With 2022 winding down, I'm using this last week of the year to direct you to some of the most popular content of the past 12 months at EricCressey.com, as this "series" has been quite popular over the past few years. Today, we start with the most popular articles of the year; these are the pieces that received the most traffic, according to my hosting statistics.
1. Why We Shouldn't Compare Kids in Sports- One of the more concerning trends I’m seeing on the youth sports scene is the how often the youngest kids are compared to their peers. In this article, I dug in on the problems with this approach:
2.Positions vs. Pressures- About 15 years ago, I attended a two-day course with Dr. William Brady, a well respected chiropractor and manual therapist in the Boston area. During the event, he said, "Biomechanics is a combination of physics and biology. Put another way, it is the study of load applied to human tissue." It was the most succinct and encompassing definition of biomechanics that I'd heard, so I frantically scribbled it down in my notes - and I've had it in the back of my mind to this day each time I've evaluated movement. This article explains why.
3. Why You Can't Feel Your Serratus Anterior Working- I received an inquiry from a follower who asked why it's so hard to "feel" serratus anterior targeted exercises. There's a fair amount to unpack in this regard, so I recorded this video on the topic.
5. Exercise of the Week: Supported Elbow CARs - This was my New Year's Day 2022 post, and it stood the test of time as one of the most popular pieces of content for the year.
I'll be back soon with another "Best of 2022" feature. Up next, the top guest posts of the year!
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The benefits of controlled articular rotations (CARs) are now well known in the strength and conditioning and rehabilitation realms, thanks to Functional Range Conditioning teachings. One way in which we've evolved this approach is by taking a closer look at the position at which we perform our elbow CARs. Historically, they've been performed with the arms at the sides, like this:
However, I think there's a lot more benefit to be gained by performing them with the upper arms supported at 90 degrees of flexion, particularly in an overhead athlete population.
Here's why:
1. With more shoulder flexion, we are able to lengthen the long head of the triceps over both joints it crosses (elbow and shoulder). In the seated position, the long head of the triceps is actually shortened as a shoulder extensor.
2. In throwing athletes, you'll commonly observe Bennett's lesions, areas of increased calcification along the posterior glenoid rim. For most athletes, they're incidental findings in asymptomatic shoulders, but in some cases, they can get too big and cause rotator cuff pathology (I relate it to a speed bump that the cuff has to go over). While the true cause of Bennett's lesions has been debated in the sports medicine world, many are of the belief that it results from traction stress from the long head of the triceps (LHOT) tendon. The tendon attaches on the supraglenoid tubercle (which is on the inferior aspect of the glenoid) and extends up to the labrum and joint capsule. LHOT also eccentrically prevents excessive elbow flexion during the cocking phase of throwing (think of it being heavily lengthened in a shorter catcher-like arm action).
So, whether you believe it's related to Bennett's lesions or not, there's a strong anatomical basis for us to say that the long head of the triceps is an extremely important - but heavily underappreciated - muscle for overhead athletes. I've seen a lot of throwers over the years who've benefited tremendously from manual therapy on the triceps - and this mobility drill is a useful proactive initiative that'll help the cause as well.
3. At positions of 90 degrees of shoulder flexion or more, we get greater serratus anterior recruitment to drive the rotational component of scapular upward rotation - but also a reduction in latissimus dorsi tone that can restrict it. This is particularly important in athletic populations that tend to carry a lot of extensor tone and live in scapular depression and/or downward rotation. It also gives these folks a break from competing against gravity, so it can actually reduce protective tension of the upper traps.
4. Building on this last point, serratus anterior also works to preserve the convex-concave relationship between the scapula and rib cage, which is particularly important to address in the aforementioned athletes who may have acquired flat (extended) thoracic spines over years of extension/rotation. These athletes crave reaching, rounding, and rotating.
You can add this to a warm-up, use it as a filler, or plug it into a cooldown. Take your time with each rep, and be sure to drive not only full elbow flexion/extension, but also pronation/supination of the forearm.
If you're looking to learn a bit more about long head of the triceps, I'd encourage you to check out my Sturdy Shoulder Solutions course, as I delve into it quite a bit as part of my upper extremity functional anatomy module.
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Measuring passive range of motion is a crucial step in any thorough movement assessment. However, it's often - both intentionally and unintentionally - measured inappropriately. Check out today's video to learn more:
If you're looking to learn more about how I evaluate, program, and coach at the shoulder joint, be sure to check out my popular resource, Sturdy Shoulder Solutions.
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Each time I run an Instagram Q&A, I get a few high school baseball players who ask how they can increase shoulder external rotation for throwing. The answer really depends on a few things, so here's a video to walk you through them.
With my last post, I kicked off the "Best of 2018" series with my top articles of the year. Today, we'll highlight the top five videos of the year.
1. Supine Banded Shoulder Flexion on Roller - I love this exercise for building thoracic spine mobility, shoulder flexion, and scapular posterior tilt.
2. Split-Stance Hip Abduction End-Range Lift-off - CSP coach Frank Duffy contributed this awesome hip mobility challenge as part of a guest post this year.
3. Landmine Lateral Lunges - This is an exercise I thought up on the fly while working with three-time Cy Young Award winner Max Scherzer, and we liked it so much that it's become a mainstay in his offseason programming.
