Baseball specific training program

I often have parents of young baseball players in Las Vegas ask me about training their child in a “baseball specific” program and working on the shoulder or rotator cuff.

A “baseball specific” program…mmm….really.

Ok you want your son to:

1. Run fast? (That’s important in every sport!!)
2. Have superior hand eye coordination for catching? (Again all sports)
3. Have a strong core and rotational strength for hitting? (EVERY sport)
4. Be able to decelerate and change direction on a dime! (mmmm…..do I really have to say it?)
5. Ok….last but not least, “strengthen the shoulder/rotator cuff” (A strong AND stable shoulder is important for everyone, not just athletes!!!)

Ok so you think that’s a “baseball specific workout” if he just works on the rotator cuff?

So some may ask, why should the baseball player be working on the rotator cuff? Is it because baseball is an overhead sport, like a swimmer, tennis player or a QB in football, and more demand is placed on the rotator cuff (and the entire shoulder joint for that matter)?

Well the answer is yes!! But would that make it a tennis or swimming program also?

Why not just make it a “build a healthy superior athlete” program?

What a player or parent must relies is that there is more to a strength and conditioning program for baseball players that just a healthy shoulder or rotator cuff!
OK…now on to the boring science stuff!

The two main bones of the shoulder are the Humerus and the Scapula.

Let’s talk about the scapula and consider why the scapula is important? Normal shoulder motion involves a coordinated rhythm between movement of the shoulder blade on the chest wall and movement of the ball in the shoulder socket. This is called the “scapulohumeral rhythm.” Because the shoulder socket is part of the scapula, many conditions involving the shoulder joint cause secondary problems related to scapular motion and position. These secondary problems can, in turn, worsen the primary condition.

Next let’s take a look at the scapulothoracic joint, it is one of the least congruent joints in the body. No actual bony articulation exists between the scapula and the thorax, which allows tremendous mobility in many directions, including protraction, retraction, elevation, depression, and rotation. The lack of bony attachment predisposes this joint to pathologic movement, and, consequently, makes the glenohumeral joint highly dependent on the surrounding musculature for stability and normal motion.

The scapula is attached to the thorax by ligamentous attachments at the acromioclavicular joint and through a suction mechanism provided by the muscular attachments of the serratus anterior and subscapularis. This suction mechanism holds the scapula in close proximity to the thorax and allows it to glide during movements of the joint. While many muscles serve to stabilize the scapula, the main stabilizers are the levator scapulae, rhomboids major and minor, serratus anterior, and trapezii.

The glenohumeral “protectors” include the muscles of the rotator cuff: the supraspinatus, infraspinatus, teres minor, and subscapularis.

These muscle groups function through synergistic cocontraction to anchor the scapula and guide movement. The scapula moves through a gliding mechanism in which the concave anterior surface of the scapula moves on the convex posterolateral surface of the thoracic cage. These muscles work together to coordinate the balance of movement between the shoulder joints, thereby maintaining scapulohumeral rhythm. When the muscles are weak or fatigued, scapulohumeral rhythm is compromised, and shoulder dysfunction results. This dysfunction can cause microtrauma in the shoulder muscles, capsule, and ligamentous tissue and lead to impingement. During all movements of the glenohumeral joint (especially movements involving more than 90° of flexion or abduction), it is of paramount importance that the scapular-stabilizing musculature be strong enough to properly position the scapula.

So is it really just about the rotator cuff when training a baseball player? Think about it, this is just a little piece of the puzzle. What about the rest of the body?

Brian Van Hook MS CSCS
Van Hook Sports Performance Training Las Vegas, Nevada

Lifting heavy weight will make you big and bulky!

OK, there is only a handful of things in this world that really aggravate me and the statement of “Lifting heavy weight will make you big and bulky” is one of them.

I often have female clients (and some uninformed personal trainers for that matter) tell me that lifting heavy weight will make you big and bulky.

This is called steroids!

Ok, first off you need to remember the following points when working with female clients (or any clients for that matter), that want to “tone up”:

1. Learn why the terms “toning, shaping, and sculpting” need to be banned from your vocabulary.

2. The treadmill is probably the last thing you need to be doing. While it is a tool, it’s not a necessity for fat loss.

3. No, you won’t become “big and bulky” just because you’re lifting weights.

Seriously, let's get down to the truth. No one should ever worry about getting too big. The reality is that the hardest thing to do as a personal trainer or strength and conditioning coach is to get someone to gain muscle mass. Strength is easy, muscle mass is much more difficult. If we acknowledge that the fear of "getting too big" is ridiculous, it is much easier to move on to the real process of training.

