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6 Reasons Anterior Core Stability Exercises Are Essential

Written on October 30, 2014 at 7:46 am, by Eric Cressey

This time of year, I'm doing a lot of assessments on professional baseball players who are just wrapping up their seasons.  One of the biggest issues that I note in just about every "new" athlete I see is a lack of anterior core control. In other words, these athletes sit in an exaggerated extension pattern that usually looks something like this:

APT

And, when they take their arms overhead, they usually can't do so without the ribs "flaring" up like crazy.

This is really just one way an athlete will demonstrate an extension posture, though. Some athletes will stand in knee hyperextension. Others will live in a forward head posture. Others may have elbows that sit behind their body at rest because their lats are so "on" all the time.

latsPosture

This isn't just about resting posture, though; most of these athletes will have faulty compensatory movement patterns, too. Once we've educated them on what better posture actually is for them, we need to include drills to make these changes "stick." Anterior core drills - ranging from prone bridges, to positional breathing, to dead bugs, to reverse crunches, to rollouts/fallouts - are a great place to start. Here's why they're so important:

1. Breathing

The muscles of your anterior core are incredibly important for getting air out. The folks at the Postural Restoration Institute often discuss how individuals are stuck in a state of inhalation, with each faulty breath creating problematic accessory tone in muscles like scalenes, lats, sternocleidomastoid, pec minor, etc. These muscles aren't really meant to do the bulk of the breathing work; we should be using our diaphragm. Unfortunately, when the rib cage flies up like we saw earlier, we lose our Zone of Apposition (ZOA), a term the PRI folks have coined to describe the region into which our diaphragm must expand to function.

Zone-of-Apposition

(Source: PosturalRestoration.com)

Bill Hartman has a great video demonstrating good vs. bad breathing here:

 

Step 1 is to get the ribs down and pelvis into some posterior tilt to reestablish this good zone. Step 2 is to learn how to breathe in this position, emphasizing full exhalation.

Step 3, as you may have guessed, is to strengthen these "newly rediscovered" patterns with good anterior core training.

2. Resisting extension.

This one is the most obvious benefit, as the muscles of the anterior core directly combat too much arching of the lower back. If you aren't controlling excessive lumbar extension, it's only a matter of time until you wind up with lower back irritation - whether it's just annoying tightness, a stress fracture, a disc issue, or something else.

3. Better force transfer and lower back injury risk reduction.

The research on core function is pretty clear: its job is to transfer force between the lower and upper body. Spine expert Dr. Stuart McGill has spoken at length about how spine range of motion and power are positively correlated with injury risk. In other words, the more your spine moves (to create force, as opposed to simply transferring it), the more likely you are to get hurt. How do you prevent your spine from moving excessively? You stabilize your core.

4. Indirect effects on rotary stability.

For a long time, I looked at control of extension as "separate" from control of rotation at the spine. In other words, we did our anterior core drills to manage the front of the body, and our chops, lifts, side bridges, etc. to resist unwanted rotation. However, the truth is that these two approaches need to be treated as synergistic.

As an example, every time I've seen an athlete come our way with an oblique strain, he's sat in an extension posture and had poor anterior core control - even though an oblique strain is an injury that occurs during excessive rotation. All you need to do is take a quick glance at the anatomy, and you'll see that external obliques (like many, many other muscles) don't function only in one plane of motion; they have implications in all threes - including resisting excessive anterior pelvic tilt and extension of the lower back.

Gray392

What this means is that you can't simply ignore coaching in one plane when you think you're training in another one. When you do your chops and lifts, you need to prevent lumbar hyperextension (arching) . And, when you do your rollouts, you can't allow twisting as the athlete descends. Finally, you can add full exhales (a predominantly anterior core challenge) to increase the difficulty on rotary stability exercises.

5. Improved lower extremity function and injury risk reduction.

Lack of anterior core control directly interferes with lower extremity function, too. If the pelvis "dumps" too far forward into anterior tilt, the front of the hip can get closed down. As I described at length here, this can lead to hip impingement.

With a squat variation, while some athletes will stop dead in their tracks with this hip "block," others will slam into posterior tilt to continue descending. This is the "butt wink" we've come to see over and over again in lifting populations. When neutral core positioning is introduced and athletes also learn to manage other extension-based compensations, the squat pattern often improves dramatically. This can "artificially" be created transiently elevating the heels, turning the toes out, or by having an athlete hold a weight in front as a counterbalance.

Additionally, athletes in heavy extension patterns often carry their weight too far forward, throwing more shear stress on the knees during lunging and squatting. The more we can keep their weight back to effectively recruit the posterior chain, the better.

