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Corrective Exercise: Muscle Imbalances Revealed Review – Upper (Part 3)

Written on September 29, 2011 at 4:29 pm, by Eric Cressey

This marks the third and final installment of my review of Muscle Imbalances Revealed – Upper Body.  In case you missed the first two parts, be sure to check out Part 1 (Dean Somerset) and Part 2 (Jeff Cubos).  In this third installment, I’ll cover the contributions from Tony Gentilcore and Rick Kaselj.  For the record, me combining these two into one installment in no way reflects how I felt about their presentations; I am just getting ready to leave for my anniversary this weekend, and need to cover them both quickly before I head out!

Tony, as many of you know, is a long-time friend of mine and works with me at Cressey Performance – and I’ve been harassing him for years now to put out a product.  He’s a great coach whose ideas and skills deserve to be showcased to a larger audience, and I’m glad that he finally got around to putting his name on something!

That said, it was a little tougher to evaluate Tony because we literally spend so much time together that our brains are very “synced up” – meaning that it’d tough for him to throw something new at me that we haven’t already integrated at CP.  That said, some highlights of Tony’s presentation:

1. I think he did a good job of distinguishing between how we program both reactively and proactively for upper extremity issues at Cressey Performance.  How one trains someone with symptoms is, in many cases, remarkably different from that same individual would be trained in the absence of those symptoms – even if the same movement impairments are present.  This is a crucial area of understanding for trainers who may want to get more involved on the corrective exercise side of things.

2. Tony outlines some of our horizontal pulling and scapular stabilization progressions.  I think the biggest take home is understanding that different people need different progressions.  Some folks with completely imbalanced programs can thrive simply from going to loads more horizontal pulling.  Others may be doing plenty of horizontal pulling, but doing it incorrectly because they lack the appropriate recruitment patterns.  These folks need very targeted scapular stabilization drills to get the ideal “big bang” effect of rowing variations.  The low-level activation drills become the warm-ups to groove the movement patterns, and the horizontal (and vertical) pulling helps to make those patterns part of the bigger picture.

3. Above all else, I feel that the strongest value of Tony’s presentation is in the cues.  If you’re an up-and-coming coach and need to learn some excellent cues to get your clients/athletes to not just pick up movements, but pick them up optimally, then this is a great purchase for you.

4. Last, but certainly not least, Tony provides some sample programming templates to demonstrate how everything fits together in a comprehensive strength training program.  It’s one thing to hear about principles and theories, but another thing altogether to appreciate how they all fit together in a comprehensive strength and conditioning program.  He provides several examples in this regard that’ll help you get comfortable with piecing everything together.

Next up was Rick Kaselj, the man responsible for bringing all these minds together.

Here were some of my favorite points from Rick’s presentations:

1. People seem to think of clavicle as motionless.  In reality, from 0-90° abduction, you only need 5-10° of clavicular upward rotation.  From 90-180° of abduction, you need 20-25° of clavicular upward rotation.  This clavicular movement can be affected by the muscles that attach directly to it (pectoralis major) or by those that indirectly impact it (muscles attaching to the scapula and/or humerus).

Now, think about where most people with acromioclavicular joint pain wind up with symptoms during abduction: the final 30° – which is known as the painful arc.  Any surprise that the symptoms occur at the point where the most amount of clavicular upward rotation is needed?  Nope.

Keep in mind that poor clavicular positioning can also impact sternoclavicular joint function, too.  Double whammy, if you’re “stuck.”

2. Rick did a good job of showing the checks and balances that occur within the rotator cuff musculature.  Shirley Sahrmann has pointed it out in her work, but I think it gets overlooked.

The supraspinatus creates a compression force into glenoid fossa.  The subscapularis, teres minor, and infraspinatus produce an inferior directed translation force on the humeral head.  The infraspinatus and teres minor also externally rotate the humeral head in frontal plane so that the greater tubercle doesn’t clog up the subacromial space.

In other words, you get a pull in, down, and into the “right kind of rotation (external rotation increases the subacromial space, whereas internal rotation closes it down).

One point I’d add to strengthen Rick’s case even further is that the subscapularis also has a posterior pull on the humeral head.  Without adequate subscapularis function during internal rotation, the pectoralis major can take over and draw the humeral head forward, causing anterior joint capsule irritation.

3. Rick’s last presentation focused on the neck, a complex area to understand for most fitness professionals.  He started off by emphasizing to get neck issues checked out, as they can be very serious.  His presentation then emphasized training strategies to prevent neck pain and work around it if it’s present.  Accurately, Rick noted that some of the big players on this front were:

a) breathing – diaphragmatic or overuse of accessory respiratory muscles?

b) posture – forward head posture or neutral spine?

c) tissue quality

d) range of motion (particularly the thoracic spine)

e) strength (particularly the deep neck flexors)

f) scapular stability

g) rotator cuff function

Sometimes, the easiest way to address an issue (or prevent it) is to look at what happens a joint below (or above).  Of course, when you’re dealing with neck issues, always refer out to a qualified professional first.

This wraps up my three-part review of Muscle Imbalances Revealed – Upper Body.  As I’m sure you can tell by now, I’m a big fan of this resource and highly suggest you add it to your library.  It’s on sale at a great price, so don’t delay in picking up a copy if this is up your alley.  With the money-back guarantee Rick’s made available, you can’t go wrong.

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Corrective Exercise: Muscle Imbalances Revealed Review – Upper (Part 2)

Written on September 27, 2011 at 7:36 am, by Eric Cressey

This marks Part 2 of my write-up on Muscle Imbalances Revealed – Upper Body, a product that really impressed me.  In my first post, I highlighted some of Dean Somerset’s great contributions to the project, and today, I thought I’d bring to light seven more great corrective exercise lessons from another excellent presenter on this resource.

Dr. Jeff Cubos is an Alberta-based chiropractor with an outstanding skill set that not only encompasses his clinical work, but also an excellent ability to relate how what he does in the clinic applies to those in the strength and conditioning field.  This “dual proficiency” was readily apparent in his presentations, too.

