It's time to play catch-up with the T-Nation authors. Nate Green
does the asking, and in this case Eric Cressey does the talking.

You may know him as the "mobility guy" or "that dude who hates
Smith machines", but Eric Cressey can't be narrowed down into a
label, unless he's the one who's doing the labeling, that is.

At 26 years old, Eric has effectively carved out his niche at
the top of the fitness industry as the go-to guy for athletes. He
understands them because he is one: a world-record holder in
powerlifting, to be exact. His masters' degree in kinesiology from
UCONN enables him to see what other coaches miss, and his
under-the-bar experience provides insight into what his athletes
can accomplish.

You can't argue with Eric Cressey's under-the-bar
experience.

Simply put, this guy is good. Very good.

So take notes. Lots of 'em.

NG: You've penned over a hundred articles, coached tons of
athletes and have effectively moved up as a well-respected strength
coach. What the heck are you up to now, smart guy?

EC: Well, along with my two business partners Pete Dupuis and
Tony Gentilcore, I opened up my own facility in mid-July. Located
about 30 minutes west of Boston, the facility is roughly 4,800
square feet, including:

• Roughly 3,500 feet devoted to strength training
equipment

• A 35-yard turf straightaway with a crash wall (we also do our
sprinting, sled work, barefoot warm-ups, and movement training
here)

• Two offices

• A hell of a lot of attitude

The facility itself is a subdivision of a 16,000 foot space we
share with America's Pastime, a baseball-specific training facility
that features eight batting cages and three pitching mounds. Yes,
Tony and I can take batting practice 15 feet from our office. It
just screams "productivity," doesn't it?

I work with a ton of baseball guys, so we've basically created a
place where they can hit, throw, sprint, and lift all in the same
trip. Since I arrived in Boston last year, my reputation has grown
very quickly (in the baseball community, in particular), and we're
actually in the process of setting up our second facility, a
"satellite" location at another baseball academy in
Framingham.

You see a lot of guys in the industry who have "fallen" into
particular realms of expertise. Mike Boyle knows hockey better than
anyone; he might be the only guy who can explain why hockey players
smell worse than any other breed of athlete. Bill Hartman could
look at a golfer's shoes and tell you he's got barnacles growing on
his infraspinatus, and explain the goofy pants phenomenon to which
Happy Gilmore alluded.

Goofy pants: yet another reason to take up
golf.

I'm at the point where I could probably list off 75 things that
I completely expect to see in baseball guys (especially pitchers),
from foot callus patterns, to glenohumeral internal rotation
deficit, to cervical rotation deficits arising from dominant-arm
patterns.

Honestly, it's a blast. Effectively, with this "at-risk"
population, I've been able to blend my two biggest passions:
performance enhancement and corrective exercise. As an added bonus,
I'm doing it in a proactive(preventing injuries) environment
when most of the rest of the baseball world is stuck in reactive mode (wait until someone gets hurt and then fix
it).

NG: Sounds awesome. What do you mean by "at-risk,"
though?

EC: Overhead throwing is unquestionably one of the single-most
damaging exercises one's body can endure. During the acceleration
phase alone, you're looking at 7,400°/second internal
rotation, 2,400°/second elbow extension, and 650°/second
horizontal abduction. Think of the muscle strength and coordination
needed to produce that power, and more importantly, to decelerate
it.

In a joint that has already sacrificed stability for mobility,
you need a perfect soft tissue function, strength, and tissue
quality — from head to toe — to stay
healthy.

If you look at any pitcher's shoulder, you're going to find
fraying in his labrum. With that much stress, only so much can go
to the soft tissues (muscles, tendons) over which we have control.
The rest is going to go on passive structures like the labrum and
menisci. In a great interview with ESPN.com, noted
surgeon Dr. James Andrews said:

"Do we have the answer to labral tears? No, a large percentage
of these still don't heal. I think we have a long way to go."
Still, though, he noted, "If you want an excuse to operate on a
baseball pitcher's throwing shoulder, just do an MRI."