6. Improved shoulder function and injury risk reduction.

The lats can be your best friend and worst enemy. On one hand, they have tremendous implications for athletic performance and aesthetics. On the other hand, if they're "on" all the time (as we often see in extension-based postures), you can't get to important positions with the right movement quality. Overactive lats will limit not only shoulder flexion (overhead reaching), but also upward rotation of the shoulder blades. I covered this in quite a bit of detail in Are Pull-ups THAT Essential?. Moreover, with respect to elbow function, overactive lats can be a big issue with allowing throwers to get true external rotation, as I discussed here:

If you're using your lats as an "all the time" core stabilizer, you aren't just at risk of extension-based low back pain, but also problems at the shoulder and elbow. If you can get your anterior core control under control and normalize the length and tone of the lats, your "healthy exercise pool" for the upper body expands dramatically. Getting overhead is easier, and you'll feel stronger in that position. The same goes for external rotation; not surprisingly, pitchers always say that their lay-back feels smoother after soft tissue work on the lats, as an example.

Wrap-up

These are just six benefits of training the anterior core, but the truth is that they could have been broken down in much more detail as they relate to specific injuries and functional deficits. If you're looking to learn more on this front - and get a feel for how I like to train the anterior core - I'd encourage you to check out my presentation, Understanding and Coaching the Anterior Core.

AnteriorCore

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Quick and Easy Ways to Feel and Move Better: Installment 60

Written on October 24, 2014 at 7:36 pm, by Eric Cressey

This installment of quick training and nutrition tips comes from Cressey Sports Performance coach Miguel Aragoncillo.

1. Spread the floor...correctly.

Spreading the floor is a cue that can get butchered very easily. For a new lifter, there is no easily understandable point of reference for what "spreading the floor" even means. Simply barking external cues such as “spreading the floor” may elicit incorrect movement patterns that are better understood with visual cuing, which saves time to begin with.

Watch and listen to this video for more detail:

2. Focus on the bigger picture.

Whether you’re a frequent gym goer, or a trainer or coach looking to help your clients, the following tip is useful when using new exercises and programs. If you’re using this information for yourself to help improve your approach to lifting, just replace the title of “athlete” with “you!"

Say a younger athlete walks into your facility on Day 1 after an assessment. This is their Day 1, and their first exercise after warm-ups is Trap Bar Deadlifts.

How heavy do you tell the athlete to go?

1. As heavy as the rep scheme will allow.
2. As heavy as they think they should go.
3. As heavy as possible, as long as the movement looks clean.
4. Teach that athlete the requisite movement patterns before progressing.

Choice number 4 is a safe bet!

If someone comes in and does not understand the concept of a Trap Bar Deadlift, it is unlikely that you will go as heavy as the rep scheme will allow, all for the simple fact that this person does not even understand the movement, let alone how to properly prepare for a max rep.

The good thing is that you can reinforce a hip hinge movement pattern in a number of ways, and it does not have to be a strict “you can only do this exercise if you have it on your sheet."

Further, sometimes, clients can come in feeling good, bad, sore, or any of a host of other sensations. While these feelings are very subjective and it is a case by case basis, the idea is that you want to keep movement quality above all else despite the external factors that you cannot control.

If a specific movement does not “feel” good due to external factors, regress appropriately. Live to fight and train another day, as opposed to blindly continuing in the fashion of “Well, it’s on the paper.”

In the case of the athlete, performing a kettlebell deadlift in a sumo stance can be appropriate depending on their training experience, especially if you have heavier kettle bells to teach a hip hinge pattern.

To put this statement in another light - how many times will any given athlete perform a deadlift, squat, or lunge? If an athlete begins an appropriately designed strength training program at the age of 14, and continues this program effectively until he is 18, you have over four years of consistent lifting to improve a specific number.

To extrapolate further, given a 4-day lifting program over 52 weeks in a year add up to 208 opportunities to practice a specific movement pattern. Take out holidays, vacation times, finals and midterms for school, and random weeks where there are snags in scheduling (likely about 7-8 weeks of "off time"), and you have a whopping 44 weeks to train a wide variety of movement patterns.

I’m in it for the long haul, so when you have an athlete hell-bent on getting a specific number, it is helpful to remember that the point is to improve in the gym in order to improve on the field.

3. Check out "The Obstacle is the Way."

One habit that I’ve gained over the past few years is learning how to pick up a book that is outside of my comfort zone in order to expand my mental horizons and challenge my current thought processes. Fortunately for me, many of the staff at CSP crush audiobooks and regular books alike, and not just anatomy and physiology minded books either.

