If you've read EricCressey.com for any length of time, you're surely aware that I'm not a fan of distance running for pitchers. I've published multiple articles (here, here, here, and here) outlining my rationale for the why, but these articles have largely been based on theory, anecdotal experience, and the research of others. Today, I wanted to share with you a bit of data we collected at Cressey Sports Performance - Florida not too long ago.
First, though, I should make a few important notes that "frame" our training recommendations and
1. Athletes absolutely must have a well-developed aerobic system in order to recover both acutely (during the training session or competition/games) and chronically (between training sessions and competitions/games). It's relatively easy to improve if approached correctly, and can yield outstanding benefits on a number of physiological fronts.
2. As long as the intensity is kept low enough during aerobic training initiatives, it won't compromise strength and power development. I wrote about this all the way back in 2003 with Cardio Confusion, but many industry notables like Alex Viada, Joel Jamieson, Mike Robertson, Bill Hartman Eric Oetter, Pat Davidson, and Charlie Weingroff have done a far better job describing the mechanisms of action in the 12 years since that article was published. Speaking generally, most folks put the "safe zone" intensity for aerobic development without strength/power compromise at approximately 60-70% of max heart rate (Zone 2, for the endurance savvy folks out there).
3. It might be a large amplitude movement (great ranges-of-motion achieved), but baseball is a low movement variability sport. Pitchers are the most heavily affected; they do the exact same thing for anywhere from 6-9 months out of the year (or up to 12, if they're making bad decisions by playing 12 months out of the year). Distance running to me does not offer significant enough movement variability to be a useful training option for developing the aerobic system.
4. The absolute best time to develop the aerobic system is early in the off-season. For the professional baseball player, this is Sep-Oct for minor leaguers, and Oct-Nov for major leaguers. This is one more strike against distance running; after a long season of being on their feet in cleats, the last thing players need is a higher-impact aerobic approach.
With these four points in mind, two years ago, I started integrating aerobic work in the form of mobility circuits with our pro guys in the early off-season. The goals were very simple: improve movement quality and build a better aerobic foundation to optimize recovery – but do so without interfering with strength gains, body weight/composition improvements, and the early off-season recharge mode.
The results were awesome to the naked eye – but it wasn’t until this week that I really decided that we ought to quantify it. Lucky for me, one CSP athlete – Chicago White Sox pitching prospect Jake Johansen – was up for the challenge and rocked a heart rate monitor for his entire mobility circuit. A big thanks goes out to Jake for helping me with this. Now, let’s get to the actual numbers and program.
Jake is 24 years old, and his resting heart rate upon rising was 56 beats per minute (bpm). If we use the Karvonen Formula for maximum HR (takes into account age and resting HR) and apply our 60-70% for zone 2, we want him living in the 140-154bpm range for the duration of his session. As you can see from the chart below – which features HR readings at the end of every set during his session – he pretty much hovered in this zone the entire time. The only time he was a bit above it was during an “extended” warm-up where I added in some low-level plyo drills just to avoid completely detraining sprint work (he’d already had a few weeks off from baseball before starting up his off-season).
When all was said and done, Jake averaged 145bpm for the 38 minutes between the end of his warm-up and the completion of the session.
He bumped up a little bit high in a few spots, but that’s easily remedied by adding in a slightly longer break between sets – or even just rearranging the pairings.
To that last point, I should also note that this approach only works if an athlete is cognizant of not taking too long between sets. If he chats with his buddies and heart rate dips too much between "bouts," you're basically doing a lame interval session instead of something truly continuous. Jake did 44 sets of low-intensity work in 38 minutes. You can't get that much work in if you're taking time to tell a training partner about the cute thing your puppy did, or pondering your fantasy football roster.
Think about the implications of this....
What do you think this kind of approach could do for the foundation of movement quality for a typical high school, college, or professional pitching staff?
Don't you think it might make them more athletic, and even more capable of making mechanical changes easier?
Don't you think they'd be less injury-resistant performing an individualized mobility circuit instead of one-size-fits-all distance running?
Do you think that maybe, just maybe, they'd feel better after an 11-hour bus ride?
Don't you think they'd bounce back more quickly between outings?
What is difficult for some coaches, though, is admitting that distance running to "build up your legs" is like changing the tires on a car with no engine, or studying for the wrong test. Just because "that's how it's always been done" doesn't mean that's how it has to stay.
Give some of these a try in the early off-season - and even during the season in place of "flush runs." They'll be a big hit with your athletes both in terms of performance and health.
