This weekend I had the opportunity to attend a seminar put on by Eric Cressey, baseball strength coach extraordinaire. If you are involved in baseball and haven’t heard of Eric, what rock are you living under??
Eric and his staff at Cressey Sports Performance provide the offseason training programs to multiple pros such as Corey Kluber and Noah Syndergaard(as of this offseason). Baseball players seek out Eric and his staff to fix them and hopefully extend their careers.
So when Eric offers a shoulder seminar in your area, you better go. Eric is a smart guy and had my mind spinning so I felt like I need to put my thoughts down on “paper” to help analyze all that I learned this weekend.
Here are a few takeaways from my day with Eric Cressey
1. Imaging tells us the damage, but not the cause
People are so quick to request an MRI when they are injured, but that only tells us one part of the story. The problem with only relying on imaging for dealing with an injury?? It does not give you the root cause.
The root of most injuries does not begin at the site of pain, but because of some imbalance or weakness elsewhere. The initial assessment, whether done by a therapist or a strength coach, should give a road map to what is needed.
2. Inefficiency and pathology may be the same thing
“Pathology” is described as any deviation from a healthy, normal or efficient condition. So could inefficient movement be considered a pathology?
I would say yes. Often the pain, which is usually considered the pathology in most medical fields, is really just a symptom of an inefficiency elsewhere.
3. Sports specificity =low amplitude of movement variability
Eric introduced to me the “Law Of Repetitive Motion” or
I=Insult/injury of tissue
N=# of repetitions
F=force or tension of each rep as a percent of maximum strength
A= Amplitude of each repetition
R=Relaxation time between reps
With the “Law of Repetitive Motion” now in the back of your head, put it in the context of sports specialization and specially the amplitude of each rep. A specialized athlete will have a decreased amplitude of movement as they do the same movement patterns over and over.
Whereas the multisport athlete has a much broader amplitude of movement within their life. In layman terms, the body does not see the exact same movement patters over and over and the same tissues are not stress over and over again.
The broad range of movement patterns decreases the likelihood of injury or insult.
4. Being weak sucks
These exact words came from Eric’s mouth. But let’s look at it in relation to the
“Law of Repetitive Motion”. The F or the percentage of maximum strength used per is decreased within each rep of sport as your max strength increases.
By getting stronger, you increase your ability to produce force and making submaximal activities less intense on the system. The lower intensity, the less relative stress that is applied on the bodies tissues.
5. Anterior capsule laxity can be “reversed”
I am not the first to say it, but baseball players should take take off from throwing after each season. Dr. James Andrews has said that young athletes should take at least 2 month and optimally 3-4 months off from throwing
Sadly, many youth and high school baseball players do not heed this advice. They throw and throw and throw in search of a stronger arm, but this may lead to injury down the road.
The rest that Dr. Andrews recommends works in two ways. First, it allows the muscles to recover and allows the athlete to focus on getting stronger. It also allows the body to “reverse” the increase in anterior shoulder capsule laxity that many baseball players pickup throughout the season.
Anterior shoulder laxity is a common characteristic of most baseball players and is in fact advantageous to a point. It allows the thrower to create a “lay-back” but too much of a good thing can turn disastrous. An athlete who keeps throwing and throwing could lead in too much anterior laxity, leading to injuries such as labral tears or biceps tendinitis.
The extended rest periods allows the body to “tighten” up the anterior shoulder, returning closer to it’s original strength.
6. Down and Back??
“Shoulder blades down and back.”
I have used this cue, and it has it’s place but are we using it wrong? Eric seems to thing it is overused and use cue terribly.
I have told many an client or patient to think “down and back” when doing shoulder exercises or when rowing. And for many people, especially some athletes, this may be driving them further into their dysfunction.
This is primarily because we over exaggerate this cue. If you are planning to use this cue, the movement is subtle and it shouldn’t have you with your chest poked out like Superman. Think about a subtle posterior tilt and retraction of the scapula on the rib cage.
7. Flexion to neutral is different than flexion from neutral
The athletic and general population are going to present differently when it comes to resting posture. The general population is typically going to present with rounded shoulders and typically a much more rounded spine posture as well.
The opposite is true for athletes. Many of them live in a gross extension pattern.
Due to these differences, training of posture will be completely different. Training is often counteracting much of what we do daily to return back to neutral.
This is why flexion based exercises should be considered for the athletic population. Athlete need to learn how to control anterior pelvic tilt, limit rib flare, and learn out to “reach” with the shoulder girdle complex.
As Eric said in his presentation, flexion to neutral is different than flexion from neutral.
8. Everybody needs something different
Cookie cutter corrective exercise and training programs are a thing of the past. Individual differences require different approaches. One exercise or approach is not going to work the same from person to person.
Evaluate your clients or patients and tailor their program to their needs. An individualized program is always going to be more effective than just handing them a sheet of exercises and trying the shotgun approach.