A school of thought with which I’ve aligned my mentality is the stoic philosophy - not just a Dead Poets Society rant on free thinking, but rather the attitude on valuing action over non-action and pontificating on the “Coulda, Woulda, Shoulda’s” of life. One book that exemplifies this actionable philosophy is The Obstacle is the Way by Ryan Holiday, and I have recommended this book to every staff member here to gain a better understanding of how to approach work, life, and other situations.

obstacle

To give a primer on the book, it essentially boils down to the aptly named title - that is, if there is an obstacle, then there is no other way around it but to simply stare it down and get to work on whatever that available solutions present themselves.

It is not quick, nor easy, but it is simple enough to understand, with possible long lasting effects, which can provide guidance in the face of adversity for any individual, not just athletes.

4. Try Greek yogurt, peanut butter, and whey protein.

Barring fancy names for a quick snack, I’ve been crushing yogurt ever since I started working at Cressey Sports Performance. Consuming Greek yogurt has allowed me to capitalize on macros, and depending on the brand of yogurt you get, you can get upwards of up to 22g of protein per cup. Add in a scoop of whey protein, and some powdered peanut butter (powdered peanut butter is used to aid in the consumption of the yogurt, and doesn’t take away from the flavor, but enhances upon it), and you have yourself a delicious snack.

I have been going with Greek yogurt, with vanilla whey protein powder, and finally adding in powdered peanut butter. It tastes like peanut butter cheesecake, which is an unreal thought in the first place.

5. Utilize a variety of movements in an exercise program.

There are hidden benefits to varying the position that you perform an exercise within your program. When you’re training the anterior core or the various anti-rotation, flexion, or extension movements, utilize different lower body positions to maximize movement variability. This will allow your body to build a stable foundation from which it can improve and build upon as you progress from one exercise to the next.

Here's a basic 3-4 month progression for cable chop variations, where you'll send 3-4 weeks on each step. This will allow a better foundation to be met prior to simply performing all exercises in a standing position.

1. Tall Kneeling Cable Chop - 3 sets of 10 reps per side
2. Half Kneeling Cable Chop (Inside Knee Up) - 3 sets of 10 reps per side
3. Standing Cable Chop - 3 sets of 10 reps per side
4. Split Stance Cable Chop - 3 sets of 10 reps per side

Further, you can vary the breathing patterns that you use within these contexts in order to optimize their effectiveness. When teaching this pattern to athletes, it is important to first allow a constant stream of inhalations and full exhalations, while watching for mechanical positioning of the lower ribs and pelvis, as ideal positioning involves reducing anterior pelvic tilt and lumbar extension (arching of the lower back). As you find yourself learning how to "own" this specific exercise, introduce a full exhale while maintaining your position as you perform the concentric portion of the exercise.

About the Author

Miguel Aragoncillo (@MiggsyBogues) is the newest strength coach at the Hudson location of Cressey Sports Performance. More of his writing can be found on www.MiguelAragoncillo.com.

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5 Great Analogies for Training Baseball Players

Written on August 6, 2014 at 8:49 pm, by Eric Cressey

In their outstanding book, Made to Stick, authors Chip and Dan Heath emphasize that a new idea will always be more readily accepted if it is incorporated into an individual’s existing schema. In an example I've used before here at EricCressey.com, if I give you the letters TICDGFASOH and then ask you to list all the letters I included to me 20 minutes later without writing them down, most of you won’t be able to accomplish the task correctly.

made_to_stick_heath1

However, if I reordered those letters as CATDOGFISH, you’d accomplish the task easily. You know the words DOG, CAT, and FISH – so it would fit into your existing schema. I work to apply this same logic to how I educate my baseball players. With that in mind, here are five analogies I like to use as part of the long-term baseball development process.

1. Arm care is just like making bank deposits and withdrawals.

To me, every action you make with your arm either takes you closer to or further away from arm health.  Every time you do your arm care drills, get in a strength training session, do some soft tissue work, or get your arm stretched out (when appropriate), you're making a deposit in your bank account. Each time you make a throw - especially off a mound - you're making a withdrawal. If withdrawals exceed deposits over the course of a year, you're likely going to go bankrupt (get injured).

2. Bad scapular positioning or scapulohumeral rhythm is like starting behind the starting line - or you're backpedaling when the starting gun fires.

I've discussed the importance of scapular positioning and scapulohumeral rhythmic for throwers in the past - especially in our new resource, Functional Stability Training of the Upper Body. Here's a video to bring you up to speed:

In this video, I talk about "ball and socket congruency." In other words, the ball can't ride up, and the socket can't stay too low. I like to refer to neutral scapular resting position as the starting line. If you sit in too much downward rotation, you're effectively setting up behind the starting line. In the photo below, the black line is where the medial border of his scapula should be at rest, and the red line is where it actually is.