And, for those of your looking for another Z2 training option, look no further.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
You know how everyone has that one friend who is just absurdly smart? You know, the kind of person who could hear something once, instantly remember it, and then instantly apply it in a productive manner?
Unfortunately, not all these people are all that motivated, so they may take their impressive ability to learn and leverage it to the max by studying everything they can get their hands on. However, when you do find one of them who is ultra motivated, you wind up with game changers. In our industry, guys like Bill Hartman and Charlie Weingroff are two that come to mind: quick learners who love to learn and apply.
That said, you can imagine my surprise and excitement when I realized that I had one of these in the making as an intern at Cressey Performance in the summer of 2011. You may have even heard of him by now: Eric Oetter. And, as this somewhat recent photo demonstrates, he's only 13 years old.
Okay, the age was a joke, but the brain power isn't. In addition to interning at CP, he's also spent a lot of quality time at Mike Robertson and Bill Hartman's facility in Indianapolis, and undertaken a bunch of continuing education coursework (PRI, DNS, and several other schools of thought).
That said, to make a very long story short, Eric's making a name for himself in the industry - and as a little example of it, I'd strongly encourage you to check out this free video on Energy Systems Development he did as part of the pre-launch for Robertson's Bulletproof Athlete resource. You'll need to opt in to view it, but I guarantee you'll find it to be well worth it.
In this presentation, Eric discusses a lot of the myths surrounding aerobic exercise and energy systems development. Most importantly, though, he provides practical recommendations to help you put this knowledge into action to improve your training programs, regardless of whether your goal (or your athletes' goals). I learned some good stuff, and I'm sure you will, too. Here is the link to check it out.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
Today, we have a guest blog from former Cressey Performance intern Eric Oetter, who is well on his way to a great career in physical therapy. Eric is an extremely bright up-and-comer from whom you'll be hearing a lot in the years to come. Here's a little sampling.
As part of the “pre-launch” phase for his new collaborative project, Elite Training Mentorship, Eric posted an outstanding video covering the lower-extremity assessment protocol he uses at Cressey Performance. For those who haven’t yet seen it, follow the link here; you won’t regret it.
In the video, Eric mentions three different factors that can contribute to mobility deficits at the hip: muscular restrictions, capsular restrictions, and bony restrictions. While the first two – muscular and capsular – can be relatively easy to decipher based on the test position of the hip, identifying bony restrictions can be tricky unless you’ve got access to a client’s radiological imaging. For this reason, it’s important to appreciate any structural variations in the skeletal system that can underlie joint malalignment at the hip.
The focus of this piece is a structural variation called hip anteversion. We’ll be covering the joint morphology associated with anteversion, along with a quick orthopedic test and some implications for programming.
What is hip anteversion?
Excerpted from the 2002 text Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann describes hip anteversion as the following:
“ … the angle of the head and neck of the femur is rotated anteriorly, beyond that of the normal torsion with respect to the shaft. The result is a range of medial hip rotation that appears to be excessive, whereas the lateral rotation range appears to be limited.”
Essentially, clients who present with this structural abnormality were born with, or have acquired, a more internally oriented neutral position for their femurs as they sit in the acetabulum (or hip socket). To be classified as anteverted, the femoral head and neck must be rotated more than 15° anteriorly with respect to the plane of the femoral condyles (Sahrmann 2002). (Conversely, a posterior rotation of the femoral head and neck would constitute a retroverted hip.)
When observed standing, clients with hip anteversion will often present with femoral adduction and genu valgum – the classic “knock-kneed” posture. As kids, these clients likely eschewed “indian-style” for W-sitting – a position much more congruent with their natural femoral alignment.
While some might also classify “pigeon-toes” as an indicator for anteverted hips, this is not always the case. In the presence of anteversion, some clients – especially athletes – will develop a tibial torsion as a result of the applied stresses to the lower extremities. This adaptation allows for a neutrally aligned sub-talar joint in the face of morphological changes up the kinetic chain.
The largest implication of hip anteversion or retroversion is a significant discrepancy between hip internal and external rotation. As described in the Sahrmann quotation above, hip anteversion creates an apparently large amount of internal rotation (IR) with a reciprocal loss of external rotation (ER).
I liken these morphological changes to those seen in the retroverted shoulder of an overhead throwing athlete. The total hip range of motion (IR + ER) can present at around 90°, or “normal”, but these measures are drastically skewed in one direction of rotation.