What does that tell us? Pathology (i.e., labrum fraying) isn't
as important as dysfunction; you can have a pathology, but not be
symptomatic if you still move well and haven't hit "threshold" from
a degenerative or traumatic standpoint. If your labrum is screwy
and you move like crap, though, you'll be booking an appointment
with Dr. Andrews sooner-than-later.

Dr. Andrews examines Ryan Kochen's screwy
labrum.

NG: Crazy stuff. I knew overhead throwing was rough on the body,
but never realized it was that extensive. Anything
else?

EC: Definitely. In my opinion (and that of many really bright
therapists), asymmetry is the single-best predictor of injury in
sports. Last time I checked, not many guys switch-hit, and
certainly none "switch-throw!" When you think about baseball guys
(pitchers in particular), it's one leg that's almost always
propelling when throwing and hitting and the other leg that's
always decelerating.

Additionally, when someone doesn't have appropriate mobility and
stability at the hips/lumbar spine/thoracic spine, violent rotation
will chew up a lower back faster than anything else. Pitching and
hitting both involve a ton of rotation at high speeds. Look at the
pitchers with the biggest rotation in their wind-up, and you'll see
the guys with the biggest history of back problems. Kevin Brown was
a great example; I think he spent 47 years on the disabled list
during his career.

Look at the most successful pitchers, and aside from Johan
Santana and Pedro Martinez, you aren't going to find many good
pitchers who are shorter than 6'0". The most successful
guys are in the 6'4" to 6'5" range, with some
even more pronounced training challenges when you get up in Chris
Young and Randy Johnson range.

With my basketball background, I've worked with eleven guys who
are 6'9" or above since 2003, and I can assure you:
that's a lot of spine to try to stabilize! Every 6'1"
weekend warrior gymrat seems to complain that he's too tall to
squat; just imagine how the bigger guys feel!

NG: How does the nature of the season and the culture of
baseball affect training?

EC: Well, it is a very long competitive season. Professionally,
with spring training, the regular season (162 games), and playoffs
(potentially), you're looking at a competitive season that could
comprise 200 games over the course of nine months (Feb-Oct).
College ball isn't much different, with many guys playing their
regular college season, then playing Legion ball (early college) or
regional leagues (later college) before returning for fall ball.
High school ball runs all spring and actually gets more involved in
the summer, as guys around here play Legion or Babe Ruth, various
showcases, and Bay State games. With a short off-season and an
in-season where you play almost daily, building and maintaining
strength, power, flexibility, and optimal soft tissue quality can
be a difficult task.

And, to be honest, as is the case with many professional sports,
while all teams have strength and conditioning professionals on
staff, the athletes aren't required to work with them if they don't
want to do so. So, you get guys who take yoga classes with their
wives or just bench press with their entourage. The other day, one
of my high school pitchers came in and told me that he saw a
professional pitcher doing pressdowns in his condo health club the
day before a start. Cutting edge, huh?

NG: So you're saying that they're getting babied?

EC: My good friend John Pallof is a great physical therapist who
has done a lot of work with pitchers, and he pointed out to me that
in spite of the fact that our pitchers pitch less than in the past,
the injury rates are higher. Check out this comparison between
Johan Santana and Nolan Ryan to which he alluded:

Pitcher	Cy Young Year	Starts	Complete Games	Innings Pitched	Strike-outs	ERA
Johan Santana	2006	34	1	233	245	2.77
Nolan Ryan	1974	42	26	332	367	2.89

NG: That's crazy!

EC: It gets better. John also pointed out that Ryan pitched 19
more seasons after this Cy Young year! Anyone want to bet that
Johan Santana won't be around in 2015? And, that's even with the
advent of the closer andset-up man working in his
favor.

Ask Robin Ventura if Nolan Ryan's training program was
effective.