ScapularDownwardRotation

Other folks may actually start in the correct position, but begin what should be upward rotation with an aberrant movement - such as a "yank" toward the midline (rhomboid dominance) or into scapular depression (lat dominance). These are the exact opposites of what you want to occur - which is upward rotation, or running toward the finish line.

3. Doing arm care drills with a faulty core recruitment pattern is like shooting a cannon from a canoe.

I always talk about how the spine and rib cage "deliver" the shoulder blade. You can do all the arm care drills in the world, but if you don't know how to keep a stable core in place, you'll never really put your shoulder girdle (or elbow, for that matter) in an ideal position to throw - and you certainly won't effectively transfer force from your lower body. Here's what a lot of athletes look like with their overhead reaching pattern:

Instead of getting good shoulder flexion and scapular upward rotation, they just go into lumbar (lower back) extension. When you see an aberrant movement pattern like this, you realize that it's no surprise that some of the same underlying movement inefficiencies can contribute to upper extremity, core, and lower extremity injuries alike. It's really just a matter of where an athlete breaks down first.

4. Committing to a college really early is like proposing to the first girl you ever date - and then letting her "shop around" for other dudes while you stay faithful.

This observation has less to do with the actual training process, but more to do with long-term management of an athlete. Why in the world does a freshman in high school need to be verbally committing to a college - especially when he can't sign on the dotted line to officially commit until his senior year? If there's one thing I've learned in life, it's that we always look back on what we did 2-3 years earlier and laugh, as we realize how misdirected we were. I do it at age 33, and you can just imagine how much faster an impressionable teenage athlete can acquire new views on the world.

It's fine to take your time and see what's out there - and any coach that pressures a freshman or sophomore to commit so young is probably not a person for whom you'd like to play. And, 99% of the time, that offer is still going to be on the table 6-18 months down the road in spite of the false deadlines they throw on you.

Finally, as an "in the know" friend reminded me the other day, don't forget that even if you verbally commit to a school, they're still out there trying to "date" other athletes. If they can find someone who they think is a better prospect than you are, they'll drop you like yesterday's newspaper. The ethical coaches don't do this, but it is nonetheless still a sad part of college sports. With that in mind, it's okay to go on "dates" with different schools and take your time in finding the one that's right for you.

Side note: if you're looking to be a more informed consumer with respect to the college recruiting process, give this a read: 25 Questions to Ask During the College Recruiting Process.

5. Stretching a loose shoulder is like picking a scab; it feels good for a bit, but only makes things uglier over the long haul.

There are a lot of hypermobile (lose-jointed) pitchers out there. It's often a big part of what makes them successful, but it comes at a cost: increased injury risk, if they don't stay on top of their stability training.

 elbow10365821_744096285641478_6191697364410130329_n

What they often lose sight of, though, is the fact that it's just as important to avoid creating instability as it is to train for stability. In other words, continually stretching a hypermobile joint is likely even worse than just leaving out your strength work. The former reduces passive stability, whereas the latter just doesn't improve active stability.

The problem is that a lot of loose-jointed players feel "tight" - and it's usually because they lay down trigger points to make up for their lack of stability. The stretching feels good in the short term, but the trigger point comes back stronger and stronger each time - until you're eventually dealing with a torn anterior (shoulder) capsule or ulnar collateral ligament. Eventually, reducing the passive stability leads to a pathology - just like picking that scab eventually leads to an infection or scar.

Want to learn more about whether or not you're hypermobile? Check out my article, Assessments You Might Be Overlooking: Installment 1.

Looking to pick up more analogies we use to educate our players - and get a better feel for our overall system? I'd encourage you to sign up for one of our upcoming Elite Baseball Mentorships. We have events in both October and November, and you won't find a more intensive baseball educational course.

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Exercise of the Week: Split-Stance High-to-Low Anti-Rotation Chop w/Rope

Written on March 11, 2014 at 9:08 am, by Eric Cressey

It's been a while since we shared a new "Exercise of the Week" video here at EricCressey.com, so I thought it'd be a good time to highlight one I was actually discussing with one of my staff members yesterday.

