My Favorite Articles of the Year

Over the years, I have always published an article at the end of each year that highlights some of the best articles of the year from my website.  I always enjoy looking back at the site analytics to find what my readers thought were my best articles.

However, sometimes I don’t agree, haha!

Sometimes some of the articles that I enjoyed writing the most weren’t the most “popular” when it comes to site visits.  Plus, I now have more websites that you may find my content, like EliteBaseballPerformance.com.

So this year, I thought I would write up a list of my “favorite” articles of the year, instead of the most “popular.”  I bet after reading them, you’ll agree!

Thanks so much to all of you for another awesome year.  For those that like sneak peeks…  We have some BIG stuff in store for 2018:

Online Training

We have just launched our new online training platform with our first flagship program, Champion Strong.  This is based on our most popular programs we use at Champion.  It’s an awesome online program for those looking for an amazing workout program that progresses each month.  You can take it to the gym with our phone app that allows you to view, schedule and log your workout for the day to track your progress.  Plus, there are great exercise demos and educational content.  If you’ve ever wanted to work with us at Champion, this is the program for you!

Our Performance Therapy and Training System

We’ve been alluding to this for a few months but we’ve been working hard to bring together everything I have learned in the last 20 years into a complete system of performance therapy and training.  We’re getting close, but it’s going to be EPIC.

Stay tuned…

My Favorite Articles of the Year

Research Updates on K-Tape, Self Myofascial Release, and Topical Analgesics

This was my favorite podcast of the year.  Lenny and I got together with Phil Page at our annual ICCUS Society meeting and asked Phil to summarize some of the latest research on K-Tape, SMR, and Topical Analgesics.  This was a fun one.  Phil is the best.

 

Should We Delay Range of Motion After a Total Shoulder Replacement?

I recently updated my online program teaching you how I evaluate and treat the shoulder over at ShoulderSeminar.com and added a new lesson on Rehabilitation of the Arthritic Shoulder.  I wrote this article to share some of the research about ROM after a total shoulder replacement.  I think there are still some misconceptions out there.

 

3 Popular Exercises I Am No Longer Using

Sometimes what is popular on the internet and social media is not best.  In this article, I show a few videos of 3 common exercises that I have stopped using, as I just think they aren’t the best.

 

Velocity Down After Weighted Balls and What Pitchers Should Do After Games

This was another fun episode of the podcast where I team up with Will Carroll, Dan Blewett, Kevin Vance, and Dave Fischer to talk about some of the things we learned at the big Sabermetrics meeting in Boston and how they are using it with their high school and college pitchers.

 

Working with the Hypermobile Athlete

This was my favorite Inner Circle presentation of the year.  I sat down with Dave Tilley and talked about some of the things to consider when working with hypermobile athletes.  This is essentially a lot of what Dave and I do each day, so there is a ton of nuggets of info in here for everyone to learn.

 

5 Ways to Get More Out of Self Myofascial Release
Self myofascial release is super popular but often performed poorly.  Follow these 5 tips and you’ll get even more out of performing them in your programs.  I have a bunch of great videos in the post for you to watch.

 

Are Weighted Baseball Velocity Programs Safe and Effective?

This was a review of our 2-year research project that we conducted at Champion in conjunction with Dr. Andrews and Fleisig of ASMI.  I published this on Elite Baseball Performance while the manuscript is in the press as I wanted the information to get out to the public and it takes months for a proper peer review and publication process.  Unfortunately, based on the reaction observed on Twitter, I’m not sure people wanted to hear the results…

 

6 Hip Mobility Drills Everyone Should Perform

In this article, I have 6 more videos going over my favorite hip mobility drills.  This is the cornerstone of most of my hip mobility programs.  I’m not a fan of torquing the joint or working into (or pushing through) end range of motion, which is, unfortunately, becoming more popular lately.  I much prefer these drills.

 

4 Ways to Modify the Squat So Everyone Can Perform

Another great Inner Circle presentation where we look at how different people may present and how that could impact their squat form and mechanics.  This is a very important concept to apply to your clients.

