Random Friday Thoughts

Written on June 13, 2008 at 9:20 am, by Eric Cressey

Hey Gang,

No transitional material this week; I’m a little scatterbrained.

1. Jeremy Frisch and company are running a great event for charity in Acton, MA on June 21. For more information, head HERE. Even if you can’t make it, these charities could really use a donation.

2. Maximum Strength isn’t just for men!

“Maximum Strength is the book where brain meets brawn in an all-inclusive guide to getting strong and in shape. Eric manages to take the sissy out of salad and add the steak. It’s a must have for busy lifters who need to make the most of their time while still getting optimum results.”

-Juliet Deane CSCS, RKC, USAW

Check it out for yourself HERE.

3. Assess, don’t assume. Still, if you’re in the strength and conditioning field and dealing with teams, it’s important to understand trends in the sports with which you work so that you can program to avoid the most common injuries.

4. On a related note, yesterday, in the time it took me to write an email, we had a kid come in with a cast up to his upper arm for a wrist injury from diving, and another guy tell me that he’s having hip surgery in July for a chronic problem. This just goes to show you that if you work with athletes – no matter how young – you need to understand injuries.

5. I’m heading to my first optometrist appointment in WAY too long this morning – and I’m kind of hoping that they find something wrong with me to justify me wearing an eye patch. At the very least, it’ll scare some of our athletes into lifting heavy stuff. I’m working on my pirate accent right now.

6. Stretching the anterior capsule in baseball players is just a bad idea.

7. There are a lot of blog readers who might not realize that I also have a newsletter that goes into far more depth on various topics each week. If you aren’t already subscribed, don’t miss out! You can sign up with the subscription set-up to the right of this screen.

8. Cadaver grafts for ACL reconstructions seem to work well if you’re older and have no aspirations of really doing anything too athletic – especially change-of-direction and jumping. If you’re younger, though, the chance of re-rupture is a lot higher, in my experience. The patellar tendon graft is pretty nice simply because the limitations of the graft site work hand-in-hand with the limitations of the ACL from a rehabilitations standpoint.

9. Great win for the Celtics last night. Waaahooooo.

10. If you want to look at the hip and knee in a non-traditional, outside-the-box way, I highly recommend Gray Cook and Brett Jones’ Secrets of the Hip and Knee DVD. It’s fantastic.

Have a great weekend!

Got Shoulder Problems? How’s your breathing?

Written on May 20, 2008 at 11:02 am, by Eric Cressey

Q: I noticed you mentioned breathing patterns as a potential issue that a good PT should address. Tony briefly explained how this relates to overall shoulder function in his Limiting Factors article if I remember correctly, and it seems to be a subject that’s been popping up quite a bit recently.

Would it be possible for you elaborate on this even further? Even just throwing out some random thoughts you may have on the topic would be great

A: Think of what happens when air enters the chest: the shoulders rise. Most people are extremely tight in levator scapulae already – so elevating the rib cage, clavicle, and scapulae further is only going to exaggerate things. Learn to breath into the belly, and you can put levator scapulae on slack a bit more.

The fundamental problem is that levator scapulae is a downward rotator of the scapula – and when it’s tight, it makes it difficult to get appropriate upward rotation to allow for safe overhead motion. This compromises the space through which the rotator cuff tendons pass. Gray Cook’s Secrets of the Shoulder delves into this in some detail.

Eric Cressey

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

How To Return to Overhead Pressing

Written on January 23, 2008 at 10:54 am, by Eric Cressey

Q: Eric – some thoughts on the overhead pressing and a question. Obviously, if the motion was symptomatic, you wouldn’t do it. However, if after soft tissue work and then thoracic mobilization and activation work on the scapular muscles, the athlete could do the ROM without the symptoms, would that be a time to introduce very light OH pressing to reinforce the activation work, and re-teach the motor pattern. As Dr. Eric Cobb says, ‘strength training “cements” your neural patterns.’

A: First off, I agree with Dr. Cobb completely; it’s why resistance training is a strong foundation for most of modern physical therapy.

For your question, though, the answer is maybe. It depends on whether you’ve got someone with a lot of bone spurring. Even if you’ve optimized upward rotation patterns, you’re still dealing with a 5mm subacromial clearance zone before the bone spurs are taken into account.

Additionally, you have to take into account the population in question. Laudner et al. found that at 60 and 90 degrees of humeral elevation, pitchers had less upward rotation than position players. We might be able to make it better, but that’s not to say that we can ever optimize it – especially under load – with the amount of throwing they do. We don’t do anything overhead with humeral head approximation except for isometric DB holds where upward rotation isn’t occurring (we’re cueing a specific scapular positioning). Gray Cook has some excellent ideas on this front in his Secrets of the Shoulder DVD.

My personal rule of thumb is that if someone feels like they need to get back to overhead pressing after a shoulder injury, they need to be pain-free for at least six months before we do so. We start with steep incline pressing with a neutral grip and move to a 1-arm DB push press – and go from there.