Focus on the movement and not the exercise

It's been a while since I wrote about athletic performance enhancement so I figured I'd go ahead and do it today.  In case you haven't gathered from my recent posts, I am focusing on the Nervous System which is pretty cool. 

My colleagues are a little perplexed, maybe even a little intimidated by this topic because it is VERY in-depth. Muscles, joints, fascia, are all fascinating subjects, don't get me wrong and for MANY, MANY years coaches have been focusing on those because it's the easiest to see (and maybe understand). However, as I look at my preparation for training my athletes this summer, I see an advantage to being much more MINDFUL of movements and not exercises. 

If you have been a long time reader of the blog, you will see that I am heavily involved in biomechanics and the movements of the joints, eccentric loading/concentric unloading of muscles, etc. Both are very important to performance enhancement because we need to know what is going on at any given time during the movement. That way, if our athlete is experiencing a physical limitation, we have some kind of starting point with the movement. We take into considerations like GRAVITY, GROUND REACTION FORCES, MASS, MOMENTUM. All of those physics-based variables. Biologically, we understand arthrokinematics and muscle function. We also need to take into account the other bodily systems like Endocrine, Immune and Nervous systems. If an athlete is hitting a plateau, those integrated systems are the places to look. Not more weight/load on the athlete. 

Is it possible that the allostatic load of the athlete is unbalanced from all of the training?I have seen athletes being driven into the ground during off season workouts only to crack under the pressure of the season. All that work for nothing! 

At 3-D Optimal Performance we offer a program that takes into consideration the needs and wants of the athlete and balances them out in a week long program that consists of:

Strength Training

Cardiovascular Conditioning

Aquatic Conditioning

Yoga/Pilates

Martial Arts

Speed and Agility Training

We do this to stimulate performance enhancement by providing novel stimuls to the athletes system so that it is not able to adapt unlike the painful and repetitive Bench Press-Squat-Deadlift routine. 

Our athletes CONSISTENTLY score high on the strength tests their schools put them through despite never lifting heavy and stay injury free (minus trauma based injuries). 

Challenge the body by challenging the brain. 

Highs and Lows in Training.

Make them think.

Make them adapt.

Make them love movement so when they get on the field it's there without hesitation.

Make them breathe and be calm so when they are in clutch situation, they don't panic.

Educate them on proper nutrition. Basic physiology doesnt change. Eat crap. Play like crap. 

Focus on the movement and not the exercise. 

Simple? Simple.

Vibration training for athletes: What it is and does it work

Recently, a friend and colleague bought a VibePlate and has been raving about it. Since I am the eternal skeptic, I decided to do a little research on WHOLE BODY VIBRATION TRAINING (WBV). 

As much I am a believer in anecdotes and experience, the scientist in me wanted to see what research had been done what it yielded. 

The history of WBV has its roots in ancient Greece for performance enhancement in athletes where they would take a saw covered with cotton and apply vibrations to a part of the body that was not functioning properly. Dr. John Kellogg Harvey was also using WBV in the 1880's and 1890's at the Battle Creek Sanitarium as part of his "wellness" protocols. 

Most recently, we have seen the Russians using WBV for their cosmonauts which was followed closely NASA and the European Space Agency to offset the effects of being in space with no gravity which caused rapid muscle and bone density loss. 

Recently, a lot of research has been done for performance enhancement as well as physical therapy and the research is very mixed but with good reason. Because the technology is not uniform across the board and there are many variations on the apparatus, the research is inconsistent. Keeping that in mind, here's what we've come up with regarding athletic performance enhancement as well as physical therapy:

1: THE EFFICACY OF THE PLATFORMS DEPENDS UPON THE TYPE OF PLATFORM. ^ ^a b Marín, PJ; Rhea, MR (2010). "Effects of vibration training on muscle power: a meta-analysis.". Journal of strength and conditioning research / National Strength & Conditioning Association 24 (3): 871–8.doi:10.1519/JSC.0b013e3181c7c6f0. PMID 20145554.

THERE ARE FOUR TYPES:

1. High Energy Lineal, found mostly in commercial vibration training studios and gyms. The vibration direction is lineal/upward eliciting a strong stretch-reflex contraction in muscle fibres targeted by the positions of training program. 

2. Premium Speed Pivotal, (teeter-totter movement) used for physiotherapy work at lower speeds and exercise workouts at “premium” speed, up to 27 Hz. Both commercial and home units are available. 