Look at the Leo Mazzone, who is widely regarded as the best
pitching coach in the major leagues. Now with the Baltimore
Orioles, Mazzone was the mind behind the Atlanta Braves pitching
staff that dominated in the early 1990s. A few of the names that
worked with Mazzone for several years are Tom Glavine (300+ wins),
John Smoltz (200+ wins and 150+ saves), and Greg Maddux (300+
wins), and they're all still pitching well at 41, 40, 41 years-old,
respectively.

Now, let's consider a few pitchers who thrived in Atlanta under
Mazzone for a year or two and then opted to go elsewhere:

Denny Neagle went 36-16 with a 3.26 ERA in Atlanta 1997-1998,
and then left to go 58-46 with a 5.24 ERA over the following seven
years, and had multiple elbow surgeries. At age 39, he's been
retired since 2005 (missed the entire 2004 season due to
injuries).

Jaret Wright revived his career by going 15-8 with a 3.28 ERA in
2004 with the Braves (on top of 11 relief appearances and a 2.00
ERA with them in 2003), then left to head to the Yankees for the
2005 and 2006 seasons. He went 16-12 with a 5.29 ERA and became a
mainstay on the NY disabled list before being traded to Baltimore,
where he only made three starts in 2007 due to shoulder problems.
There is speculation that this shoulder problem will end his career
at age 31.

Russ Ortiz went 36-16 with a 3.99 ERA in 2003-2004 with Atlanta,
but has since had multiple stints on the disabled list while
amassing a 7-22 record and 6.85 ERA in three seasons with three
different teams. At 33, he's now scheduled for Tommy John surgery
and will miss the entire 2008 season.

Sure, you can talk about Atlanta being a pitcher's park and the
Braves' traditionally strong lineup being supportive of having a
good W-L record, but that doesn't speak to injury rates, longevity,
or the success Glavine and Maddux have had after leaving Atlanta.
Maddux played ten seasons with the Braves, and Glavine played 19
(16 in the major leagues).

What's Mazzone doing differently than other pitching coaches?
He's notorious for believing in having his guys throw quite a bit
between starts: twice as much, in fact.

NG: So is throwing more on off-days the secret?

EC: It might be; it's tough to say. To be honest, they're making
these guys move when in many cases, they're accustomed to just
working every fifth day and then sitting around knocking back
sunflower seeds and Gatorade.

I talked about Nolan Ryan earlier. Roger Clemens is notorious
for his rigorous training programs, and he's pitching well into his
40s. Interestingly, Dr. Andrews operated on his shoulder in his
second year in the majors; you have to wonder if that "wake-up
call" early-on set him up for long-term success. He's also clearly
very in-tune with his body. Just a few weeks ago, I read an article
where Clemens commented on how he felt blisters on his right foot
were the cause of some elbow troubles he was experiencing.

Roger Clemens with the 20-strikeout ball he wouldn't have
thrown without Dr. Andrews.

So, I'd say active recovery and just moving is the best bet. I
love to get my pitchers in to lift (lower body in particular) the
day after they throw. We consolidate these two types of CNS
intensive stress into 24-hour blocks; it gives them plenty of
recovery before they throw a bullpen session and get another lift
before their next start. And, in place of long jogs for recovery,
I'd much rather see low-intensity resistance training circuits
along the lines of what I wrote in Cardio Confusion. If you're going to
do bloodflow work, it might as well help address muscular
imbalances and provide injury prevention benefits.

NG: You alluded to the difference between pathology and
inefficiency earlier; can you please go into a bit more detail? We
want some practical information.

EC: Think of a car that people run and run and run without doing
maintenance. Chances are that it's got tons of stuff wrong
with it (movement dysfunction), but when it "goes," they just say
it's the spark plug, heater motor, or radiator (specific
pathologies: i.e., oblique strains, hamstrings strains, disc
herniations, UCL injuries). Our medical model is much like
the Average Joe mechanic; they just fix what is wrong with your car
(ultrasound, NSAIDs, rest, blah, blah). If it was that
mechanic's own car, though, it never would have gotten in such bad
shape.

