Random Monday Thoughts: 9/13/10

Written on September 13, 2010 at 3:09 am, by Eric Cressey

1. In today’s big news, I simply want to tell you to be on the lookout for a HUGE week here at EricCressey.com.

First, we’re going to be having some awesome content in conjunction with the launch of my new product, Show and Go: High Performance Training to Look, Feel, and Move Better.

Expect some awesome video content and more details about the product over the next week – but if you want to see it, you need to make sure that you are signed up for my newsletter.  If you haven’t already done so, you can subscribe using the following opt-in form (which will also get you access to a sweet deadlifting tutorial):

Along these same lines, the new and improved EricCressey.com will be debuting alongside the launch of Show and Go on the 20th.  It will blow our current set-up out of the water.

2. I’m going to be relatively brief today, as I’m headed down to Reebok’s corporate headquarters in Canton, MA this morning to film some videos on the needs and benefits of strength and conditioning.  I’ve been down there a few times with some of our pro guys who have endorsement deals when they’ve shopped in the athlete/employee store, and the entire “campus” is pretty darn impressive:

3. The good folks at Men’s Health tracked me down for an on-the-fly video tutorial in the lobby at Perform Better in Providence back in June, and the video is now available online. It goes through a few example of thoracic and glenohumeral joint mobility drills we use with our athletes. A special thanks goes out to CP intern Dave Rak for his help in demonstrating this while I was coaching it.

You can find more drills like these (and the rationale for them) on our Optimal Shoulder Performance DVD set.

4. While this article isn’t as shocking to those of us in the fitness industry who are appalled at the ridiculously low standards our industry has set for allowing someone to become a personal trainer, I’m sure it was to the general public who read it.  And, it’s very well written.  Check it out: For a Price, Area Firm Certifies the Novice as a Fitness Expert.  Sad, but true.

5. My fiancee and I have a minor league pitcher staying with us for a week while he’s in town to get evaluated and do some training on a post-rehab stint.  He’ll head back to his hometown through the end of the year, and then come back to train with us for the nine weeks leading up to spring training.

On Thursday night, we were watching the NFL season opening in my living room – and I was writing programs on my laptop.  He commented something along the lines of “Damn, you really do work all day, don’t you?”  As I thought about it, I guess I really do.  I’m usually up at 6AM to make breakfast and see my fiancee before she heads off to work, and then I go right to writing/consulting work up through about 10:15AM, when I head over to the facility, get in my lift, and then coach from 12PM to 6PM or so.  Then, it’s back home – often to do more programming, answer emails, and – right now – finish up this new project.

He asked me what my ultimate career goal was, and I told him that it essentially amounted to doing my writing in the morning, and then coaching my pro/college guys during the day, and then 1-2 hours of high school guys right after school.  He looks at me and goes, “That’s still a nine-hour day, man!”

As you can probably tell, I’m not particularly good about shutting things down.  The reason is really simple: I love what I do.  I still need to get better at turning it off more often, though!

6. On a related note, our pro baseball off-season is in full swing now.  I did one evaluation on Wednesday and three on Thursday – on top of the guys who have already started up (or are working off some of our programs elsewhere in the country before they come up).  It should be a great crew of guys getting after it, and we’re all really excited about what the next six months has in store for us.  Thus far, the most entertaining moment has been Royals’ prospect Tim Collins’ triumphant return to Cressey Performance – where he walked around the gym and high-fived all 20 or so clients (even the ones he didn’t know) who were in the facility at the time.

7. Our boy is back – and the offer to train for free at CP still stands for him!

Quick Fixes to Common Training Injuries

Written on August 11, 2010 at 8:59 am, by Eric Cressey

Call it a law of weightlifting: no matter how careful you are, at some point you’re gonna get hurt. Now you probably won’t decapitate yourself with a barbell or tear a pec or even rupture your spleen—the weightlifter’s injuries are rarely that cool or sudden.