3. Medium Energy Lineal, the majority of lineal platforms produced. These are usually made of plastic; some have 3-D vibration which is low quality. They give slower and less consistent results. 

4. Low Speed Pivotal units. These can give “therapy” benefits. Other machine types are low Energy/Low amplitude lineal and Low energy/High amplitude lineal with varying uses from osteoporosis prevention, therapy for improved blood circulation and flexibility and limited fitness training.

2. The SHORT TERM effects of WBV show that more motor units (read: brain) and their muscle fibers are incited more than non WBV training. Because of this hyper stimulation of the neuromuscular system, more force is able to be produced. However, MORE is not better. The WBV must be monitored closely as it can overwhelm the system causing fatigue. 

1. ^ ^a b Delecluse, C; Roelants, M; Diels, R; Koninckx, E; Verschueren, S (2005). "Effects of whole body vibration training on muscle strength and sprint performance in sprint-trained athletes.". International journal of sports medicine26 (8): 662–8. doi:10.1055/s-2004-830381. PMID 16158372.
2. ^ Lamont, Cramer, Gayaud, Acree, Bemben: Effects of different vibration interventions on indices of counter movement vertical jump performance in college aged males, Poster presentation ACSM, 2006
3. ^ Cormie, P; Deane, RS; Triplett, NT; McBride, JM (2006). "Acute effects of whole-body vibration on muscle activity, strength, and power.". Journal of strength and conditioning research / National Strength & Conditioning Association 20 (2): 257–61. doi:10.1519/R-17835.1. PMID 16686550.
4. ^ Bosco, C; Iacovelli, M; Tsarpela, O; Cardinale, M; Bonifazi, M; Tihanyi, J; Viru, M; De Lorenzo, A et al. (2000). "Hormonal responses to whole-body vibration in men.". European journal of applied physiology 81 (6): 449–54.PMID 10774867.
5. ^ Rittweger, J; Schiessl, H; Felsenberg, D (2001). "Oxygen uptake during whole-body vibration exercise: comparison with squatting as a slow voluntary movement.". European journal of applied physiology 86 (2): 169–73.doi:10.1007/s004210100511. PMID 11822476.
6. ^ Rittweger, J; Ehrig, J; Just, K; Mutschelknauss, M; Kirsch, KA; Felsenberg, D (2002). "Oxygen uptake in whole-body vibration exercise: influence of vibration frequency, amplitude, and external load.". International journal of sports medicine23 (6): 428–32. doi:10.1055/s-2002-33739. PMID 12215962.
7. ^ Abercromby, Amonette, Paloski, Hinman: Effect of knee flexion angle on neuromuscular responses to whole-body vibration, Abstract presented at NSCA National Conference, July 2005

3. WBV training does increase circulation to both the muscles and lymphatic system by the 30-50 times per second contractions and relaxation of the muscles which could prove very useful in post-workout/game activities as a way of active recovery. Again, the system would have be closely monitored and combined with other therapies to maximize recovery for athletes. 

1. ^ Kerschan-Schindl, K; Grampp, S; Henk, C; Resch, H; Preisinger, E; Fialka-Moser, V; Imhof, H (2001). "Whole-body vibration exercise leads to alterations in muscle blood volume.". Clinical physiology (Oxford, England) 21 (3): 377–82.PMID 11380538.
2. ^ Lohman Eb, 3rd; Petrofsky, JS; Maloney-Hinds, C; Betts-Schwab, H; Thorpe, D (2007). "The effect of whole body vibration on lower extremity skin blood flow in normal subjects.". Medical science monitor : international medical journal of experimental and clinical research 13 (2): CR71–6. PMID 17261985.
3. ^ Stewart, JM; Karman, C; Montgomery, LD; McLeod, KJ (2005). "Plantar vibration improves leg fluid flow in perimenopausal women.". American journal of physiology. Regulatory, integrative and comparative physiology 288 (3): R623–9.doi:10.1152/ajpregu.00513.2004. PMID 15472009.
4. ^ Oliveri, DJ; Lynn, K; Hong, CZ (1989). "Increased skin temperature after vibratory stimulation.". American journal of physical medicine & rehabilitation / Association of Academic Physiatrists 68 (2): 81–5. PMID 2930643.