4. Rhomboids Functional Anatomy - this webinar is an excerpt from my popular new resource, Sturdy Shoulder Solutions.
5. Knee-to-Knee Rollover Medicine Ball Stomp - this new medicine ball drill was a power training exercise thought up by my CSP-FL business partner, Shane Rye. The knee-to-knee approach encourages the athlete to stay in the back hip longer.
I'll be back soon with the top guest posts of 2018!
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Today, I've got a video post for you, and it builds on the Joint-by-Joint approach that's been popularized by Gray Book and Mike Boyle. In the video, I discuss how we can apply the joint-by-joint theory to the elbow, particularly in the context of pitching injuries. Check it out:
If you're looking to learn more about the elbow, I'd encourage you to check out my presentation on the topic, Everything Elbow.
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I wanted to introduce you to a new exercise we've been playing around with lately. I created the bent-over thoracic spine rotation with hip hinge because I was looking for a way for athletes to avoid compensatory movements as we worked on thoracic spine mobility in the standing position. Essentially, you'll often see folks with limited thoracic spine mobility move East-West with the hips or laterally flex through the spine as they try to find motion in spite of their limitations. By pushing the butt back to the wall, we effectively block off compensatory hip motion (and work on a better hip hinge pattern at the same time).
Key coaching points:
1. By having the eyes follow the hand, you get some cervical rotation to help things along.
2. Make sure the upper back is moving and you aren't just "hanging out" on the front of the shoulder. This is especially true in a throwing population who may have acquired anterior shoulder laxity.
3. We'll usually do eight reps per side. This can be included as a single set during a warm-up, or for multiple sets as fillers during a training session (we'll often plug it in between medicine ball sets).
4. This is a better option for those who have active range-of-motion limitations to thoracic spine rotation, as opposed to passive limitations. In the case of the passive limitations, athletes are better off with things like side-lying windmills, where they have assistance from gravity (instead of having to compete against it).
To learn more about how we assess, program, and coach around the thoracic spine (and entire shoulder girdle), be sure to check out Sturdy Shoulder Solutions.
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It's often been said that anything can be fixed with duct tape and WD-40. And, as a guy with extremely limited handyman skills, I really like this flowchart.
While this might seem like a dramatic oversimplification with respect the human body, I think there are actually some noteworthy parallels. To prove this, let's take a look at a study my buddy, Mike Reinold, co-authored back in 2008. While they looked at range of motion changes in professional pitchers after an outing, the findings of the study that I always keep coming back to have more to do with the absolute range of motion numbers in the data set (moreso than the changes). Take a look:
Looking at the mean shoulder total motion pre-throwing, MLB pitchers averaged about 191 degrees. However, when you look at the standard deviation of 14.6 degrees, you'll see that there were guys down around 175 degrees (very hypomobile or "tight"), and others up around 206 degrees (very hypermobile or "loose").
Speaking very generally, the tight guys need more WD-40 (range of motion work), and the loose guys need more duct tape (stability training). Now, here's what you make your mark as a coach: identify the exceptions to this rule.
For example, when you have an otherwise "tight" guy who comes back from a long season in with a significant range of motion increase at a joint, it could mean that he's developed instability (e.g., blown out a ligament). Or, maybe you see an otherwise "loose" guy who has lost a considerable amount of range of motion, it could mean that he's really hanging out in a bad pattern, developing musculotendinous shortness/stiffness that "overpowers" his ligamentous laxity. Or, he might be really out of alignment, or have developed a bony block.
Identifying outliers - exceptions to the rules - is a crucial part of evaluation success and subsequent programming. As I've often said, don't just focus on average.
Speaking of lessons to be learned in managing overhead throwing athletes, education and individualization are key components of how we roll out our Summer Collegiate Elite Baseball Development Program. You can learn more HERE.
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Here's another Sturdy Shoulder Solutions sale inspired post. The Modified Pigeon with 1-arm Child's Pose is another new drill we've busted out in our warm-ups to get a little more bang for our buck. It's particularly useful for pitchers, who need to get into their lead hip (adduction) while getting lat length, scapular upward rotation, and apical expansion on the throwing shoulder.
A few big coaching points:
1. You should feel a stretch in the outside of the front hip, but nothing in the knee (particularly the inner part). If you're feeling it in your knee, you've probably set up incorrectly.
2. Think of a stretch along the entire outside of the torso and arm: quadratus lumborum, lats, and long head of triceps, especially. If you pinch at the front/top of the shoulder, ease off it a bit.
3. Breath in through the nose and exhale fully through the mouth as if you're blowing out birthday candles (and hold for a count of three before inhaling again). You should feel your abs turn on as the shoulder stretch increases. Do five breaths.
You can learn more about how I assess, program, and coach at the shoulder girdle - and save $50 through Sunday at midnight - at www.SturdyShoulders.com.
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With this week's $50 off sale on Sturdy Shoulder Solutions, (using coupon code podcast5), let's cover a question I got a while back. A reader asked whether it was ever useful to train shoulder internal rotation. With the lats and pecs (both internal rotators) always getting blasted in a typical strength training program, is any specific work for internal rotation ever recommended? My response warranted a three-part video, which I've compiled into one here:
To learn more about how I assess, program, and coach at the shoulder girdle, check out Sturdy Shoulder Solutions. It's on sale for $50 off through Sunday at midnight. Just use coupon code podcast50 at checkout.
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