Nope, you’ll probably just end up with a bum shoulder, a pinched elbow, a bad back, or creaky knees, all the result of years of faulty movement patterns, poor training habits, or just general wear and tear. And while these injuries are always frustrating, they’re often manageable.

Because it’s hard to build a good-looking body when you’re hurt, I talked with Eric Cressey and Mike Robertson about how these body parts probably got jacked up in the first place, and asked them for simple strategies to get you healthy.

Continued Reading…

Case Study: More than Just Rotator Cuff Exercises

Written on August 5, 2010 at 6:30 am, by Eric Cressey

I had a one-time consultation client at Cressey Performance yesterday, and when I noticed that he had some interesting stuff going on, it made me realize that I need to do more “case studies” here in the blog.

This guy had a history of on-and-off right-sided lower back and left shoulder pain.  Basically, it would act up every once in a while, then calm down when he cut out exercising.  Then, he’d return to training for a bit – only to have another set-back.  It has been one step forward, and one step back for years.

Now, if you’d seen this guy move, you’d realize that the lower back and shoulder stuff were clearly closely related.  If you’re at all familiar with the Postural Restoration Institute, he was a classic Left AIC pattern: adducted/internally rotated right hip and  abducted/externally rotated left hip – and the compensations working their way up to lead to a low right shoulder and prominent left rib flair.  Everything was definitely related.

Not surprisingly, he’d been told he had scoliosis previously – but the “interesting” thing about it is that this was an acquired posture.  He hadn’t had these when he was a kid; he developed them when he was a rower who was always on the right side of the boat.  If you can acquire them, you can “unacquire” them – but it takes time.

We’re getting him started on some drills to iron out his hip imbalances, but for the sake of this blog, I wanted to highlight what we saw with his shoulder, as I think it includes some great take-home messages on how to manage shoulder function – both in the presence and absence of pain.

If you look at the research, if you look at shoulder total motion (internal rotation + external rotation with the scapula stabilized at 90 degrees of abduction), you should see symmetry between right and left in a healthy shoulder.  The internal and external components may be different between sides (e.g., more external rotation and less internal rotation in a throwing shoulder), but the total motion should be the same.  When it’s not, “normalizing” total motion should be a primary goal, whether you’re trying to address or prevent shoulder issues.

In our case study’s situation, here is what we measured with the goniometer:

Left: 39° (IR) + 98° (ER) = 137° (TM)
Right: 58° (IR) + 109° (ER) = 167° (TM)

In other words, it was a 30° total motion deficit, with most of that deficit coming from internal rotation.

The logical next step would be to manually stretch the shoulder girdle, right?  Well, certainly, it may be justified.  However, before I go having an athlete crank on a somewhat “delicate” joint, I like to see what we can do to get that area to relax without even touching it.

The first thing we did was simply close down that left rib cage flair a bit while flexing his left hip and flexing his left arm overhead.  And, we just left him there to breath for 30 seconds or so.  Then, we remeasured:

Left: 44° (IR) + 104° (ER) = 148° (TM)

In other words, we got 11° of total motion without ever touching his shoulder.  His body did that work just by getting air in with a new posture (no left rib flair).

Next, I simply had him get on all fours and go through a pretty low-key thoracic spine mobilization with his arm gently positioned behind his back so that it was on absolutely no stretch.  He did eight reps on each side, using cervical motion to drive a bit of thoracic extension and rotation and scapular movement.  Then, we remeasured:

Left: 46° (IR) + 107° (ER) = 153° (TM)

There’s another 5° of total motion, and it got us a lot closer to where he needs to be – without ever touching his shoulder. And, the coolest part was that when he stood up, the low right shoulder was markedly less prominent – and it was a positioning that “stuck around” for the rest of his session.