So, in a nutshell, we have a very REACTIVE model of training
when, in reality, PROACTIVE is "where it's at." Multiple
pathologies can come from the same inefficiency, so we have to work
backward from what we see pathology-wise. A good example is
the classic mindset regarding rotator cuff injury; everyone wants
to just look at rotator cuff strength and do some stim +
NSAIDs. The truth is that I can think of nine factors ahead
of rotator cuff strength that optimize shoulder health and
function:

1. Scapular stability

2. Thoracic spine range of motion

3. Cervical spine function

4. Breathing patterns

5. Mobility of the opposite hip

6. Mobility of the opposite ankle

7. Overall soft tissue quality (especially posterior
capsule)

8. Glenohumeral (ball-and-socket joint) range of
motion

9. Footwear optimization

10. Rotator cuff strength

Rotator cuff function is lower down on the ladder simply because
the rotator cuff is reflexive and you don't have to worry about
firing it in everyday life. Nobody actively tightens up
infraspinatus to decelerate a baseball throw or pick up a suitcase.

Also, you can more easily compensate for a lack of rotator cuff
function with added scapular stability (as evidenced by the number
of people with internal impingement - a hypermobility problem - who
can get by without surgery). I think I may need to rewrite my
Cracking the Rotator Cuff Conundrum article!

Cressey demonstrates the Cuban press in 2003: he now prefers
the dumbbell version.

NG: Hear that, everyone? I think it's time to strike that
article from the record for good.

EC: Now, imagine taking that junk car out in a high-stakes
setting: the Autobahn or a monster car show. It's an at-risk
situation, just like overhead throwing sports (and baseball in
particular, as it has a verylong competitive season). Think
back to all the screwy labrums you'll see under a MRI; only some of
those are going to be symptomatic. All of the above factors
(especially internal rotation range of motion) are going to be
criteria that separate those with pain from those without
it.

1/3 of all athletes have disc bulges that go completely
undiagnosed. The difference? The amount of stability
they have at their lumbar spine, and dozens of other factors that I
think of as I stare off into blackness at 3 AM every day. You're
talking to the guy who looked at his girlfriend's pronator calluses
on the third date!

"Hey, Eric, I'll show you my pronator
calluses."

NG: Wow, that's smooth. You have about as much game as a third
string water boy on the junior high B team. Change the subject
before I make fun of you too badly.

EC: The point is that pathologies really don't mean jack; it's
just an indicator that things have reached threshold and someone
got a wake-up call. This year, we've seen a ton of oblique strains
in professional baseball. Manny Ramirez, Carlos Beltran, Chris
Young, Bobby Abreu, and Eric Bedard come to mind in this year
alone, and those are just a few of the bigger names that I can list
without even looking into it.

These oblique strains could have been a hammy, adductor,
quadratus lumborum, lumbar disc issue, piriformis contracture, or
fiery case of gonorrhea (okay, that last one was an
embellishment). They all related to a lumbar
extension-rotation syndrome. Imagine being rotated to one
side too far at your lumbar spine. When you try to get back
to your "ideal" end range on the OPPOSITE side, the oblique is
going to have to stretch further than it normally ever
would.

Optimal training programs, in my opinion, are based on
establishing an ideal joint-specific mobility-stability
set-up. Stabilize the knees, lumbar spine, scapulae, and
glenohumeral joints and mobilize the ankles, hips, and thoracic
spine. Once you've done this, start slapping down some
maximal strength, reactive ability, and the sky is the limit.

When I start hearing about the "core stability" stuff many of
these guys are doing, my bullshit meter goes through the roof when
the words "sit-ups, Russian twists, hyperextensions, and
side-bends" start coming up.