Here were a few highlights:

1. From an alignment standpoint, you can envision the core like a house – where the diaphragm is the ceiling, and the pelvic floor is the floor.  Just like with the house, too, the ceiling and floor should be parallel.  Having an anterior pelvic tilt and rib flair dramatically alters this:

2. Good training to address this issue isn’t just about stretching hip flexors and activating glutes, though; it’s about retraining breathing, “owning” one’s breathing in various positions, and progressing that respiratory function (and, in turn, rib positioning) into more comprehensive strength exercises.

3. Jeff does the best job I’ve seen of discussing breathing drill progression – and how to sync them up with progressive strength training programs.  Just as importantly, though, he does a great job discussing the role of the diaphragm, utilizing an excellent video to show exactly how it works (as you watch it, be sure to check out how the right diaphragm attachment point is more prominent on the spine).  I’ve mentioned many times in the past in the blog about how we utilize breathing drills, and folks always want to know what they are.  Unfortunately, you can’t really just describe a breathing drill; you need to show it and add specific cues.  Jeff does exactly that.  Here’s a good excerpt on the assessment side of things, too:

4.  Dr. Cubos also discusses bits and pieces of both the Dynamic Neuromuscular Stability (DNS) and Postural Restoration Institute (PRI) philosophies.  Having been to seminars for both disciplines, I can tell you that Jeff does a great job of presenting this valuable, but sometimes confusing information in as user-friendly a format as one possibly can.  It’s a cursory overview, but enough to give you an introduction to these philosophies to find out if they’re right for you.

5. Even if you aren’t planning to delve deeply into these disciplines, Jeff covers a few specific cues that you can apply to breathing correctly on every exercise you do – especially if you (or your clients) are stuck in anterior pelvic tilt, lordosis, and an elevated ribs posture.  For instance, Jeff uses the cue of performing a few diaphragmatic breaths at the point of greatest tension in a movement; this will enable an athlete to “own” that position more quickly.  He uses the example of holding for a count of “one-one-thousand” at the top position of the quadruped extension-rotation:

6. I’ve got to great lengths in several previous blog posts to distinguish between tendinitis (inflammatory) and tendinosis (degenerative) – and Dr. Cubos did a good job of reaffirming things on that front (tendinosis is much more common than tendinitis).  However, he took it even further with some excellent information on the “continuum” of tendinopathies.  I’ve spoken about how we’re all waiting to reach “threshold” (presentation of symptoms), but haven’t paid a lot of attention to sub-clinical tendinopathies.  Here’s how Jeff portrayed the continuum:

Reactive Tendinopathy – This is acute overload (too much, too soon).  Soft tissue treatments are beneficial, but not locally to the tissue in question.  An example that immediately comes to my mind is a supraspinatus tendinosis; manual therapy to the pec minor, posterior rotator cuff, etc. would be very helpful, but working directly on the supraspinatus could exacerbate the problem significantly.

Tendon Dysrepair – Dr. Cubos referred to this as “a failed attempt at healing, and a disorganization of the connective tissue matrix.”  Immediately, I thought of someone with chronically crank hamstrings following a previous strain.  Direct soft tissue work has much more immediate and profound benefits.

Degenerative Tendinopathy – This is the obnoxious, long-term tendinosis we’ve come to know – whether it’s an Achilles tendon or common extensor tendon (Tennis Elbow).  Here we have cell death, disorganization of the connective tissues, and less collagen.  Unfortunately, full resolution isn’t that common – but most people can respond over time to the right kind of rehabilitation programs.

7. Last, but certainly not least, Jeff introduces his audience to several common soft tissue treatment approaches, including Active Release Technique, Fascial Manipulation, Functional Range Release, and the various modalities of Instrument Assisted Soft Tissue Mobilization.  In describing each, he outlines why some may be better for others in certain instances, as well as the differences between approaches.  I think this is a “must-watch” for trainers to understand the skills of the manual therapists to whom they refer, and also up-and-coming rehabilitation specialists to decide which approaches they’ll utilize in their professional careers.

All in all, Dr. Cubos was another new name (for me, at least) that I was glad to come across – and I’ll definitely be following him more moving forward.  And, in addition to Cubos and Somerset’s contributions, there are a host of other great professionals who have contributed to the entire Muscle Imbalances Revealed – Upper series, which is currently on sale with a 60-day money back guarantee, too, so check it out here.

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Corrective Exercise: Muscle Imbalances Revealed Review – Upper (Part 1)

Written on September 25, 2011 at 3:54 pm, by Eric Cressey

Last summer, Rick Kaselj sent me the eight webinars from his new collaborative product, Muscle Imbalances Revealed – Upper Body, to review.  I was really excited to check them out, as I’d enjoyed the initial version of the Muscle Imbalanced Revealed (MIR) series.

Unfortunately, my enthusiasm to watch it was overtaken by a crazy busy summer schedule and I only got around to looking it over a few months later.  I regretted that it took me so long, as I really enjoyed what I viewed.  That said, I thought I’d use today’s piece to comment on my favorite take-homes from one presenter, Dean Somerset, who I thought did an exceptional job.  Be sure to read through to the end, as Rick has a great discount on the entire Muscle Imbalances Revealed series in play this week.

Anyway, Dean’s presentation was a pleasant surprise for me in the initial Muscle Imbalances Revealed collection, as I had not been familiar with his work prior to the product.  As it turned out, he did a great job of delving into the fascial system, which is no easy task, considering that even the foremost experts on “fascial fitness” recognize that we still have a tremendous amount to learn in this regard.

His presentations this time around didn’t deviate from that initial trend, either; I really enjoyed them for a number of reasons; here are my top seven:

1. Dean did the best job of outlining a clear rationale for foam rolling that I’ve seen in the industry thus far – and did so in a very layman-friendly format.  In highlighting the role of Ruffini endings – which are slow adapting, low threshold mechanoreceptors that respond to direct pressure (like foam rolling) – Dean showed that they can decrease tone of tissues in the presence of stretch and inhibit sympathetic nervous system activity.