Sure, manual stretching of the shoulder is probably warranted for him to get those last 14 degrees, and I don’t expect him to maintain all this range indefinitely after this session.  He’ll need to be consistent with the movements to regain range bit-by-bit and use his strength training to ingrain it in his movement patterns, but the point is that the less aggressive, seemingly indirect, and self-applied interventions are often the best way to get lasting results.  And, when they work, it makes you realize just how “synced up” our entire body is from head-to-toe.

For more information on the best assessments and corrective exercises for the shoulder, check out our Optimal Shoulder Performance DVD Set.

Related Posts

Shoulder Range-of-Motion Norms
Mobilizing the Throwing Shoulder: The Do and Don’t

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used by Cressey Performance Pitchers after they Throw!

Stuff You Should Read: 8/2/10

Written on August 2, 2010 at 4:54 am, by Eric Cressey

Here are a few blasts from the past that I think you’ll like to kick off the week:

Peak Power or Vertical Jump – Which one should you test in athlete training programs, and why?

Back Squatting with a Posterior Labral Tear – This is a good follow-up to last week’s post on shoulder mobility with squatting because sometimes, even good mobility won’t matter.

5 Relative Strength Myths – I wrote this article back in 2005, and as I look back on it, in many ways, it helped to set the stage for my Maximum Strength book.

Random Tuesday Thoughts: 7/27/10

Written on July 27, 2010 at 6:00 am, by Eric Cressey

1. I haven’t done a “Random Friday Thoughts” blog in a while, so in the spirit of randomness, I thought I’d throw you a curveball and kick off the week with some Tuesday random thoughts.

2. Last week, I booked two plane tickets to Halifax, Nova Scotia for my fiancee and I.  She’s a bridesmaid in a wedding up there in a few weeks, so I’ll be making the trip as well.  As part of being what amounts to a “third wheel” for the weekend (the only people I know other than Anna in the entire wedding are the bride and groom), I’ll have quite a bit of downtime while in the area.  Any readers out there have any suggestions for what to do in Halifax?  It’s not hockey season, and I don’t drink Molson, so I’m at a bit of a loss…

Also, just out of curiosity, when did one have to sell off all his/her internal organs in order to afford a flight to Halifax?  Roundtrip airfare was over $1,500, and Air Canada followed up with an email that said, “We also mandate that you name your first child after us.”

3. I wrote a guest blog for Men’s Health last week; check it out: A Quick Fix for Stiff Shoulders.

4. Also on the writing note, I’ve written a few guest chapters lately.  The first was a strength and conditioning chapter for an upcoming pitching book for young baseball players and their parents.  The second (which is still a work in progress) is a chapter for a new IYCA project.  So far, it’s coming along really well – and I’m really honored to be on-board for this with a group of really talented guys who are trying to do something very special.

5. Tonight (Tuesday), Boston Red Sox Head Athletic Trainer (and Optimal Shoulder Performance co-creator) Mike Reinold is hosting a free webinar: “What’s New for 2010.”  Click here for more information.

6. Speaking of Mike, he had a great post last week about Epicondylitis and Cervical Radiculopathy.  It’s a great adjunct to my “Understanding Elbow Pain” series from back in May.  If you missed it, here’s a link to the sixth (final) installment (and you can link back to the previous five).

7. I realized the other day that there is one big thing I’ve always considered in our training programs for pitchers, but failed to mention on this blog: they need both open- and closed-chain hip mobility, as the right and left hips must rotate independently of one another during the stride to the plate. Here’s a good example:

You can see that Beckett is just short of stride foot contact here – which means that he’s at just about maximal hip external rotation on the lead leg…in open chain motion.  The femur is rotating on the acetabulum.

Meanwhile, he’s riding out his trailing leg…in closed chain motion.  The acetabulum is rotating on the femur.

As such, adequate mobility training for pitchers should include a combination of both open- and closed-chain drills, although I’d say that the majority should be closed-chain.

