“Without knowledge action is useless and knowledge without action is futile.”
Abu Bakr, Philosopher
“Without applicable knowledge and its proper execution, you’re f*cked.”
Jess Banda, Humanitarian
Prepare yourself, here comes a truth bomb…knowledge, in and of itself, is not very useful. The proper execution of knowledge however, is everything. Why? Because until knowledge is applied, it remains theoretical. Given the option between working with someone who possesses either academic knowledge or practical experience, I’ll take the latter. And while the dictionary defines a professional as “a person who belongs to one of the professions, especially one of the learned professions,” my definition of a true professional, is “one who applies the knowledge and insights acquired through academics to real experiences.”
In the strength and conditioning field, new methods are developed through practice and experience, not research studies. I agree with Lyn Jones, former Director of Coaching for U.S.A. Weightlifting Federation, when he stated “Sport scientists are, in fact, only sport historians-they scientifically demonstrate what coaches knew a few Olympics earlier.” Unfortunately, within the past few years, people have increasingly been confusing academic knowledge with practical experience. And thanks to the sheer quantity of user-generated content found on the internet, where everyone is an “expert,” it’s become increasingly difficult to assess their credibility and determine whether they possess the experience to offer any perspective.
Within our field, there is no greater disconnect between academic knowledge and its proper and successful application, than in the training of overhead athletes. For the first part of this article, we’ll look at a muscle group that possesses the greatest potential for improving throwing velocity: the rotator cuff.
My research into designing effective rotator cuff training protocols began in 2005, when I was presented without he opportunity to work with Connecticut high school baseball pitcher Matt Harvey. Expectations for Matt were high, as his fastball speed averaged between the 85-90 mph range and was generating a lot of interest among pro baseball scouts. During his junior year in high school, it was a common sight to have over 15 pro scouts with radar guns, standing behind the backstop, clocking his throwing velocity. However, in discussions with Matt’s father Edward, we came to the conclusion, that by adding a few pounds of lean body mass and building up the strength of his rotator cuff muscles, Matt could realize his full throwing genetic potential. Before working together, Matt’s rotator cuff training program was based around rubber tubing and high reps. During our first training sessions, Matt’s rotator cuff were so weak, he could only manage to perform 8 reps with 5 pounds on seated dumbbell external rotations. It was only after we sufficiently strengthen his rotator cuff muscles, working up to 37.5 pounds for 8 reps on the seated dumbbell external rotations, that he started to throw fastballs up to the 98 mph range. Here’s a key concept: Matt was throwing at high velocities in spite of his original training program. However, only by applying sound principles and putting them to practice, was he finally able to throw to his full genetic potential. It’s the difference between adequate and optimum. In 2007, Matt was ranked by Baseball America, as the top high school prospect. After three years playing for the University of North Carolina, Matt was the seventh overall pick, by the NY Mets in the 2010 MLB draft.
Late 2007, I was presented with another opportunity to further develop my approach to rotator cuff training, working with another Connecticut high school pitcher, Hunter Brown. As with Matt, Hunter’s rotator cuff training program was also centered around rubber tubing and pink vinyl dumbbells, which kept his fastball between 74-77 mph. It was only after building his training program around dumbbells that his throwing velocity was finally able to break 80 mph, with his fastballs reaching between 84-87 mph. Again, Hunter’s rotator cuff training program, was hindering his progress. Only by applying training principles based on valid strength training principles and knowledge of anatomy beyond the standard “origin-insertion” that my athlete’s performance could be improved and more importantly, sustained.
What You Need To Know
Overhead motion athletes, whether throwing a baseball, swinging a racquet, or spiking a volleyball, repeatedly subject their shoulders to extreme forces and torques. So a proper understanding of the function of rotator cuff muscles as they apply to overhead motion sports is vital, for both performance and injury prevention.