Eric Cressey doesn't want to hear about Russian twists for
core stability.

To take it a step further, there are bits and pieces of Yoga
that have merit, but embracing the entire collection of exercises
is a big mistake for guys already involved in a high-velocity
rotational sport. I played the politically correct card on that
one, huh?

NG: Yeah, but it'll probably still get you a good 50 hate
emails.

EC: Yeah, well, "what is popular is not always right, and what
is right is not always popular." I know what I'd rather
be.

Think about it; how does an in-place, extremely low-velocity
training initiative like yoga help a guy who is expected to exert
force maximally on a moment's notice, and usually without
sufficient warm-up? And please don't give me the relaxation bit. If
you want to relax, get a massage or sleep. Most athletes don't
sleep enough as it is.

So, with that said, think stability at the lumbar spine,
progressing to good rotational training (wood chops, med ball
throws, land mines) where the rotation comes at the hips, thoracic
spine, and shoulders. That's what you mobilize in a more dynamic
context.

NG: You spoke earlier about asymmetries in baseball guys. How
are you testing them?

EC: While I've got a ton of "on the fly" tests we use, I'm a big
believer in the single-leg triple jump as my prime indicator
— both qualitatively and quantitatively — of symmetry
(or lack thereof). When we perform the test, we're looking at
several things:

1. Total jump distance: this is a good measure of overall
athletic ability, as the more reactive the athlete, the better
they'll get on each subsequent jump.

2. Side-to-Side differences: anything over 15% from side to side
is very concerning, and I prefer to always see these differences
below 5%.

3. Landing Mechanics: this is very subjective, obviously, but if
the guy looks like he's going to fold up like a lawn chair on each
landing, you've got a lot of work to do.

NG: Interesting, but that was never in the "Bigger, Faster,
Stronger" mentality! So, working on symmetry and the related
strength imbalances will dramatically change an athlete?

EC: Absolutely. Here's a good example for you.

Last October, I started working with a 6'1", 161-pound high
school senior named Kevin Scanlan. As a junior, Kevin was throwing
78-80 mph and finished with a 4-5 record for a team that lost in
the first round of the Division 1 playoffs.

When I first tested Kevin, he was a 16-inch side-to-side
difference over the three jumps. A 5+ inch difference between right
and left per jump is pretty significant.

So, we worked to address the inefficiency with work on soft
tissue quality and joint-specific mobility and stability training,
all the while slapping on some maximal strength and reactive
ability. As spring rolled around, he also started throwing again
with Sean O'Connor, a great local pitching coach.

When the season rolled around, Kevin was up 18 pounds to 179,
and his fastball was regularly being clocked at 88 mph. His curve
ball had become more effective largely because the drop-off from
his fastball was even more significant, and he'd set himself up to
develop a great change-up.

At the end of the regular season, he was 12-0 with a 0.19 ERA
and Division 1 Massachusetts State Player of the Year hardware
honors. He went on to go 4-0 with a save in the playoffs, leading
Lincoln-Sudbury to its first Division 1 state
championship.

Interestingly enough, Kevin actually batted right around .400
all year while hitting in the 4 and 5 spots in the lineup. Believe
it or not, I had trained him all off-season under the impression
that he would be sacrifice bunting every time he got up, or that
they'd just DH for him. I guess moving efficiently will make you
better at everything you do!

NG: Those are some nasty improvements, but as you told me
earlier, there's more.

EC: Yeah, the funniest part is yet to come. Kevin, his coach,
and even his parents took some heat from a local sports writer for
his pitch count during the playoffs. It worked out to 509 pitches
over the course of 17 days (an average of right about 30 per
day).