4. In the LONG TERM, studies have not show that the WBV is any more effective than conventional training methods to increase STRENGTH. The research time and time again showed insignificant residual power increases. It was noted that the WBV training had to be maintained over a period of time to effect the changes that they did. A one time training session or treatment would not have sufficed. 

1. ^ ^a b c d Delecluse, C; Roelants, M; Verschueren, S (2003). "Strength increase after whole-body vibration compared with resistance training.". Medicine and science in sports and exercise 35 (6): 1033–41.doi:10.1249/01.MSS.0000069752.96438.B0. PMID 12783053.
2. ^ ^a b Delecluse, C; Roelants, M; Diels, R; Koninckx, E; Verschueren, S (2005). "Effects of whole body vibration training on muscle strength and sprint performance in sprint-trained athletes.". International journal of sports medicine26 (8): 662–8. doi:10.1055/s-2004-830381. PMID 16158372.
3. ^ Lamont, Cramer, Gayaud, Acree, Bemben: Effects of different vibration interventions on indices of counter movement vertical jump performance in college aged males, Poster presentation ACSM, 2006
4. ^ Cormie, P; Deane, RS; Triplett, NT; McBride, JM (2006). "Acute effects of whole-body vibration on muscle activity, strength, and power.". Journal of strength and conditioning research / National Strength & Conditioning Association 20 (2): 257–61. doi:10.1519/R-17835.1. PMID 16686550.

5. Vibration therapy has been shown to alleviate pain, HOWEVER, this was not WBV. In the study below, it showed that vibration stimulation reported that 70% of patients reported pain alleviation. With this kind of therapy, a few factors were important:

1. Application of therapy had to be on or close to area of injury insult, at the antagonistic muscle or trigger point
2. In most patients suffering from musculoskeletal pain the best pain reducing effect was obtained when the vibratory stimulation was applied with moderate pressure (at which contact was achieved with underlying bone) at a frequency of 50-150 Hz. To obtain a maximal duration of pain relief the stimulation had to be applied for 30-45 minutes.
3. In comparison with high or low frequency TENS, vibratory stimulation was found to be as effective and in some patients even more effective in reducing chronic musculoskeletal or orofacial pain. The effect of 20 Hz, 100 Hz and 200 Hz vibratory stimulation, high frequency TENS, low frequency TENS and "placebo" vibratory stimulation was examined in various chronic musculoskeletal pain syndromes. 82% of the patients experienced a relief of pain with any of the above mentioned methods; 47% of the patients experienced a reduction of pain with vibratory stimulation or TENS stimulation. 

WHAT DOES THIS ALL MEAN?

Well, the jury is still out for the most part. WBV is a nice tool used in the right hands but it is not a panacea by any stretch of the imagination. Like most training methods, WBV has to be applied at the right place, time, and to the right person. Could tri-planar work infused with WBV be highly effective. Sure looks like it will be in the short-term. Do we need it??? Probably not. Looks like you can get the same results without it. Is it a nice toy to have? Sure! Hopefully, it will not become another toy in the corner like oh so many toys become. 

I challenge my colleagues who are using the WBV training to take it beyond the standards and come up with something great that will be long lasting as well as beneficial. Can it be done? Sure as long as they remember that there is a NEURO in the Neuromusculoskeletal system and let science and not fiction guide the process. 

Thoughts?

Best,

Will

Stylishly Scientfic: Staying warm for outdoor workouts

I am going to start to do this more often in this blog so I can bring in a different perspective. I've asked my good friend, Read Wall, of Read's Clothing Project who is an expert in what I call Functional Fashion (my cheesy words, not his). In this post, Read gives great suggestions on what to wear during the fall and winter seasons and I will throw in a little science of why you should stay warm during your workouts.




Cold Weather Workouts


As the weather get colder…and colder…and colder…where was I going with this? Oh right, it's cold outside. It would be easy to call it quits and spend the winter on the treadmill dreaming of green leaves, shorts, and the gentle warmth of the spring sun. But we can't do that. For a number of reasons. First, the treadmill is boring. Like, fork in the eye boring. Second, staying inside deprives the body of vital vitamin D, which, among other health benefits, makes us fell not-crappy all the time. I think we can all agree that's a good thing.

But we need to remember to dress for the weather. Breathable, technical fabrics, layered correctly, provide the perfect level of warmth without sacrificing movement or, just as important, style. Look good, feel good, right?