The split-stance high-to-low anti-rotation chop w/rope is one of my favorite "catch-all" core stability exercises.  While it primarily challenges rotary stability (the ability of the core to resist rotation), we also get some anti-extension benefit from it.  Because the cable is positioned higher up, we must use our anterior core to prevent the lower back from arching in the top position.  By adding a full exhale on each breath, you can increase the challenge to the anterior core even further – and, as Gray Cook would say, use breathing to "own the movement."  Check it out:

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Another important consideration that may be overlooked is the fact that rotational movements in sports include both low-to-high (tennis forehands/backhands) and high-to-low (overhand throwing, baseball hitting, tennis/volleyball serving) patterns, yet for some reason, we see a lot more low-to-high or purely horizontal patterns trained.  I love the idea of getting the arms up overhead more often, particularly in athletes who may lose upward rotation, or people who just sit at desks all day with their arms at their sides.

We'll usually work this in during the latter half of a strength training session, and do it for 2-4 sets of 6-10 reps. This video was actually taken from The High Performance Handbook video database, as this exercise was featured in the 16-week program.

HPH-main

Enjoy!

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Coaching Cues to Make Your Strength and Conditioning Programs More Effective – Installment 8

Written on February 18, 2014 at 8:14 am, by Eric Cressey

It's time for the eighth installment of my series on coaching cues.  Try putting these three cues to work for you.

1. Bear hug a tree.

I love anti-rotation chops as a way to train rotary core stability. Unfortunately, a lot of people butcher the technique so that they can really load up the weight on these. In short, the closer the arms are to the body, the easier the exercise.  So, if you really bend the elbows, you can use a lot more weight without getting as good of a training effect.  With that in mind, I tell folks to "bear hug a tree" as they're doing these exercises, as it ensures that the elbows are only slightly bent, but still well out in front of the body.

2. Be heavy on the pad.

Chest-supported rows (also known as T-bar rows) are an awesome exercise to strengthen the upper back, and the presence of the pad on the front of the torso is a great external focus point to keep the lifter's technique sound.  That is, of course, only if people use it!

One of the most common mistakes I see is that people will keep their hips on the lower pad, but then extend heavily through their lumbar spine (lower back) to lift the weight.  In reality, it should be a neutral spine posture from top-to-bottom; the ribs have to stay down. The cue I like to give athletes is to "be heavy on the pad." Keeping the chest firmly on the pad prevents the rib cage from flaring up when it should just be movement of the scapula and upper arms.

3. Pull the bar into your upper back.

This was a coaching cue that made a huge difference with my squat. One of the biggest mistakes you see lifters make when back squatting is that they don't take control of the bar. Rather than pulling it down into the upper back to create a good "shelf," they just let it sit there. The last thing you want to be under heavy weights is passive.  By pulling the bar into the upper back, you not only dictate the bar path (it can't roll), but also get the lats engaged as a core stabilizer.

While on the topic of squatting, if you're looking for a thorough squat technique resource, I'd encourage you to check out Jordan Syatt's new resource, Elite Performance Squatting. It's a great two-hour presentation.

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Strength and Conditioning Stuff You Should Read: 2/7/14

Written on February 7, 2014 at 6:52 am, by Eric Cressey

Here is this week's recommended strength and conditioning reading.  As it turns out, you could call this the Assess and Correct edition, as it features the three of us who collaborated on this product:

The Secret to Ab Training – Mike Robertson did an awesome job introducing some movements you've probably never seen before.  That said, we've been using them at Cressey Performance with great results for quite some time now.

Thoughts on Long-Term Athletic Development and Training Young Athletes – Bill Hartman doesn't write very often, but when he does, he crushes it!

3 Things Everyone Should Know About the Shoulder – This is a quick read, but has some really useful takeaways if you're looking to wrap your head around shoulder assessment and training.

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Quick and Easy Ways to Feel and Move Better: Installment 53

Written on February 3, 2014 at 10:05 am, by Eric Cressey

It's time for this week's quick strength and conditioning tips!

1. Elevate the feet to make stir the pot a more challenging core stability exercise.

Stir the pot is a great anterior core stability exercise, but a lot of folks claim that it gets too easy.  One quick solution to this is to just elevate the feet on a 12" box, as it effectively works very similarly to a push-up progression.  As an added bonus, you'll get a little bit more serratus anterior recruitment in this position, so you could actually consider it a shoulder health drill, too.

2. Work with gravity before you work against it.

I talk a lot to our staff about the importance of sequencing warm-ups correctly.  As examples, we always do our positional breathing drills before our mobility work, which would progress from ground-based to standing.  One more thing I like to emphasize is the importance of working with gravity before you work against it. 

I've talked about how the bench t-spine mobilization and back-to-wall shoulder flexion are two of my favorite drills for helping to get people out of extension – and we make sure to do them in this order.  With the bench t-spine mobilization, we're using gravity to help us get a good stretch on the lats and long head of the triceps, on top of taking the thoracic spine into some extension.  We just brace the core and resist extension at the lower back.