2. Another way he made his point was with a great analogy.  Much like we have fast-twitch and slow-switch muscles, we have receptors that may act in similar ways.  On one hand, we have “fast twitch” receptors like golgi tendon organs and muscle spindles that function with the musculotendinous units.  On the other hand, we have “slow twitch” receptors like Ruffini endings and Pacini fibers that exist in the fascial tissues.  Because the muscules, tendons, ligaments, and fascial tissues are really all continuous with each other, there exists a great amount of interaction between these slow and fast twitch receptors – much like the interaction of different muscle fiber types.  They are all responsive – in both positive and negative directions – to chronic training stimuli – and sitting on your arse in front of a computer screen for years on-end.

3. Dean noted that fascia carries an electrical charge that is never off; it’s just “on” at different levels.  Certainly, it’s far more “on” with exercise than at rest – and it’s the reason that contractions can last for hours post-exercise.  If you have an individual who isn’t able to tone down (pun intended) that contraction in the post-exercise period, you’re likely dealing with someone who’ll have chronic movement impairments.  If this electrical charge is always present, it can ultimately alter movement to the point that joint structure can actually change (think of the reactive changes in an acromion process, as an example).  Appropriate training enables one to get the benefits of exercise without creating negative long-term adaptation in this regard.

4. What is appropriate training for fascial fitness, though?  Dean cites the same seven components to an appropriate program that I outlined here, but he does so with a very valuable qualifications: adequate hydration status is absolutely crucial to making the most of any training status.  Repeated stretch bouts during the warm-up period allows for more water content for the fascia; each successive stretch improves hydration to allows for better elasticity and tensile strength, which in turn provides better joint stability and force production.

5. I like guys who solve problems.  I love using spiderman variations in our warm-ups, as they are great hip mobility drills.  Unfortunately, though, they don’t always look so hot when you have someone with poor thoracic mobility trying to get their elbow down to the inside of their thighs.  Many folks will wind up rounding over – which is certainly not ideal.  Imagine Quasimodo doing this drill and you’ll get what I mean.

Dean’s solution – which provided me with a “why didn’t I think of that?” moment – was to bring the thigh up to the torso.  In other words, do the forward lunge component onto a 12-inch plyo box so that folks can get the hip mobility benefits without compromising thoracic positioning.  Sweet.

6. I thought Dean did an excellent job of highlighting that it can take years to improve fascial fitness substantially.  Super-immobile individuals usually take years and years of either sedentary lifestyles or terrible training habits to get to that point, and unless they’re ready to dramatically overhaul their mindsets and daily habits, it can be like swimming upstream when correcting bad posture.  Be consistent when addressing these limitations, but also be patient.

7. I love the fact that he commented on all the normal roles of the core – force transfer, resisting movement, returning from a position outside of neutral – but also highlighted that optimal core function is essential for optimal respiratory function.  Anyone who reads this blog regularly knows that we use a lot of specific breathing drills, so I was glad to see a bright dude in the industry backing me up on this one!

This is really just the tip of the iceberg with respect to not only Dean’s two presentations, but the entire Muscle Imbalances Revealed – Upper Body package, which also includes webinars from Rick Kaselj, Jeff Cubos, and my business partner, Tony Gentilcore.   I’ll highlight a few more of my favorite takeaways in my next post, but in the meantime, I’d strongly encourage you to check this great resource out for yourself.

To sweeten the deal, Rick has put the entire Muscle Imbalances Revealed product on sale for $210 off the normal price through tomorrow (Friday) at midnight.  It’s a fantastic deal on a product that I highly recommend – and one that comes with a 60-day money-back guarantee, plus several cool bonus features (including two interviews Rick did with me).  Click here to check it out.

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Strength and Conditioning Stuff You Should Read: 9/23/11

Written on September 23, 2011 at 7:53 am, by Eric Cressey

Here are a few strength and conditioning recommendations for the week:

The Right Way to Stretch the Pecs – This is an old article of mine at T-Nation that I just referred to with an online consulting client.  It made me realize that this good information has been lost in the archives – and it’s definitely worth a read.

The Dangers of and Solutions to Indoor Air Pollution – Filed this one under general health, as opposed to strength and conditioning or nutrition, but it’s still a great read from Brian St. Pierre.

Moneyball – This isn’t much of a strength and conditioning recommendation, either, but I will say that it was a movie I really enjoyed.  I was invited to a premiere of the flick here in Boston last night, and as a “baseball guy,” I thought it was really well done.

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Baseball Strength and Conditioning: Early Off-Season Priorities 6-10

Written on September 21, 2011 at 8:15 am, by Eric Cressey

In Part 1 of this off-season baseball strength and conditioning series, I outlined the first five of my top 10 priorities when dealing with baseball players at the start of their off-season.  Today, I round out the top 10 “general” things always seem to be addressing with players coming in after a season.

1. Regaining lost mobility – This is an incredibly loaded topic that goes far beyond the scope of any blog or article, as it’s an entire two-day seminar or book! You see, losses in mobility – the ability to reach a desired position or posture – can be caused by a number of issues – and usually a combination of several of them.  Tissues can actually lose sarcomeres and become short after immobilization or significant eccentric stress (as with the deceleration component of throwing).  They can become stiff because of inadequate stability at adjacent joints (learn more HERE), protective tension (e.g., “tight” hamstrings in someone with crazy anterior pelvic tilt), or neural tension from an injury (e.g., disc herniation causing “tight” hamstrings).

The “Short vs. Stiff” issue is why you need to have a variety of tools in your “mobility toolbox.”  You need focal modalities like Active Release, Graston, and ASTYM techniques to assist with dealing with short tissues, whereas you need more diffuse modalities like traditional massage and foam rolling for dealing with stiffness (although both modalities can certainly help in the other regards, this is how I prefer to use them).