Whereas a retroverted shoulder presents a favorable adaptation in baseball, the same cannot always be said for the athlete with anteverted hips.
If undiagnosed or mismanaged, hip anteversion can create pathology. Expect issues like knee pain, back pain, and hip instability (Sahrmann 2002). For this reason, it’s imperative to recognize anteversion when it presents and apply the programming modifications necessary to accommodate this structural abnormality.
So how can I test for it?
Although checking IR and ER in both supine and prone can highlight limitations in the capsule or surrounding hip musculature, you’ll need an extra orthopedic test at your disposal to clear the skeletal system. For this purpose, we’ll use the Craigs’s test.
Assuming you’re following the assessment outlined in Eric’s video, the best time to perform a Craig’s test is immediately after you’ve assessed a client’s hip rotation in prone, especially if you detect a glaring asymmetry between IR and ER.
Note the client in the photos below – here, we see an excessive amount of IR (~50°) met with limited ER (only ~20°). With a rotational deficit of ≥30°, this client may have some torsional issue at play; thus, a Craig’s test indicated.
With the client remaining in prone the knee held in flexion, the Craig’s test is performed by first palpating the same side greater trochanter, a landmark on the femur that protrudes laterally about 5 inches below the iliac crest. Make sure to apply flat-hand contact with the pads of the fingers – this posture allows for greater sensory feedback and precision. Once this position is assumed, begin internally and externally rotating the femur through its full range of motion.
As you rotate the leg, you’ll notice the greater trochanter tracking against your fingertips, becoming more or less prominent depending on the direction of rotation. Start shortening your oscillations until you determine the position at which the trochanter is most prominent laterally and pause once you locate it. At this range of rotation, the femoral head is optimally situated within the acetabulum.
We get a positive Craig’s test when the hip rotation at the point of ideal femoral alignment is ≥15° into IR. Also, we can now classify the hip as anteverted, providing useful insight for the dexterous coach.
Check out the video below to see a Craig’s test performed on our client from above.
One thing worth noting – a 1992 study by Ruwe et al. showed the Craig’s test to be more reliable than radiological techniques in the assessment of femoral torsion. So, even if you have client X-rays available, a Craig’s test is still worth administering.
If the Craig’s test is positive, how should I alter programming?
Now that we’ve performed a Craig’s test and determined whether or not any torsional qualities exist, it’s time to write an effective program that respects our findings. Here are a few do’s and don’ts to consider when programming:
• DON’T stretch the hip into external rotation – this only creates impingement. We wouldn’t force the retroverted shoulder of a pitcher into an end-range sleeper stretch, so we need to take the same approach with an anteverted hip. Even though the hip is a much more durable joint, there’s no reason to drive motion that a client simply doesn’t have, as this only serves to jam the femoral head against the acetabulum.
• DO increase the amount of core work in clients with femoral torsion. When someone is stuck in internal rotation at the hip, the kinematics of the lower-extremities become predisposed towards a pronation pattern (sub-talar pronation, tibial/femoral IR, and anterior pelvic tilt).
The hip external rotators often become excessively stiff and overused, as they are constantly checking motion into adduction, internal rotation, and flexion. While increasing external rotator strength will improve the first two, we can employ the posterior fibers of external oblique and rectus abdominis to aid in flexion control, creating a more stable pelvis. By doing so, we’re also increasing stiffness at the lumbar spine, fighting any compensatory motion created by the hip external rotation deficit.
As far as exercise selection goes, focus on half-kneeling chops/lifts and anti-extension – both integrate the hips and core simultaneously to check hip flexion ROM. I especially like rollout variations for clients with hip anteversion, which are highlighted in Eric’s video below.
• DON’T introduce quad-dominant lifts until the client shows dramatic improvements in hip stability. The pronation pattern I described above is essentially a cookbook for ACL and MCL injuries. In a population that is likely anteriorly tilted at the pelvis and anterior weight bearing, the last thing we want to do is make them even more reliant on their quads. An adroit posterior chain should precede any anterior chain-focused movement.
• DO hammer the posterior chain as if your life depended on it. While this statement could serve as a mantra for most general population programming, it is even more important when dealing with anteversion of the hip. These clients sometimes present with femoral control so poor, our first goal is to simply get them to baseline.
Mastering stability in the sagittal plane takes precedence. Start bilateral with deadlift and box squat variations and increase stability demands as the client advances. Great second tier progressions include single-leg RDLs, single-leg hip thrusts, and bowler squats, all of which introduce frontal and transverse plane stability.