Legendary strength and conditioning coach Mike Boyle once said “getting too big should be put to rest with other foolish statements. For example, imagine a client telling you:

"I'm not going to concentrate on nutrition. I'm concerned I'll get too lean."

"I'm not going to exercise regularly, I'm afraid that I'll develop too much consistency."

"I'm not going to do any cardiovascular work; I don't really want to live past 50 anyway."

All of these statements are as foolish and inane as "I don't want to lift heavy weights, I don't want to get too big".

Seriously, stop and think about it. For many women, it’s not uncommon to carry around a purse that weighs more than a tank on a daily basis. Likewise, they carry groceries, move furniture around, carry their children, or any number of daily “life” stuff that requires them to lift heavy things. However, when asked to lift a barbell, and label it “exercise,” they immediately protest that it will turn into some she-man or something. It’s crazy.

Don’t believe me? Ok let’s look at some research:

1. In a 2002 study, for example, scientists looked at what happened when women performed various resistance exercises at different weights and repetitions (85 percent of their maximum ability for 8 reps, versus 45 percent for 15). Subjects lifting more weight fewer times burned more energy and had a greater metabolic boost after exercise.

2. In another study published in July 2010, scientists followed 122 women for six years. They found that those who were assigned to do resistance exercises three times a week — sets of 8 reps at 70 to 80 percent of their ability — lost the most weight and body fat.

3. In 2007 a similar two-year study of women who did strength training with challenging weight twice weekly found similar effects on body and “intra-abdominal” fat

Seriously, I could go on forever! Do yourself a favor and do a little research on your own!

Soooo many times I have gotten the statement from female clients that they are looking to lose that extra 10-20 lbs of fat they gained in the past and that they want to “tone up” and they are very adamant that high reps is where it’s at because that’s what their last trainer did.

For the last few days I have been training a women that has finally broken down and started to listen to what I have to say. I can only hope she sticks with it! Now she is in good shape, but she wants to “tone up” more and get a little “leaner”, in the past she has spent 2 to 2 1/2 hours on the treadmill or elliptical machine every day while lifting the little pink dumbbells to work on her strength. OMG, that’s like a 3 hour workout! She is skeptical because of the lack of volume I give her. She want to do everything 25 times.

If you would like to learn more I urge you to read a great book called “The New Rules of Lifting for Women” you can get in on Amazon for less than 20.00! The book goes into much more detail on the subject than I can post on the blog.


A few more key point to take home: From a article by Tim Kontos, David Adamson, and Sarah Walls from elitefts.com

1. For women, toning is what happens when the muscle is developed through training. This is essentially bodybuilding without testosterone. Since the testosterone is not present in sufficient amounts, the muscle will develop, but it won’t gain a large amount of mass. The “toned” appearance comes from removing the fat that is covering a well-developed muscle.

2. Muscle bulk comes from a high volume of work. The repetition range that most women would prefer to do (8–20 reps) promotes hypertrophy (muscle growth). For example, a bodybuilding program will have three exercises per body part. For the chest, they will do flat bench for three sets of 12, incline for three sets of 12, and decline bench for three sets of 12. This adds up to 108 total repetitions. A program geared towards strength will have one exercise for the chest—flat bench for six sets of three with progressively heavier weight. This equals 18 total repetitions. High volume (108 reps) causes considerable muscle damage, which in turn, results in hypertrophy. The considerably lower volume (18 reps) will build more strength and cause minimal bulking.

3. Heavy weights will promote strength not size. This has been proven time and time again. When lifting weights over 85 percent, the primary stress imposed upon the body is placed on the nervous system, not on the muscles. Therefore, strength will improve by a neurological effect while not increasing the size of the muscles.

4. Bulking up is not an overnight process. Many women think they will start lifting weights, wake up one morning, and say “Holy shit! I’m huge!” This doesn’t happen. The men that you see who have more muscle than the average person have worked hard for years to get that way.

5. What the personal trainer is prescribing is not working. Many female athletes come into a new program and say they want to do body weight step-ups, body weight lunges, and leg extensions because it’s what their personal trainer back home had them do. However, many of these girls need to look in a mirror and have a reality check because their trainer’s so-called magical toning exercises are not working. Trainers will hand out easy workouts and tell people they work because they know that if they make the program too hard the client will complain. And, if the client is complaining, there’s a good chance the trainer might lose that client (a client to trainer equals money).

6. Bulking up is calorie dependant. This means if you eat more than you are burning, you will gain weight. If you eat less than you are burning, you will lose weight. Unfortunately, most female athletes perceive any weight gain as “bulking up” and do not give attention to the fact that they are simply getting fatter. As Todd Hamer, a strength and conditioning coach at George Mason University said, “Squats don’t bulk you up. It’s the ten beers a night that bulk you up.” This cannot be emphasized enough.

