Baseball Strength and Conditioning Programs: How Much Rotator Cuff Work is Too Much? – Part 2

Written on January 10, 2012 at 9:34 pm, by Eric Cressey

In part 1 of this feature, I talked about how many throwers actually overuse the rotator cuff because they don’t appreciate that throwing in itself is a tremendously stressful challenge to the shoulder.  I also made the point that cuff timing is more often the problem than cuff strength, so many folks are really training the rotator cuff incorrectly with thousands of reps of band exercises.  Let’s examine that in a bit more depth.

First, I should preface this piece by saying that I think there are definitely places for utilizing bands to strengthen the rotator cuff in a baseball training context.  They obviously provide outstanding convenience for on-field work and travel circumstances, as well as scenarios where players may not have qualified professionals at hand to help with manual resistance work and rhythmic stabilizations. Some cuff work is better than no cuff work!  Additionally, many players swear by bands during the warm-up phase to help with getting blood flow to the shoulder complex with a bit of activation at the same time.

However, there are two primary issues with relying exclusively on bands:

1. In an external rotation variation, the resistance is actually greatest at the point (near maximal external rotation) where the athlete is weakest.  In other words, the band doesn’t ideally accommodate the strength curve.  This is a huge concern for me, as one of the biggest things I notice in athletes is that when training in a position of somewhat significant external rotation, they can’t “pick up” the resistance quickly enough. More on this later.

2. Most people simply overlook eccentric control.  This is something that is coachable, no doubt, but most people do band exercises for so many reps per set that the athlete can quickly lose focus and resort back to bad habits.

As you can imagine, these are shortcomings that also exist – albeit to a slightly lesser extent – with cable and dumbbell/plate external rotation rotator cuff strength exercises:

So, how do we overcome these shortcomings while helping to address rotator cuff timing?  You have two great options.

1. Rhythmic Stabilizations

The true role of the rotator cuff is to stabilize the humeral head (ball) in the glenoid fossa (socket).  And, during throwing, it does a ton of work, as the humerus goes through extreme ranges of motion in all three planes.  Rhythmic stabilization drills are a great way to train the cuff to fire quicker, and they’re particularly valuable because you can train them at various points in the range of motion, modifying the challenge depending on how stable an individual is in a given position.  Plus, this is an outstanding way of monitoring cuff function over the course of weeks and months with athletes you see regularly; regular improvements are easily perceived.

You’ll notice that I don’t crank him back to extreme external rotation in this video; rather, we stop short of it and just assume that we’ll get some carryover in stability a bit further (as per previous research on carryover of isometric exercise).

The sky is really the limit in terms of how you train this one; we have about a dozen variations that we use on a daily basis.  A few quick guidelines:

a. The more congenital or acquired laxity an athlete has, the less aggressive you’ll want to be with your perturbations. When someone is less proficient, gently destabilizer, and apply the perturbations closer to the shoulder.  When someone is more stable, perturbate a bit more firmly, and apply it further down the arm.

b. I generally start those with significant laxity with closed chain exercises so that they can draw some stability from the floor.  Here’s an example:

c. Make sure that the scapula is positioned appropriately; it certainly shouldn’t be protracted, but don’t crank it into excessive retraction, either.  Just keep it from winging off the rib cage.

d. I like 2x/week rhythmic stabilizations during off-season training.  We typically integrate it between sets on lower-body strength training days.

2. Manual Resistance External Rotations

These drills are “where it’s at.”  On one hand, they are the best strength-building exercise for the cuff because they train it in its most function context: eccentric control.  However, more specific to today’s point, they are great for improving cuff recruitment at the most vulnerable point in the throwing motion: lay-back.