So get outside, even when it looks like Ernest Shackelton wouldn't. Run, do some body weight movements, even grab a kettlebell. It's good for you.

Here are some ways to keep from getting frostbite while doing so:

Zoot RUNfit Jacket (ZootSports.com)- I've been running with this jacket for about a year now. It's gotten me through a lot. Cold can be tough, but this jacket is tougher.

2XU Thermal Run Tights (2XU.com)- If you've got it, flaunt it. Rock the tights.

Nike Thermal Running Pants (Store.Nike.com)- And if you can't, these will work, too.

Patagonia R1 Hoody (Patagonia.com)- An essential layering piece. Cool colors but warm where you need it.

Accessories (Note: Important!)

Patagonia Lightweight Glove Liners (Patagonia.com)

Patagonia Cap 4 Beanie (Patagonia.com)


Q: SO WHY WOULD I WANT TO STAY SO WARM DURING WORKOUTS?

A: Well, that's a great question. The easiest answer is so that we can avoid hypothermia, where the body temperature drops too low to allow for normal bodily functions to occur which includes, but not limited to, neuromuscular and cognitive function decline. WHOA...That is not good at all and through simple solutions like wearing the appropriate clothes, we can prevent a lot of that. When our body starts to sense a temperature drop, it will divert energy and heat to keep our core body temperature up as much as possible while pulling heat away from our extremities like hands and feet. This can get dangerous especially if we are in an activity like jogging, where our feet and hands are being desensitized because of the cold. The vasoconstriction, or tightening of the blood vessels to reduce blood flow to the muscles also reduces blood flow to the nerves which means we do not respond very well to gravity, ground reaction forces, mass and momentum. Because of our loss of proprioception, we may be more prone to injury.


Q: WAIT...HYPOTHERMIA? CAN YOU GO INTO MORE DETAIL ABOUT WHAT IT IS AND WHAT CAUSES IT?


A: Hypothermia "a decrease in the core body temperature to a level at which normal muscular and cerebral functions are impaired." - Medicine for Mountaineering.

This is caused by a a number of factors which include:

•Cold temperatures
•Improper clothing and equipment
•Wetness
•Fatigue, exhaustion
•Dehydration
•Poor food intake
•No knowledge of hypothermia
•Alcohol intake - causes vasodilation leading to increased heat loss

Q: SO I SEE THAT THE FIRST TWO FACTORS ARE COLD TEMPERATURES AND IMPROPER CLOTHING AND EQUIPMENT.  IT SEEMS THAT I CANNOT CONTROL THE TEMPERATURES, BUT I DO HAVE CONTROL OVER WEARING PROPER CLOTHES.

A: Yes! Great observation and you see the wisdom in Read's selections where he is recommending the ZootRunFit Jacket which is a great outer shell that will keep too much heat from escaping. The 2XU Thermal Run pants, that will "wick away" the sweat from the body which you know is important as the body starts to sweat to cool itself down from the exertion but gets into a dangerous situation when we are soaked with sweat in cold weather. We cannot stop the sweating but can control the effects with layering of clothes. Finally, the gloves and beanie are important as well. Most will be wearing socks but many will neglect wearing gloves which are super important as the hands are the most distal part of the arm and will be low on the priority list of blood flow if the core temperature needs to be regulated.

Q: OKAY, I UNDERSTAND HYPOTHERMIA AND I WILL DO MY BEST TO STAY WARM BY DRESSING PROPERLY BUT I'D STILL LIKE TO KNOW THE SIGNS OF HYPOTHERMIA. WHAT ARE THEY?

A: According to the OUTDOOR ACTION GUIDE from Princeton University are 3 stages of hypothermia: 1) Mild 2) Moderate and 3) Severe. With Severe Hypothermia being the most life threatening.