7. Most of the so-called experts are only experts on how to sound like they know what they are talking about. The people who “educate” female athletes on training and nutrition have no idea what they’re talking about. Let’s face it—how many people do you know who claim to “know a thing or two about lifting and nutrition?” These so-called experts are the reason you see so many women doing sets of 10 with a weight they could do 20 or 30 times. They are being told by the experts that this is what it takes to “tone” the muscles. Instead, they are only wasting their time doing an exercise with a weight that is making no contribution to the fitness levels or the development of the muscle.


Brian Van Hook MS CSCS
Van Hook Sports Performance Las Vegas

Shoulder exercise rant, “Empty Can” (EC) exercise

One of my D1 baseball players recently came into the training center today after his first workout with the team strength and conditioning coach and told me about an exercise that got me steamed! (Honestly the whole workout he described was seriously lacking, but this really stuck out). The particular shoulder exercise was the “Empty Can” (EC) exercise. Now I should say the empty can has long been a basis in physical therapy circles when it comes to shoulder rehabilitation. Dr Frank Jobe (the Dr. who performed the first Tommy John surgery in 1974), a well known shoulder specialist, was the first to come up with this exercise. Since then it has become widely known as an isolation exercise for the supraspinatus, even though recent research has show otherwise (3,4,5).

Well with the little history lesson over I wanted to get back to my main concern which was the fact that the strength coach was having the baseball players perform the EC exercise with their arm elevation above a 60 degree angle. (All the way overhead for that matter). Now I have to say I am not a fan of the EC but if you’re going to do them, you need to stay below 60 degrees to prevent impingement of the rotator cuff tendon (2) between its insertion on the greater tuberosity of the humerus and the acromion process.

So why don't I like the EC exercise? Well, according to a study by Reinold et al, the EMG activity of the supraspinatus in the empty can (thumbs down) vs. the full can (thumbs up) is the same. The difference lies in the activity of the deltoid. The empty can produces high levels of activity in the middle deltoid when compared to the full can. So why is this problem? The strong pull of the deltoid pulls the head of the humerus superiorly. It overpowers the supraspinatus and rotator cuff muscles that act to depress and stabilize the head of the humerus. It basically creates forced impingement. Mmmm...Not a good thing for an athlete!

Mike Reinold states in his article, “If the deltoid overpowers the supraspinatus, the rotator cuff cannot keep the humeral head centered within the glenoid fossa and superior migration occurs. Superior humeral head migration = impingement. Not good, and that is why it hurts. There are numerous other anatomical and biomechanical reasons to not use the empty can exercise, but if the full can has the same EMG activity I don’t see the controversy.” Yep, thats why I read his stuff!! (BTW, Mike Reinold is the Head Athletic Trainer and Assistant Director of Medical Services of the Boston Red Sox Baseball Club, check him out at http://www.mikereinold.com/)

Ok, back the the science stuff.....the full can (thumbs up) offers the same benefits for the supraspinatus but produces much less surrounding musculature activity in the deltoid. This allows the humerus to stay nice and comfy in the glenoid fossa in a neutral position. By not forcefully internally rotating the humerus, we don’t re-create impingement in the sub-acromial space. Along with internally rotating an abducted arm we can also get scapular protraction, and anterior tilt. The combination decreases the sub-acromial space resulting in the possibility of more impingement.

The problem with this exercise is simple. When you maximally internally rotate your Humerus (shoulder) the sub-acromial space is greatly decreased when compared to a neutral or externally rotated position. So, when you raise your arm towards shoulder height or higher you are most likely going to impinge the Infraspinatus tendon or other tissues.

Now that you know I’m not a fan of the EC exercise, but you chose to do them yourself you should perform them with proper technique. This requires individuals to internally rotate their shoulder as a means of increasing tension and maximizing activation of the supraspinatus. When raising the arm overhead in the scapular plane, the humerus is required to externally rotate at approximately 60 degrees to prevent impingement of the rotator cuff tendon (2) between its insertion on the greater tuberosity of the humerus and the acromion process. Internal rotation of the arm as required during the EC technique provides a means to improve activation of the supraspinatus, however it prevents the necessary external rotation required to raise the arm overhead without impingement.

Individuals who exceed 60 degrees of elevation during the EC may place themselves at risk for shoulder impingement (1,2). This risk may be avoided by strict adherence to proper form, particularly by avoiding arm elevation above the 60 degree angle. Although the EC may be prescribed for an individual with a shoulder disorder, those previously diagnosed with shoulder impingement have a tendency towards worsening their condition when performing movements similar to the EC, therefore the risk of impingement may outweigh the benefit.