Overhead motion athletes include:
- throwing athletes (baseball, football, javelin, cricket)
- volleyball players
- racquet athletes (tennis, squash, badminton)
- military/law enforcement (task specific needs)
And while not categorized as overhead athletes, I recently included military and law enforcement personnel into this category. Due to the stress and mechanics of firing multiple rounds with long firearms, shotguns and carbines, strong rotator cuff muscles help maintain shooting accuracy and speed. Giving credit where it’s due, I learned this from a discussion with Charles Poliquin, who experienced it first hand, while consulting for a major federal law enforcement agency.
Instead of focusing on each of these sports individually, even though this information is applicable to them, we’ll focus on baseball pitchers, as they produce the greatest velocities and torques of all overhead motion sports. Just how violent of a maneuver is throwing a baseball? Consider the following:
- The point from which a pitcher cocks his arm back, to when he releases the ball, takes only .05 seconds, during which the humerus accelerates up to 9,500 deg/sec
- Once the pitcher has released the baseball, he decelerates his arm to a complete stop within .03-.05 seconds
- Upon release, momentum distraction forces up to 1.5 times body weight act on the shoulder and elbow joints
So what does this have to do with the rotator cuff muscles? Everything. First, due to their stabilizing function at the shoulder joint, the rotate cuff muscles keep the humeral head within the glenoid fossa. Keep in mind, throwing a baseball is basically a controlled attempt at trying to throw your arm out and away towards home plate and the rotator cuff muscle’s stabilizing function becomes extremely important during the deceleration phases of throwing. So if you’re a pitcher weighing 200 pounds, at the point you’re about to release the baseball, distraction forces up to 300 pounds are trying to rip your arm out of joint. Second, once the baseball has been released, the rotator cuff muscles function as decelerators of the humerus. While two large muscles, the latissimus dorsi and pectoralis major are accelerators of the humerus, deceleration of the humerus falls primarily to the four considerably smaller rotator cuff muscles. When you factor in the distinct characteristic of eccentric contractions recruiting fewer motor units than a concentric contraction, thereby subjecting these fewer recruited motor units to a greater stress, you understand why the majority of throwing injuries occur during the deceleration.
Now that you understand the function and level of involvement of the rotator cuff muscles in overhead motions, it becomes clear that throwing velocity, in most instances, is limited, not by the strength of your accelerating muscle, but by the ability of the rotator cuff muscles to counteract the forces and torques generated during the throwing motion. This limiting of your throwing velocity to a manageable and tolerable level is a self-imposed restraint, a protective action, much like your golgi tendon organs protect you from injury and winning a Darwin Award.
So now that we have identified the muscle group primarily responsible for limiting your throwing velocity, the question then becomes, which are the most efficient methods for training the rotator cuff muscles? To put us on the right path, we must first answer the following:
- What muscle fiber type would best be capable of countering forces equal to 1.5 times body weight?
- What muscle fiber type is best suited for decelerating a limb moving up to 9,500 deg/sec, in less time than it takes you to blink?
Low-threshold motor units? High-threshold motor units? The answer becomes obvious, doesn’t it? However, when discussing my training protocols with “baseball performance specialists,” they attempt to dismiss my approach to rotator cuff training by referencing a study published in the Journal of Orthopaedic & Sports Physical Therapy: “Fiber Type Composition of Cadaveric Human Rotator Cuff Muscle.” In this often quoted study, the researcher’s aim was to identify the fiber type composition of the rotator cuff and teres major muscles, using tissue samples harvested from nine cadavers. Their results found that “the rotator cuff muscles have a heterogeneous fiber type composition.” Really? However, a few issues arise:
- tissue samples were harvested from only nine cadavers
- the age of the subjects were between 53-87 years
- the physical activity history of the subjects was unknown (needless to say, I don’t believe any major league pitchers were part of the study)
Realizing the shortcomings of their research, the researchers concluded the study by stating “The advanced age of the cadaver specimens may limit the extrapolation of our findings regarding fiber type composition to younger individuals.” These same coaches who reference the study however, always forget to mention this last part. This is a classic example of coaches going “cafeteria style” on a research study, referencing sections that support their personal preferences, while disregarding the rest.
