Home Posts tagged "James Andrews"

Strength and Conditioning Stuff You Should Read: 8/14/17

Happy Monday! I've got some recommended strength and conditioning resources for you, but before I get to them, I want to quickly remind you that the early-bird registration deadline for my September 17 seminar near Washington, DC is this Thursday, August 17. This event will sell out, as I only have a few spots left, so if you're interested in attending, don't delay on registration. Here's the information page.

Baseball America Podcast Interview with Dr. James Andrews - This was an an excellent 18-minute conversation between Will Carroll from Motus and Dr. Andrews. They covered Dr. Andrews' latest observations on arm injuries in youth baseball players.

Do You Need a Navy Seal? - This article from Dr. Brandon Marcello is a few years old, but warrants reincarnation in light of recent developments with alternative, military-inspired training approaches in the general and athletic populations.

Sabotaging Your Sales Pitch: 4 Mistakes to Avoid - My business partner, Pete Dupuis, presents a little fitness business advice. In this post, he covers the lead conversion conversation - and how to not screw it up!

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If you want to throw hard, you have to firm up on the lead leg...and at the right time and in the right direction. Cleats can definitely help athletes "get away" with a bit more in this regard, as they guarantee a larger base of support (foot stays on the ground) and generally have a lot more medial/lateral support than normal sneakers. It's one reason why many pitchers throw considerably harder outside than they do off indoor (turf) mounds. That said, if you're going to pitch off a turf mound, do yourself a favor and make sure that you've got a sneaker that isn't too flimsy - especially side to side. You shouldn't roll out of the shoe (which we see in the right video). Take note of the same pitcher on the left in the @newbalance #mx20v6, a minimalist sneaker that is lightweight but still provides adequate medial/lateral support. Exact same delivery, but markedly different outcomes. Full disclosure: I helped design this shoe - but the lessons are the same regardless of what you're wearing. Thanks for the demos, @joeryan34! #cspfamily #pitching #pitchingdrills #minimalistshoes

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Preventing Baseball Injuries: Actions Speak Louder Than Words

We're at a point in time where just about everyone knows that throwing a baseball year-round is a bad idea. Moreover, we know that it's best for kids to avoid early sports specialization. 

Dr. James Andrews has been outspoken against early specialization and year-round throwing for roughly a decade.

John Smoltz devoted a big chunk of his Hall-of-Fame acceptance speech in Cooperstown to discouraging kids and parents from early specialization and year-round baseball.

JohnSmoltz

Seahawks coach Pete Carroll recently referred to the trend of kids playing only one sport as "an absolute crime."

USA Baseball launched their Pitch Smart campaign - featuring an advisory board of many MLB team doctors and athletic trainers - to prevent overuse in youth baseball.

All the way back in 2006, a landmark study by Olsen et al. clearly demonstrated strong associations between injuries requiring surgery and pitching "more months per year, games per year, innings per game, pitches per game, pitches per year, and warm-up pitches before a game" as well as showcase appearances during adolescence. Overuse is the one factor that predicts injury over and over again in the research.

A 2011 study demonstrated that players in warm weather climates had less shoulder strength and more problematic range-of-motion adaptations than those in cold weather climates. And, speaking from personal experience from having Cressey Sports Performance facilities in both states, it's been far more challenging to develop players in Florida than it is in Massachusetts. There is simply too much baseball competing with general athletic development.

These are just a few examples, too. Hundreds of professional athletes have spoken out against early sports specialization. College coaches have in some cases refused to recruit one-sport athletes. And, there are more anti-specialization posts and websites freely available on the Internet than one could possibly imagine. Yet, the problem isn't even close to going away, and injuries still at all-time highs.

Now, I can understand how some players, parents, coaches, and scouts don't stay on top of the American Journal of Sports Medicine and might have missed this important information. What I can't understand is how they'd miss it when the world's most recognized orthopedic surgeon is speaking out against it. Or how they can miss it when one of the most accomplished pitchers of the last century devotes the biggest media spotlight of his life to bashing early sports specialization. Or how they'd overlook one of the premier coaches in the NFL so vehemently putting down the practice. Or how a governing body like MLB would devote time, money, and resources to a problem that they think will have a significant negative impact on the future of the game beyond just the billions of dollars that are already being wasted on players on the disabled list.

The problem is not a lack of knowledge; the problem is a lack of action and consequences.

