Post 10: Limitations In Training Overhead Athletes

          So by the time you finish reading the title, you're thinking rotator cuff. Do we really understand what needs to be considered and addressed when dealing with these athletes though? Or what types of limitations there are on their training? Based on things I remember doing while training as a baseball player, not really. Classic strength and conditioning professionals are being dumped in favor of new ones with athletic training backgrounds especially in professional sports. Let's be honest, the number one priority of strength coaching is keeping players on the field. It makes no difference if all your baseball players can bench over 250 if they all have debilitating shoulder conditions.

          The rotator cuff is comprised of four muscles on the scapula. Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. They all work together to allow movement while maintaining the integrity of the glenohumeral joint. The Infraspinatus and T. Minor allow for external rotation of the humeral head, the supraspinatus for abduction of the arm, and finally only the subscap for internal rotation.

Anatomy of The Rotator Cuff

          This intricate and delicate musculature is responsible "pound for pound" for some of the most ballistic movement in sport, throwing in baseball and football, as well as serving in tennis and volleyball. Acceleration and deceleration, in other words concentric and eccentric contractions respectively are major components of athletic movement, as was the case in the hitters hips in Post 9: "Prevalence of Oblique Strain in Rotational Athletes." In the previous paragraph, I said "only the subscap for internal rotation" and I said it for a reason. The Infraspinatus and T. Minor are responsible for external rotation of the shoulder and the subscap is the antagonist in this movement.

          To put this in perspective, a recommended pitcher's training ratio for chest to upper back is 1:3. If We need an equal or even a 1:2 ratio of external to internal rotation to make up for the difference in muscular CSA (cross sectional area) we shouldn't be training resisted external rotation in our athletes during times of the year they are not throwing/serving etc. Why? The same reason we shouldn't be training equal amounts of rotation on dominant and non-dominant sides in our hitters, On-Field Volume. Every time an athlete cocks the shoulder into position to throw or serve, they perform ballistic and resisted (racket, ball etc.) external rotation. We are therefore training the subscap in proportion to the infraspinatus and t. minor, the latter two are subject, additionally to the on-field stresses and volume. Our athletes only train internal rotation, to try and offset the imbalances that are prevalent especially in pitchers and infielders. 

          What other things do we need to consider when addressing training for the overhead athlete? Impingement is huge. Impingement is the result of the acromion inflaming the bursa and consequently the supraspinatus tendon, even causing the muscle to fray in bad cases. Strength coaches want to press, they SHOULD want to press, you can gain great foundational strength from pressing. But there are safe ways to do it. Overhead pressing is bad news, that should come as no surprise, and doing so with a pronated grip or using a barbell forces athletes into internal rotation so we should scrap that before we even consider. Swiss bars are great tools for pressing with pitchers using a "palms in" grip, and can be done on flat, decline, and incline benches, and the floor to change things up a bit. Dumbbells also afford us this freedom, to press with the elbows abducted, the same can be said for pulling, this is why we prefer narrow grip chins to pull ups as well. The same can be said for squatting, squats are the bench press of the lower extremities, so we all love to do them. Safety squat bars, front squats, and larger cambered bars also provide opportunity for overhead athletes to get heavy bilateral lower body work done without forcing the shoulders into pronation in the scapular plane.

          The last thing we need to consider is upper back strength. Rotator cuff strength is only beneficial if we have sound scapular stabilization to supplement it. I think I read Mike Boyle as saying that rotator strength with a weak upper back "would be like shooting a cannon out of a canoe," I've heard that statement before, but not in this case. Phenomenal analogy. Scapular stabilization is critical for decreasing typical laxity in the upper back and providing a strong base from which the strength of the rotator becomes useful. You can get away with almost any type of horizontal pull or row, shrugs, or scap shrugs. Like I've said before, be creative, but keep the objective in mind. 

-Alex