6 Mistakes: Fitting Round Pegs into Square Holes

There's one old adage that gets used quite a bit in the world of
strength and conditioning and physical therapy. "If you only have a
hammer, everything looks like a nail." But you know what? It's an
adage because it's true!

A lot of people probably dislike me because I'm not a cut and
dry, black-and-white issue guy. I won't just tell you to "do this"
or "do that." I'm pretty sure that "it depends" is the correct
answer to 90% of the questions I'm asked regarding corrective
exercise and strength and conditioning.

I get irritated when I see people trying to go
"one-size-fits-all" with fitness training. Obviously, this has
implications in terms of performance and physique improvements, but
because I'm such a functional anatomy geek, I need to explain how
trying to jam a round peg in a square hole can lead to
injuries.

game

You've got to make sure the training suits the
trainee.

1) Forcing Deep Squatting on a Flexed Spine
In the training world, not squatting deep is sacrilegious. Many
lifters have been relegated to the deep, dark corners of the
Internet after posting videos of squatting only to parallel, or
worse, above, and being berated by their keyboard warrior
counterparts.

Unfortunately, that depth isn't really safe for everyone.
Flexibility and stability limitations (outlined in my To Squat or
Not To Squat newsletter) can lead to lumbar flexion (rounding) as one approaches
the rock-bottom position. So, as heretical as it might sound, some
people just aren't made for squatting deep.

Here's a perfect example: Omri Geva is a Cressey Performance
athlete who's a member of the USA Skeleton Developmental Team.
Relative to his overall body size, he has a freaky long spine, with
some serious hypermobility.



I doubt there are many lifters out there who can do that in
shoes, let alone barefoot.

Now, here's the thing... his long spine (and its pliability in
flexing) is advantageous for his sport, which involves sprinting in
a position of lumbar flexion. Take a look at him in
action.

This is flexion without axial loading. However, loading
his spine in flexion would quickly chew up his back. Like everyone,
Omri has a certain "cut-off" point at which his spine slips out of
neutral and into flexion.

Watch what happens when we take him from a 14" box height
(appropriate, as it keeps him in neutral) to a 13" box, where he
slips into flexion.



Remember that we want to squat to get better at our chosen
sports, and enhance our quality of life. Is that extra inch of
depth really going to make that big a difference in how you
look? Even if it did, is the extra risk of injury worth
it?

I'm all for deep squatting, but it's important to individualize
squat depth for everyone.

2) Forcing Overhead Pressing on Overhead Throwing Athletes
I recently gave a presentation about training overhead throwing
athletes. In it, I mentioned that I didn't use overhead presses
with any of my baseball guys. When I returned home, I already had
four emails from strength coaches and trainers asking me why not.
They each read something like this:

"Why you don't do any overhead training with your throwing
athletes? Isn't it important to maintain balance in the shoulder
musculature and, by eliminating that plane of movement, are we not
putting our athletes at a greater risk for injury?

If an athlete is structurally and mechanically sound in their
movement, shouldn't they be okay when performing overhead
movements?"

Now, if you think about it, that second question actually
answers the first. I've never seen a pitcher who is "structurally
and mechanically sound" in his movements, and the research has
verified that.

Some key points I've mentioned in other articles:

• Compared to position players, pitchers have less
scapular upward rotation at 60 and 90 degrees of abduction.(1) Upward
rotation is extremely important for safe overhead activity. So, the
more you throw, the more screwy your upward rotation potential
gets.

• 86% of major league pitchers have supraspinatus
partial thickness tears.(2)

• While the labrum provides approximately 50% of
the stability in the glenohumeral joint, all pitchers have some degree
of labral fraying.(3)..

• Considerable research suggests that congenital
shoulder instability is one of the traits that make some pitchers better
than others, as it allows for more external rotation during the
cocking phase to generate velocity.(4)

• Most pitchers lack internal rotation range of
motion (ROM) due to posterior rotator cuff, and possibly capsular,
tightness and morphological changes to bone (retroversion). This
increases the risk of anterior instability.(5)

Retroversion in action,

• Subscapularis strength is incredibly important
to prevent anterior shoulder instability in the above scenario.(5)
Ask any good manual therapist and they'll tell you that almost everyone
you see has some degree of subscapularis shutdown.

Now, with all that said, telling an overhead throwing athlete to
perform an overhead press is like giving him a 1984 Chevy Cavalier
with no brakes, and sending him into the Daytona 500. It's a
disaster waiting to happen.

3) Wearing Spandex Just Because You're "a
Cyclist"
Summer is upon us, and here in New England that means plenty of
folks with big fat rumps have taken to the roads with their bikes
and their horribly inappropriate Spandex shorts.

Oh, so wrong.

If you're a competitive cyclist, triathlete, or
volleyball player, then by all means, rock 'em. Also, if
you're an attractive female and you have the inclination,
regardless of the activity, you can rock 'em.

Oh, so right.