When you were a little kid and stole a cookie from the cookie jar - even after your mother told you it was off limits - you got punished for doing so. If you didn't have consequences, you'd keep stealing cookies. Unfortunately, this isn't an option with youth baseball. Really, the only consequence is injury, and it's surprisingly not that great a teacher.

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A lot of kids and parents continue to make the same mistakes even after an arm surgery and extended layoff. They've been brainwashed to think that the only way kids can succeed in baseball is to play year-round to keep up with other kids and get exposure to college coaches and pro scouts. There are too many coaches, showcase companies, and scouting services lining their pockets by lobbying hard to make these false assumptions stick. 

If knowledge ("eating too many cookies is bad for you") isn't working, and it's hard to deliver consequences, what's the next step? You've got to make it really hard to get to those cookies - and they better taste like crap if you do manage to do so. 

Stepping away from this analogy, the big governing bodies that matter need to step up their game. Here are six quick changes that I personally feel could have a profound impact on reducing injury rates across all levels:

1. Major League Baseball needs to implement a high school scouting "dead period" from October 1 through January 1. It is entirely hypocritical for MLB to push PitchSmart, but turn a blind eye when literally hundreds of scouts are showing up for October-December showcases and tournaments that directly compete with the PitchSmart initiative. Most of the highest-profile players aren't even attending these events anymore (advisors know it's an unnecessary injury risk), and there is absolutely nothing a scout would see in November that they can't see in the spring during the regular season.

2. MLB should also mandate that no pitcher can throw in more than three consecutive games - including "getting hot" (throwing in the bullpen, but not entering the game). Some might criticize me for this, but after extensive interaction with relievers at this level, I firmly believe that bullpen mismanagement is one of the biggest problems in MLB pitching injuries. Fans and the media only see the actual number of appearances, but when you factor in the number of times a pitcher "gets hot" without entering the game, you have relievers who are literally throwing over 120 times in a season.

3. The NCAA needs to implement innings limits on freshman and sophomore pitchers. Keep freshman pitchers to 120 innings and sophomore pitchers to 140 (combining the college season and summer ball). Additionally, any pitcher who throws more than 120 innings during the spring/summer should have a mandatory 60-day period of no throwing prior to starting fall ball.

4. The NCAA should also implement a conservative pitch count limit for college starters. I think 130 is a good place to start, and while I still think it's unnecessarily high, it reins in those coaches who'll leave a guy in for 150+ pitches. Sadly, this happens far too often in college baseball these days, and there are zero repercussions (although I do commend ESPN's Keith Law for always calling these coaches out on Twitter).

5. State athletic associations in warm weather climates need to structure high school seasons to allow for athletes to compete in multiple sports. As an example, in Massachusetts, the high school baseball season begins on the third Monday in March, while the first basketball practice is November 30. If a high school basketball player wants to play baseball, he might only have a 1-2 week overlap during that month - and it only happens if his team goes deep into the playoffs.

Conversely, the high school baseball season here in Florida begins on January 18, while the last regular season basketball game doesn't occur until January 30. The state championship games take place February 23-27 - which is roughly halfway through the baseball season! There is absolutely no reason for a high school baseball season (in which teams play about 30 games) needs to start prior to March 1.

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That extra six weeks would make a huge difference in getting more baseball players to also participate in winter sports and help to get a baseball out of young hands a bit longer. And, you'd see a lot more players well prepared on day 1 of baseball tryouts because they'd have more off-season preparation under their belts. It would simply force teams to play three games per week instead of two; this is exactly what's done in Northern states (and they'll sometimes play four, if weather interferes).

6. Similar to point #4, state athletic associations should also have regulations on permissible pitch counts for high school arms. I think 115 pitches is a good number.

Closing Thoughts

I should note that I actually think Little League Baseball does a solid job of disseminating information and including specific regulations within the game and between games. The changes - at least in my eyes - should rest with high school athletic associations, the NCAA, and Major League Baseball. Impact will come from the top down.

As you can see, with only two exceptions, I'm much more about managing the competitive year than I am about micromanaging pitch counts. And, the two pitch count recommendations I put out are remarkably conservative and just reaffirm common sense (which, unfortunately, isn't so common anymore). Pitch counts alone haven't proven to be tremendously effective, but do have a place when implemented alongside guidelines for managing the overall baseball calendar.

There is absolutely no reason for skeletally immature middle and high school baseball players to have longer competitive seasons than professional players.