 

What is the Best Graft Choice for ACL Reconstruction?

Lenny Macrina wrote a great guest post discussing some of the options for ACL reconstruction.  We get questions like this a lot on the podcast, so thought an article was long overdue.

 

The True Hip Flexor Stretch

The hip flexor stretch has become a very popular stretch in the fitness and sports performance world, and rightly so considering how many people live their lives in anterior pelvic tilt.  However, this seems to be one of those stretches that I see a lot of people either performing incorrectly or too aggressively.  I talked about this in a recent Inner Circle webinar on 5 common stretches we probably shouldn’t be using, but I wanted to expand on the hip flexor stretch as I feel this is pretty important.

I’ve started teaching what I call the “true hip flexor stretch.”

I call it the true hip flexor stretch as I want you to truly work on stretching the hip flexor and not just torque your body into hip and lumbar extension.  It’s very easy for the body to take the path of least resistance when stretching.  People with tight hip flexors and poor hip extension often just end up compensating and either hyperextend their low back or stress the anterior capsule of the hip joint.

I explain this in more detail in this video:

 

The good thing is, there is a simple and very effective.  Once you adjust and perform the true hip flexor stretch, most people say they never felt a stretch like that before, hence the name “true hip flexor stretch.”

 

True Hip Flexor Stretch

To perform the true hip flexor stretch, you want to de-emphasize hip extension and focus more on posterior pelvic tilt.  Watch this video for a more detailed explanation:

 

Key Points

  • There is a difference between a quadriceps stretch and a hip flexor stretch.  When your rationale for performing the stretch is to work on stretching your hip flexor, focus on the psoas and not the rectus femoris.
  • Keep it a one joint stretch.  Many people want to jump right to performing a hip flexor stretch while flexing the knee.  This incorporates the rectus and the psoas, but I find far too many people can not appropriately perform this stretch.  They will compensate, usually by stretching their anterior capsule too much or hyperextending their lumbar spine.
  • Stay tall.  Resist the urge to lean into the stretch and really extend your hip.  Most people are too tight for this, trust me.  You’ll end up stretch out the anterior hip joint and abdominals more than the hip flexor.
  • Make sure you incorporate a posterior pelvic tilt.  Contract your abdominals and your glutes to perform a posterior pelvic tilt.  This will give your the “true” stretch we are looking for when choosing this stretch.  Many people wont even need to lean in a little, they’ll feel it immediately in the front of their hip.
  • If you don’t feel it, squeeze your glutes harder.  Many people have a hard time turing on their glutes while performing this stretch, but it is key.
  • If you still don’t feel it, lean in just a touch.  If you are sure your glutes and abs are squeezed and you are in posterior pelvic tilt and still don’t feel it much, lean in just a few inches.  Our first progression of this is simple to lean forward in 1-3 inches, but keep your pelvis in posterior tilt.
  • Guide your hips with your hands.  I usually start this stretch with your hands on your hips so I can teach you to feel posterior pelvic tilt.  Place your fingers in the front and thumbs in the back and cue them to posterior tilt and make their thumbs move down.
  • Progress to add core engagement.  Once they can master the posterior pelvic tilt, I usually progress to assist by curing core engagement.  You can do this by pacing both hands together on top of your front knee and push straight down, or by holding a massage stick or dowel in front of you and pushing down into the ground.  Key here is to have arms straight and to push down with you core, not your triceps.

 

 

I use this for people that really present in an anterior pelvic tilt, or with people that appear to have too loose of an anterior hip capsule.  In fact, this has completely replaced the common variations of hip flexor stretches in all of our programs at Champion.  This works great for people with low back pain, hip pain, and postural and biomechanical issues related to too much of an anterior pelvic tilt.

Give the true hip flexor stretch a try and let me know what you think.

 

 

How to Perform Lower Body Plyometrics

The latest Inner Circle webinar recording on How to Perform Lower Body Plyometrics is now available.

How to Perform Lower Body Plyometrics

This month’s Inner Circle webinar is on How to Perform Lower Body Plyometrics.  In this presentation, I demonstrate the different types of plyometric exercises you can perform for the lower body and show some of my favorite progressions.