8. Today’s Mike Robertson’s birthday; head over to RobertsonTrainingSystems.com and show him a little love.

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Stuff You Should Read: 7/20/10

Written on July 20, 2010 at 4:48 am, by Eric Cressey

Here’s this week’s list of recommended reading:

Total Football Training – I just got an advanced copy of San Francisco 49ers strength coach Duane Carlisle’s new product, and read it over this past weekend.  There’s some really good stuff in there – definitely a good fit for the football players reading this blog. It includes an eight-week off-season training program where all the drills are demonstrated on the accompanying DVDs.

Inverted Row Ignorance – Here’s one from the archived that reminds us once again just how often this exercise is absolutely butchered.

The Right Way to Stretch the Pecs – Here’s a T-Muscle article that gives you some practical suggestions on loosening up these chronically tight muscles without throwing your shoulders under the bus.

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AC Joint Impingement vs. “Regular” Shoulder Impingement

Written on July 7, 2010 at 5:32 am, by Eric Cressey

I’ve seen a few acromioclavicular (AC) joint impingement cases at our facility in the last couple of weeks and thought it’d be good to do a quick blog to talk about how different they are from “regular” (external) shoulder impingement cases.  And, it is a very important differentiation to make.

I’ve already written at length about AC joint issues in Getting Geeky with AC Joint Injuries: Part 1 and Part 2.  And, I kicked out a two-part series called The Truth About Shoulder Impingement; here are Part 1 and Part 2.

While I talk a lot about the symptoms for both, several provocative tests for these issues, and training modifications to avoid exacerbating pain under these conditions, there was one important “differential assessment that I missed.”  Mike Reinold actually taught me it as we were planning the Optimal Shoulder Performance DVD set.

Just paying close attention to (and asking about) where folks have their pain during overhead motion can tell you quite a bit.  In an external impingement – where we’re talking about the rotator cuff tendons and bursa rubbing up against the undersurface of the acromion – you’ll usually get pain as folks approach 90 degrees of abduction (arm directly out to the side).  That pain will persist as they go further overhead, and in my experience, start to die off as they get to the top.

Conversely, for those with AC joint impingement – what is essentially bone rubbing up against bone – you see a “painful arc” only at the last portion of abduction:

You can usually confirm your suspicions on this front with direct palpation of the AC joint and checking to see if folks have pain when reaching across the chest.

Much of the training modifications will be the same for these two conditions, but there are also going to be several key things that should be managed completely differently.  For instance, front squatting someone with an AC joint issue would not be a good idea due to the direct pressure of the bar on the AC joint; it would, however, be just fine for most cases of external shoulder impingement.  In another example, some serious AC joint issues are exacerbated even by just doing the end-range of a rowing motion (to much shoulder extension/horizontal abduction) – whereas even folks with full-blown rotator cuff tears can generally do rows pain-free.

Assess, don’t assume!

For more information – including loads more assessments like these – check out the Optimal Shoulder Performance DVD set.

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Bodyblades for Baseball Pitchers?

Written on June 29, 2010 at 8:00 am, by Eric Cressey

Q: What do you think of Bodyblades and how – if at all- should they be incorporated into a pitcher’s routine?

A: As many of you know, I’m a fan of integrating rhythmic stabilization drills that train the true function of the rotator cuff: maintaining the humeral head in the glenoid fossa.  I wrote about it in some depth HERE, and Mike Reinold and I spent quite a bit of time on it in our Optimal Shoulder Performance DVD set.

Of course, if you compare the perturbations to stability that the Bodyblade provides, it appears to simulate some of what you’d get with a rhythmic stabilization drill.  So, it’s probably a good alternative to a pitcher who doesn’t have a training partner, therapist, or coach who can provide those destabilizing torques.  Shirts, apparently, are optional.

That said, to me, using a Bodyblade is a more closed-loop (predictable) drill, whereas manual rhythmic stabilizations are more open-loop (unpredictable).  So, it goes without saying that the benefits of “surprise” stabilization probably extend a lot further – and they don’t cost a penny.  Moreover, I’ve heard claims about the Bodyblade being an effective way to build muscle, which (outside an untrained population) just isn’t going to happen.  There are also much better ways to train the core.

