train athletes, and wanted to thank you for all of the knowledge you have passed along, as it has been a big factor in designing my own training philosophy. The majority of my athletes are baseball and football players in the high school and collegiate level, and I had question for you regarding my baseball players specifically.
Nearly every player I work with (and for the most part every pitcher I have worked with), has tight shoulders due to over-use, being imbalanced, and weak. I have them performing a ton of upper back work in comparison to pressing movements, rotator cuff work, sleeper stretches, and myofascial release. It helps greatly, but they still seem to never get back to a full range of motion or an actual natural throwing motion. Because of this, I was wondering what you thought about adding in shoulder dislocations using a dowel rod or broomstick to help with shoulder mobility.
Because the players I work with are either in college because of their ability to play baseball, or have a chance at being drafted or getting a good college scholarship from their arms, I want to make sure that everything I do makes them better instead of hurting them in the long run for what looks like a quick fix when they are with me.
I’d love to hear any thoughts you might have on helping increase shoulder mobility and the shoulder dislocation exercise, in particular.
A: First off, thank you very much for your kind words and continued support.
Unfortunately, to be blunt, I think it would be a terrible idea and you would undoubtedly make a lot of shoulders (and potentially elbows) worse.
Most pitchers will have increased external rotation (ER) on their dominant side, and as such, increased anterior instability. If you just crank them into external rotation and/or horizontal abduction, you will exacerbate that anterior instability. Think about what happens in the apprehension-relocation test at the shoulder; the relocation posteriorly pushes the humerus to relieve symptoms by taking away anterior instability.
We are extremely careful with who we select for exercises to increase external rotation, and it is in the small minority. Most pitchers gain ~5 degrees of external rotation over the course of the competitive season, as it is. If we are going to have them do mobilizations to increase ER, it’s only after we’ve measured their total motion (IR+ER) as asymmetrical and determined that they need ER (a sign is ER that is less on the dominant shoulder). And, any exercises we provide on this front are done in conjunction with concurrent scapular stabilization and thoracic spine extension/rotation – as you’d see in a side-lying extension-rotation drill.
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.
While we’re on the topic, be careful about universally recommending sleeper stretches. There is going to be a decent chunk of your baseball players that don’t need it at all. In particular, if you have a congenitally lax (ultra hypermobile) athlete (high score on Beighton laxity test), a sleeper stretch will really irritate the anterior shoulder capsule and/or biceps tendon.
These players don’t really need to be stretched into IR; they just need loads of stability training. You’ll find that these guys become more and more common at higher levels, as congenital laxity serves as a sort of “natural selection” to succeed for some people. So, universally prescribing the sleeper stretch becomes more and more of a problem as you deal with more and more advanced players and could be jacking up multi-million dollar arms. You’ll even find guys who can gain 10-20 degrees of internal rotation in a matter of 30 seconds - without any shoulder mobilizations – just with the appropriate breathing patterns. It just doesn’t work for everyone. Honestly, the only way to know is to assess; each pitcher is unique.
The obvious question then becomes “why are you seeing shoulder “tightness.?” Is it postural? Is it an actual range of motion you’ve assessed? Is it guarding/apprehension in certain positions? And, what is a “natural throwing motion?” They said Mark Prior had “perfect mechanics” and he has been injured his entire career.
What is “natural” is not what is “effective” in many cases, so you have to appreciate that throwing is an unnatural motion that may be necessary for generating velocity, creating deception, and optimizing movement on a certain pitch.
It might seem like shameless self-promotion, but I would highly recommend that you pick up the DVD set Mike Reinold and I recently released: Optimal Shoulder Performance.
It covers all of this information in great detail, plus a ton more. Baseball players – and particularly pitchers – are a unique population as a whole, and within that population, each one is unique.
I’d also strongly encourage you to check out Mike Reinold’s webinar, “Assessing Asymmetry in Overhead Athletes: Does Asymmetry Mean Pathology?” It’s available through the Advanced CEU online store.
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Written on June 17, 2010 at 7:44 am, by Eric Cressey
Here are a few blogs/articles you might want to read over:
A Quick Fix for Painful Push-ups – This one comes from the EricCressey.com archives; I was reminded of it by a reader inquiry yesterday and thought I’d bring it back to the forefront, as it’s valuable information.
Adapting Vertical Pulls – Here’s an innovative idea from Bill Hartman. I tried it out, and it seems to work pretty well. We’ll be experimenting with it more with our new clients with shoulder pain moving forward.
Jays’ Odd Couple are a Mound of Trouble – This is a great – and entertaining – article about CP athlete and Blue Jays prospect Tim Collins and his teammate Trystan Magnuson.