This webinar will cover:

  • The different types of plyometric exercises you can perform for the lower body
  • How I progress from two leg to one leg drills
  • How I progress different planes of motions
  • The keys to choosing the best exercise for your goal

To access this webinar:

 

Should We Delay Range of Motion After a Rotator Cuff Repair Surgery?

Over the last several years, there has been a trend among orthopedic surgeons to delay the start of rehabilitation, specifically range of motion exercises, following rotator cuff repair surgery.

It’s my opinion that this trend started in response to the research that has been reported in the past that show issues with tendon healing rates and a large percentage of rotator cuff repairs are not intact at follow up examination.

For example, I previously discussed the outcomes of arthroscopic rotator repairs and noted that at the one year follow up after surgery, 68% had an intact rotator cuff. 32% had a full thickness tear again.

So physicians did what they tend to do… They started to get more conservative and delayed the start of rehabilitation. I’ve discussed a similar to approach to rehabilitation following total shoulder replacement.

But does delaying the start of range of motion after rotator cuff repair surgery even help improve outcomes?

Does immobilization after rotator cuff repair increase tendon healing?

A systematic review was published in the Archives of Orthopaedic and Trauma Surgery that looked at 3 randomized control trials comparing immediate versus delayed range of motion follow rotator cuff repair surgery.

The authors reported a few findings.

Most importantly, there was no difference in tendon healing rate, showing that early range of motion is safe to perform and not the reason why people may retear.

Range of motion improved earlier in the immediate range of motion group, but was similar at the year mark. This is consistent with many past studies. Again physicians read into this and use this stat to favor delayed range of motion, stating that patients are all the same at 1 year postoperative. However, as we all know, restoring motion is key to the patient’s’ subjective and functional outcomes. Similarly, functional outcomes were achieved sooner in the immediate range of motion group.

Based on this systematic review, I would continue to recommend performing control range of motion following rotator cuff repair surgery as it appears to be safe and effective at restoring motion and function sooner than if we delay rehabilitation.

Learn More About How I Evaluate and Treat the Shoulder

I’m pretty excited to announce I have revised my acclaimed online program teaching you exactly how I evaluate and treat the shoulder to now include a lesson on the arthritic shoulder! If you want to learn more about how I work with rotator cuff repairs, and everything else related to the shoulder, you’re going to want to take my online course.

 

Should We Delay Range of Motion After a Total Shoulder Replacement?

Total shoulder replacement surgery is being performed more and more each year.  Our current patients were more active in sports in their youth, potentially increasing the chances of developing an arthritic shoulder.  They also want to remain active as they age, potentially increasing the likelihood that they want to have a total shoulder arthroplasty surgery to allow them to remain active.

Over the years, the surgical technique for a total shoulder replacement has improved, though I’m not sure our rehabilitation approach has also improved.  If our patients are younger and want to be more active after total shoulder replacement, then perhaps our rehabilitation programs should adjust based on their goals.

Rehabilitation Following Total Shoulder Replacement

Historically, a conservative approach was appropriate for many patients, as their needs and activity goals were less aggressive than many patients today.  It was acceptable to have a moderate loss of range of motion in exchange for less pain in their shoulder.

Many surgeons continue to recommend a conservative approach to the restoration of range of motion following surgery.

It is true that one of the primary goals of the postoperative rehabilitation following total shoulder replacement is to protect the subscapularis.  The subscapularis muscle is taken down to some extent during the surgical procedure and the integrity of this muscle has been correlated to the overall outcome of the procedure.

Other motions, such as behind the back and shoulder extension behind their body, also place the arthroplasty in a disadvantageous position and can lead to dislocation of the joint.

But even with these precautions, I am still an advocate of early range of motion, especially if you respect these restrictions.

Passive ROM and Active ROM are Not the Same

A recent report was recently published in Journal of Shoulder and Elbow Surgery that may actually be causing some confusion on when to start range of motion.