Lastly, exercises that force the femur into an abducted and externally rotated state are contraindicated – sumo deadlifts provide a great example. Even though pulling sumo is a fantastic variation for hip strength, it can create malalignment in the acetabulum if the hip is anteverted. In this case, it’s safer to stick with either trap bar deadlift or conventional deadlift variations.
Conclusion
Hip anteversion isn’t something you’ll likely see in every client. Johns Hopkins Medical School reports the prevalence to be ~8-10%, but that number varies based upon cultural norms and neurodevelopmental patterns, which can alter skeletal growth.
Regardless, it is an important structural variation to recognize and program for, especially in an athletic population. Taken as supplement to Eric’s lower-extremity video, I hope this article provides you another piece towards building a better assessment.
About the Author
Eric is currently a senior at the University of Georgia majoring in Exercise and Sport Science, with plans to pursue a Doctorate of Physical Therapy. After concluding a Division-1 football career at the Georgia Institute of Technology, Eric has ardently pursued his passion for coaching, garnering experience with clients of all ages and ability levels through internships at both Indianapolis Fitness & Sports Training and Cressey Performance. His articles can be found on EricCressey.com, 8weeksout.com, and in Fighting Fit magazine. You can follow him on Twitter or reach him via email at ecoetter@gmail.com.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
Today's guest blog comes from former Cressey Performance intern Eric Oetter. Eric was one of the best interns we've ever had, and writing like this is just one example of why.
In Thomas Myers’ groundbreaking work Anatomy Trains, several “lines” of fascially connected muscles are presented. Myers denoted these lines as “anatomy trains” (thus giving rise to the title of his now famous book). For those unfamiliar, fascia is a seemingly endless web of connective tissue, which envelops and unites the musculoskeletal, nervous, and circulatory systems of the body. Though manual therapists have treated the fascial system for centuries, Myers has played a pivotal role in introducing the concepts fascia and musculoskeletal tensegrity to the strength and conditioning community.
Tying the bottom of the foot to the scalp through fascial connections up the posterior surface of the body, the superficial back line remains the most referenced of Myers’ anatomy trains. While this line certainly has implications in extension (above the knee), propulsion, and full-body pronation, it’s far from being the only line yielding practical application and solutions for strength and conditioning coaches and movement therapists.
Patrick Ward wrote an excellent guest piece on Mike Robertson’s blog last year concerning the deep front line and its effect on diaphragm functionality. I’ll follow suit with some examples of how the functional back line can produce stability across the posterior lumbo-pelvic-femoral complex.
Functional Back Line Anatomy
Tying one humerus to the contralateral tibia, the two functional back lines take the following path across the dorsal surface of the body:
Shaft of humerus --> Latissimus dorsi --> Lumbodorsal fascia --> Sacral fascia --> Sacrum --> Gluteus maximus --> Shaft of femur --> Vastus lateralis --> Patella --> Subpatellar tendon --> Tuberosity of tibia
From behind, the lines look like a giant “X”, intersecting at the pelvis. The two key components in this discussion will be the latissimus dorsi and the glute max, as well as how their muscular actions can affect the sacro-illiac joint.
Sacro-Iliac Joint Stability: Form Closure vs. Force Closure
The sacro-illiac (SI) joint is comprised of the articulation between the illium and the sacrum and lies right in the middle of both functional back lines, deep to the lumbosacral fascia. Much like a crack in the sidewalk, the joint acts as a predetermined fracture to defer stress across the pelvis.
Viewed from the back, the SI joint resembles a key fitting into a lock– the grooves on either side of the posterior illium are congruous with the lateral sacrum. This “lock-and-key” structure can be described as an instance of form closure. Essentially, the innate stability of the joint is provided by bony approximation.
While form closure can create stability, it’s not truly authentic. For example, we can create stability in the lumbar spine by shearing it into extension and using bony approximation to prevent movement. I hope all reading agree that such a situation is less than ideal.
A superior option would be the force closure of a joint system. As opposed to form closure, where the morphology of the joint system creates stability, force closure entails the surrounding musculature dynamically stabilizing a joint by “pulling it tight”.
Relating to our previous example of the SI joint, imagine how much better it would be to stop relying solely on the ligaments that cross the joint andinstead employ the powerful glute max and lat, which cross superficially as part of the functional back line, as both become continuous with the lumbosacral fascia.
While using the functional back line to create force closure is useful in cases of general instability, it can be especially valuable in the instance of sacral torsion, where, as shown in the CT scan below, the sacrum rotates one way and creates strain on the contralateral tissues/ligaments as they are pulled taught.