You need to understand retraining breathing appropriately and how posture affects respiratory function.  If you live in extension, you’ll have a poor zone of apposition in which the diaphragm can function.  The average human takes over 20,000 breaths per day.  If you don’t use your diaphragm properly, more of the stress is placed on the supplemental respiratory muscles: sternocleidomastoid, scalenes, pec major and minor, upper trapezius, and latissimus dorsi (to only name a few).  What are some insanely common sites of trigger points in just about everyone – especially thrower? Sternocleidomastoid, scalenes, pec major and minor, upper trapezius, and latissimus dorsi.  Improving respiratory function can be a complete game changer when it comes to enhancing mobility.  If you see a baseball player with a low right shoulder, prominent anterior left ribs, adducted right hip, huge anterior pelvic tilt, and limited right shoulder internal rotation, it’s almost always a slam dunk.

(Check out www.PosturalRestoration.com for more details on this front)

You may need low-load, long-duration static stretches to improve length in tissues that have lost sarcomeres.  This research has been around in the post-surgery community for decades (1984 research example here), but it’s actually not used all that much in strength and conditioning programs – presumably because of time constraints or the fact that most coaches simply don’t know how well it can work in the right people.

Finally, as we noted in our Assess and Correct DVD set, you also need dynamic flexibility drills in your warm-ups to reduce tissue and joint stiffness, and subsequent strength exercises in your strength and conditioning program to create adequate stability at adjacent joints to “hold” that new range of motion in place.

Many physical therapist employ heat early in a session to decrease stiffness prior to strengthening exercises, too.  The point is that there may be many different ways to skin a cat – but there are also a lot different types and sizes of cat.  And, for the record, I don’t condone skinning cats; it’s just a really gruesome analogy that has somehow “stuck” in our normally very politically correct society. Weird…but let’s move on.

2.Improving dynamic stabilization of the scapula – I say “dynamic stabilization” because you don’t just want scapular stability; you want a scapula with appropriate tissue length, stiffness, and density to allow for the desired movement.  A scapula that doesn’t move might be “stable,” but that’s not actually a good thing!

Truth be told, the scapular stabilizers generally fatigue before the rotator cuff does.  And, when the scapula isn’t positioned appropriately, the rotator cuff is at a mechanical disadvantage, anyway.  Additionally, poor scapular control can present as an internal rotation deficit at the shoulder, as you’ll just protract the shoulder excessively in place of internally rotating.  In other words, you can do all the rotator cuff exercises you want, but you don’t increase strength of the periscapular muscles, you’ll be spinning your wheels.  There are loads of drills that we use, but forearm wall slide variations are among our favorites:

3. Enhancing global strength while minimizing reactive training – As I’ve already noted in this series, we’re certainly spending a lot of time addressing specific areas of weakness like the rotator cuff, scapular stabilizers, and anterior core. However, I should be very clear that we’re still using “money” strength exercises like variations of the deadlift, single-leg exercises, squatting (in some of our guys), pull-ups, rows, push-ups, and dumbbell bench presses to get strong.  That said, the volume and intensity come down a ton on the reactive training side of things.  We’ll give our guys a few weeks off altogether from sprinting, as they’ve usually done a lot of that all season.  Plus, nixing all the sprinting and jumping for a few weeks ensures that they won’t tweak anything, given the soreness they’ll be working with from the strength training program – and it allows us to increase strength faster.

4. Putting guys in the right footwear – One thing that many folks don’t appreciate about playing baseball every day from February to October is the sheer amount of time one spends standing around in cleats, which will never be as comfortable as sneakers or going barefoot.  As such, one of the first things we do with most of our guys is get them into a good pair of minimalist shoes for training, as it gets them away from the rigidity, separation from the ground, and ankle mobility deficits that come with wearing cleats.  As I wrote previously, I’m a big fan of the New Balance Minimus.

Keep in mind that we ease guys into these minimalist shoe options, rather than throwing them in the footwear 24/7 right away.  They’ll start out just wearing them during training, and increase from there, assuming all goes well.

5. Normalizing sleep schedules - Professional baseball players (and really all professional athletes) have terrible sleep schedules.  Because most games are night games, they generally go to bed around 1-2AM and wake up anywhere from 7AM to 11AM.  The early risers I know will usually take a nap before going to the park, whereas the guys who sleep in roll out of bed and go straight to the park.  Additionally, much of this sleeping comes on planes and buses, which aren’t exactly comfortable places to get quality sleep.  I’m a firm believer that one hour of sleep before midnight is worth two hours after midnight – but this simply isn’t an option for professional baseball players.

That said, we try to normalize things as much as possible in the off-season.  All our athletes are encouraged to try to go to bed and wake up at the same time – and to hit the hay before 11pm every night.  Any naps they can get during the day are a bonus, too!

Wrap-up

While I’ve outlined ten things we address in the early off-season, these are really just the tip of the iceberg, as every player is unique and needs an individual approach.  That said, the one general theme that applies to all of them is that we’re shifting paradigms – meaning that some things about our philosophy may differ from what they’ve experienced.  Some guys may be accustomed to just “football workouts.”  Others may have been coddled with foo-foo training programs where they didn’t work hard.  Some guys ran distances. Some guys crushed the rotator cuffs every day while ignoring the rest of the body.

The point is that it’s not just our job to find what we feel is the best fit for these athletes, but also to educate them on why the unique program we’ve designed for them is a better approach than they can get anywhere else.

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Baseball Strength and Conditioning: Early Off-Season Priorities 1-5

Written on September 19, 2011 at 6:20 pm, by Eric Cressey

We’ve got over 100 professional baseball players scheduled to be at Cressey Performance for their off-season training, so it goes without saying that I’ve been doing a lot of evaluations over the past two weeks – and writing the individualized strength and conditioning programs in accordance with those assessment results.  To that end, I thought I’d use a two-part series to highlight the top 10 “general” things I find myself addressing with guys coming in after the long season.