In the study, the authors compared a group of patients that began range of motion immediately versus a group that delayed 4 weeks.  The authors reported that the immediate range of motion group gained more motion, restored it earlier, and also showed an earlier increase in functional outcome scores.

However, 96% of the patients that delayed range of motion showed healing of the lesser tuberosity osteotomy, while only 82% of the immediate range of motion group showed healing.  Furthermore, functional outcomes scores 3 months and 1 year after surgery were similar between the groups.

This has led to many recommending a delay in range of motion.  But…

When looking deeper at the methods, the authors chose to use the rope and pulley and stick elevation range of motion exercises.  As we all know, these are not passive range of motion exercises, they are active assisted range of motion exercises.

There’s a big difference between passive and active range of motion exercises!

Previous EMG studies have shown the rotator cuff to be between 18-25% active and the deltoid to be between 21-43% active during these exercises.  Not very passive.  Conversely, passive range of motion exercises have been shown to be between 3-10% active.

This is a big difference.  I believe passive range of motion is appropriate, as long as you respect the restrictions on restoring external rotation to protect the subscapularis and avoid behind the body and behind the back motions to protect the replacement.
Immediate Range of Motion Restores Function Faster

Since we all work with these patients after surgery, we know that they are always happier when they restore their motion sooner.  And this increase in range of motion is likely related to the earlier improvement in functional outcome scores.

I think there is a middle ground of immediate, yet cautious, passive range of motion.  Again, I want to reiterate, “passive” range of motion.  Not active.

By focusing on this, I believe our patients will have much better outcomes.

Learn More About How I Evaluate and Treat the Shoulder

I’m pretty excited to announce I have revised my acclaimed online program teaching you exactly how I evaluate and treat the shoulder to now include a lesson on the arthritic shoulder!  If you want to learn more about how I work with the arthritic shoulder, patients following total and reverse shoulder replacements, and everything else related to the shoulder, you’re going to want to take my online course.

 

3 Popular Exercises I Am No Longer Using

It’s almost 10 years since I wrote one of my most popular articles on this website, My Top 5 LEAST Favorite Exercises.

I still dislike all of those exercises, and today I wanted to share 3 more exercises that I am not going to use anymore. These are pretty popular exercises, so I expect many to disagree with me. I actually have no problem with you using these exercise, I just wanted to share some reasons why I have started to critically assess the value of them, and have considered not performing them anymore

 

Side Planks

Woah, I’m starting by throwing out a haymaker! Side planks?!? But everyone needs side planks!

Side planks are actually a great exercise for the core, and fairly common staple in people’s core programs. But over the years I have found that many people have complained about the impact the side plank position has on their shoulders.

So I would modify their programs. And then it would happen with someone else. And someone else.

I think the position has the shoulder abducted slightly below 90 degrees of abduction and then puts full body weight through the joint in a super orientated force vector:

So I’ve added side planks as an exercise I’m not going to be using much in the future. There are variations that may work that place less strain on the shoulder, like the feet-off-the-bench variation, but other functional activities like weighted carries can likely provide a similar treatment or training effect, while not irritating the shoulder.

Now, realize I am biased. I work with a lot of people with shoulder pain and hypermobility. So perhaps my population tend to not handle them as well. But if my population doesn’t, maybe your population won’t either.

 

TRX Y’s

Next up is the TRX Y. I love the TRX, and the TRX Rip Trainer, two great devices. But I’ve always felt uncomfortable when performing a shoulder Y exercise using the TRX.

The shoulder Y is designed to incorporate upward rotation of the scapula, protraction, and posterior tilt of the scapula. It’s a great exercise for the lower trapezius.

However, when performed on the TRX, the Y exercises is drastically different, involving more scapular retraction and upward shrugging. Plus, the Y exercise is much more subtle, using your body weight, even at an angle, simply overloads the exercise and causes compensation. I think this promotes poor habits.

Just because two exercises may look the same, like the TRX Y and the Prone Y, doesn’t mean they have the same effect on the body.

 

Hip Flexor Stretch

My 3rd exercise is the wall hip flexor stretch. I’ve been pretty vocal on the fact that many people do this stretch poorly, hyperextending their back and placing more stress on their anterior hip capsule than on their hip flexors.