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Career Capital in the Fitness Industry: Part 2

In the first installment of this two-part article, I discussed why "Follow Your Passion" isn't usually very good advice in any realm, but especially in the fitness industry. In case you missed it, you can check it out: Career Capital in the Fitness Industry: Part 1.

To briefly bring you up to speed, author Cal Newport emphasizes that acquiring "rare and valuable skills" is far more important to long-term job satisfaction, as we're more likely to enjoy careers in which we are wildly proficient. These skills are known as "career capital," and we can "redeem" them for improved quality of life - whether it's better pay, more influence within a company, more flexible hours, working from home, or a number of different benefits. As Newport's title related, you need to be So Good They Can't Ignore You.

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Newport's points got me to thinking about what "rare and valuable skills" one needs to be very successful in the fitness industry. I think it's a particularly interesting question, as there are a ton of people that make career changes to enter the fitness industry because (and these are just a few factors):

a) A lot of people love to exercise, so being around exercise all day seems fun.

b) It's perhaps the starkest contrast to a desk job, which many people abhor.

c) Wearing workout clothes to "work" sounds cool.

d) Fitness jobs generally provide more flexible hours, albeit it inconvenient times (you work while others play).

e) There is very little barrier to entry in the fitness industry; anyone can be a personal trainer TODAY, if they so desire.

While a lot of people are able to make enough to "survive"with this transition, it's a big stretch to say that a lot of people THRIVE. Folks who make a ton of money and have outstanding job satisfaction are few and far between.

Not surprisingly, a lot of people fall flat on their faces with this career change. It's usually that they can't get a sufficient, sustainable clientele off the ground, or that they just realize that the new career isn't what they expected it to be. What separates those who manage to succeed, though? Here are the "rare and valuable skills" I see as tremendously valuable for "sustainability"in the fitness industry.

1. Professionalism

This matters in any industry, but it's especially important in the fitness industry, where it's tremendously easy to differentiate yourself because there are so many remarkably unprofessional trainers out there. There are trainers taking calls on their cell phones during sessions, and others who refuse to wear sleeves while training clients. There are coaches who have been using the same program for 25 years, and others who are sleeping with clients. Heck, I once had an intern show up for his first day of work in a Miller Light t-shirt! You really can't make this stuff up. Call me crazy, but....

[bctt tweet="If you want to thrive as a fitness PROFESSIONAL, it's a good idea to actually act PROFESSIONALLY."]

Professionalism isn't something that comes in a day, though. I didn't really appreciate what it meant when I was just getting started in the fitness industry; my views on it have changed over the course of the past 15 years. Image - both your own and that of your business - evolves over time. As an example, it might start with showing up on time and looking the part early on in a career, whereas 15 years later, it might be making sure that your staff doesn't say anything stupid on social media to detract from your professional image. So, you could say that you're actually cultivating a specific kind of professionalism within the fitness industry - and no matter how good a person or hard a worker you think you are, it takes time to build.

2. Versatility

I think this might be the single-most important factor governing success in the fitness industry.

Being versatile enables you to make friends with introverts and extroverts alike. It helps you to work with kinesthetic, auditory, and visual learners. It makes you to be accessible over multiple communication medius: email, phone, text message, and Skype (to name a few). It assists you in managing different personalities on your staff, if you wind up in a leadership position. It makes evolving easier in a very dynamic field. It's what allows you to acquire new skills and become a bigger contributor to a team. One of our Cressey Sports Performance staff members, Chris Howard, is a great example. He can evaluate athletes, write programs and coach - but also has a master's degree in nutrition and is a licensed massage therapist. And, he can make friends with anyone. He's built versatility capital.

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I should note: don't confuse versatility with trying to be everything to everyone. It just means that you'll be able to get better results underneath the specific umbrella where you're most qualified - and chances are that there will be more "umbrellas" under which you can choose to fall. Yes, you can redeem your versatility capital for the ability to pick what you enjoy doing (and that's what Chris has done at CSP).

3. Perseverance

Again, perseverance is important in any career, but it's particularly vital in the fitness industry, where you will have to pay your dues early on. This might include unpaid internships, brutally long hours (including the dreaded AM/PM split), and standing around on hard floors for 12 hours each day. And, you have to realize that in that last hour of the day, no matter how much your feet hurt and you want to go to sleep, you have to deliver the same quality product to clients.