Now that you understanding the extraordinary forces which must be opposed by the rotator cuff muscles, you’d be correct in concluding that elite pitchers possess a greater number of high-threshold motor units in their rotator cuff muscles compared to the average person. Taking it even further, a pitcher throwing in the upper 90s mph, possesses a greater number of high-threshold motor units than a pitcher maxing out in the low 80s mph. Yes, other factors come into play, such as overall conditioning, mechanics, and genetics, however even these factors cannot make up for weak, or improperly trained rotator cuff muscles. Drill this into your head: you will only throw as fast as you can safely decelerate your arm.
So how do we design an effective resistance training program to strengthen these high-threshold motor units? That’s the $64,000 question.
The Perils of Rubber Tubing
If you’ve ever experienced any shoulder discomfort and been evaluated by a medical professional, chances are you were given a handout sheet, depicting line drawings of a figure performing various external rotation exercises with rubber tubing. These external rotation exercise “cheat sheets” have become the favorite of medical professionals for anything shoulder related. Judging by the affinity medical professionals have for these sheets, you’d think that the 4-6 exercises depicted in them, could cure whatever your shoulder ails might be. It’s a complete mystery how these few exercises can heal any shoulder injury. Maybe they work like aspirin…they just “know” what to fix.
Unfortunately, rubber tubing has left the domain of rehabilitation settings and has become the implement of choice for the majority of baseball pitchers and quarterbacks. The main reason, next to their low cost and maintenance, is because the majority of physical therapist and strength coaches, believe them to be appropriate for the “delicate” rotator cuff muscles. Having previously dispelled the notion of the rotator cuff muscles being made out of porcelain, here is the main reason for getting rid of rubber tubing completely: linear resistance curve.
In every exercise, there are specific portions of the range of motion where you are stronger, due to improved leverage. How your strength varies at various joint angles can be represented by strength curves. There are three types of strength curves:
- Bell-shaped – represents exercises in which muscular tension is greatest in the middle of the exercise and then decreases through the rest of the movement. Arm curls, allowing you to lift greater weight if only the middle portion of the exercise is performed, represent bell-shaped curves.
- Ascending – represent exercises in which the muscular tension is greatest at the end of the concentric portion of the exercise. Squats and presses, allowing you to lift greater weight if only the last quarter or last half of the exercise is performed, represent ascending strength curves.
- Descending – represent exercises in which muscular tension decreases at the end of the concentric portion of the exercise. Rowing exercises, allowing you to lift greater weight if only the first quarter or first half of the exercise is performed, represent descending strength curves.
The key is realizing that the amount of muscular tension you generate varies as your joint moves through its range of motion. The problem with rubber tubing is that initially, it offers little to no resistance, but as the band is stretched, it provides progressively greater resistance in a linear pattern. This ascending linear resistance pattern continues for as long as the rubber tubing is elongated or ruptures. So what you say? For most exercises, rubber tubing generates the greatest tension when muscles are least able to produce force: at the end range of a joint’s motion. Initially, this misalignment between the linear resistance pattern and the strength curve of the exercise won’t lead to catastrophic injuries, but if utilized for extended periods of time, it might lead to tendonitis. Which makes you wonder why you see rubber tubing in physical therapist’s office? Ensuring future business? Much like opening a Curves fitness center next to a Krispy Kreme.
Inevitably, someone is always quick to mention that there are “100s of published studies….blah blah blah…in support of elastic resistance.” My answer: everything works for a while. As I’ve said before, it’s a matter of adequate vs. optimum. However, one of my biggest gripes is in the way they’re utilized. Usually, most trainees fix one end of the rubber tubing to a vertical stationary object, stretch the band and start banging out reps, without any consideration to form, range of motion, or tempo. I’ve seen people exert greater mental effort when choosing a brand of bottled water than in how they’re performing their reps. Other considerations: How do you ensure you’re utilizing the same resistance with every set of an exercise? Do you always stand the same exact distance away from the fixed end of the rubber tubing? Is the rubber tubing you utilize impervious to flex fatigue? Will it always provide the same resistance no matter how many times it’s been stretched…much like Rosie O’Donnell’s pantyhose? And how do you determine whether to progress to the next larger diameter of rubber tubing? Do you just wake up one day and think “Time to take this bitch to the next level, time for the orange bands!” I think you get my point. Progressive overload is a cornerstone of our field, but for strength adaptations to occur, the loads utilized must be applied in a consistent and progressive manner. Rubber tubing supplies neither.