Brian Van Hook, MS, CSCS
Van Hook Sports Performance Las Vegas, NV


References

1. Norkin CC and Levangie PK. Joint Structure and Function. A Comprehensive Analysis. Philadelphia: F.A. Davis Company, 1992. pp. 207–238.

2. Brossmann J, Preidler KW, Pedowitz RA, White LM, Trudell D, and Resnick D. Shoulder impingement syndrome: Influence of shoulder position on rotator cuff impingement—an anatomic study. AJR Am J Roentgenol 167: 1511–1515, 1996.

3. Boettcher CE, Ginn KA & Cathers I. Which is the Optimal Exercise to Strengthen Supraspinatus? Medicine & Science in Sports & Exercise 2009; March: p 1979-1983

4. Escamilla RF, Yamashiro K, Paulos L & James R. Andrews JR. Shoulder Muscle Activity and Function in Common Shoulder Rehabilitation Exercises. Sports Med 2009; 39 (8): 663-685

5. Reinold MM, Macrina LC, Wilk KE, Fleisig GS, Dun S, Barrentine SW, Ellerbusch SW, Andrews JR. Electromyographic Analysis of the Supraspinatus & Deltoid Muscles During 3 Common Rehabilitation Exercises. Journal of Athletic Training 2007;42(4):464–469. (Download full research article in PDF format)

6. The Empty Can Exercise: Considerations for Strengthening the Supraspinatus Strength & Conditioning Journal: April 2009 - Volume 31 - Issue 2 - pp 38-40

Shoulder Impingement?

Hey Hook, my shoulder hurts when I raise my arm above my head!

I have gotten this from several athletes that come in to train and are coming off of a season of playing sports (mostly baseball and football) that often complain of this problem. So I thought I would make a quick post on the subject.

Shoulder impingement is one of the leading causes of chronic shoulder pain in athletes and adults who perform constant or repetitive movements involving raising the arm at shoulder height or above. It is not that uncommon; I had shoulder pain in college when playing football, and if I don’t take care of my shoulder, all of the old pains come rushing back even after all these years.

The rotator cuff is a tendon linking four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. These muscles cover the "ball" of the shoulder (head of the humerus). The muscles work together to lift and rotate the shoulder.

The acromion is the front edge of the shoulder blade. It sits over and in front of the humeral head. As the arm is lifted, the acromion rubs, or "impinges" on the structures within the subacromial space, a limited space found between the head of the humerus and the acromion, the curved bony prominence from the top of the shoulder blade. The structures most commonly involved in shoulder impingement are the supraspinatus tendon of the rotator cuff, subacromial bursa and the long biceps tendon.

By building stronger shoulders, the signs and symptoms caused by shoulder impingement will be eliminated. To understand how shoulder impingement is caused, it is essential to start with the basic anatomy of the shoulder joint complex.

The Shoulder?

The shoulder has the largest range of motion of any joint in the human body. It is especially designed to allow great degrees of mobility without difficulty and pain. However, because of its ability to move in a wide plane of motions, the shoulder is the least stable joint in the body, making it highly susceptible to injuries during overhead and rotational arm movements. (one of the reasons I am NOT a fan of overhead lifting with any type of overhead athlete like a pitcher, swimmer or QB)

Each shoulder girdle is formed by a clavicle (collarbone) and a scapula (shoulder blade). The clavicle attaches to the breastbone to form the sternoclavicular joint, whereas the head of the humerus attaches to the scapula’s shallow socket called the glenoid fossa to form the glenohumeral joint, the major shoulder joint.

The rotator cuff muscles, consisting of the supraspinatus, infraspinatus, teres minor and subscapularis, fuse together and form a cuff or band surrounding the top of the humerus to hold it securely in place and to lift rotate the shoulder. Without an intact rotator cuff, the head of the humerus would move excessively off the center of the glenoid fossa, possibly resulting in impingement.

The subacromial space is frequently involved in shoulder impingement. Located below the acromion process and above the humeral head, the subacromial space contains the tendons of the rotator cuff, the long heads of the biceps and the subacromial bursa.

The bursae function as the gliding forces that reduce friction between tendons and bones. In a relaxed and neutral position, the size of the space is fairly wide; however, on arm elevation and inward rotation, the space narrows, consequently pinching on the structures within the subcromial space. To protect the structures from the squeezing effect, the subacromial bursa reduces the pressure.

If the impingement becomes too repetitive or too forceful, the involved structures are injured, leading to shoulder pain, weakness and reduced range of motion.


If you’re having problems I would suggest you speak with your sport coach or contact your doctor to refer you to a qualified specialist to address this problem.

Brian Van Hook MS, CSCS

Strength Training in Las Vegas