Conversely, with the back-to-wall shoulder flexion, we have to work against gravity to get the arms overhead the correct way.

This might seem like minutia, but the stiffness reduction we get by working with gravity makes it much easier to work against gravity, as there is less bad stiffness we need to overcome to get to good movement.

3. Hold light weights in your hands to increase the challenge on dead bugs.

Just as we saw with stir the pot, dead bugs can quickly become far too easy.  We'll always add a big exhale at the bottom position of each rep, but even still, this becomes too easy for most lifters.  And, while not every exercise is supposed to be made harder, we do have some wiggle room in this regard with dead bugs.  You can hold some 5-10 pound plates in each hand:

4. Buy a spice rack – or at least a bunch of spices that would theoretically go in a spice rack if you owned one.

Want to add some variety to your bland diet? Having an extensive collection of spices at your fingertips can go a long way in making the same food taste entirely different from one day to the next.  Try turmeric on eggs, or mix up some homemade Mexican seasoning for your chicken by combining chili powder, cayenne pepper, garlic powder, onion powder, sea salt, and anything else you want to add to the mix! 

One of the biggest advantages of buying the rack as a whole is that it gives you a chance to sample a lot of different options. Once you’ve discovered the spices you like, you can always look to buy them in bulk later on.

spicerack

5. Think "chest before chin" on push-up variations.

One of the most common push-up technique mistakes I encounter is athletes who substitute forward head posture in place of scapular retraction.  When this happens, you'll see the nose get close to the floor while the lower back is heavily arched, the upper back is rounded over, and the elbows are flared out.  I encourage athletes to get the chest to the floor before the chin get there, as it encourages them to be patient and allow the torso to descend.  Of course, you have to be careful to not allow the athlete to crank into a big arch to puff the chest out – but it's still a super-effective cue, particularly with those with less training experience.

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Is Thoracic Spine Extension Work Necessary? – Part 3

Written on January 24, 2014 at 5:58 am, by Eric Cressey

Today marks the third and final installment of Eric Schoenberg's series on thoracic mobility drills – and whether or not they're indicated.  In case you missed them, be sure to check out Part 1 and Part 2.

In the final piece of this series, I want to tie things together with a few foundational concepts that we use in the daily management of our athletes and emphasize in our Elite Baseball Mentorships.

Eric C. has written about the concept of relative stiffness on this blog on numerous occasions.  So, feel free to refer back to his articles for more background information.  Relative stiffness or relative flexibility was introduced to me by Shirley Sahrmann and the incredible faculty at Washington University in St. Louis. This is a pillar of their Movement System Impairment model

Today, I am going to discuss how relative flexibility impacts the thoracic spine and shed some more light on why T-spine extension work is not always necessary in the baseball athlete.          

Relative flexibility describes the relationship of how the amount of stiffness (or tension) in one area of soft tissue (muscles, ligaments, tendons, etc.) results in compensatory movement at an adjoining joint that is controlled by less stiffness.  This relationship can change (positively or negatively) based on the exercises we choose and the manner in which we perform them.

There are countless examples of relative stiffness in the body.  One of the most common examples that we see involves the lumbar spine.  If the lats are stiffer than the anterior core, then the athlete will be more prone to an extended posture. The athlete will compensate with lumbar extension with overhead activity.  The video that I included in part 2 of this series is a good example:

In this video, Lats, lumbar extensors > (stiffer than) Anterior Core = Lumbar extension tendency.

Note: Clearly, there is a lot more involved (fascia, ligaments, structural issues, motor control, relative position of adjacent joints, etc.) than just this simple math problem, but for the scope of this article, we will leave it at this.  This example is fairly straightforward and I think we are all on the same page here.  We would not program activities that would further encourage lumbar extension and drive the improper recruitment and motor pattern.

In this case, we know that simply “stretching” or foam rolling the lats will not work in isolation. We need to go ahead and “stiffen” the anterior core, while at the same time, downregulating the overuse of the lats.  We often will do this by using exericses that encourage a neutral alignment with overhead activity (i.e. wall slides, back to wall shoulder flexion) as well as limiting the amount of carrying by our sides (e.g. deadlifts, dumbbell lunges, farmer’s walks, etc.) and instead, focusing on options like bottoms-up kettlebell carries, landmine presses, and goblet variations.

In the case of someone that is in too much thoracic extension (or relative thoracic flexion), though, things can get a little more confusing.  The athlete will have increased stiffness of the thoracic extensors vs. flexors: Thoracic Extensors > (stiffer than) Thoracic Flexors = Thoracic extension tendency.