1. Planning the off-season schedule – Each player is 100% unique in this regard.  As examples, a guy who threw 50 innings would be able to start a throwing program sooner this off-season than a guy who racked up 150 innings.  Some guys goes to instructional league in Florida or Arizona, and others play winter ball.  Guys headed to minor league spring training report later than those headed to big league spring training.  In short, everyone has different timetables with which to work, so it’s important to get an appreciation for it well in advance for the sake of long-term planning.

2.Discussing role/status within the organization – This priority aligns with #1.  You manage a first-round draft pick who may be a guaranteed big leaguer if he stays healthy somewhat differently than you’d manage someone who was drafted in the 48th round and paid a $1,000 signing bonus.  The former has the world on a silver platter for him, whereas the latter really needs to improve with dramatic improvements in order to stick around in pro ball. In this situation, you have to be willing to get a bit more aggressive with the programming of the “underdog.” I wrote about this two years ago in a feature on CP athlete and Oakland A’s prospect Shawn Haviland.

3. Mastering the sagittal plane – When the season ends, it seems like a lot of strength and conditioning coaches are super anxious to start up loads of aggressive medicine ball drills and change of direction work.  I’m a firm believer that guys need to master the sagittal plane before they head out and spend a lot of time in the frontal plane – especially when it comes after a long season of aggressive rotational activity.  In some guys, we omit medicine ball work altogether for the first month of the off-season while we work to enhance anti-rotation and anti-extension core stability.  You’d be amazed at how many athletes can’t do a decent prone bridge, rollout, or reverse crunch on their first day back because their anterior pelvic tilt is so excessive that their anterior core strength is virtually absent.

Other athletes need to spend a lot of time simply working on single-leg exercises.  While these exercises are performed in the sagittal plane, the athletes are still stabilizing in the frontal and transverse planes.  The “sexy” work in these planes comes in subsequent months.

Of course, some athletes do a great job of taking care of themselves during the season and come back with complete control in the sagittal plane.  As long as they aren’t too banged up, we’ll certainly get them right back in to medicine ball exercises.

4. Regaining rotator cuff strength – It’s a huge struggle to improve cuff strength when an athlete is constantly throwing – especially when we’re talking about a pitcher who is racking up 100+ pitches – and the eccentric stress that accompanies them – every fifth day.  Since most professional pitchers get about 10-16 weeks off from throwing each fall, those 2-4 months become absolutely crucial for regaining cuff strength at an optimal rate.  It’s one reason why it drives me absolutely bonkers when a guy takes a full month off after the season ends.

I discussed our general approach to improving rotator cuff function in Clearing Up the Rotator Cuff Controversy.  Of course, all this work is accompanied by loads of work on thoracic mobility, scapular stabilization, breathing exercises, and soft tissue work.

5. Normalizing diet and, in turn, vitamin/mineral status – There are a ton of guys who want to stick with healthy food options during the season.  Unfortunately, that can be very challenging on a minor league salary, less-than-stellar clubhouse food, and extensive travel.  All our professional players complete three-day diet records at the start of the off-season, and when reviewing those, we tinker with food selection, meal frequency, and supplementation.

If a guy is overweight, we don’t try to take 30 pounds off him in two weeks; rather, we focus on improving food quality and allow the increased training volume to take care of the rest.  Most guys will undergo a pretty dramatic body composition shift in the first 6-8 weeks of the off-season, anyway, so there is no need to get “aggressive” with caloric reductions at this point when they should be all about regeneration and feeling good.

Of course, if they’re skinny, we’ll get them crushing more food right away!

These are just the first of many key areas of focus for early in the off-season.  Check back soon for Part 2!

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Strength and Conditioning Stuff You Should Read: 9/16/11

Written on September 16, 2011 at 7:38 am, by Eric Cressey

Here’s this week’s list of recommended strength and conditioning reading:

40 Years of Insight: Part 1 and Part 2 – This two-part series from Dan John was fantastic and should be recommended reading for not only those in the strength and conditioning field, but also those who lift weights for health, performance, and recreation.

Contemporary Cardio – This piece by Charlie Weingroff was an excellent look at how his thoughts on cardio have evolved.  It is a bit “sciency,” but very informative.  I can tell you from our experience over the past 18 months with PRI that the comments on “breathing diaphragmatically” are spot-on with everything from improved work capacity to reduced tone in undesirable places.

Real Deal Baseball Training – Just a friendly reminder that the introductory sale on this product ends tonight at midnight.  The feedback I’ve received via email from those who have purchased on my recommendation the other day has been quite positive.

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A Real Deal Baseball Training Review

Written on September 14, 2011 at 11:35 am, by Eric Cressey

With our professional baseball off-season training crew at Cressey Performance starting to pick up steam, I’m taking today off for a last chance to enjoy summer.  I’m taking my grandmother and great aunt to Fenway Park this afternoon.  Let’s just say that the love of baseball is in my gene pool – so it should be a fun game!

Speaking of off-season training, I wanted to quickly give you a heads-up that Dan Huff and Joe Meglio just released Real Deal Baseball Training, an off-season strength and conditioning program specifically for baseball players, and it’s on sale for a very affordable $17.95 through this Friday night.

I’ll be honest: I get emails literally every day from people asking me to create a baseball product.  While I intend to do so, I want it to be perfect – so I’m constantly tinkering with how I plan to approach it as we make subtle modifications to how we train baseball players of a wide variety of ages and ability levels.  Unfortunately, while I’ve been contemplating things, a lot of baseball players and coaches out there have been using horrendous strength and conditioning programs and techniques.  These approaches aren’t making them durable and high-performing; rather, they’re breaking them down and killing off the athleticism they need.

Dan and Joe can really help in this regard. While this program is considerably different than our approaches at Cressey Performance, that’s one reason why I liked it.  There is more than one way to skin a cat, and I, for example, actually picked up some new movement training drills that I’ll implement with our guys.