Signs of hypothermia are the "-UMBLES" of stumbles, mumbles, fumbles, and grumbles which show changes in motor coordination and levels of consciousness


b. Mild Hypothermia - core temperature 98.6 - 96 degrees F
•Shivering - not under voluntary control
•Can't do complex motor functions (ice climbing or skiing) can still walk & talk
•Vasoconstriction to periphery

c. Moderate Hypothermia - core temperature 95 - 93 degrees F

•Dazed consciousness
•Loss of fine motor coordination - particularly in hands - can't zip up parka, due to restricted peripheral blood flow
•Slurred speech
•Violent shivering
•Irrational behavior - Paradoxical Undressing - person starts to take off clothing, unaware s/he is cold
•"I don't care attitude" - flattened affect

d. Severe Hypothermia - core temperature 92 - 86 degrees and below (immediately life threatening)

•Shivering occurs in waves, violent then pause, pauses get longer until shivering finally ceases - because the heat output from burning glycogen in the muscles is not sufficient
to counteract the continually dropping core temperature, the body shuts down on shivering to conserve glucose
•Person falls to the ground, can't walk, curls up into a fetal position to conserve heat
•Muscle rigidity develops - because peripheral blood flow is reduced and due to lactic acid and CO2 buildup in the muscles
•Skin is pale
•Pupils dilate
•Pulse rate decreases
•at 90 degrees the body tries to move into hibernation, shutting down all peripheral blood flow and reducing breathing rate and heart rate.
•at 86 degrees the body is in a state of "metabolic icebox." The person looks dead but is still alive.

e. Death from Hypothermia

•Breathing becomes erratic and very shallow
•Semi-conscious
•Cardiac arrythmias develop, any sudden shock may set off Ventricular Fibrillation
•Heart stops, death

Q: WHOA! THE FACT THAT YOU CAN DIE FROM HYPOTHERMIA IS SCARY. WHAT SHOULD I DO IF I AM EXPERIENCING IT?

A: Well, the first thing I will say is that I am not a doctor so I am obligated to say SEEK PROPER EMERGENCY CARE IMMEDIATELY! Do not pass go or collect $200. This is your life and if you have any doubt in your mind, please seek some professional care.

The OUTDOOR ACTION GUIDE suggests the following:

The basic principles of rewarming a hypothermic victim are to conserve the heat they have and replace the body fuel they are burning up to generate that heat. If a person is shivering, they have the ability to rewarm themselves at a rate of 2 degrees C per hour.
Mild - Moderate Hypothermia

1. Reduce Heat Loss

•Additional layers of clothing
•Dry clothing
•Increased physical activity
•Shelter

2. Add Fuel & Fluids

It is essential to keep a hypothermic person adequately hydrated and fueled.
a. Food types
•Carbohydrates - 5 calories/gram - quickly released into blood stream for sudden brief heat surge - these are the best to use for quick energy intake especially for mild cases of hypothermia
•Proteins - 5 calories/gram - slowly released - heat given off over a longer period
•Fats - 9 calories/gram - slowly released but are good because they release heat over a long period, however, it takes more energy to break fats down into glucose - also takes more water to break down fats leading to increased fluid loss

b. Food intake
•Hot liquids - calories plus heat source
•Sugars (kindling)
•GORP - has both carbohydrates (sticks) and proteins/fats (logs)

c. Things to avoid

•Alcohol - a vasodilator - increases peripheral heat loss
•Caffeine - a diuretic - causes water loss increasing dehydration
•Tobacco/nicotine - a vasoconstrictor, increases risk of frostbite

3. Add Heat

•Fire or other external heat source
•Body to body contact. Get into a sleeping back, in dry clothing with a normothermic person in lightweight dry clothing

Severe Hypothermia

1. Reduce Heat Loss

•Hypothermia Wrap: The idea is to provide a shell of total insulation for the patient. No matter how cold, patients can still internally rewarm themselves much more efficiently than any external rewarming. Make sure the patient is dry, and has a polypropylene layer to minimize sweating on the skin. The person must be protected from any moisture in the environment. Use multiple sleeping bags, wool blankets, wool clothing, Ensolite pads to create a minimum of 4" of insulation all the way around the patient, especially between the patient and the ground. Include an aluminum "space" blanket to help prevent radiant heat loss, and wrap the entire ensemble in plastic to protect from wind and water. If someone is truly hypothermic, don't put him/her naked in a sleeping bag with another person.

2. Add Fuel and Fluids

•Warm Sugar Water - for people in severe hypothermia, the stomach has shut down and will not digest solid food but can absorb water and sugars. Give a dilute mixture of warm water with sugar every 15 minutes. Dilute Jello™ works best since it is part sugar and part protein. This will be absorbed directly into the blood stream providing the necessary calories to allow the person to rewarm themselves. One box of Jello = 500 Kilocalories of heat energy. Do not give full strength Jello even in liquid form, it is too concentrated and will not be absorbed.
•Urination - people will have to urinate from cold diuresis. Vasoconstriction creates greater volume pressure in the blood stream. The kidneys pull off excess fluid to reduce the pressure. A full bladder results in body heat being used to keep urine warm rather than vital organs. Once the person has urinated, it precious body heat will be used to maintain the temperature of vital organs. So in the end urinating will help conserve heat. You will need to help the person urinate. Open up the Hypothermia Wrap enough to do this and then cover them back up. You will need to keep them hydrated with the dilute Jello solution described above.