When we do a drill like this, I encourage the athlete to “pick it up early.”  In other words, I won’t apply downward pressure (eccentric overload) until they apply some external rotation force into my hand).  This is another variation I like to use:

Some quick guidelines for manual resistance external rotations:

a. Emphasize eccentric overload, but make sure you aren’t pushing all the way down, as most people will go into scapular anterior tilt as they are more internally rotated.  Pushing someone all the way down puts the shoulder in a pretty vulnerable position, as scapular stability is lost and the subacromial space is closed down.

b. Given that you have to apply the force further down the arm, make sure that the athlete isn’t cheating by just utilizing the wrist extensors.

c. Use the other hand to ensure ideal scapular positioning on manual resistance side-lying external rotations at 30 degrees abduction.  In the manual resistance external rotations at 90 degrees in the scapular plane, your other hand should “cup” the elbow to make sure that the rotation is taking place at the shoulder (as opposed to horizontal adduction/abduction).

d. I like to utilize manual resistance external rotations twice a week during the off-season, usually toward the end of upper body strength training sessions.  We’ll use less manual resistance work in this regard, though, when guys start to ramp up their throwing, as it tends to create a bit more soreness.

This wraps up our look at a different perspective on how to attack rotator cuff exercises with timing – and not just strength – in consideration.  For more information, I’d encourage you to check out Optimal Shoulder Performance: From Rehabilitation to High Performance.

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Baseball Strength and Conditioning Programs: How Much Rotator Cuff Work is Too Much? – Part 1

Written on January 9, 2012 at 8:15 am, by Eric Cressey

I just got back from presenting in front of 3,500 coaches at the American Baseball Coaches Convention in Anaheim.  I had an absolute blast, and since I received some great feedback from many coaches in attendance after my talk, I thought I’d use the first few posts of this week to recap a few highlights of my presentation.  To start off, one statement I made that I know turned some heads was:

I think most people overtrain the rotator cuff nowadays, and they do so with the wrong exercises, anyway.

To illustrate my point, I’m going to ask a question:

Q: What is the most common complication you see in guys as they rehabilitate following a Tommy John Surgery?

A: Shoulder problems – generally right around the time they get up to 120 feet.

Huh?  Shoulder pain is a post-operative complication of an elbow surgery?  What gives?

First, I should make a very obvious point: many of these guys deal with shoulder stiffness as they get back to throwing simply because they’ve been shut down for months.  That I completely expect – but remember that it’s stiffness, and not pain.  They always throw their way out of it.

The more pressing issue is what is taking place in their rehabilitation – and more specifically, what’s taking place with the synergy between their rehabilitation and throwing program. Let me explain.

Rehabilitation following a UCL reconstruction is extensive.  While different physical therapists certainly have different approaches, it will always be incredibly heavy on rotator cuff strength and timing, as well as adequate function of the scapular stabilizers.  Guys always make huge strides on this front during rehab, but why do so many have shoulder pain when they get further out with their long tossing?  The answer is very simple:

Most people don’t appreciate that throwing a baseball IS rotator cuff training.

Your cuff is working tremendously hard to center the humeral head in the glenoid fossa.  It controls excessive external rotation and anterior instability during lay-back.

It’s fighting against distraction forces at ball release.

And, it’s controlling internal rotation and horizontal adduction during follow-through.

Simultaneously, the scapular stabilizers are working incredibly hard to appropriately position and stabilize the scapula on the rib cage in various positions so that it can provide an ideal anchor point for those rotator cuff muscles to do their job.

A post-op Tommy John thrower – and really every player going through a throwing program – has all the same demands on his arm (even if he isn’t on the mound, where stress is highest).  And, as I wrote previously in a blog about why pitchers shouldn’t throw year-round, every pitcher is always throwing with some degree of muscle damage at all times during the season (or a throwing program).

Keeping this in mind, think about the traditional Tommy John rehabilitation approach.  It is intensive work for the cuff and scapular stabilizers three times a week with the physical therapists – plus many of the same exercises in a home program for off-days.  They’re already training these areas almost every day – and then they add in 3-6 throwing sessions a week.  Wouldn’t you almost expect shoulder problems?  They are overusing it to the max!  This is a conversation I recently had with physical therapist Eric Schoenberg, and he made another great point:

Most guys – especially at higher levels – don’t have rotator cuff strength issues; they have rotator cuff timing issues.

