Post 9: Prevalence of Oblique Strain in Rotational Sports

          Oblique strains have become a fad injury in the last year or two. More specifically, in rotational sports. This issue first sparked my interest in the ALCS last year when Victor Martinez injured himself hiting a homerun - intercostal strain. We talked a little the following morning about what it is that's causing these guys to blow out internal/external obliques, and in conjunction with a little reading, it's not so confusing anymore.

         Rotation (which only occurs upwards from T8 vertebra) and lateral flexion of the trunk is primarily achieved by engaging the internal/external obliques. So why not train them that way? Well, a few reasons actually. 

1.        It has been common practice for athletes to train rotation with resistance using the obliques on the general pretense that if you can rotate with a 20 pound med ball, imagine how fast you can rotate with a 31oz bat! Because of the crude logistics of this idea, many people have done it for a long time. Now, although this is far from the only contributing factor to oblique injury, consider the following: A serious baseball player spends the better part of his day on the field. He probably takes at least 150 swings a day. A pitcher probably throws just as often towards the ends of his conditioning weeks if you count anything equal and upward of warmup throws. Assuming 150 reps as the on-field volume, add that to the week's resisted rotations in the weightroom. Assume this is 400 reps weekly (50 per side for 4 days.) Unless our hitter is ambidextrous, he's now done 200 reps on his weak side (half the weight room volume,) and 350 reps on his dominant side (including on-field volume.) That's not even considering throws he makes on the field, assuming he's a position player. These left-right differences, or asymmetries are far beyond the ones that occur naturally in the body. Tightening, and subsequent shortening on the non-dominant side for Martinez (a left-handed hitter with a right-side strain) is simply an overuse injury.

2.        Now, it IS true that these muscles are involved in trunk rotation and lateral flexion. However, in the opinion of an AT, PT, or a good S&C coach, the most important function of the abdominal group is spinal stabilization. In light of this, take a look next time at how violent the rotations are in sports like tennis, baseball and hockey. The aggressive rotation of the shoulders and thoracic spine work with aggressive rotation of the hips. These are the ballistic book ends of the core and cervical spine. When these fast torsional forces are applied at either end of the core, as well as the cervical and lumbar spines. This puts the abdominal muscles where they need to RESIST rotation, not ASSIST rotation. Given that this is the case, the old method of training rotation with resistance, should be canned in favor of training against rotational resistance. This trains the core to keep the spine in a neutral and natural position during events involving powerful rotation. What I'm eluding to here is that neutral spine position doesn't allow for core muscles to become unnaturally long or short (providing training volumes are symmetrical, as well as compensation for left or right-handedness.) Consequently, preventing shortening and lengthening injuries (strains) of these rotational core muscles can be achieved by training resistance to rotation. (Sample exercises at the end of this post.)

          Eric Cressey released an article in March last year about oblique strains in baseball. In it, he also talks about training resistance to lumbar hyperextension. Cressey says: "While on the topic, it’s also important to resist lumbar hypextension, as poor anterior core strength can allow the rib cage to flare up (increases the stretch on the most commonly injured area of the obliques: at the attachment to the 11th rib on the non-throwing side) and even interfere with ideal respiratory function (the diaphragm can’t take  on its optimal dome shape, so we overuse accessory breathing muscles like pec minor, sternocleidomastoid, scalenes, etc)." Great Points.

            Cressey also touches on another interesting point in the same article regarding the ability of the hips to produce these torsional forces. He brings attention to the fact that rotational power is concentrically generated by the hip of the trail leg while the lead hip is responsible for eccentrically decelerating the same action. In a nutshell, the antagonistic relationship as it pertains to rotation in this case is identical every time a hitter swings from the same side of the plate. This ties in to today's article because the lead leg can not be expected, as Cressey says, to dissipate all the force generated by the trailing hip. Some of this force is relayed to the core muscles as they function to resist rotation and keep the spine where it wants to be. 

          So, out with the old, in with the new. Dump your rotation with resistance program, and adopt some resistance to rotation. Be creative, but keep the goal in mind. Here are a couple of exercises I like for these purposes. Half Kneeling Pallof Press Half Kneeling Cable Anti-Rotation Press. The second one there looks like rotation WITH resistance, however, pay closer attention. The rotation occurs at the T-SPINE and SHOULDERS, but the core is resisting the rotation that occurs in the shoulders and t-spine, that being said, these exercises still need to be performed on both legs. 

-Alex