The product is completely online, so you can access it immediately.  It gives you four months of comprehensive strength and conditioning programs – and includes a handy video database that shows you technique for all the drills in the program. The program also includes a 30-day money back guarantee, in case it’s not a good fit for you.

For more information, check out the Real Deal Baseball Training page, where Dan Huff has a video describing it in more detail for you.

 

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Is Dairy Healthy? The Whole Story – Part 3

Written on September 13, 2011 at 7:24 pm, by Eric Cressey

Today marks the third and final installment of Brian St. Pierre’s guest series on dairy consumption. In Part 1 and Part 2, he covered a lot of ground on the total health impact of dairy foods. If you missed them, I highly suggest reading these before you continue here with Part 3.

Pasteurization – The Good, the Bad and the Ugly

I am going to assume that you all know that pasteurization is the method by which milk is heated to destroy bacteria that may cause harm, as I am not going to get into technicalities of what it is and the different techniques available. Anyway, it does seem all well and good right? It destroys harmful bacteria, making contamination almost impossible.  Is it really all it is cracked up to be, though?

When Louis Pasteur came up with the process, our food production was terrible. Sanitation was poor, and (thanks to Pastuer) we’d really just begun to understand that germs caused illness.  Animals (like cows) were not brought up in pristine conditions.  Folks were starting to mass-milk cows in these unsanitary conditions, too – so there was certainly an increased likelihood of getting sick and ending up with serious health problems, as medicine back then surely wasn’t what it is today.

This was before the creation of the FDA or any other food regulatory system, and before Upton Sinclair’s The Jungle showcased to the nation how disgusting our food production was (incidentally, that book led to the creation of the FDA, but that is beyond the scope of this article). It is completely logical to believe that pasteurization was a huge breakthrough, and a necessity at the time of its inception. At the time, pasteurized milk was safer than raw. The question is though, is that still the case today?

Let me back up a second and talk about glutathione, our body’s master antioxidant. Glutathione has many important functions:

  • Neutralizes free radicals and peroxides
  • Maintains blood levels of antioxidants vitamins C and E
  • Helps the liver and white blood cells in the detoxification of foreign compounds and carcinogens
  • Is essential for the optimized immune function
  • Plays a key role in a plethora of metabolic and biological processes like DNA synthesis, protein synthesis, prostaglandin synthesis and more.

We know that whey protein’s cysteine content is responsible for much of its ability to boost glutathione, but not all of it. This ability may also come from two biological fractions found in whey: beta-lactoglobulin and serum albumin. These proteins contain some very special glutamyl-cysteine bonds that tend to enter our blood stream intact, and are much more readily turned into glutathione. Unfortunately, it seems that when whey protein undergoes extensive heat treatment, these two delicate fractions are destroyed.

This is not only problem in whey protein powder processing, but also with pasteurizing milk. In fact, pasteurization in general decreases the whey protein concentration in milk. The heat causes the proteins to denature and associate with the casein proteins. The higher the temperature – as when milk is ultra-pasteurized – the greater the denaturing of whey.

In fact, whey normally makes up about 20% of the protein in raw milk. Gentle pasteurization (high temperature, short time) causes this to drop down to about 12-13%, while ultra-pasteurization causes whey to fall to only about 5% of the total protein content!

On top of that, exposing raw milk to different heat treatments also affected those delicate biological fractions of whey.  In raw milk, beta-lactoglobulin makes up almost 90% of the whey protein. After gentle pasteurization, it makes up just under 70%, and after ultra-pasteurization it drops down to just over 20%!

In addition to the beta-lactoglobulin, serum albumin levels are also affected by pasteurization. Gentle pasteurization has been found to decrease serum albumin levels by 40%, while ultra-pasteurization reduced it by 77%!

After reviewing the evidence, does raw milk seem healthier? I would say one could make a very strong argument that this is the case. Is raw milk any less safe?  This is also debatable, but in my opinion it is probably only an issue for pregnant and nursing moms, as well as young children.  For them, I am hesitant to recommend raw milk, regardless of the potential benefits.  For everyone else, the choice is yours – if your state allows it.

Whole Fat Milk Leads to Greater Muscle Growth?

I haven’t discussed the role of dairy in muscle growth yet in spite of the fact that it’s surely of interest to you – so let’s get to it now. Researchers compared skim milk to whole milk in the post-training period to see which would produce greater anabolic effects.  They pitted 14oz of skim milk against 8oz of whole milk, to make them calorically equal.  Theoretically, the results should be even or in the favor of skim milk, since it had six more grams of protein.  The research actually showed that whole milk was more effective than skim, despite the lower protein content and equal total calories.

Another notch in favor of whole-fat over fat-free, and while it is just one study, at the very least it seems clear that fat (specifically milk fat), is certainly not going to inhibit results if consumed post-training.

In Conclusion

If you made it this far, I applaud you, as this was an absolute beast of an article. You have just read almost 3,000 words on dairy, so give yourself a little pat on the back.

In my mind, and from the totality of the data, it is clear that if you choose to consume dairy (and I’m not even saying you have to) your best bet for health and body composition purposes would be whole-fat, grass-fed and lightly pasteurized (or raw) options.

However, finding companies that make such products can often be difficult. To make matters worse, not all organic dairy options are created equal, and not all are even grass-fed. In fact, many organic dairies produce milk and dairy that is no better than conventionally-produced grain fed options.  To find out whether the organic dairy available to you is of high quality, or even grass-fed, check out this report from the Cornucopia Institute. It will provide you with national and local organic dairy options, as well as how much time their cows spend on pasture, whether they receive antibiotics and more.

For example, Organic Valley and Whole Foods 365 are two brands that are available nationally and received good reviews. In contrast, Horizon, the largest organic dairy producer, would not even provide their information to the Cornucopia Institute. I don’t know about you, but I am not willing to consume food from a company that is not transparent about its production practices.

In the end, the choices are yours, so choose wisely.