This is why I always laugh on the inside when I hear an up-and-coming trainer complaining about having to work "floor hours" at a commercial gym. They don't realize that every single second they spend on that gym floor - even if they aren't actually training a client - is building a little toughness that'll sustain them over the long haul. It's better to build a callus (have plenty of exposure to being on the floor) than it is to develop a blister (jump into a training position cold turkey, only to wind up with knee and low back pain and a cranky demeanor by the end of your first day).

As an aside, I'll never hire anyone I hear complaining about old bosses or jobs....ever. If that's all that you can think of discussing during a job interview or in a cover letter, you have a negativity problem, lack the ability to walk a mile in another's shoes, and don't really understand how true learning and professional growth takes place.

4. Unique Expertise in a Specific Population

I'm a firm believer that the fitness industry is getting more and more "niched." Athletes are specializing earlier, and winding up with more "specialized" injuries that require specific preventative and rehabilitative training approaches. People are more overweight and unhealthy than ever, and it's given rise to entirely new industries. If you need proof, just consider how many more bariatric surgeries and hip replacements we are doing now than we did 20 years ago! The world is changing, and becoming more specialized. As the somewhat hackneyed saying goes, "generalists starve while specialists thrive."

Here's the problem, though: [bctt tweet="You have to be a good generalist before you become a specialist."] It takes years to acquire a skill set broad enough that you can select the areas where you're particularly proficient and leverage them to create a sustainable (and enjoyable livelihood). It's why doctors do residencies and fellowships after they've finished med school course work and clinical rotations! Nobody gets to go directly to a fellowship just because they have an undergraduate degree; they have to earn that right over time. Effectively, they're redeeming career capital to pursue a specialty.

Fitness works similarly. If you haven't taken the time to learn structure (anatomy), function, dysfunction, assessment, and programming in a broad group of clients/athletes, you'll never be prepared to handle a specific population. There is a right and wrong way to move, and you need to appreciate it before getting to how specific individuals deviate from it.

Once you get past this general education stage, though, you can really change the game. Candidly, most of the resumes I encounter for internships and jobs look very much the same. What jumps out at me is when something has a unique specialty that jumps off the page; they demonstrate that they have the potential to add instant value to our business. When they can do that AND fill an existing need we have, it's a great fit.

On our staff, Greg Robins is a great example. When he initially applied, I loved his military background, which made him an instant leader and someone that could oversee our internship program. He also had a track record of building successful bootcamp programs (and got ours off the ground at CSP).

robins

Since then, he's gotten heavily into powerlifting, attended multiple Postural Restoration Institute courses, and taken a particular interest in hip dysfunction cases and sprint mechanics. He's expanding his skill set in particular realms without diluting the general foundation he'd established. You can't build a pyramid without a strong foundation, but once that foundation is in place, you can do some cool stuff - and cool stuff earns you career capital.

5. A Mental Library

If you haven't heard of Dr. James Andrews, you'd be wise to look him up. Suffice it to say that he's the most renowned sports orthopedist of all time.  I've been fortunate to interact with him at a few conferences and over the phone when he's provided second opinions on MRIs over the years, and he's as good a person as he is a surgeon. Dr. Andrews is widely renowned not only for his surgical skills, but also for his tremendous bedside manner and accessibility.

However, what I think is perhaps even more remarkable - and what makes Dr. Andrews such a sought-after consultant - is the fact that he has an absurd number of case studies compiled in his brain. No matter how ugly and atypical your shoulder, elbow, knee, or hip MRI is, he's probably seen 500 just like it over the years. He can speak to whether these issues respond to conservative treatment, and if so, what the best course of action is. If not, he can speak to whether surgery is warranted, and if so, what procedure is the right fit. You just can't get that with the small town orthopedic surgeon who does two rotator cuff repairs each year, and treated one ACL tear back in 2002. Interacting with a lot of people builds a lot of career capital in your memory "bank."

If you need any proof that being good at what you do is a great predictor of job satisfaction, Dr. Andrews is 72 years old and still going strong. I don't imagine that he needs the money at this point, and he actually does a lot of pro bono outreach work to try to combat overuse injuries in youth sports. Compiling and redeeming career capital put him in a position pursue this mission.

Again, there are parallels in the fitness industry. At risk of sounding overconfident, I get to interact with over 100 throwing shoulders/elbows every single day, so I've built a great sample size from which to draw over the past eight years.