For more information, check out the Optimal Shoulder Performance DVD set.

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Healthy Shoulders with Terrible MRIs?

Written on June 23, 2010 at 6:00 am, by Eric Cressey

In the same grain as Monday’s post on lower back pain, today, I thought I’d highlight some of the common findings in diagnostic imaging of the shoulder, as these findings are just as alarming.

Do you train loads of overhead throwing athletes (especially pitchers) like I do?  Miniaci et al. found that 79% of asymptomatic professional pitchers (28/40) had “abnormal labrum” features and noted that “magnetic resonance imaging of the shoulder in asymptomatic high performance throwing athletes reveals abnormalities that may encompass a spectrum of ‘nonclinical’ findings.”  Yes, you can have a torn labrum and not be in pain (it depends on the kind of labral tear you have; for more information, check out Mike Reinold’s great series on SLAP lesions, starting with Part 1).

This isn’t just limited to baseball players, either; you’ll see it in handball, swimming, track and field throwers, and tennis as well.  And, it isn’t just limited to the labrum.  Connor et al. found that eight of 20 (40%) dominant shoulders in asymptomatic tennis/baseball players had evidence of partial or full-thickness cuff tears on MRI. Five of the 20 also had evidence of Bennett’s lesions.

The general population may be even worse, particularly as folks age. Sher et al. took MRIs of 96 asymptomatic subjects, finding rotator cuff tears in 34% of cases, and 54% of those older than 60 – so if you’re dealing with older adult fitness, you have to assume they’re present in more than half your clients!

Also, in another Miniaci et al. study, MRIs of 30 asymptomatic shoulders under age 50 demonstrated “no completely ‘normal’ rotator cuffs.”  People’s MRIs are such train wrecks that we don’t even know what “normal” is anymore!

As is the case with back pain, these issues generally only become symptomatic when you don’t move well – meaning you have insufficient strength, limited flexibility, or poor tissue quality.  For more information on how to screen for and prevent these issues from reaching threshold, check out Mike Reinold and my Optimal Shoulder Performance DVD set.

Related Posts

13 Fun Facts About Optimal Shoulder Performance
Why President Obama Throws Like a Girl
3 Things Everyone Should Know About the Shoulder

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used by Cressey Performance Pitchers after they Throw!

Floor Press vs. Pin Press vs. Board Press

Written on June 14, 2010 at 6:56 am, by Eric Cressey

Q: I would like to know what the main differences are between floor presses and pin presses in the power rack, obviously with the same range of movement. Usually, in talking about injury at the shoulders, the advice is to drop full range of motion in the bench press in favor of floor press; does the pin press in the power rack – starting around middle point – accomplish the same thing? In a strength program for a healthy individuals, do these two similar movements have same utility?

A: My experience with the pin press is that it is not as effective as a floor press or board press because the lifter isn’t in a good position to appropriately “set” the scapular stabilizers to lock the shoulder blades down and back.  As a result, the lifter tends to shrug up – which allows the shoulder blades to anteriorly tilt – which can exacerbate the shoulder impingement that may already be occurring.

Moreover, I believe that it is important to have a lifter lower the bar, as opposed to starting from a dead-stop.  This way, we not only teach eccentric control of the muscles acting at the shoulder girdle, but we also train the movement by learning the appropriate bar path.  Considering the number of individuals who take the bar too high on the chest and let the elbows flare out when benching, I think it’s important to use movements like board presses and floor presses in lieu of the pin press.  Otherwise, we won’t get rid of clowns like this.

That said, generally speaking, I prefer board presses first, followed by floor presses, and then (if at all) pin presses.  These, of course, come much later than push-up variations and (usually) dumbbell exercises.

For more information on the specific return-to-pressing progressions that we use with the athletes and clients we see with shoulder impingement, AC joint issues, and a host of other shoulder conditions, check out the Optimal Shoulder Performance DVD Set.