References

Douglas F, Greenberg R, Farrell H, Edmondson L. Effects of ultra-high-temperature pasteurization on milk proteins. J Agri Food Chem. 1981 29(1):11-15

Morales F, Romero C, Jiménez-Pérez S. Characterization of industrial processed milk by analysis of heat-induced changes. Inter J Food Sci Tech. March 2000 35(2):193–200

Elliot TA, Cree MG, Sanford AP, Wolfe RR, Tipton KD.  Milk ingestion stimulates net muscle protein synthesis following resistance exercise.  Med Sci Sports Exerc. 2006 Apr;38(4):667-74.

About the Author

Brian St. Pierre is a Certified Sports Nutritionist (CISSN) and a Certified Strength and Conditioning Specialist (CSCS). He received his degree in Food Science and Human Nutrition with a focus in Human Nutrition and Dietetics from the University of Maine, and he is currently pursuing his Master’s degree in Human Nutrition and Dietetics from the same institution. He was the Nutritionist and a Strength and Conditioning Coach at Cressey Performance in Hudson, MA for three years. He is also the author of the Show and Go Nutrition Guide, the accompanying nutrition manual to Eric Cressey’s Show and Go Training System.

With his passion for seeing his clients succeed, Brian is able to use his knowledge, experience, and energy to create highly effective training and nutrition programs for clients of any age and background. For more information, check out his website.

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Is Dairy Healthy? The Whole Story – Part 2

Written on September 11, 2011 at 8:01 pm, by Eric Cressey

Today marks the second installment of Brian St. Pierre’s guest contribution on the topic of dairy consumption.  In case you missed Part 1 – which discussed the history of dairy consumption, how dairy production has drastically changed, and the benefits of grass-feeding – you can find it HERE.

The Skinny on Dairy Fat

Whole or full-fat dairy is actually a topic I want to cover in a lot of detail.  I personally feel that this is a grossly misunderstood topic, and I want to clarify several things here.

There is actually a good amount of research, in several populations, that shows that full-fat dairy consumption is associated with lower BMI, lower waist circumference, and lower risk of cardiovascular disease (especially stroke). Yes, you read that right: whole fat dairy is associated with a decreased risk of CVD, especially stroke. Low-fat or fat-free dairy is actually often associated with increased BMI and waist circumference (though to be fair this is not always the case).

In fact Dr. Ronald Krauss, one the world’s leading lipid researchers, showed that while saturated fat from dairy does raise LDL, it is an increase in large, fluffy and benign LDL – not the small, dense and atherogenic LDL.

Whole fat dairy from grass-fed cows contains a boatload of powerful vitamins and healthful fatty acids.  These vitamins are fat-soluble, meaning they are bonded to the fatty acids in the dairy, and are therefore nearly non-existent in fat-free dairy, same for the fatty acids obviously.  The fat is where vitamins A, D, E and K2 are, as well as conjugated linoleic acid (CLA), butyric acid, omega-3 fatty acids, trans-palmitoleate and medium chain triglycerides.  Low-fat and fat-free dairy are woefully lacking in these properties.

CLA is present in human body fat in proportion to dietary intake, and has been shown to be a powerful ally in the fight against cancer.  Meat and dairy from grass-fed animals provide the richest source of CLA on the planet, containing three to five times more CLA than feedlot-raised animals.  CLA has been found to greatly reduce tumor growth in animals, and possibly in humans as well.  In a Finnish study, women who had the highest levels of CLA in their diet had a 60% lower risk of breast cancer than those with the lowest levels.  Simply switching from conventionally-raised grain-fed meat and dairy to pasture-raised grass-fed versions would have placed all the women in the lowest risk category.

In addition, CLA may also help to fight against heart disease. In a study of 3626 Costa Rican men and women (a country that uses traditional pasture-grazing for dairy cows), people with the highest level of CLA in their body fat were 49% less likely to have had a heart attack, compared to those with the lowest level. This may be due to CLA intake and tissue levels being associated with greater amounts of large and fluffy LDL, and inversely associated with small and dense LDL.

Vitamin D is pretty much the best thing since sliced bread, and getting some from food is always a good thing.  Low blood levels of vitamin D are associated with lowered immunity, increased risk of 17 cancers (and counting), increased risk of heart disease, neurological and psychological disorders (including ADD and depression), diabetes, stroke, hypertension, bone loss, and loss of muscle mass and strength as we age and more.

Omega-3s are absolutely amazing, as they may improve nerve, brain, eye, heart and cardiovascular function as well as decreasing inflammation, joint pain, arthritis, psychological disorders, and risk of breast cancer and heart disease – all while improving mood and body composition!

Medium chain triglycerides are unique fatty acids that are more readily utilized as fuel rather than stored as energy, as well as particular ones, like lauric acid, containing anti-viral and anti-microbial properties.

Vitamins A and E are powerful antioxidants.

Butryric acid may help with bodyweight regulation, and is a primary fuel source for our intestinal flora.

Notice that I didn’t mention vitamin K2 yet?  That is because I was saving what might be the best for last.  Several studies have found that a higher vitamin K2 intake is associated with a lower risk of heart attack, ischemic stroke, cancer incidence, cancer mortality and overall mortality.  Men with the highest vitamin K2 consumption had a 51% lower risk of heart attack mortality and a 26% lower risk of all cause mortality compared to men consuming the lowest amount!

One of the ways vitamin K2 improves cardiovascular health is its ability to prevent and decrease arterial calcification by 30-40%.  And, this only speaks to vitamin K2’s effects of cardiovascular health; it is also crucially important for proper fetal development and bone health, to name a few additional benefits.

What about Dairy and Diabetes?

With little fanfare, a study recently came out by Dr. Dariush Mozaffarian and colleagues. Why so little fanfare, you ask? Because the study suggests that dairy fat may actually protect against diabetes, and that goes against conventional wisdom and government recommendations.

Dr. Mozaffarian and company collected two measures of dairy fat intake in 3,736 Americans. They took six 24-hour dietary recall questionnaires, as well as taking blood levels of trans-palmitoleate. Trans-palmitoleate comes almost exclusively dairy fat and red meat fat, and therefore it reflects the intakes of these foods. Dairy provided most of the trans-palmitoleate fatty acid in this study.

Adjustments were made for confounding factors, and trans-palmitoleate levels were associated with a smaller waist circumference, higher HDL cholesterol, lower serum triglycerides, lower C-reactive protein, lower fasting insulin and lower calculated insulin resistance. In addition to that awesome data, people who had the highest levels of trans-palmitoleate had 1/3 the risk of developing diabetes over the 3 year study period.

Again, it is important to note that trans-palmitoleate is a fatty acid, and so is only significant from whole fat dairy, not from low-fat or fat-free. The investigators also noted that “greater whole-fat dairy consumption was associated with lower risk for diabetes.” This is an important distinction as it wasn’t just trans-palmitoleate levels that were associated with the decreased risk, but the actual consumption of the food that provides that element was as well.

Here’s another nice quote from the authors: “Our findings support potential metabolic benefits of dairy consumption and suggest that trans-palmitoleate may mediate these effects. They also suggest that efforts to promote exclusive consumption of low-fat and nonfat dairy products, which would lower population exposure to trans-palmitoleate, may be premature until the mediators of the health effects of dairy consumption are better established.”

While it is certainly possible that trans-palmitoleate is mediating a lot of these positive health outcomes that were associated with it, in all reality it only makes up a tiny fraction of the fat content of milk. I tend to believe that instead it is more of a marker of dairy fat intake, with the benefits more likely coming from the other elements contained in dairy fat – CLA, vitamin K2, butyric acid, vitamin D, etc.

Stay tuned for part 3!

References

Berkey CS, Rockett HR, Willett WC, Colditz GA.  Milk, dairy fat, dietary calcium, and weight gain: a longitudinal study of adolescents.  Arch Pediatr Adolesc Med. 2005 Jun;159(6):543-50.

Rosell M, Håkansson NN, Wolk A.  Association between dairy food consumption and weight change over 9 y in 19 352 perimenopausal women.  Am J Clin Nutr.  2006 Dec;84(6):1481-1488.

University of Gothenburg (2009, November 4). Children Who Often Drink Full-fat Milk Weigh Less, Swedish Research Finds. ScienceDaily.

German JB, Gibson RA, Krauss RM, et al.  A reappraisal of the impact of dairy foods and milk fat on cardiovascular disease risk.  Eur J Nutr. 2009 Jun;48(4):191-203.

Bonthuis M, Hughes MCB, IbiebeleTI, Green AC, and van der Pols JC.  Dairy consumption and patterns of mortality of Australian adults.  Eur J Clin Nutr.  2010;64:569–577.

Elwood PC, Strain JJ, Robson PJ, et al.  Milk consumption, stroke, and heart attack risk: evidence from the Caerphilly cohort of older men.  J Epidemiol Community Health.  2005;59:502-505

Elwood PC, Pickering JE, Hughes J, Fehily AM, Ness AR.  Milk drinking, ischaemic heart disease and ischaemic stroke II. Evidence from cohort studies.  Eur J Clin Nutr. 2004 May;58(5):718-24.

Krauss RM, et al. Change in dietary saturated fat intake is correlated with change in mass of large low-density-lipoprotein particles in men. Am J Clin Nutr. 1998 May;67(5):828-36.

Aro A, Männistö S, Salminen I, et al. Inverse association between dietary and serum conjugated linoleic acid and risk of breast cancer in postmenopausal women. Nutr Cancer. 2000;38(2):151-7.

Smit LA, Baylin A, Campos H.  Conjugated linoleic acid in adipose tissue and risk of myocardial infarction.  Am J Clin Nutr. 2010 Jul;92(1):34-40.

Sjogren P, Rosell M, Skoglund-Andersson C, et al. Milk-derived fatty acids are associated with a more favorable LDL particle size distribution in healthy men. J Nutr. 2004 Jul;134(7):1729-35.

Geleijnse JM, Vermeer C, Grobbee DE, et al.  Dietary Intake of Menaquinone Is Associated with a Reduced Risk of Coronary Heart Disease: The Rotterdam Study.  J Nutr.  2004 Nov;134:3100-3105.

Gast GC, de Roos NM, Sluijs I, et al.  A high menaquinone intake reduces the incidence of coronary heart disease.  Nutr Metab Cardiovasc Dis.  2009 Sep;19(7):504-10.

Nimptsch K, Rohrmann S, Kaaks R, Linseisen J.  Dietary vitamin K intake in relation to cancer incidence and mortality: results from the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg).  Am J Clin Nutr. 2010 May;91(5):1348-58.

Spronk HM, Soute BA, Schurgers LJ, et al.  Tissue-specific utilization of menaquinone-4 results in the prevention of arterial calcification in warfarin-treated rats.  J Vasc Res. 2003 Nov-Dec;40(6):531-7.

Mozaffarian et al. Trans-palmitoleic Acid, Metabolic Risk Factors, and New-Onset Diabetes in US Adults. Ann Internal Med. 2010.

About the Author

Brian St. Pierre is a Certified Sports Nutritionist (CISSN) and a Certified Strength and Conditioning Specialist (CSCS). He received his degree in Food Science and Human Nutrition with a focus in Human Nutrition and Dietetics from the University of Maine, and he is currently pursuing his Master’s degree in Human Nutrition and Dietetics from the same institution. He was the Nutritionist and a Strength and Conditioning Coach at Cressey Performance in Hudson, MA for three years. He is also the author of the Show and Go Nutrition Guide, the accompanying nutrition manual to Eric Cressey’s Show and Go Training System.

With his passion for seeing his clients succeed, Brian is able to use his knowledge, experience, and energy to create highly effective training and nutrition programs for clients of any age and background. For more information, check out his website.

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