However, we often see the emphasis remain on bench T-spine mobs, quadruped extension/rotations, and side-lying windmill variations? This results in two problems:

  1. The athlete will actually become hypermobile (segmentally) and develop a local stability issue. (inverted U-curve)
  2. The athlete has difficulty “getting out of extension” due to increased relative stiffness of the thoracic extensors, lats, and scapulothoracic musculature.

This inability to properly flex the spine at ball release can result in a decrease in the required scapular upward rotation and elevation to maintain proper scapulohumeral and glenohumeral joint congruency.  This is a fancy way of saying that if your upper back isn’t positioned correctly, the ball won’t sit flush with the socket. This process can contribute to some of the shoulder and elbow pathologies that we so commonly see in the throwing population.

Baseball_pitching_motion_2004

There is one more point that needs to be addressed to complete this series – and that is the role of the rectus abdominus in thoracic spine mobility.  In this case, the athlete will present in too much thoracic flexion and may appear as though they would benefit from T-spine extension mobility drills.  However, this athlete will not benefit from these exercises unless we appreciate the following point.

When we cue an athlete to limit his extension or “rib flare” we often say “ribs down”.  This seems like a relatively benign cue to help promote a neutral spine and pelvic orientation.  However, we must be sure that the athlete is able to properly recruit external obliques (often with lower level exercises such as back to wall shoulder flexion or a dead bug variation) to help achieve this movement correction.

The reason for this is that increased stiffness of rectus abdominus (dominance) limits ability of T-spine to move out of flexion (or neutral).  Using our relative stiffness example from before, if: Rectus abdominus > (stiffer than) Thoracic Extensors = Thoracic Flexion Tendency.

Therefore, if an athlete is actually is in too much flexion… i.e. sway back (most commonly – posterior tilt and lumbar extension – hanging on rectus as their anti-gravity muscle), he will have a very difficult time getting out of flexion.  This occurs regardless of how many T-spine drills we prescribe.  This is akin to stretching rectus femoris when someone is stuck in a faulty thoracic and lumbopelvic position.

rfstretch

The best approach in our case above is to “allow” t-spine mobility (extension) to occur by decreasing rectus dominance and getting someone out of T-spine flexion.  I am all for cuing the ribs down and establishing alignment, but HOW we get an athlete to do this is of the utmost importance.  The main point here is forcing T-spine extension in the presence of increased relative stiffness of rectus abdominus is not going to give us results.  In other words, weak external obliques will result in rectus overuse and thoracic “immobility” regardless of how many T-spine mobility drills we include in our programs. 

To summarize, this is a very important (and difficult) concept that – like everything else – requires a trained eye and an individualized approach.  If an athlete has too much thoracic and lumbar extension, this can result in scapular depression and downward rotation via, among others things, excessive lat dominance, which leads to a lot of our shoulder and elbow dysfunction.  On the other hand, too little thoracic extension results in scapular anterior tilt and decreased glenohumeral external rotation (“lay back”), also resulting in dysfunction and pathology. 

As a quick review, you want to be able to answer the following questions before prescribing T-Spine extension exercises:

  • Is there a lack of T-spine extension (or rotation). If not, then why prescribe T-spine extension mobility drills?
  • Where is the extension coming from (upper or lower T-spine, L-spine, C-spine)?
  • Is the athlete already at end-range extension and if so, is our attempt to “gain” extension at end-range creating unwanted motion elsewhere? (hypermobility)
  • Lastly, if an athlete presents with mal-alignment (too much thoracic extension or thoracic flexion): first, identify it, then determine why this is happening prior to simply prescribing a bunch of mobility exercises.

Conclusion

This point, along with many others, is a main reason why we chose to develop the Elite Baseball Mentorship program.  As we gather together in these groups, many conventionally accepted ideas and concepts are questioned and explored and the demand for proof (whether it be from research or experience) requires us all to think more critically.  Most importantly, with baseball-related injuries continuing to rise, this allows us to question the status quo of generally accepted baseball-specific protocols.  Ultimately, this collaboration allows us all to advance the bar and develop a better opportunity for our athletes to meet their goals through better health and performance.

Also, if you are interested in more information like this, we would love to see you at one of our Elite Baseball Mentorships. We'll be hosting these events in June, October, and December of 2014. Please click here for more information.

Author’s Note: I would like to thank Michele Ionno, MS, SPT (Wash U Program in Physical Therapy) for his contribution to the 3rd phase of this blog series.