In throwing – the single-fastest motion in all of sports – you’re better off having a cuff that fires at the right time than a cuff that fires strong, but late.  Very few rotator cuff exercise programs for healthy pitchers take that into account; rather, it’s left to those doing rehabilitation.  Likewise, most of the programs I see altogether ignore scapular stability and leave out other ways to train the cuff that are far more functional than just using bands.

Now, apply this example back to the everyday management of pitchers during the season. Pitchers are throwing much more aggressively: game appearances, bullpens, and long toss.  They need to do some rotator cuff work, but it certainly doesn’t need to be every day like so many people think.

I’ll cover how much and what kind in Part 2.  In the meantime, if you’d like to learn more about the evaluation and management of pitchers, check out Optimal Shoulder Performance.

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Strength Exercise of the Week: Prone External Rotation

Written on January 4, 2012 at 6:33 am, by Eric Cressey

The prone external rotation is a strength exercise for the posterior rotator cuff that we’ve added to our strength and conditioning programs over the past few months with good success.  And, while the primary goal is to increase shoulder stability via improved rotator cuff function, the truth is that this drill also served as a motor control exercise to reeducate folks on what should be moving and when.

We use this drill a lot with guys who are in a dramatic anterior pelvic tilt, and start everything with the “gluteus tight, core braced” cues.  Effectively, this means that you force the athlete to actually externally rotate the shoulder instead of simply arching through the lower back to get to the desired “finish” point.  You’ll be amazed to see how many athletes have significantly less “observable external rotation” when they are locked into neutral spine.

You also want to cue the athlete to keep the scapula (shoulder blade) on the rib cage, but he/she doesn’t need to be aggressively pulled into scapular retraction in order to get there.

Once the scapula is set, I tell athletes to think about getting the ball to rotate in the socket without allowing the head of the humerus to slide down toward the table.  This is a very important cue, as many athletes will allow excessive anterior migration of the humeral head during external rotation exercises; we want them to learn to keep the ball centered in the socket.  If an athlete is really struggling with this, we may place a rolled up towel or half-roller underneath the anterior shoulder as feedback on where things should be.

Very rarely will we load this up, and in the rare instances we do, it wouldn’t be for more than 2.5 -5 pounds.  The shoulder is a joint with a broad range of movements that mandate a lot of dynamic stability, so we want to make sure things are working perfectly.

I’ll generally include this movement in the warm-ups for sets of eight reps – or we may use it as a filler on a lower-body day between sets of more compound strength exercises.  It can also serve as a great follow-up to shoulder mobility drill geared toward improving external rotation, as this is an avenue through which you can add stability to the range-of-motion you’re creating.

Give it a shot in your strength and conditioning programs and then let me know how it goes in the comments section below!

For more exercises along these lines, I’d encourage you to check out our Optimal Shoulder Performance DVD set.

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The Best of 2011: Articles

Written on December 25, 2011 at 6:57 pm, by Eric Cressey

With 2011 winding down, I’ll be dedicating this week to the best content of the year, based on traffic volume at EricCressey.com.  I’ll kick it off today with my most popular articles from the past year.

1. My New Favorite Training Shoe – This post received more than 3,000 views more than #2.  Apparently, footwear is a topic about which folks were anxious to read, and I gave a detailed review of all the minimalist footwear options I’ve tried – and folks shared it a ton.  Additionally, based on feedback on my Twitter account, a lot of people purchased the New Balance Minimus based on my recommendation and have absolutely loved it.

2. Your Arm Hurts?  Thank Your Little League, Fall Ball, and AAU Coaches. – This post received well over 1,000 Facebook “shares” and loads of Tweets, and I’m hopeful that this is indicative of parents, coaches, and players learning about how to approach arm care and throwing programs intelligently.  I think it was also popular because it was a good blend of scientific evidence and simple, everyday logic.