ECCishek

Some trainers have seen dozens of post-pregnancy cases, cardiac/pulmonary rehab folks, or NFL Combine prep cases . The only way to acquire a fully loaded memory bank is to encounter a lot of people in a specific population.

Closing Thoughts

These are just five examples of where one can acquire career capital in the fitness industry - and there are certainly many more ways to do things. Additionally, under each one of these examples are many specific actions that can build to create a "wealth" of knowledge and experience - "rare and valuable skills" - that can someday surely be redeemed for a career you'll genuinely love. That same success and job satisfaction aren't guaranteed if you simply "following your passion," though, so be sure to take that advice with a big grain of salt.

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Strength and Conditioning Stuff You Should Read: 3/5/13

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

Engineering the Alpha - My good friends John Romaniello and Adam Bornstein co-authored this book, and it is now available for pre-order.  Full disclosure: I have not read it yet.  However, I know how much time, dedication, and knowledge these two put into it - and it's sure to be fantastic, with a great combination of fitness/strength and conditioning stuff and recommendations on making your life cooler overall (if you like reading Tim Ferriss' stuff, you'll also enjoy this).  They also have a ton of cool bonuses for those who pre-order this week.

Noted Surgeon Dr. James Andrews Wants Your Athlete to Stay Healthy By Playing Less - Here's a great interview at Cleveland.com with Dr. Andrews.  While I wish they'd used the word "competing" instead of "playing" in the title, it is a valuable read - and an excellent follow-up to my post from last week, 20 Ways to Prepare Young Athletes for Success in Sports and in Life.

Set a PR Every Week - Dave Dellanave wrote an excellent article on autoregulatory training for T-Nation.

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Pitching Injuries: It’s Not Just What You’re Doing; It’s What You’ve Already Done

A while back, this article on pitching injuries became the single-most popular piece in EricCressey.com history:

Your Arm hurts?  Thank Your Little League, Fall Ball, and AAU Coaches

In that feature, I made the following statement:

We can do all the strength training, mobility work, and soft tissue treatments in the world and it won’t matter if they’re overused – because I’m just not smart enough to have figured out how to go back in time and change history. Worried about whether they’re throwing curveballs, or if their mechanics are perfect?  It won’t matter if they’ve already accumulated too many innings.

While athletes might be playing with fire each time they throw, the pain presentation pattern is different.  You burn your hand, and you know instantly.  Pitching injuries take time to come about. Maybe you do microscopic damage to your ulnar collateral ligament each time you throw – and then come back and pitch again before it’s had time to fully regenerate.  Or, maybe you ignore the shoulder internal rotation deficit and scapular dyskinesis you’ve got and it gets worse and worse for years – until you’re finally on the surgeon’s table for a labral and/or rotator cuff repair.  These issues might be managed conservatively if painful during the teenage years (or go undetected if no pain is present) – but once a kid hits age 18 or 19, it seems to automatically become “socially acceptable” to do an elbow or shoulder surgery.

Sure enough, just yesterday, reader Paul Vajdic sent me this article from the Shreveport Times. The author interviews world-renowned orthopedic surgeon Dr. James Andrews about the crazy increase in the number of Tommy John surgeries he'd performed over the past decade.

A comment he made really jumped out at me, in light of my point from above:

""I had a kid come in, a 15-year-old from Boca Raton, (Fla.), who tore his ligament completely in two,' Andrews said. 'The interesting thing is when I X-rayed his elbow with good magnification, he has a little calcification right where the ligament attaches to the bone. We're seeing more of that now. He actually got hurt with a minor pull of the ligament when he was 10, 11, 12 years of age. That little calcification gets bigger and, initially, it won't look like anything but a sore elbow. As that matures, it becomes more prominent. It turns into an English pea-size bone piece and pulls part of the ligament off when they're young.'"

In other words, it takes repeated bouts of microtrauma over the course of many years to bring an athlete to threshold - even if they have little to no symptoms along the way.  Injury prevention starts at the youngest ages; otherwise, you're just playing from behind the 8-ball when you start training high school and college players.

In addition to walking away with the perspective that young kids need to be strictly managed with their pitch counts, I hope this makes you appreciate the value of strength and conditioning programs at young ages, too.  For more information, check out my post, The Truth About Strength Training for Kids.

We can't prevent them all, but I do think that initiatives like the IYCA High School Strength Coach Certification in conjunction with pitch count implementation and coaching education are a step in the right direction.

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