Training the Rotator Cuff Muscles
While the four rotator cuff muscles work synergistically to decelerate the humerus, both the infraspinatus and teres minor demonstrate the highest activity during the deceleration phase. As such, we’ll concentrate our efforts to exercises which preferentially recruit these two muscles. While there are literally hundreds of external rotation exercises variations, which might make it challenging to recall which exercise primarily recruits which muscle, here’s an easy to remember tip: the position of the elbow dictates which rotator cuff muscle has the most efficient line of pull. When your elbow is positioned high, relative to your shoulder, the infraspinatus has a favorable line of pull and when your elbow is low, relative to your navel, the teres minor has a favorable line of pull.
The Magic is in the Details
The key to deriving benefit from my protocol, is to follow it exactly as written. Everything has been combined for cumulative effect and removing one element diminishes the return on your time and effort invested. Adequate vs optimum.
Frequency of training: For my protocol, you’ll be training your rotator cuff muscles twice a week. Here are some options, based on different training splits:
Day 1: Rotator cuff, arms/shoulders
Day 2: Legs
Day 3: Off
Day 4: Rotator cuff, torso
Day 5: Off
Day 1: Rotator cuff, torso
Day 2: Legs
Day 3: Off
Day 4: Rotator cuff, arms/shoulders
Day 5: Off
Day 1: Rotator cuff, upper body strength
Day 2: Lower body strength
Day 3: Off
Day 4: Rotator cuff, upper body dynamic
Day 5: Lower body dynamic
Day 1: Rotator cuff, full body
Day 2: Full body
Day 3: Off
Day 4: Rotator cuff, full body
Day 5: Full body
Yes, there are numerous other training splits in existence, for instance, you might train your eyelids on Monday and your perineum on Friday, but whatever your training split, ensure at least one day off between rotator cuff training sessions. Due to their size, the rotator cuff muscles recover quickly, allowing us to maximize training adaptations by training them twice a week.
Order of Exercises: Regardless of your training split, always perform the external rotation exercises FIRST within your training session. Yes, even when training torso. The only exception would be when training bench press with less than four reps. One trait of all successful coaches is that they have their athletes perform exercises for their weakest exercise or muscle group first within a training session. Giving priority to your weak links prevents you from training them when your CNS and involved muscle groups are fatigued. While it may seem training rotator cuff muscles prior to pressing exercises, might decrease the amount of weight you use, I have yet to witness it. In most instances the opposite is true, as training the rotator cuff muscles first within your workout, will improve the “mind-muscle” connection as well as their intra and inter-muscular coordination, thereby facilitating their stabilizing function. This will be extremely visible with athletes that have neglected to perform any external rotation exercises, or utilized rubber tubing. Ben Prentiss, PICP 5, who has produced four Stanley Cup winners, has all his athletes train their rotator cuff muscles in this manner.
Number of Repetitions: High-threshold motor units are best trained using low reps, no surprise there. As the rotator cuff muscles are predominately high-threshold motor units, the highest number of reps you’ll perform is twelve. While twelve reps are above a rep range normally associated with strength gains, they allow you to improve the neural efficiency of your rotator cuff muscles before progressing to a more appropriate rep range. Strength training is about coaxing the CNS into a more efficient state. While it’s common to see athletes perform external rotation exercises for 20 reps, this is strongly discouraged. As the rotate cuff muscles are predominately made up of high-threshold motor units, training them with reps intended for endurance, encourages them to behave characteristically like low-threshold motor units. Perhaps the steady increases in pitching injuries experienced in MLB and Little League Baseball, is due to the over reliance of rubber tubing, pink vinyl dumbbells and 20 rep rotator cuff training programs? Is it possible to sue a strength coach for stupidity?