3. Tim Collins: Why Everyone Should Be a Kansas City Royals Fan (at least for a day) – This was my favorite post of the year, as it was a chance to celebrate a good friend and long-time Cressey Performance athlete who is everything that is right about Major League Baseball. As a cool little aside, traffic to this article played a large part in having “Tim Collins” trending on Twitter during his MLB debut on Opening Day in March.

4. Weight Training Programs: You Can’t Just Keep Adding – It sounds like many of my readers were glad to hear that I was doing some writing on managing training stress.  There is a lot of common sense in this one, but sometimes, that’s what people need!

5. Strength Training Programs and Squat Technique: To Arch or Not to Arch? – Here’s a very misunderstood topic in the area of strength and conditioning technique.  You’ll be happy to know that I’ll be addressing it in great detail in the new Functional Stability Training resource that Mike Reinold and I are releasing soon.

6. Shoulder Hurts? Start Here. – In this piece, I outlined three sure-fire strategies that just about everyone can employ regardless of their shoulder issues.

7. Healthy Food Options: Why You Should Never Take Nutrition Advice from Your Government – One of the biggest surprises for me in 2011 was that my readers absolutely ate up (no pun intended) nutrition content, and summer Cressey Performance intern Tyler Simmons’ guest blog perfect example.   He shared some great (and controversial) thoughts in this guest blog.

8. Correcting Bad Posture: Are Deadlifts Enough? – People want results, and they want them fast.  This post touched on whether or not the deadlift could be an optimal “shortcut” for getting to where you want to be.

9. Why the Gym’s Out-of-Business and the Porn Store’s Thriving – This was proof that I can write about just about anything.  Don’t ever expect to see a content drought here at EricCressey.com.  The timing for this was really good, as I got the idea to write it right around the time that we released The Fitness Business Blueprint.

10. Lifting Heavy Weights vs. Corrective Exercise: Finding a Balance – I can definitely see how folks found this topic so interesting, as it’s a very challenging balance to strike.  In fact, it was even a very challenging piece around which to wrap my brain!

This wraps up our top 10 posts of 2011, but I’ll be back soon with more “Best of” highlights from 2011.  Next up, I’ll list my top product reviews of the year.

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Strength and Conditioning Stuff You Should Read: 11/28/11

Written on November 28, 2011 at 6:48 am, by Eric Cressey

Here’s a list of recommended strength and conditioning reading to kick off the week:

13 Fun Facts About Optimal Shoulder Performance – Because our OSP DVD set is on sale for 15% off until tonight at midnight, I figured it’d be a good chance to highlight a bit about the product and its creators.  (Click here to purchase the DVD, by the way)

Trigger Points and a Sympathetic State – This is Patrick Ward’s follow-up blog to the one on soft tissue therapy and stress resistance that I mentioned last week.  Part 2 is just as good as Part 1!

Flax Oil vs. Fish Oil – This was a well-researched piece by Robert Yang on a topic about which I’ve had many client inquiries over the years.  It’ll be nice to have a resource to which I can send them.

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Upcoming Reinold and Cressey Seminar

Written on October 3, 2011 at 5:07 am, by Eric Cressey

I thrilled to announce that I’ll be collaborating with Mike Reinold once again – this time on a seminar, Functional Stability Training, to take place on Sunday, November 20, 2011 at Cressey Performance in Hudson, MA.

Here’s the agenda for the day:

• Functional Stability Training – An integrated approach to rehabilitation and performance training – Reinold
• Recent Advances in Core Performance - Understand the concept of Functional Stability Training for the Core, true function of the spine, and how this impacts injuries, rehab, and training – Reinold
• Maintaining a Training Effect in Spite of Common Lumbar Spine and Lower Extremity Injuries – Outlines the causes and symptoms of several common injuries encountered in the lower extremity, and how to train around these issues to keep clients/athletes fit during rehabilitation – Cressey
• Understanding and Controlling Extension in Athletes – Looks into the causes of and problems with excessive lumbar extension, anterior pelvic tilt, and rib flairs in athletes – Cressey
• Lunch (Provided)
• LAB – Assessing Core Movement Quality:  Understanding where to begin with Functional Stability Training exercises for the core – Reinold
• LAB – A Dynamic Progression of Core Performance Exercises  - Progression from simple core control to advanced rehab and training techniques – Reinold
• LAB – Understanding and Controlling Extension in Athletes – Progresses on the previous lecture with specific technique and coaching cues for exercises aimed toward those with these common issues – Cressey
• LAB – Advanced Stability: Training Power Outside the Sagittal Plane – Traditional power training programs are predominantly focused on the sagittal plane, but in most athletic endeavors – especially rotational sports – power must be displayed in other planes of motion – Cressey

It’s our goal to optimize the learning environment and have lots of interaction with all of those in attendance, so to that end, we’ll be keeping the seminar to 50 people or less.  Given that our Optimal Shoulder Performance seminar in 2009 sold out in under a week, this one is sure to do the same – so don’t delay in registering, if this is of interest.

For more information, or to sign up, check out www.FunctionalStability.com.

Here’s what some of our previous seminar attendees have had to say about their experiences seeing us live:

Related Posts

13 Fun Facts About Optimal Shoulder Performance
Weight Training Programs: Assess, Don’t Assume

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Lose Fat, Gain Muscle, Get Strong, and Laugh a Little – Installment 5

Written on June 30, 2011 at 8:01 am, by Eric Cressey

I haven’t published much strength and conditioning randomness of late, so here goes.

1. Here’s a research study that demonstrates relationships among a variety of scheduling and recovery factors and injury rates.  The part I found most interesting was that researchers observed that sleeping fewer than six hours the night prior to a competition led to a significant increase in fatigue related injuries.

Additionally, while it wasn’t specifically observed in the study, my anecdotal observations are that kids who play 14 games in a weekend are more likely to hate their sports, have too many insignificant trophies, and live in their parents’ basement until age 35 because they have a weird sense of entitlement and absolutely no idea how to interact on a social level with anyone who isn’t on their AAU teams.

2. Speaking of young athletes, interval training works better for them, too.  There’s absolutely no reason for a young soccer player to be running miles and miles at a steady-state.  Kids need to get strong and learn to run fast before they try to run fast for a long time.  Interval training is a nice “bridge” between the two when applied correctly during the off-season period.

3. Here’s an excellent study with a biomechanical analysis of the hex/trap bar deadlift technique as compared to the conventional deadlift technique.  It backs up a lot of the comments I made last month with my deadlift series from last month, which you can find at the following links:

How to Deadlift: Which Variation is Right for You? – Part 1 (Conventional Deadlift)
How to Deadlift: Which Variation is Right for You? – Part 2 (Sumo Deadlift)
How to Deadlift: Which Variation is Right for You? – Part 3 (Trap Bar Deadlift)

4. Here’s an interesting article in Radiology Today about the use of MRI in college athletes as a pre-screening tool – and potentially even an aid in optimizing strength and conditioning programs.

Because a lot of the observations on MRI may be “subclinical” (meaning they are findings that occur without the presence of symptoms), there may be merit (albeit at a big cost) to using screens like this as part of an initial (or on the fly) evaluation of an athlete to dictate a training or “prehab” program.  For instance, observing a subclinical patellar tendinopathy may mean you do more soft tissue work around the knee and more heavily emphasize glute activation and minimize quad dominant squatting (among other things) to keep that tendon from reaching a symptomatic threshold.

There are, of course, some significant drawbacks.  For starters, MRIs are expensive and time consuming, so not everyone could get them.  How do you decide who deserves it – especially in the era of Title IX?

Second, you’re assuming that strength and conditioning coaches are qualified and capable to organize programs around what’s found on a radiology report.  Generally speaking, there isn’t a ton of individualization in collegiate strength and conditioning because coaches have so many athletes assigned to them and it isn’t feasible.  It makes me wonder if you could prevent more injuries if you simply hired 3-4 more strength and conditioning coaches for what it would cost you to get an extra radiologist and imaging technician.