His "argument" was that 28 orthopedic surgeons compiled a chart
recommending pitch counts for 17-18 year olds:

• One day rest: 28 pitches

•Two days rest: 63 pitches

•Three days rest: 82 pitches

• Four days rest: 106 pitches

I'm certainly not saying that we should allow our pitchers to do
this regularly, but I was present to know that a) Kevin's mechanics
never changed (a common problem with fatigue), b) that his legs
were more tired than his arm, and c) he was doing a lot of the
stuff I'd showed him to keep himself healthy. And, in consideration
of the fact that this little "burst" only exceeded recommendations
by 10-15% at most, I thought it was a lame argument to make. I
guess that's why he's writing columns and not training
athletes.

NG: So you're saying that the research isn't
legit?

EC: Not necessarily. I'm just saying that it's important to
consider who the "average" 17-18 year-old pitcher is. He eats Lucky
Charms for breakfast, a bagel and chips for lunch, and lives on
Gatorade and sunflower seeds during his game. Afterward, he goes
home and pushes the vegetables on his plate aside or just covers
them in enough ranch dressing to drown a small village.

Breakfast of choice for the average American 17-18 year-old
baseball player.

He doesn't sleep enough or consume enough calories. He's never
worked with a pitching coach or even lifted a weight. He wears high
top Nike Shox sneakers that weigh as much as a cinderblock. He's
fragile, so these recommendations are good for him.

Kevin was paying attention to soft tissue quality with the foam
roller and lacrosse ball. He was stretching his posterior capsule,
mobilizing his thoracic spine and hips, and doing scapular
stability work. He squatted, deadlifted, and did a wide variety of
DB pressing, pull-ups, push-ups, single-leg work, and reactive
training. Kevin bought Nike Frees within a week of me making the
recommendation.

His catcher (another one of my athletes) approached me
pre-season to help them put together a pre-game warm-up to keep
them both healthy. He had great coaches, and was smart enough on
the mound to know that he didn't always have to throw gas to be
effective. He had learned to eat better, which was previously a
huge weakness for him.

If most of the research is on untrained little league guys, why
are we extrapolating it out to trained athletes and even
major-leaguers?

I'm a guinea pig?! Say it ain't so!

If a resistance training research study used untrained subjects,
it would be the mockery of the entire strength and conditioning
industry. Hell, it never would make it to
publication!

These recommendations are meant to protect the kids, not treat
the more advanced like kids.

NG: How about training modifications? Are you doing anything
differently with these guys?

EC: Absolutely. A few things you'll never see our baseball guys
do are overhead pressing and straight-bar benching. We use
dumbbells or multi-purpose bar for our heaviest pressing; this
specialty bar allows us to use a neutral grip (easier on the
shoulders), and has a greater stability component because of its
tendency to wobble back and forth.

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Our guys also do a lot of push-up variations: band-resisted
push-ups, T-push-ups, blast strap push-ups, you name
it.

There are tons of pull-up variations and horizontal pulling at
least three times a week. We incorporate a lot of grip work with
thick handles, wrist rollers, the Invanko Supergripper, DB hex
holds, plate pinches, and regular old elbow and wrist curl
variations.

We do a lot of reactive stuff with our guys and have specific
warm-up protocols that address the imbalances of the throwing and
hitting motions. All the warm-ups are done barefoot after the
athletes spend time on soft tissue work with the foam roller and
lacrosse ball.

In terms of lower body training, we do plenty of deadlift and
squat variations. The majority of the squatting is front squats or
back squats with the safety-squat bar or giant cambered bar.

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These bars keep our baseball guys from the at-risk position
(shoulder external rotation with abduction) under loading.

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All of them do a ton of single-leg work. In a three-day set-up,
we go static unsupported on Day 2, and a dynamic accelerative or
decelerative on both Days 1 and 3.

We're big advocates of "fillers" between sets. Our guys are
always incorporating scapular stability work, posterior capsule
stretching, ankle mobilizations, and the like between sets of
compound movements. These options don't interfere with rest
intervals, but definitely help keep our guys healthy
long-term.

NG: Good stuff, Eric. Thanks for the insight!