About the Author

Eric Schoenberg, MSPT, CSCS is co-owner of Momentum Physical Therapy, located in Milford, MA.  He can be reached at eric@momentumpt.com

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Quick and Easy Ways to Feel and Move Better: Installment 52

Written on January 14, 2014 at 6:31 am, by Eric Cressey

It's been a while since we published an installment of Quick and Easy Ways to Feel and Move Better, but we're back at it today, thanks to CP coach Greg Robins, who has these five tips for you:

1. With deadlift technique, take tension out of the bar one hand at a time.

In my experience the single most difficult lesson to teach a newcomer to deadlifting is how to leverage their weight against the bar. This concept goes by many names, for example: taking the slack out, pulling the tension out, etc. Whatever your cue of choice, learning how to leverage is the “ah-ha” moment for many new lifters. In the following video, I demonstrate a drill that I find very helpful. It may just need to be done in the beginning stages of learning the lift, or it might be something you use for the rest of your life. Either way, it’s definitely worth a look:

2. Use this example to teach the difference between retraction and posterior tilting of the shoulder blades.

To piggy back off the video in point 1, check out this quick video on how to differentiate between retraction, and posterior tilting of the shoulder blades, and why it’s important to learn the latter when setting up for a deadlift.

3. Mimic a good standing posture with prone bridge variations.

The prone bridge, or “plank” exercise is probably the most popular core training exercise since the sit-up. It is an absolute go-to in our programming when teaching people how to resist extension and train the anterior core properly. Unfortunately, it’s also butchered more often than not.

A truly well done prone bridge is one that mimics correct alignment in a good standing posture. It is NOT just a position sans any low back extension. Let’s take a look at what I mean.

First, you need to position the shoulder blades correctly. Too often, people will excessively protract the scaps and embrace a more rounded over upper back position, seen here:

IMG_9444

Instead, slightly tilt the shoulder blades back, and place them in a position more like the one seen here:

IMG_9447

Next, do not allow excessive flexion of the spine from top to bottom:

IMG_9446

In this last picture, we are allowing the person to completely dominate the movement with the rectus abdominis and are not promoting proper recruitment from the internal and external obliques or the transverse abdominis.

To bring this all together, here is a picture of good standing posture with 90 degrees of shoulder flexion; note the similarities to a properly executed prone bridge.

IMG_9442

4. Try out this variation of the lower trap raise.

I like this variation for a few reasons:

  • It allows some of the more extended populations to stay in a better spinal positioning.
  • It promotes proper positioning of the shoulder blades in a back squat or overhead squat exercise.
  • It takes away some of the resistance gravity places on us in a prone positioning.
  • It helps develop a proper squat pattern and bottom position
  • It’s efficient, allowing people to train multiple aspects of good movement at the same time.
  • For more advanced populations you can get rid of the wall, and do it in a freestanding deep squat position.

5. Remember that not everything needs to be “difficult.”

Throughout a strength-training program, you will have exercises that are meant to be loaded up to their limit, and others that are there purely to practice a position or motor control pattern. As a client or athlete becomes more advanced, certain exercises will become less challenging. This doesn’t mean that you need to continually find ways to make a movement harder and harder. Too often, when we do so, we take away from the integrity of the movement.

Sure, you can load up your basic deadlift, squat, and lunge patterns until the cows come home, but exercises like the rollout, prone bridge, or side plank will eventually reach a limit in ways that you can productively make them “harder.” This by no means renders them useless, though. In fact, by loading them excessively, or adding an infinite amount of bells and whistles to them, you will mostly find ways to compensate and stray further from their intention. As they become easier to complete, it just changes their purpose from one of teaching the body, to one of reminding the body how to recruit properly.

Some exercises do have a ceiling, and once it’s reached, you don’t need to try and blast through it. Let them serve their purpose, and let the big movements account for your substantial progressions.

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The Best of 2013: Guest Posts

Written on December 29, 2013 at 7:58 am, by Eric Cressey

I've already highlighted the top articles and videos I put out at EricCressey.com in 2013, so now it's time for the top guest posts of the year.  Here goes…

1. 7 Myths of Strength Training for Women – This post by former Cressey Performance intern Sohee Lee made me realize that we need to feature more female-specific content in 2014, as it was a huge hit!

2. Sleep: What the Research Actually Says – The good folks at Examine.com contributed this incredibly well-researched hit from 2013.

Tank454

3. 6 Common Turkish Get-up Mistakes – CP coach Greg Robins walks you through the issues we find ourselves correcting most frequently with this complex exercise.

4. Pelvic Arch Design and Load-Carrying Capacity – Dean Somerset never disappoints with his creative topics and awesome insights on functional anatomy and corrective exercise.

5. 5 Indirect Core Stability Exercises for the Upper Body – Greg Robins gets his second hit in the top 5! There are some great video demonstrations here.

I'll be back soon with the top strength and conditioning features from 2013.

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