Third, and perhaps most importantly, there are a lot of “false positives” on MRI.  I’ve written about this quite in the past and covered it in our Optimal Shoulder Performance DVD set, but you are headed down a very slippery slope when you start treating the image rather than the athlete.  In other words, how one moves and feels is far more important than how one’s MRI looks.  I can guarantee you that the overwhelming majority of my overhead throwing athletes have labral fraying, partial thickness supraspinatus tears, and a host of other “normal” findings for this population.  If I immediately contraindicated a ton of exercises in my program because I knew this, I’d likely be setting them back with regressions in their programming when they actually needed progressions.

What are your thoughts on this final issue?  If you had the resources, would you MRI every athlete in a college athletic program?  How would you pick which region to MRI?

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Shoulder Hurts? Start Here.

Written on May 16, 2011 at 7:45 am, by Eric Cressey

As you can probably imagine, given that I deal with a ton of baseball players – and the fact that I’ve written about shoulder pain a ton over the past decade – a lot of people initially come to Cressey Performance because their shoulder hurts.  It might be rotator cuff pain, AC joint irritation, or any of a host of other issues, but you’d be surprised at how many similarities there are among the ways that you address most of these issues.

The problem is that pain can throw a wrench in your plans and limit you in your ability to get to exactly where someone needs to improve movement-wise.  For instance, you might have someone who has a significant glenohumeral (ball-and-socket) internal rotation deficit, but it’s hard to manually stretch them into internal rotation without further irritating a cranky AC joint.  Or, someone with a partial thickness rotator cuff tear may be dramatically limited in shoulder flexion, but even shoulder flexion with assisted scapular posterior tilt and upward rotation exacerbates their symptoms.  Very simply, you can’t just pound round pegs into square holes when it comes to dealing with a delicate joint like the shoulder – and that applies to both asymptomatic and symptomatic shoulders.

To that end, there are three initiatives that I think are the absolute most important places to start in just about every case.

First, I’m a huge advocate of soft tissue work with a skilled manual therapist.  In our office, we have a massage therapist and chiropractor who performs both Active Release and Graston.  And, we make sure that any physical therapist to whom we refer clients uses manual therapy as an integral part of their treatment approach.  Whether you’re a regular exerciser or not, tissues can get dense, nasty, and fibrotic, and integrating some hands-on work on the pec minor, posterior rotator cuff, lats, scalenes, sternocleidomastoid, and several other areas can dramatically reduce an individual’s symptoms and improve range-of-motion instantly – and that allows us to do more with a corrective exercise program.

Understandably, not everyone has access to a qualified manual therapist all the time, so you can always utilize self-myofascial release in the interim.  Here, in a video from Show and Go: High Performance Training to Look, Feel, and Move Better, CP massage therapist Chris Howard goes over a quick and easy way to loosen up the pecs:

The second area where you really can’t go wrong is incorporating thoracic spine mobilizations.  The thoracic spine has direct interactions with the lumbar spine, rib cage, cervical spine, and scapulae; as a result, it has some very far-reaching effects. Unfortunately, most people are really stiff in this region – and that means they wind up with poor core and scapular stability, altered rib positioning (which impacts respiration), and cervical spine dysfunction.  Fortunately, mobilizing this area can have some quick and profound benefits; I’ve seen shoulder internal rotation improve by as much as 20 degrees in a matter of 30 seconds simply by incorporating a basic thoracic spine mobility drill.

That said, not all thoracic spine mobility drills are created equal.  Many of these drills require the glenohumeral joint to go into external rotation, abduction, and horizontal abduction in order to drive scapular posterior tilt/retraction and, in turn, thoracic spine extension and rotation. If you’ve got a cranky shoulder, this more extreme shoulder position usually isn’t going to go over well.  So, drills like the side-lying extension-rotation are likely out:

For most folks, a quadruped extension-rotation drill will be an appropriate regression:

And, if the hand position (behind the head) is still problematic for the shoulder, you can always simply put it on the opposite shoulder (in the above example, the right hand would be placed on the left shoulder) and keep the rest of the movement the same.