Training this line in isolation can certainly provide benefit, but why not implement a big-bang strength exercise that integrates the entire line at once?
Here are two great examples of how to train the functional back line in a more dynamic fashion.
Split-Stance Low Cable Row
The split-stance low cable row provides an excellent presentation of shortening the functional line from both ends, thus force closing the SI joint. The latissimus dorsi aids in the horizontal pull while the contralateral glute max stabilizes the pelvis in the transverse plane to fight rotation. (Remember, any unilateral movement is inherently rotational.)
Coaching Cues:
Place the cable stack with a D-handle attachment at its lowest height.
Set up facing the stack with feet about hip width apart. Imagine that you’re standing on railroad tracks – when you take the step back to set up, the only movement should be in the sagittal plane.
Pack the chin, brace the core, and then flex the hips to the point that the torso is angled at about 45°. Put most of your weight through the outside of your up-foot heel.
Perform a row, holding at the top for a one count.
Potential Corrections:
Look for lumbar extension in two places – the initial set-up and as a substitution for scapular retraction. Think “neutral spine” throughout.
Scapular elevation and shoulder hyperextension are common compensation patterns during horizontal pulling. Think of rowing “back-and-down” and only to the point that the scapula gets to the thoracic spine.
Make sure that you or your client feels the front-leg hip musculature kick on to stabilize – if not, play with the set-up a little until those external rotators are contracted.
The split-stance low cable row can be a great horizontal-pull variation for any client, but especially for those experiencing lumbosacral instability. I’d recommend placing it as an accessory exercise on upper body days – 3-4 sets of 8-10 reps.
1-arm Cable Rotational Row
Serving as a progression to the split-stance low cable row described above, the cable rotational row is a fantastic movement to dynamically integrate the functional back line into a more advanced pulling variation with much greater demand placed on the glute max. I view this movement much like the horizontal pull version of a push-press – the lower body drives the action with the upper body coming along for the ride.
Coaching Cues:
Set up a few feet away and perpendicular to a cable stack with feet about a step outside of hip width. The D-handle should be about waste height.
Offset the feet so that the toes of the inside foot (closest to the stack) line up with the middle of the arch on the back foot. This positioning is crucial to maximize external rotation/abduction of the front hip.
Grab the D-handle and allow the load to pull you toward the cable stack. Maintain an erect torso and packed chin throughout. You’re allowed to let the back foot toes come up, but keep the front planted in position.
Once you’re facing the cable stack with arm outstretched, drive hard through the front heelto extend the front hip/knee while simultaneously pulling the D-handle across your torso.
Hold the end position – hip extended/abducted, scapula retracted, and eyes straight ahead – for a count of one before reversing the movement.
Potential Corrections:
I find some clients tend to lead the row with cervical rotation, finishing the movement looking away from the cable stack. These biomechanics are sub-optimal, so make sure to cue a packed chin.
Rowing from this position can prove awkward, as there is a tendency to try and row around your torso. Fight this urge by keeping the cable close to your body – it should be in contact with your shirt as you finish the row.
Achieving full hip extension on the front leg is a must – make sure the movement is initiated by driving the lateral heel into the ground almost as if you were going to step away from the stack.
The benefits of the rotational cable row are numerous, but two stick out in my mind. First, it drives a powerful and dynamic contraction of the functional back line, which as we’ve seen can have ramifications for pelvic/SI stability. Secondly, this variation has huge carryover for some of our rotary sport athletes who rely on the connection between shoulder and contralateral hip to develop force.
As mentioned above, use this as a progression to the split-stance low cable row or with some of your athletic clientele – think in the range of 3-4 sets of 6-8 reps per side.
Conclusion
The functional back lines can be powerful players in creating stability across a region of the body that demands it. In cases of lumbo-pelvic-femoral instability, utilization of these lines can be as crucial for correction as they are for performance enhancement.
I hope the two exercises described above help give some practical application for the functional back lines in action – let me know in the comments!
About the Author
Eric is currently a senior at the University of Georgia majoring in Exercise and Sport Science, with plans to pursue a Doctorate of Physical Therapy. After concluding a Division-1 football career at the Georgia Institute of Technology, Eric has ardently pursued his passion for coaching, garnering experience with clients of all ages and ability levels through internships at both Indianapolis Fitness & Sports Training and Cressey Performance. He can be reached at ecoetter@gmail.com.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