3. Add Heat

Heat can be applied to transfer heat to major arteries - at the neck for the carotid, at the armpits for the brachial, at the groin for the femoral, at the palms of the hands for the arterial arch.

•Chemical heat packs such as the Heat Wave™ provides 110 degrees F for 6-10 hours.
•Hot water bottles, warm rocks, towels, compresses
•For a severely hypothermic person, rescue breathing can increase oxygen and provide internal heat.


Afterdrop

Is a situation in which the core temperature actually decreases during rewarming. This is caused by peripheral vessels in the arms and legs dilating if they are rewarmed. This dilation sends this very cold, stagnate blood from the periphery to the core further decreasing core temperature which can lead to death. In addition, this blood also is very acetic which may lead to cardiac arrythmias and death. Afterdrop can best be avoided by not rewarming the periphery. Rewarm the core only! Do not expose a severely hypothermic victim to extremes of heat.


I hope this was informative from a style and a scientific standpoint. We all want to reach our best and by being smart and working hard, we can get to those goals. Please make sure you dress properly if you are going to do outdoor workouts during the cold months. We hear a lot on the news about people suffering from heat stroke but we also hear about many who are struck by the various stages of hypothermia.

If you have any comments or questions to either Read or I, please send mail to will@3doptimalperformance and I will pass any questions on to Read.

Read is also the designer of 3 great shirts for men that are made especially for athletes focusing on a nice fit. What is great is that Read is donating part of the proceeds to help promote education in Africa. Please visit his site at http://www.readsclothingproject.com/.

Stay warm!

Read Wall and Will Stewart

How to save your throwing arm from injury

Recently, I have had to deal with a few injuries related to throwing with my athletes that has also been concurrent with a rise of throwing injuries of a few professional athletes like Stephen Strasburg and Brett Favre.

Some of these injuries are not serious and the athlete can continue playing but others, like Strasburg, unfortunately, ended their seasons prematurely.

What do all of these have in common?

The short answer was that there was more than likely a breakdown somewhere in the kinetic chain that caused the body's tissues to be overexerted in a compensation that lead to the injury. That's the easy answer. The bigger question is WHERE in the kinetic chain was there a breakdown?


THROWING BASICS 101

When we look at throwing in any sport, we see a VERY complex skill. It requires the full body to be completely coordinated to achieve a efficient and injury free motion. This means that the from the big toe up to the top of the head, everything must be in working order and orderly working.

Proper joint motion must occur at the right time, place and speed so that the muscles and connective tissue that are attached can ECCENTRICALLY LOAD so that they can create the CONCENTRIC UNLOAD/EXPLODE which results in the throw.

When there a glitch in the process somewhere, we get an overloaded compensation somwhere else in the body that leads to an injury. For Straburg and Favre, it's focusing in on their elbows. For other throwers, it can go into places like the shoulder and lower back. It just depends on the person.

The question is now HOW DO WE TRAIN AND CONDITION FOR THE SKILL OF THROWING FOR POWER AND ACCURACY AS WELL AS FOR INJURY PREVENTION?

The process lies within Applied Functional Athletic Development design. In my other post 5 WAYS TO PREPARE YOUR ATHLETE FOR SUCCESS, I outlined the process focusing on the foot and ankle, but the same process applies for skill of throwing to develop an proficient injury free motion. It is:

1) Functional Prep

2) Fundamental Movement

3) Complex Movement

4) Skill (Throwing, in this case)

A lot of times, people tend to skip the one step or another and when that happens, we can get SOME results but not as comprehensive as is possible using the 4 step process.

In the next blog post, we will go over the Fundamental Preparation that everyone who is starting to throw, throwing or maybe post rehab should do. We'll also do some investigations into some of the elbow injuries that throwers suffer from. There are already posts on Rotator Cuff impingement  and Shoulder Instability.

Please send any questions or comments to Will@3doptimalperformance.com.

Thanks,

Will