Last, but certainly not least, you can almost always work on forward head posture from the get-go with someone whose shoulder hurts.  We start with standing chin tucks, and then progress to quadruped chin tucks.

Additionally, working on cervical rotation is extremely valuable, although teaching that is a bit beyond the scope of this post.

Keep in mind that these three broad initiatives are really just the tip of the iceberg when it comes to a comprehensive corrective exercise plan that would also include a focus on scapular stabilization and rotator cuff exercises, plus additional mobility drills.  They are, however, safe entry-level strategies you can use with just about anyone to get the ball rolling without making a shoulder hurt worse in a strength and conditioning program.

For more information on what a comprehensive shoulder rehabilitation program and the concurrent strength and conditioning program should include, check out Optimal Shoulder Performance, a DVD set I co-created with Mike Reinold, the Head Athletic Trainer and Rehabilitation Coordinator of the Boston Red Sox.

The Optimal Shoulder Performance DVD is a phenomenal presentation of the variables surrounding shoulder health, function, and performance. It combines the most current research, real world application as well as the the instruction on how to implement its vast amount of material immediately. After just one viewing, I decided to employ some of the tactics and methods into our assessment and exercise protocols, and as a result, I feel that myself, my staff and my clients have benefited greatly.

Michael Ranfone BS, CSCS, LMT, ART
Owner, Ranfone Training Systems

A Great Read on Shoulder Instability

Written on March 30, 2011 at 6:39 am, by Eric Cressey

My next blog (which is one of the best things I’ve ever written, in my opinion – so don’t miss it!) will go live tonight, but in the meantime, I wanted to encourage you to check out a great two-part article from my buddy Mike Reinold, the head athletic trainer and rehabilitation coordinator for the Boston Red Sox (not to mention the co-creator of the Optimal Shoulder Performance DVD set).  Mike delves into shoulder instability in great detail:

Key Factors in the Rehabilitation of Shoulder Instability: Part 1

Key Factors in the Rehabilitation of Shoulder Instability: Part 2

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Shoulder Mobility Drills: Scapular Wall Slides vs. Doorway Slides

Written on February 4, 2011 at 9:18 am, by Eric Cressey

The other day, I received an email from a Show and Go customer who noticed that the scapular wall slide and the doorway slide were two similar, but not identical shoulder mobility drills included in the program.  He asked if I could talk a bit more about the differences between the two – and when to use both.

First, let’s have a look at the two exercises.  Here’s the scapular wall slide:

And, here’s the doorway slide:

As the voice-over on the video above notes, the scapular wall slide is an acceptable fit for just about any workout routine.  The only exceptions would be those who have upper extremity pain with overhead motions (rotator cuff tears, etc.).

However, we can utilize the doorway slide in certain folks to get to where we want to be a bit faster.  More specifically, these folks are the ones who are REALLY immobile in their upper extremity and wouldn’t even be able to get their arms back even close to the wall on the wall slides.  So, in addition to not making them feel bad about their “tight shoulders”, the doorway slide actually allows us to use the doorway as a stretching implement to get a gentle stretch across the anterior shoulder girdle (predominantly pec major and minor).  There are three very important coaching points:

1. Don’t let the head poke forward, as a forward head posture is simply a substitution for not retracting/depressing the scapulae or horizontally adducting the humerus.

2. Don’t crank too aggressively on the shoulders; it should be a subtle stretch.  And, it shouldn’t be used with those (particularly overhead throwing athletes) who already have increased external rotation and, in turn, more anterior laxity.

3. Make sure to focus on pulling the shoulder blades down and back as the elbows are lowered.  You shouldn’t have movement of the humerus without movement of the scapula.

For more shoulder mobility drills and the rationale for them, I’d encourage you to check out our Optimal Shoulder Performance DVD set.

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