The Exercises and Implements Used: To ensure progression and relieve boredom, each of your two weekly training programs will utilize different exercises and implements, dumbbells and cable pulleys. Alternating between different implements provides a different training stimulus in the form of two different resistance curves: dumbbells overload the stretched, or lower, position of the range of motion and cable pulleys overload the contracted, or upper, position. Making use of the distinct loading characteristics provided by dumbbells and cable pulleys, allows for efficient strength development due to the unique muscle fiber recruitment patterns of the two implements.
External Rotation with dumbbell, arm supported and abducted
- sit with your back against Scott bench, arm resting on top of support pad
- shoulder is abducted 90 degrees, elbow is flexed 90 degrees
- lower dumbbell under control to fully stretched position
- keep back against support pad to ensure proper form
External Rotation with dumbbell, arm supported and in front of body
- elbow of the working arm is positioned onto the VMO
- the non-working arm is positioned behind you on the bench to minimize any swaying
- lower dumbbell under control to fully stretched position
External Rotation with low cable pulley, handle over navel
- stand sideways to low pulley, positioning your hand directly over your navel
- keep your arm abducted approximately 20-30 degrees
- externally rotate your arm outward, using your shoulder as the pivot point
- ensure your elbow maintains the same distance from your torso throughout the motion
- if necessary, place a rolled up towel underneath your armpit to maintain a consistent angle
External Rotation with low cable pulley, rope handle over navel
- grasp the rope handle with your hand supinated
- position your little finger against your navel
- maintain a supinated hand position through the motion
- follow the same instructions as for the handle variation of this exercise
The program will consist of two phases, with two training days within each phase.
A) External Rotation with dumbbell, arm supported and abducted
A) External Rotation with low cable pulley, handle over navel
For both exercises, perform 3 sets of 10-12 reps, on a 2-0-2-0 tempo. If performing this exercise solo, take 90 seconds rest between sets. If supersetting with another muscle group, take 60 seconds rest between exercises. Use a weight which allows for 10-12 properly executed reps only. Higher reps ensure improved muscle fiber recruitment and the controlled concentric tempo minimizes cheating, which will build a solid foundation for the heavier weights used during the phase two.
A) External Rotation with dumbbell, arm supported and in front of body
A) External Rotation with low cable pulley, rope handle over navel
For both exercises, perform 3 sets of 7-9 reps, on a 4-0-1-0 tempo. Use a weight which allows for 7-9 properly executed reps only. If performing this exercise solo, take 100 seconds rest between sets. If supersetting with another muscle group, take 90 seconds rest between exercises. Due to the heavier weights and faster concentric tempo utilized, it will be extremely tempting to cheat by swaying your upper body during the concentric contraction. If this occurs, it’s a sure sign that the weight you’re using is beyond your current capabilities. Check your ego at the door and utilize a proper weight.
When training smaller muscle groups, micro-loading because extremely important. As the dumbbells in most commercial gyms increase at five-pound increments, it’ll be extremely difficult to individualize a weight to your current strength needs. The best micro-loading system I’ve used is manufactured by Pace Weights. Their magnetic micro-weights are available in 1/2 pound increments, making them a must have item when performing this program.
If you’ve made it this far, you now know more about training the rotator cuff muscles properly, than 90% of the strength coaches out there. It’s important to note, that this program is not only for those participating in overhead motion sports, but for anyone wanting to optimize their shoulder function and especially for those wanting to improve their bench press numbers. However, proper training of the rotator cuff muscles is only half of the solution, the other half involves proper training of the lower trapezius fibers, or “trap 3.” While the rotator cuff muscles are the “brakes” which decelerate the humerus, the trap 3 is vital for injury prevention during all phases of any overhead motion. Stay tuned for Part two.
If It Was Easy, Everyone Would Be Doing It