However, if you're using cycling to shed some pounds, you need
to be as non-aerodynamic as possible – for your sake and ours. Having to stare at your supersized posterior chain
when we drive around you is like living under power lines. We know
something's wrong, but we can't put our finger on the extensive
damage it's doing to us until it's too late.

4) Doing Dips on a Shoulder with Acromioclavicular Joint
Problems
Traditionally, the acromioclavicular (AC) joint has been
associated with traumatic shoulder separations, but one issue that
has become more and more prominent over the past 25 years has been
atraumatic osteolysis of the distal clavicle.

Interestingly, this increase parallels the increase in
popularity of resistance training during that same time period. In
1982, Cahill noted that of 46 cases observed in a particular study,
45 of the subjects participated in weight
training.(6)

We know that weight training is incredibly valuable, and that
full ROM is crucial for long-term success. However, if you've got
osteolysis, or are on your way – or if you have a history of
traumatic AC joint problems – pressing exercises that pull
you into full extension can be a problem.

We've seen people who've dealt with the issues, and most of them
have a big history of dips and (obviously) benching in their pasts.
When the problem is at its worst, benching with full ROM is
painful, but dips are absolute murder. I've simply decided to avoid
them for anyone who has ever had AC joint symptoms.

If you've got a bad history, cross dips off your
list.

Interestingly, my experience has been that if you iron out the
other related inefficiencies at the shoulder and just do partial
ROM pressing (board presses, floor presses), in most cases, you'll
be able to return to full ROM benching down the road, once the pain
settles down. I suspect that it has a lot to do with the fact that
the scapulae can be locked in place on a bench, whereas they're
moving with dips.

Of course, some people struggle long-term with these issues and
go the surgical route (distal clavicle resection). It's actually
not too bad a surgery and the recovery is relatively
quick.

5) Running to Get Fit Instead of Getting Fit to
Run
If you're overweight and think that running is a safe (or
effective) way of addressing that problem, you're sorely
mistaken.

I present exhibits A and B, taken at this year's Boston
Marathon. I was out to watch a Cressey Performance client and
friend participate, and once I saw the mayhem taking place, I just
had to bust out my digital camera. These videos were taken at
approximately mile 6. That means these two guys still had another
20.2 miles of running ahead of them.



If you ever see me moving like this, please just put me out of
my misery. And, if you move like this, you might consider
doing the same... or at least implement some corrective
exercise.

I'll be blunt: The overwhelming majority of people move like
absolute crap. When you take a body that moves like crap, and move
it like crap for an extended period of time with very little range
of motion or rest – and add in ground reaction forces
– you make a lot of physical therapists and orthopedic
surgeons wealthy.



6) Using the Clean-Grip for Front Squats

I'm partially skewed by the fact that we work with a ton of
baseball players for whom hand, wrist, and forearm health is really
important, but we really don't teach the clean grip to anyone for
our front squatting.

There are a lot of folks, athletes and weekend warriors, who
lack the wrist flexibility to perform the lift with the proper
clean grip. We want to front squat most of them from day one, so
even if we wanted to work on the flexibility to eventually get to a clean grip, they'd be more comfortable with our other
set-up by that time anyway.

That said, we generally teach our athletes the cross-face
version where the thumbs are at the end of the knurling and there
are fists – not open hands – pushing the bar back
toward the neck. Don't attempt this in jeans unless you're Dave
Draper and can front squat 315 butt-to-heels like it's air.

Of course, if someone comes to us already using the clean-grip,
and they're comfortable, I'm fine with it. Mike Boyle has also
introduced a great option with wrist straps.

Wrap-up

Remember, as much as you might like getting hammered, you don't
have to nail everything. No... wait... I mean just because you have a hammer, that doesn't mean that everything is a
nail.

Each trainee is unique and needs to be treated accordingly. What
works for your buddy or your coach might not work for you. Review
these six steps and see what changes you may need to consider, so
that you can custom-fit your training program to your body
and needs.

References

1. Laudner KG, Stanek JM, Meister K. Differences in scapular
upward rotation between baseball pitchers and position players. Am
J Sports Med. 2007 Dec;35(12):2091-5.

2. Reinold, M. (2008, June 6). Current concepts in treating the
overhead athlete. Second Annual Distinguished Lecture Series in
Sports Medicine in Boston, MA.

3. Andrews, JR, Carson, WG, McLeod, WD. Glenoid labrum tears
related to the long head of the biceps. Am J Sports Med. 1985
Sep-Oct;13(5):337-41.

4. Bigliani, LU, Codd TP, Connor PM, Levine WN, Littlefield MA,
Hershon SJ. Shoulder motion and laxity in the professional baseball
player. Am J Sports Med. 1997 Sep-Oct;25(5):609-13.

5. Borsa PA, Laudner KG, Sauers EL. Mobility and stability
adaptations in the shoulder of the overhead athlete: a theoretical
and evidence-based perspective. Sports Med. 2008;38(1):17-36.
Review.

6. Cahill, BR. Osteolysis of the distal part of the clavicle in
male athletes. J Bone Joint Surg Am. 1982 Sep;64(7):1053-8.

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