Random Friday Thoughts: 4/24/09

Written on April 24, 2009 at 5:35 am, by Eric Cressey

1. It’s been a crazy week ever since Anna and I got engaged on Sunday.  You never truly realize how many people you know until they all try to email/call/text you at once to say congratulations.  With my cell phone and email inbox going crazy, I kind of felt like Jerry Maguire – minus the whole weird scientology and jumping on Oprah’s couch stuff.

2. On Wednesday, I got out to watch two high school games where CP athletes pitched, and then headed to Fenway to watch the Sox beat the Twins.  In Game 1, Weston High Sahil Bloom had a no-hitter through 6 2/3 innings before giving up a bloop single, and then Auburn High’s Tyler Beede threw six innings.

3. Next week, I’ll be publishing the first installment of a collection of nutrition articles from Eric Talmant.  Eric has some very forward-thinking ideas to share, and it’ll make a nice weekly addition to EricCressey.com.  Be sure to check them out.

4. I’m getting really excited for this year’s Perform Better Summits.  I’ll be speaking in Providence, RI and Long Beach, CA (there is also one in Chicago); I’d definitely encourage you to check the events out if you live in that neck of the woods.  My presentations should question the “diagnostic norms” – in much the same way that I did with this week’s newsletter.

5. Speaking of newsletters, I got several inquiries after I ran this one about the medicine ball training we do with our pitchers. In particular, folks were curious about the medicine ball we used in drills like this:

The medicine balls in question can be found HERE.

6. I’ve written quite a bit in the past about how a glenohumeral internal rotation deficit can be one contributing factor (among others) to medial elbow injuries in overhead throwing athletes.  The other day, someone asked me if I had any scientific evidence to support this idea.  The answer would be a resounding YES.

Very simply, if you lack internal rotation, you’ll go to the elbow to “regain” that lost range-of-motion.  It’s the same reason that ankle mobility deficits can lead to knee pain, and hip mobility deficits can lead to knee and lower back pain.

7. I don’t really “get” how this whole Delicious bookmarking thing works, but Jon Boyle (who helps out with the blog) recommended I start sending him recommendations of good stuff I’ve read.  You can find some of my recommended reading/viewing off to the right-hand side of the page.  If there are books you recommend I check out, by all means, please post suggestions in the comments to these blogs; I’m always looking for new reading material.

Have a great weekend!

Hip Pain In Athletes

Written on April 13, 2009 at 7:28 pm, by Eric Cressey

A New Perspective on Dieting

We’ve got some great content lined up for you in this newsletter, but before getting into that I want to give you a quick heads-up on something really cool.

Joel Marion just posted some interesting free videos for you about how you can use strategic dietary cheating and carbohydrate cycling to accelerate fat loss; they’re worth checking out before they get taken down in a day or two.  If you are someone who is interested in losing body fat, yet aren’t terribly excited at the idea of “dieting” or giving up your favorite foods, then you really need to check these out.

While I don’t necessarily agree with all of Joel’s methods, I do like the fact that he’s a big believer that fat loss nutrition doesn’t have to be “painful” – and he’s always looking for ways to turn “good” into “optimal.”  As a result, he’s gotten great results with clients time and time again.
See what he’s got up his sleeve this time over at CheatYourWayThin.com.

Also, at that page, you can register for a special list for a presale in which you’ll be able to get his brand new complete system at a $50 discount.  It’s a very sweet deal.

Now, on to the content…

A Common Cause of Hip Pain in Athletes

Hip pain – particularly of the anterior (front of the hip) variety – is a very common problem in the weight training population.

In her book, Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann discusses Femoral Anterior Glide Syndrome in excellent detail.  And, while it may seem like an obscure diagnosis, it’s actually a really common inefficiency we see in a weight training population.

In order to understand this syndrome, you have to appreciate the attachment points and functions of the hamstrings and gluteus maximus.  With the hamstrings, you’ll notice that they attach to the ischial tuberosity of the pelvis (with the exception of the short head of the biceps femoris, which attaches on the femur), and then run down to a point inferior to (below) the knee.  In other words, they are a two-joint muscle group.  All of the hamstrings aid in knee flexion, and all but the short head of the biceps femoris also aid in hip extension.

Conversely, the glutes attach on the pelvis and the femur; they’re a one-joint muscle – and this is why they can so directly impact hip health.

You see, when the hamstrings extend the hip (imagine the hip motion that happens when one comes out of the bottom of a squat), they do so in a “gross” fashion.  In other words, the entire leg extends.  In the process, there is little control over the movement of the femoral head (“ball” in the “ball-and-socket” hip joint) – and it tends to migrate forward during hip extension, giving you a femoral anterior glide syndrome.  In the process, it can irritate the anterior joint capsule, and this irritation can give a sensation of tightness in the front of the hip.

Fortunately, the glutes can help prevent the problem.  Thanks to their point of attachment on the superior aspect of the femur (closer to the hip), they have more direct control over the femur as it extends on the hip.  As a result, they can posteriorly pull the femoral head during hip extension.  So, in an ideal world, you get effective co-contraction of the hamstrings and glutes as one extends the hip; they are a system of checks and balances on one another.  If you use the hamstrings too much in hip extension, you’re just waiting to develop not only femoral anterior glide syndrome, but also hamstrings and adductor magnus (groin) strains and extension-based back pain.

As an aside, this hamstrings/glutes relationship is somewhat analogous to what you see at the shoulder with the subscapularis posteriorly pulling the humeral head as the infraspinatus and teres minor allow it to drift forward.  That’s another newsletter altogether, though!

Once the femoral anterior glide issue is in place, the first course of action is to stop aggressively stretching the hip flexors.  While the issue gives a sensation of hip flexor “tightness,” in reality, stretching the area only exacerbates the anterior hip pain.  A better bet is to just ditch the stretching for a few days, and instead incorporate extra glute activation work, as detailed in Assess and Correct.  Eventually, though, one can reintegrate both static and dynamic hip flexor stretches.

Just as importantly, it’s important to identify the causes.  We’ll see this issue in runners who have no glute function, but more commonly, I’ll see it in a weight training population that doesn’t understand how to complete hip extension.  Here’s what a hamstrings-dominant hip extension pattern would look like with squatting.

The final portion of hip extension is when the glutes are most active, so it’s important to “pop the hips through” at lockout of deadlifts, squats, pull-throughs, and other exercises like these.  In the same squat example, it’s really just as simple as standing tall:

Of course, this is just the tip of the iceberg when it comes to hip issues in athletes, but it’s definitely something we see quite a bit.

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Muscle Size vs. Mobility

Written on April 8, 2009 at 5:36 am, by Eric Cressey

Q: At what point do you think that muscle size affects one’s range of motion? Just interested in your thoughts. I’m a golfer and my  flexibility is important; there isn’t much point for me to be really strong but not able to move properly.

A: Well, it would be joint- and population-specific. On the joint side of things, as an example, the elbow flexors (biceps, to the lay population) and knee flexors (hamstrings) can restrict elbow and knee flexion, respectively, if they get too big. Or, the pecs may inhibit horizontal adduction ROM. This list goes on and on.

I don’t feel that simply making a muscle bigger means that you lose range-of-motion in that specific muscle, as the improvements are to cross-sectional area. If this was the case, the elbow flexors would be restricting us in extension, and the pecs would be restricting us in horizontal abduction, but as the examples above show, that’s just not happening.

Provided that flexibility training is good, and structural balance is prioritized in programming, there is no reason to believe that you can’t be big and flexible.

Now, it’s important to consider the sporting population in question.  A powerlifter isn’t going to need as much mobility as, say, a baseball pitcher.  One guy needs to be efficient in a short range of motion, while the other needs to be efficient through a larger range of motion.

In pitchers, external rotation ROM is a good predictive factor for velocity.  On top of that, horizontal abduction at stride foot contact is huge, according to the research.

So, in order to have good pitching specific ROM, you need to have adequate length of the muscles that internally rotate and horizontally adduct the shoulders.  And, the big muscle that does this is the pectoralis major.  Bench until the cows come home, shorten it up, and then you’ll lose that ROM.

Now, ask anyone who has ever trained baseball pitchers, and they’ll tell you that pitcher gain external rotation over the course of a season simply from throwing.  Guys who don’t weight-train properly can certainly impede this velocity-aiding adaptation.

This, of course, is an example specific to baseball pitching, and demands would be different for golfers.

Stuff You Should Read: 4/7/09

Written on April 7, 2009 at 5:00 am, by Eric Cressey

This week’s recommended reading:

LiftStrong - this compilation of writings from dozens of coaches and trainers is fantastic, and I was honored to contribute. Alwyn Cosgrove – a two-time cancer survivor – pulled this great resource together, and all proceeds benefit the Leukemia and Lymphoma Society.  For a small price, you get over 800 pages of content on a CD, and help out a great cause.

Lay Back to Throw Gas - This one is fitting, in light of all the baseball that’s finally being played this week.

Lower Back Pain and the Fitness Professional

Random Friday Thoughts: 3/27/09

Written on March 27, 2009 at 5:15 am, by Eric Cressey

1. I’m feeling good.  It was our quietest week of the  year at CP, so I’ve actually had a few days to get myself a bit organized.  If this pace keeps up, I might even actually get my voice back by the time 2010 rolls around.  I’m sure I’ll be sick of the quiet by next week, but the good news is that there is a lot of baseball to watch, and UCONN is still looking good in March Madness.

2. Another reason to smile is that we had two high school sophomores (ages 16) hit 89mph readings on the radar gun outside in cold Massachusetts this week.  The best part is that they weren’t “everyone throws 90mph on the internet” readings; they were actually legitimate.  It’s going to be a fun spring around it; it’s always nice to see guys rewarded for their hard work in the off-season.

3. Morgan Alexander – a member of the 2006 Canadian 4-man Bobsleigh team that finished fourth in the Olympics – is in town to train with me this week.  Yesterday, he and I visited CP client Steph Holland-Brodney’s third-grade class at a local elementary school.

On one hand, it fascinated me how brilliant these kids are with respect to working computers; each of them has a laptop at each desk, and they are incredibly proficient.  Then, just as I’m about convinced that the future of America is bright with these kids, autograph time comes.  Obviously, they wanted Morgan’s autograph (and he signed a ton), but it never ceases to amaze me that they asked for mine, too.  I signed sneakers, balloons, and note cards – and I’m pretty sure that I devalued them completely (if that’s even possible) just with my signature.

4. Anyone who thinks that throwing submarine-style is easier on the arm needs to check out this picture (thanks to Paul Connolly for sending it along).  This is some serious external rotation.

As you can tell, the real change in his throwing posture comes from the hips and trunk, not so much from the arm.  As such, he’ll encounter all the same flexibility deficits that regular pitchers experience if they don’t take care of their bodies.

5. The folks at Precision Nutrition published a great article about artificial sweeteners, particularly Splenda.  Check it out: Splenda: Is it Safe?

That’s all for today.  Have a great weekend, folks!

A Good Rule of Thumb for Working with Injured Pitchers

Written on March 26, 2009 at 6:06 am, by Eric Cressey

If you have a pitcher athlete with good shoulder ROM (normal GIRD and symmetrical total motion), sufficient thoracic spine mobility, good scapular stability, and adequate 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; this cannot be seen in a doctor’s office!  Changing lead leg positioning is a quick way to indirectly (and negatively) impact the position of the arm.  Guys who stay closed have to throw across their body, and guys who fly open often have problems with the arm trailing too far behind (out of the scapular plane).

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

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Pitchers vs. Quarterbacks vs. Swimmers

Written on March 18, 2009 at 7:45 am, by Eric Cressey

Q: I know that you’re tops when it comes to keeping baseball guys (especially pitchers) healthy and performing at the top level. How would your approach to training baseball players in general, and pitchers more specifically, differ when working with somewhat similar athletes such as:

(a) football quarterbacks

(b) swimmers other than backstrokers

(c) swimmers specializing in the back stroke

I realize there would be obvious differences, especially for C, since that is actually the opposite of pitching, so I’d love to hear some of your general thoughts on this.

A: This is actually a great question.  I guess it’s one of those things you do subconsciously and then think about after the fact.  I’m assuming you are referring to the shoulder and elbow demands in particular, so I’ll start with that.

Training football quarterbacks and pitchers would be virtually identical in terms of demands on the hips, ankles, and shoulders.   Anecdotal experience tells me that there would be a higher correlation between hip dysfunction and shoulder/elbow problems in pitchers than in quarterbacks, though.

Swimmers would be similar at the shoulder, but I don’t see the same kind of correlation b/t hip and shoulder dysfunction.   Obviously, though, issues like scapular stability, thoracic spine range-of-motion, and tissue quality would all be present in all three populations.

Backstrokers would have comparable scapular stabilization demands, but different glenohumeral rotation patterns. With them, you assess total shoulder rotation and go from there (this is my strategy with everyone, but it just warrants extra mention in this discussion).

Above all, you’ve got to realize that while you might see trends in different athletic populations, each one is still unique, so assessment tells you what you need to know. For instance, I have a few pro pitchers throwing well over 90mph, and from looking at their shoulders, you’d never know they had ever thrown a baseball in their lives.  At initial testing (i.e., right after the long season ended), the total motion among my eleven pro pitchers from this past off-season ranged from 133 degrees to 186 degrees. The guy with 186 degrees actually had more external rotation (135 degrees) than the least “lax” guy had in total motion!

So, a guy with a 3/4 arm slot is going to have different adaptive changes than a guy who is more over-the-top or sidearm – and you can certainly carry those variations across the board to different throwing styles in football, and the wide variety of shoulders you’ll see in a swimming population that might be proficient in more than one stroke.

Related Posts:
Flexibility Deficits in Pitchers
The Truth About Impingement: Part 2

Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance – From Rehabilitation to High Performance.

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used by Cressey Performance Pitchers after they Throw!

Static Posture Assessment Mistakes: Part 2

Written on March 17, 2009 at 5:30 am, by Eric Cressey

In a continuation of last Tuesday’s post, here’s another common mistake you’ll see in the static posture of overhead throwing athletes.  Many times, folks will see a low-shoulder like the one below and automatically assume is means “scoliosis.”

In reality, this is a function of both the structural and functional adaptations that take place in a baseball pitcher’s shoulder girdle over the course of a throwing career.  I am not of the belief that you can altogether eliminate this, given the structural adaptations that have taken place over the course of years of throwing. However, I firmly believe (and have observed frequently) that as long as one normalized range of motion and strength/stability of the rotator cuff and scapular stabilizers, modest improvements in this posture can come about. Phil Donley goes into great detail on this topic in his presentation in the 2008 Ultimate Pitching Coaches Bootcamp DVD Set.

It is worth mentioning that in some populations, this may be a function of an ankle, hip, lower back, or other issues.

For more assessment information, check out Building the Efficient Athlete.

Sign-up Today for our FREE Baseball Newsletter and Receive and Receive a Copy of the Exact Stretches
used by Cressey Performance Pitchers after they Throw!

It’s the Most Wonderful Time of the Year…

Written on March 16, 2009 at 6:09 am, by Eric Cressey

You might find it weird that I’m playing this song on March 16.

Then again, if you really know me, you know exactly what I mean.  Yes, folks, it’s the first day of the high school baseball season.  Loads of great kids busted their humps with us this off-season, and now we get to go out and watch them perform.  I’m also excited to take a few road trips to catch our pro guys in action.  I love it.

Meanwhile, we’ve been getting more and more variety around Cressey Performance.  While about 74% of our clients are baseball players, and we always had people from different disciplines, we’ve been getting a lot more hockey, football, basketball, and endurance athletes, plus adult fitness clients.  I love being a “baseball guy,” but variety is always great, too.

We’ve had a good run of weather in the Boston area, too.  Anytime you can get temperatures over 60 degrees F in Boston before St. Patrick’s Day, you’ve got to consider yourself pretty lucky.  A few of us have been sprinting stadiums over at Soldiers Field at Harvard for the past few weekends, and the weather’s been really cooperative.

I also get to travel a fair amount this time of year for seminars.  And, while I am not fond of sitting in airports, I love interacting with fitness professionals and strength and conditioning coaches at these events.  Everyone has a unique story to tell, and I enjoy getting questions that push me to be better at what I do.  It’s also a great chance to catch up with great friends and colleagues across the country who I may only see 2-3 times per year.

It’s also an extremely productive time for me as a writer.  My days at the facility start a bit later now, so I can focus a bit more on writing.  And, when I write at night, I know I can always listen to the online broadcast of one of our pro baseball guys playing anywhere from Portland, Oregon to Myrtle Beach, South Carolina.  If you have particular topics you’d like covered in blogs, newsletters, or articles, by all means, please offer some suggestions in the comments section below.  I’ve already got a new product in the works.

And, perhaps most significantly, this time of year is when I make my best gains in the gym.   It’s just my nature to put all our athletes’ needs way ahead of my own, and that usually manifests itself in the form of achy knees from spending long hours on the hard floor at CP. I’ve also been sick twice this winter, which is unheard of for me; I never get sick.  In fact, I lost my voice for both Friday and Saturday and was practically coaching in Morse code and “thumbs-up/thumbs-down” signs.  I’m feeling better now, though.

As a result, my training frequency and volume isn’t as high during the baseball off-season, but once things get going in March-May, we ramp it up.  Later this morning, I’m headed over to get a massage to get the ball rolling.

So, if you don’t have anything to smile about today, just smile on my behalf!

Random Monday Thoughts: 3/2/09

Written on March 2, 2009 at 6:15 am, by Eric Cressey

1. There were no Random Friday Thoughts last week, as my girlfriend and I were in Fort Lauderdale for a quick 3-day “the guys are off to spring training, so Eric is going to regain his sanity” vacation.  As you read this, I’ll have just returned to Boston (Sunday night), refreshed and ready to go for the last three weeks before the high school baseball season starts.

2. With almost all the guys done for the off-season, I figured that this was as good a time as any to send out some spring training well wishes to all the Cressey Performance pro baseball guys:

1. Chad Rodgers (Braves)
2. Will Inman (Padres)
3. Tim Collins (Blue Jays)
4. Tim Stronach (Mets)
5. Shawn Haviland (A’s)
6. Nate Nelson (Blue Jays)
7. Steffan Wilson (Brewers)
8. Steve Hammond (Giants)
9. CJ Retherford (White Sox)
10. PJ Zocchi (Indians)
11. Matt Morizio (Royals)
12. Ryan Reid (Rays)
13. Matt Kramer (Braves)
14. Dave Wasylak (Nationals)
15. Jason Lavorgna (free agent)
16. Matt Cooney (free agent)
17. Chris Gusha (free agent)

Good luck this season, fellas.  Thanks for all your hard work.

3. I often get asked what we do with folks who can’t go right to foam rolling with the Foam Roller Plus (a more diesel version that is just foam on top of PVC).

In these folks, we usually start them with a foam-only roller – and ideally one that has been “broken in.”

Another option that Cressey Performance has pioneered is suited up in catcher’s gear before rolling.  Safety first, folks.

4. Just wanted to give you a quick heads-up on an upcoming seminar (4/17-4/19) in Central Virginia with an outstanding line-up of speakers.  I’m bummed that I can’t make it, but you should definitely check this out if you’re in the area:

Central Virginia Performance Seminar

They have limited the event to 75 attendees, so be sure to register sooner than later.

5. My girlfriend had the Oscars on last weekend, and I couldn’t help but wonder who the heck this guy is and what he did to Ferris Bueller!

Have a great weekend!