I popularized the use of the True Hip Flexor Stretch to help people shift focus on the right structures.

But even I sometimes felt that some people were Ok to do the standard wall stretch if they were “loose enough.”

You know what, I think those loose people actually just compensated more, like in the below video. So if we are really working on the flexibility of the hip flexors or on anterior pelvic tilt, I think we should all probably be sticking to a variation of the true hip flexor stretch and maybe just leaning forward more, than going back to the wall.

 

I really want to hear what you think, hit the comments below and let me know if you agree, disagree, or have more to add to this list! I don’t hate these exercises for everyone, but for now, these are a few I’m going to use less frequently.

 

 

Working with the Hypermobile Athlete

The latest Inner Circle webinar recording on Working with the Hypermobile Athlete is now available.

Working with the Hypermobile Athlete

This month’s Inner Circle webinar is on Working with the Hypermobile Athlete. In this presentation, I’m joined with my colleague at Champion, Dave Tilley, to discuss our approach to working with hypermobile athletes.  Dave works with a lot of gymnasts, so has a great perspective on the topic.

This webinar will cover:

  • How do you assess for hypermobility, rather than just flexibility or soft tissue mobility
  • How does rehabilitation differ for the hypermobile athletes
  • The role of fatigue and capacity in working with hypermobility athletics
  • How we manage the fine line between hypermobility and instability

 

To access this webinar:

5 Ways to Get More Out of Self Myofascial Release

With the popularity of self myofascial release skyrocketing over the last decade, we’re seeing people rolling all over the place.  And for good reason…

Foam rolling helps you feel and move better.

Foam rollers are great, and I have talked about other self myofascial release tools that I highly recommend you try.  But it’s not always just about WHAT you are using to roll out, it’s also about HOW you are performing self myofascial release that is important.

If you combine some of our basic understanding of functional anatomy with our understanding of movement, we can really enhance how you perform self myofascial release to get even better results.

5 Ways to Get More Out of Self Myofascial release

To illustrate this concept, I wanted to share 5 videos demonstrating how you can enhance how you perform self myofascial release.

Reduce the Surface Area

My first video discusses the concept of reducing the surface area while rolling.  Again, foam rollers are great.  But depending on the tissue you are focusing on when rolling, you may want to reduce the surface area.

When you get used to foam rolling and are looking for a deeper sensation, putting the same amount of body weight on a smaller surface area will obviously increase the applied pressure.

This is also helpful when you are foam rolling an area that is hard to place full body weight on the roller, like the calf, as you will be able to apply more pressure.

 

Roll in 360 Degrees

In the next video, I discuss the ability to use a mobility sphere to be apply to easily alter the direction of rolling, instead of just back and forth using a foam roller.  This is one of my favorite progressions.

 

Hold a Spot

Often times when rolling, you’ll find one spot that is really tender.

Once you find a tender spot, combine our treatment technique of sustained pressure on the area.  Stop rolling and hold pressure on that spot for 10-30 seconds.  The goal is not to crush the spot, but rather to gentle hold and increase pressure as the tenderness subsides.

You’ll be surprise how the spot will decrease in tenderness after holding the spot.

 

Add Active Motion

The next variation is also a simulation of our treatment techniques, this time a pin and stretch.  Again, when you find a tender spot, hold it for a duration, then add some active motion of that muscle group.

Focus on slowly moving the muscle through full range of motion while sustain pressure.

Move Another Muscle

On a similar note, you can also pin one muscle and stretch an adjacent muscle.  The example I use in the video below is the hamstring and adductor group.  You can pin the adductor and slowly flex and extend the knee to move the hamstring.

 

These examples are just 5 of the many ways we enhance self myofascial release with our patients and clients at Champion.  I’d love to hear what you do as well.  By combining some of our treatment concepts, we think you can really get a lot more out of your self myofascial release.

If you like this type of content, be sure to follow me on Instagram and Facebook, I’ve been sharing a lot of videos like this: